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McHugh SM, Kheirelseid E, Hyde S, Conway PF. Perceptions of online surgical-focused learning amongst surgeons during the COVID pandemic: A scoping review 2020-22. Surgeon 2024; 22:e94-e99. [PMID: 38142195 DOI: 10.1016/j.surge.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/21/2023] [Accepted: 11/21/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION During the COVID pandemic many centres adopted e-learning as a tool to adhere to social distancing recommendations while continuing to provide ongoing postgraduate medical education. We aimed to complete this scoping review in order to map experience and perceptions amongst surgeons and surgical trainees to remote learning during the COVID pandemic. METHODS Using Arksey and O'Malley's five step model for conducting a scoping review, a systematic search strategy was undertaken across three online databases SCOPUS, MEDLINE and Web of Science. Only original articles in English in the field of postgraduate education in surgery were included. RESULTS 44 studies were selected for review. Of these 44, 21 were studies of perception of a newly developed e-learning tool/platform. 17 were surveys of surgeon's attitudes towards e-learning during the COVID pandemic. The remaining 6 studies were studies of knowledge or skills acquired through new e-learning, which included a survey of experience. The United States was the most common country of origin with General Surgery the most represented surgical speciality. Response rates across all three study subgroups were on average >60%. Surgeon's experience of e-learning was reported in only positive terms in 86% (n = 38/44) of studies. CONCLUSIONS This paper is informative in that it focuses specifically on surgeons' perceptions of a e-learning tools used in addition to skills or knowledge gained. Positive e-learning experience reported in these studies may lead to more blended learning curriculums being developed, deployed and evaluated going forward.
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Affiliation(s)
- S M McHugh
- University of Limerick, Limerick, Ireland; Royal College of Surgeons in Ireland, Dublin 2, Ireland.
| | - E Kheirelseid
- Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - S Hyde
- University of Limerick, Limerick, Ireland
| | - P F Conway
- University of Limerick, Limerick, Ireland
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Layrisse Landaeta V, Dincheva GR, Hong JS, Kim A, Verzani Z, Yuan V, Zhang C, Chao SY. Acute Appendicitis in the Epicenter of the COVID-19 Pandemic: A New York City Single-Center Experience. Am Surg 2024; 90:780-787. [PMID: 37915247 DOI: 10.1177/00031348231204909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
BACKGROUND Appendectomy is the gold standard for simple appendicitis. During the coronavirus-19 pandemic, it was estimated that appendectomies in the United States decreased by 24%. We aimed to describe trends in acute appendicitis management at a center located in one of the largest epicenters of the pandemic. METHODS This is a retrospective cohort study in a single institution located in Queens, New York, of patients who presented with acute appendicitis. A pre-COVID time period, March-June 2019, was compared to peak-COVID, March-June 2020, and late-COVID, March-June 2021. RESULTS Of the 382 patients admitted with appendicitis during the time periods, 164 were admitted pre-COVID. Appendicitis presentations decreased by 44% during peak-COVID and 23% in late-COVID. Patients were younger during peak-COVID compared to pre-COVID (39 vs 34 years old, P = .036). Incidence of complicated appendicitis in pre-, peak-, and late-COVID was equivalent (41% vs 46% vs 45%) and operative management was similar (85% vs 76% vs 79%). Non-operative patients had shorter lengths of stay (pre- vs peak-COVID: 4.6 vs 2.9 days, P = .006). Readmission rates were similar between the cohorts across time periods. CONCLUSIONS During peak-COVID, there was a significant decrease in presentation of acute appendicitis but clinical presentation and outcomes remained similar between the cohorts. Patients who were managed non-operatively may be discharged earlier without increased rates of readmissions.
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Affiliation(s)
| | | | - Julie S Hong
- Department of Surgery, New York-Presbyterian/Queens, Queens, NY, USA
| | - Angelina Kim
- Department of Surgery, New York-Presbyterian/Queens, Queens, NY, USA
| | - Zoe Verzani
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Victoria Yuan
- Department of Surgery, New York-Presbyterian/Queens, Queens, NY, USA
| | - Charles Zhang
- Department of Surgery, New York-Presbyterian/Queens, Queens, NY, USA
| | - Steven Y Chao
- Department of Surgery, New York-Presbyterian/Queens, Queens, NY, USA
- Department of Surgery, Weill Cornell Medicine, New York, NY, USA
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Deva A, Juthani R, Kugan E, Balamurugan N, Ayyan M. Utility of ED triage tools in predicting the need for intensive respiratory or vasopressor support in adult patients with COVID-19. Am J Emerg Med 2024; 78:151-156. [PMID: 38281375 DOI: 10.1016/j.ajem.2024.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Serum and radiological parameters used to predict prognosis in COVID patients are not feasible in the Emergency Department. Due to its damaging effect on multiple organs and lungs, scores used to assess multiorgan damage and pneumonia such as Pandemic Medical Early Warning Score (PMEWS), National Early Warning Score 2 (NEWS2), WHO score, quick Sequential Organ Failure Assessment (qSOFA), and DS-CRB 65 can be used to triage patients in the Emergency Department. They can be used to predict patients with the highest risk of seven-day mortality and need for intensive respiratory or vasopressor support (IRVS). PURPOSE The primary purpose was to find the score with the highest AUC in predicting IRVS and mortality at seven days. Additional objective was to find out any independent factors associated with IRVS and mortality. METHODS The data of adult patients who presented to the Emergency Department (ED) between April 1, 2021 and June 30, 2021 were collected. The WHO score, CRB-65, DS-CRB 65, PMEWS, NEWS2, and qSOFA score were calculated for all patients. Statistical analysis was done and an ROC curve was calculated for all the tools for mortality and need for IRVS at seven days. FINDINGS 677 patients presented to the Emergency Department with COVID-19 during the period above. Presence of Diabetes Mellitus (p = 0.001), Hypertension (p = 0.001), and chronic kidney disease(CKD) (p = 0.04) was significantly associated with need for IRVS. Age, duration of symptoms, pulse rate, respiratory rate, room air saturation, mental status at admission, and time to IRVS need were identified as independent predictors of in-hospital mortality. The longer the time to IRVS need from ED arrival, the higher the likelihood of mortality. PMEWS (0.830) had the highest AUC, followed by NEWS2 (0.805). A PMEWS cut-off of 6.5 was 74.2% sensitive and 78.3% specific in predicting the need for IRVS. ROC analysis to predict 7-day mortality showed that PMEWS had an AUC of 0.802 (0.766-0.839). QSOFA performed poorly in predicting IRVS (AUC 0.645) and 7-day mortality (AUC 0.677). CONCLUSION PMEWS may be used for triaging patients presenting to the Emergency Department with COVID-19 and accurately predicts the need for IRVS and seven day mortality.
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Affiliation(s)
- Anandhi Deva
- Department of Emergency Medicine & Trauma, JIPMER, Puducherry, India
| | - Ronit Juthani
- Department of Medicine, Saint Vincent Hospital, Worcester, MA, United States.
| | - Ezhil Kugan
- Department of Emergency Medicine & Trauma, JIPMER, Puducherry, India
| | - N Balamurugan
- Department of Emergency Medicine & Trauma, JIPMER, Puducherry, India
| | - Manu Ayyan
- Department of Emergency Medicine & Trauma, JIPMER, Puducherry, India
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Jones C, White L, Slater J, Pluquailec J. Hospitality Work as Social Reproduction: Embodied and Emotional Labour during COVID-19. Sociology 2024; 58:471-488. [PMID: 38496360 PMCID: PMC10940102 DOI: 10.1177/00380385231189190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
This article focuses on how the imaginary of a 'safe' environment was visualised and conveyed within the hospitality sector during the COVID-19 pandemic, drawing on diaries and interviews with 21 workers in the UK. Our findings show increased workloads for hospitality staff, compounded by anxieties of risk and individualised COVID-19 regulation work. This includes workers' negotiations of corporeal boundaries and distancing from customers, the visible cleaning of communal areas and recuperation and care work for their own bodies and others in shared living spaces. We draw on conceptualisations of embodied and emotional labour to understand these experiences, reflecting on the importance of the actions performed by workers in maintaining community spaces and creating customer confidence in safely enjoying a 'hospitable' environment. This article contributes to social science scholarship of embodied and emotional labour, hospitality and social reproduction.
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Massimi L, Cinalli G, Frassanito P, Arcangeli V, Auer C, Baro V, Bartoli A, Bianchi F, Dietvorst S, Di Rocco F, Gallo P, Giordano F, Hinojosa J, Iglesias S, Jecko V, Kahilogullari G, Knerlich-Lukoschus F, Laera R, Locatelli D, Luglietto D, Luzi M, Messing-Jünger M, Mura R, Ragazzi P, Riffaud L, Roth J, Sagarribay A, Pinheiro MS, Spazzapan P, Spennato P, Syrmos N, Talamonti G, Valentini L, Van Veelen ML, Zucchelli M, Tamburrini G. Intracranial complications of sinogenic and otogenic infections in children: an ESPN survey on their occurrence in the pre- COVID and post-COVID era. Childs Nerv Syst 2024; 40:1221-1237. [PMID: 38456922 DOI: 10.1007/s00381-024-06332-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND COVID-19 pandemic is thought to have changed the epidemiology of some pediatric neurosurgical disease: among them are the intracranial complications of sinusitis and otitis (ICSO). According to some studies on a limited number of cases, both streptococci-related sinusitis and ICSO would have increased immediately after the pandemic, although the reason is not clear yet (seasonal changes versus pandemic-related effects). The goal of the present survey of the European Society for Pediatric Neurosurgery (ESPN) was to collect a large number of cases from different European countries encompassing the pre-COVID (2017-2019), COVID (2020-2021), and post-COVID period (2022-June 2023) looking for possible epidemiological and/or clinical changes. MATERIAL AND METHODS An English language questionnaire was sent to ESPN members about year of the event, patient's age and gender, presence of immune-deficit or other favoring risk factors, COVID infection, signs and symptoms at onset, site of primary infection, type of intracranial complication, identified germ, type and number of surgical operations, type and duration of medical treatment, clinical and radiological outcome, duration of the follow-up. RESULTS Two hundred fifty-four cases were collected by 30 centers coming from 14 different European countries. There was a statistically significant difference between the post-COVID period (129 children, 86 cases/year, 50.7% of the whole series) and the COVID (40 children, 20 cases/year, 15.7%) or the pre-COVID period (85 children, 28.3 cases/year, 33.5%). Other significant differences concerned the presence of predisposing factors/concurrent diseases (higher in the pre-COVID period) and previous COVID infection (higher in the post-COVID period). No relevant differences occurred as far as demographic, microbiological, clinical, radiological, outcome, morbidity, and mortality data were concerned. Paranasal sinuses and middle ear/mastoid were the most involved primary site of infection (71% and 27%, respectively), while extradural or subdural empyema and brain abscess were the most common ICSO (73% and 17%, respectively). Surgery was required in 95% of cases (neurosurgical and ENT procedure in 71% and 62% of cases, respectively) while antibiotics in 99% of cases. After a 12.4-month follow-up, a full clinical and radiological recovery was obtained in 85% and 84% of cases, respectively. The mortality rate was 2.7%. CONCLUSIONS These results suggest that the occurrence of ICSO was significantly increased after the pandemic. Such an increase seems to be related to the indirect effects of the pandemic (e.g., immunity debt) rather than to a direct effect of COVID infection or to seasonal fluctuations. ICSO remain challenging diseases but the pandemic did not affect the management strategies nor their prognosis. The epidemiological change of sinusitis/otitis and ICSO should alert about the appropriate follow-up of children with sinusitis/otitis.
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Affiliation(s)
- L Massimi
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University Medical School, Rome, Italy
| | - G Cinalli
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - P Frassanito
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - V Arcangeli
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C Auer
- Department of Neurosurgery, Johannes Kepler University Linz, Kepler University Hospital GmbH, Linz, Austria
| | - V Baro
- Pediatric and Functional Neurosurgery, Department of Neurosciences, University of Padova, Padua, Italy
| | - A Bartoli
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - F Bianchi
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S Dietvorst
- University Hospitals Leuven, Leuven, Belgium
| | - F Di Rocco
- Hôpital Femme-Mère-Enfant, Université de Lyon, Lyon, France
| | - P Gallo
- Birmingham Children's Hospital, Birmingham, UK
| | - F Giordano
- University of Florence, Florence, Italy
- Meyer Children's Hospital IRCCS, Florence, Italy
| | - J Hinojosa
- Hospital Sant Joan de Déu, Barcelona, Spain
| | - S Iglesias
- Hospital Regional Universitario de Malaga, Malaga, Spain
| | - V Jecko
- Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - G Kahilogullari
- Department of Neurosurgery, Ankara University, Ankara, Turkey
| | - F Knerlich-Lukoschus
- Division Pediatric Neurosurgery, Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany
| | - R Laera
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - D Locatelli
- Neurosurgery Department, Università Dell'Insubria, Ospedale di Circolo e Macchi Foundation, Varese, Italy
| | - D Luglietto
- Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - M Luzi
- Azienda Ospedaliero Universitaria Delle Marche, Ancona, Italy
| | | | - R Mura
- Meyer Children's Hospital IRCCS, Florence, Italy
| | - P Ragazzi
- Department of Pediatric Neurosurgery, Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
| | - L Riffaud
- Rennes University Hospital, Rennes, France
| | - J Roth
- Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - A Sagarribay
- Hospital Dona Estefânia-Centro Hospitalar Universitário, Lisboa, Portugal
- Hospital CUF Descobertas, Lisboa, Portugal
| | - M Santos Pinheiro
- Centro Hospitalar Lisboa Norte-Hospital Santa Maria, Lisboa, Portugal
| | - P Spazzapan
- University Medical Center-Ljubljana, Ljubljana, Slovenia
| | - P Spennato
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - N Syrmos
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - L Valentini
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - M L Van Veelen
- Erasmus MC Sophia Children's Hospital, Rotterdam, Netherlands
| | - M Zucchelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto Scienze Neurologiche Di Bologna, Boulogne, Italy
| | - G Tamburrini
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University Medical School, Rome, Italy
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Pedersen AB, Risbo N, Viberg BL, Palm H, Röck ND. Incidence, Quality of Care, and Mortality in Hip Fracture Patients in the Course of the COVID Pandemic: A Population-Based Cohort Study. J Gerontol A Biol Sci Med Sci 2024; 79:glae009. [PMID: 38198665 DOI: 10.1093/gerona/glae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND We assessed the incidence, quality of in-hospital care, and mortality for hip fracture (HF) patients in Denmark before and during the coronavirus disease (COVID) pandemic. METHODS We obtained data from the Danish registries in the COVID period (March 11, 2020 to January 27, 2021, overall and in 5 periods) and compared it to a pre-COVID period (March 13, 2019 to March 10, 2020). We calculated the proportion of patients (%) that have fulfilled all the relevant quality indicators (a composite score of 100%) and adjusted hazard ratios (HR) with a 95% confidence interval (CI) for 30-day mortality. RESULTS The incidence of HF was 5.7 per 1 000 person-years both in pre-COVID and COVID periods. About 35% of patients had a composite score of 100% in the COVID period compared to 28% in the pre-COVID period (proportion ratio 1.23 [95% CI: 1.17-1.30]). Fulfillment of all individual quality indicators was similar or higher in the COVID period. 30-day mortality was 9.5% in pre-COVID period, compared to 10.8% in the COVID period (HR 1.15 [95% CI: 1.02-1.30]). HRs varied from 1.07 (95% CI: 0.89-1.29) to 1.31 (95% CI: 1.06-1.62) in 5 COVID periods. In-hospital mortality was 4% in pre-COVID versus 4.4% in COVID period. CONCLUSIONS The incidence of HF in Denmark remained unchanged. The quality of in-hospital care was higher in the COVID compared to pre-COVID period. Unfortunately, 30-day mortality was also higher, highlighting the importance of recognizing diversity of social networks, home support, and digital health intervention after discharge for outcome of HF patients.
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Affiliation(s)
- Alma B Pedersen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nickolaj Risbo
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Bjarke L Viberg
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Henrik Palm
- Department of Orthopaedic Surgery, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark
| | - Niels Dieter Röck
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
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Hing N, Russell AMT, Rawat V, Bryden GM, Browne M, Rockloff M, Thorne HB, Newall P, Dowling NA, Merkouris SS, Stevens M. The COVID-19 lockdown experience suggests that restricting the supply of gambling can reduce gambling problems: An Australian prospective study. J Behav Addict 2024; 13:146-162. [PMID: 38345618 DOI: 10.1556/2006.2023.00085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/09/2023] [Accepted: 12/22/2023] [Indexed: 03/28/2024] Open
Abstract
Background and aims COVID-19 lockdowns limited access to gambling but simultaneously elevated psychosocial stressors. This study assessed the relative effects of these changes on gambling risk status during and after the Australian COVID-19 lockdown from late-March to late-May 2020. Methods The study administered three surveys to people who had gambled within the past year at T1. Wave 1 asked about before (T1, N = 2,125) and during lockdown (T2, N = 2,125). Subsequent surveys focused on one year (T3; N = 649) and two years after lockdown (T4, N = 458). The dependent variable was changes in reporting any problem gambling symptoms (PGSI 0 vs 1+). Bivariate analyses and multinomial logistic regression tested for significant associations with: demographics, psychosocial stressors (perceived stress, psychological distress, loneliness, health anxiety about COVID, financial hardship, stressful life events), gambling participation and gambling frequency. Results Gambling participation and at-risk gambling decreased between T1 and T2, increased at T3, with little further change at T4. When gambling availability was curtailed, decreased gambling frequency on EGMs, casino games, sports betting or race betting, and lower psychosocial stress, were associated with transitions from at-risk to non-problem gambling. When gambling availability resumed, increased EGM gambling frequency, decreased online gambling frequency, and higher psychosocial stress were associated with transitions from non-problem to at-risk gambling. Discussion and conclusions Gambling availability appears a stronger influence on gambling problems, at the population level, than psychosocial risk factors. Reducing the supply of high-risk gambling products, particularly EGMs, is likely to reduce gambling harm.
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Affiliation(s)
- Nerilee Hing
- 1Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 6 University Dr, Branyan, QLD 4670, Australia
| | - Alex M T Russell
- 2Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 400 Kent St, Sydney, NSW 2000, Australia
| | - Vijay Rawat
- 3Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 120 Spencer St, Melbourne, VIC 3000, Australia
| | - Gabrielle M Bryden
- 1Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 6 University Dr, Branyan, QLD 4670, Australia
| | - Matthew Browne
- 1Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 6 University Dr, Branyan, QLD 4670, Australia
| | - Matthew Rockloff
- 1Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 6 University Dr, Branyan, QLD 4670, Australia
| | - Hannah B Thorne
- 4Experimental Gambling Research Laboratory, School of Health, Medical and Applied Sciences, CQUniversity, 44 Greenhill Rd, Wayville, SA 5000, Australia
| | - Philip Newall
- 5School of Psychological Science, University of Bristol, 12a Priory Road, Bristol, BS8 1TU, United Kingdom
| | - Nicki A Dowling
- 6School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia
| | - Stephanie S Merkouris
- 7Deakin University, Geelong, Australia, School of Psychology, 1 Gheringhap St, Geelong, VIC 3220, Australia
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Naunheim MR, DeVore EK, Huston MN, Song PC, Franco RA, Bhattacharyya N. Increasing Prevalence of Voice Disorders in the USA: Updates in the COVID Era. Laryngoscope 2024. [PMID: 38525993 DOI: 10.1002/lary.31409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/03/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE To estimate the current prevalence of voice disorders among adults in the United States; to determine the association of individual factors with voice disorders. METHODS The 2022 National Health Interview Survey (NHIS) was analyzed to identify adults reporting voice problems in the past 12 months. Demographics were assessed, as well as the duration, severity, and resolution of the voice problem. The relationship between voice problems, gender, lost workdays, and long COVID was investigated. A comparison to the 2012 NHIS was made to determine changes in voice disorder prevalence. RESULTS 29.9 million Americans (95%CI[28.3-31.5]) annually report a voice problem, representing 12.2% of the population (95%CI[11.7-12.8%]). Overall, 26.8% and 13.2% reported the severity of their voice problem as moderate or severe, respectively. Only 5.1% (95%CI[4.3-6.0%]) of respondents sought treatment. Most voice problems were resolved within 1 week (53.0%,95%CI[50.9-55.1%]). Females were more likely than males to report a voice problem (14.4% vs. 10.0%,95%CI[13.7-15.1] and [9.3-10.7], respectively). The 17.6 million Americans with long COVID symptoms were more likely to have voice complaints than those without (21.1% vs. 11.6%,95%CI[18.9-23.5%] and [11.1-12.1%], respectively). Lost workdays were not significantly higher for those with voice disorders compared to those without (17.1 vs. 12.9 days,95%CI[12.0-22.1] and [11.0-14.8], respectively). CONCLUSIONS Voice problems affect approximately 1 in 8 adults in the U.S. annually, demonstrating an alarming increased prevalence since 2012 using the same survey methodology. Relatively few individuals seek care for their voice problem, despite significant self-reported impact. Further study is required regarding the impact of COVID and changes in voice use patterns on voice disorders. LEVEL OF EVIDENCE 3 Laryngoscope, 2024.
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Affiliation(s)
- Matthew R Naunheim
- Harvard Medical School, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Elliana K DeVore
- Harvard Medical School, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Molly N Huston
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, U.S.A
| | - Phillip C Song
- Harvard Medical School, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Ramon A Franco
- Harvard Medical School, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Neil Bhattacharyya
- Harvard Medical School, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
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Yeradi M, Dunn E, Hou A, Johansen PM, Rainone GJ. Post- COVID Analysis of Which United States Medical Schools Produce the Most Neurosurgery Residents: 2021-2023 in Review. World Neurosurg 2024:S1878-8750(24)00461-3. [PMID: 38522786 DOI: 10.1016/j.wneu.2024.03.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 03/15/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE The process surrounding application to the national residency matching program changed drastically because of COVID. Virtual interviews, pre-interview zoom socials, and limitations on sub-internships are major changes that applicants worldwide have had to overcome. The available literature does not reflect the impact of major changes to the interview process. Here, we examine the neurosurgery resident cohort from 2021-2023 to investigate differences between United States medical schools pre- and post-COVID. METHODS A database was constructed reporting the number of students matched to neurosurgery for U.S. medical schools (MD and DO) from 2021-2023. Percentage of total graduates matched to neurosurgery was calculated and institutions were ranked by this metric. This rank was compared to the rank reported by Antar et al in 2021. Variables were compared across the pre- and post-COVID cohorts. RESULTS Case Western, Johns Hopkins, Mayo Clinic, Vanderbilt, University of Illinois and University of California San Francisco produced the most neurosurgical residents as a percentage of total graduates. There was a statistically significant difference in the post-COVID cohort between medical schools with a home program vs those without. For the top 20 ranked U.S. News medical schools, there was a statistically insignificant increase in the number of graduates matched to neurosurgery CONCLUSIONS: With the data provided, there have not been many significant changes in which medical schools produce the most neurosurgery residents since COVID changes were implemented. The playing field has remained relatively the same in the setting of major changes that were made.
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Affiliation(s)
- Michael Yeradi
- Department of General Surgery, Creighton University Hospital, Omaha, Nebraska, USA
| | - Emma Dunn
- University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Annabel Hou
- University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Phillip M Johansen
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, USA
| | - Gersham J Rainone
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, USA.
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10
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Oncu S, Korkmaz D. Evaluation of the relationship of treatment and vaccination with prognosis in patients with a diagnosis of COVID-19. Inflammopharmacology 2024:10.1007/s10787-024-01457-4. [PMID: 38493271 DOI: 10.1007/s10787-024-01457-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Coronavirus disease 2019 (COVID-19) has affected millions of people worldwide and caused mortality. Many factors have been reported to affect the prognosis of COVID-19. In this study, we aimed to investigate the effects of drug therapy and vaccination on prognosis in patients hospitalized with a COVID-19 diagnosis. METHODS In this single-center, cross-sectional study, data were retrospectively collected from patients receiving inpatient treatment at a university hospital with a diagnosis of COVID-19 between January 1, 2020, and April 30, 2022. The patients' demographic and clinical characteristics were recorded. The Chi-square, Cox and logistic regression was performed, P < 0.05 was considered statistically significant. RESULTS Total 1723 patients (50.1% were men, mean age: 60.6 ± 16.90) who had not been vaccinated rate was 27.0% (> 3 doses: 45.7%). Mortality rate was 17.0%. Increasing age, male, a high Charlson Comorbidity Index (CCI), and no vaccination significantly increased mortality (P < 0.05). The mortality rate was significantly lower in the chloroquine treatment group than in the other treatment groups. Increasing age, male, and a high CCI were determined to be factors that significantly increased the length of hospital stay (LOHS). LOHS found to be significantly lower in the favipiravir or chloroquine groups compared to the remaining treatment groups (P < 0.001). Both mortality and the LOHS significantly differed according to AST, d-dimer, ferritin, and GFR. CONCLUSION This study primarily investigated the effect of treatment and vaccination on the prognosis of COVID-19. This was determined to be prepared for another potential pandemic that may arise due to COVID-19.
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Affiliation(s)
- Seyma Oncu
- Department of Pharmacology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey.
| | - Derya Korkmaz
- Department of Infectious Disease, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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11
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Dain AS, Diorio C, Fisher BT, Hankins JS, Witmer CM, Boustany M, Burton M, Ferrolino J, Sadaf S, Ross HS, Maron G. Description of a national, multi-center registry of patients with sickle cell disease and SARS-CoV-2 infection: Data from the Pediatric COVID-19 United States Registry. Pediatr Blood Cancer 2024:e30909. [PMID: 38469996 DOI: 10.1002/pbc.30909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/05/2024] [Accepted: 01/26/2024] [Indexed: 03/13/2024]
Abstract
Children with sickle cell disease (SCD) are at risk of complications from viral infections, including SARS-CoV-2. We present the clinical characteristics and outcomes of pediatric patients with SCD from the Pediatric COVID-19 United States Registry who developed acute COVID-19 due to SARS-CoV-2 infection (n = 259) or multisystem inflammatory syndrome in children (MIS-C; n = 4). Nearly half of hospitalized children with SCD and SARS-CoV-2 infection required supplemental oxygen, though children with SCD had fewer intensive care (ICU) admissions compared to the general pediatric and immunocompromised populations. All registry patients with both SCD and MIS-C required ICU admission. Children with SCD are at risk of severe disease with SARS-CoV-2 infection, highlighting the importance of vaccination in this vulnerable population.
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Affiliation(s)
- Aleksandra S Dain
- Division of Hematology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Caroline Diorio
- Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Brian T Fisher
- Division of Infectious Diseases, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jane S Hankins
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Pennsylvania, USA
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Pennsylvania, USA
| | - Char M Witmer
- Division of Hematology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Mickael Boustany
- Division of Infectious Diseases, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Madeline Burton
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Pennsylvania, USA
| | - Jose Ferrolino
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Pennsylvania, USA
| | - Salma Sadaf
- Division of Infectious Diseases, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Hailey S Ross
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Pennsylvania, USA
| | - Gabriela Maron
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Pennsylvania, USA
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12
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Faghy MA, Duncan R, Hume E, Gough L, Roscoe C, Laddu D, Arena R, Asthon REM, Dalton C. Developing effective strategies to optimize physical activity and cardiorespiratory fitness in the long Covid population- The need for caution and objective assessment. Prog Cardiovasc Dis 2024:S0033-0620(24)00039-2. [PMID: 38460898 DOI: 10.1016/j.pcad.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 03/03/2024] [Indexed: 03/11/2024]
Abstract
The Post Covid-19 Condition (commonly known as Long Covid) has been defined by the World Health Organisation as occurring in individuals with a history of probable or confirmed SARS CoV 2 infection, usually within 3 months from the onset of acute Covid-19 infection with symptoms that last for at least two months which cannot be explained by an alternative diagnosis. Long Covid is associated with over two hundred recognised symptoms and affects tens of millions of people worldwide. Widely reported reductions in quality of life(QoL) and functional status are caused by extremely sensitive and cyclical symptom profiles that are augmented following exposure to physical, emotional, orthostatic, and cognitive stimuli. This manifestation prevents millions of people from engaging in routine activities of daily living (ADLs) and has important health and well-being, social and economic impacts. Post-exertional symptom exacerbation (PESE) (also known as post-exertional malaise) is an exacerbation in the severity of fatigue and other symptoms following physical, emotional, orthostatic and cognitive tasks. Typically, this will occur 24-72 h after "over-exertion" and can persist for several days and even weeks. It is a hallmark symptom of Long Covid with a reported prevalence of 86%. The debilitating nature of PESE prevents patients from engaging in physical activity which impacts functional status and QoL. In this review, the authors present an update to the literature relating to PESE in Long Covid and make the case for evidence-based guidelines that support the design and implementation of safe rehabilitation approaches for people with Long Covid. This review also considers the role of objective monitoring to quantify a patient's response to external stimuli which can be used to support the safe management of Long Covid and inform decisions relating to engagement with any stimuli that could prompt an exacerbation of symptoms.
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Affiliation(s)
- Mark A Faghy
- Biomedical and Clinical Exercise Science Research Theme, University of Derby, Derby, UK; Healthy Living for Pandemic Event Protection Network (HL-Pivot), Illinois, Chicago, USA.
| | - Rae Duncan
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Emily Hume
- Faculty of Health and Life Sciences, Northumbria University Newcastle, Newcastle upon Tyne, UK
| | - Lewis Gough
- School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Clare Roscoe
- Biomedical and Clinical Exercise Science Research Theme, University of Derby, Derby, UK
| | - Deepika Laddu
- Healthy Living for Pandemic Event Protection Network (HL-Pivot), Illinois, Chicago, USA; Department of Physical Therapy, University of Illinois at Chicago, Chicago, USA
| | - Ross Arena
- Healthy Living for Pandemic Event Protection Network (HL-Pivot), Illinois, Chicago, USA; Department of Physical Therapy, University of Illinois at Chicago, Chicago, USA
| | - Ruth E M Asthon
- Biomedical and Clinical Exercise Science Research Theme, University of Derby, Derby, UK; Healthy Living for Pandemic Event Protection Network (HL-Pivot), Illinois, Chicago, USA
| | - Caroline Dalton
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
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13
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Abd-Alrazaq A, Nashwan AJ, Shah Z, Abujaber A, Alhuwail D, Schneider J, AlSaad R, Ali H, Alomoush W, Ahmed A, Aziz S. Machine Learning-Based Approach for Identifying Research Gaps: COVID-19 as a Case Study. JMIR Form Res 2024; 8:e49411. [PMID: 38441952 PMCID: PMC10916961 DOI: 10.2196/49411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 11/14/2023] [Accepted: 02/06/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Research gaps refer to unanswered questions in the existing body of knowledge, either due to a lack of studies or inconclusive results. Research gaps are essential starting points and motivation in scientific research. Traditional methods for identifying research gaps, such as literature reviews and expert opinions, can be time consuming, labor intensive, and prone to bias. They may also fall short when dealing with rapidly evolving or time-sensitive subjects. Thus, innovative scalable approaches are needed to identify research gaps, systematically assess the literature, and prioritize areas for further study in the topic of interest. OBJECTIVE In this paper, we propose a machine learning-based approach for identifying research gaps through the analysis of scientific literature. We used the COVID-19 pandemic as a case study. METHODS We conducted an analysis to identify research gaps in COVID-19 literature using the COVID-19 Open Research (CORD-19) data set, which comprises 1,121,433 papers related to the COVID-19 pandemic. Our approach is based on the BERTopic topic modeling technique, which leverages transformers and class-based term frequency-inverse document frequency to create dense clusters allowing for easily interpretable topics. Our BERTopic-based approach involves 3 stages: embedding documents, clustering documents (dimension reduction and clustering), and representing topics (generating candidates and maximizing candidate relevance). RESULTS After applying the study selection criteria, we included 33,206 abstracts in the analysis of this study. The final list of research gaps identified 21 different areas, which were grouped into 6 principal topics. These topics were: "virus of COVID-19," "risk factors of COVID-19," "prevention of COVID-19," "treatment of COVID-19," "health care delivery during COVID-19," "and impact of COVID-19." The most prominent topic, observed in over half of the analyzed studies, was "the impact of COVID-19." CONCLUSIONS The proposed machine learning-based approach has the potential to identify research gaps in scientific literature. This study is not intended to replace individual literature research within a selected topic. Instead, it can serve as a guide to formulate precise literature search queries in specific areas associated with research questions that previous publications have earmarked for future exploration. Future research should leverage an up-to-date list of studies that are retrieved from the most common databases in the target area. When feasible, full texts or, at minimum, discussion sections should be analyzed rather than limiting their analysis to abstracts. Furthermore, future studies could evaluate more efficient modeling algorithms, especially those combining topic modeling with statistical uncertainty quantification, such as conformal prediction.
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Affiliation(s)
- Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | | | - Zubair Shah
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Ahmad Abujaber
- Nursing Department, Hamad Medical Corporation, Doha, Qatar
| | - Dari Alhuwail
- Information Science Department, College of Life Sciences, Kuwait University, Kuwait, Kuwait
- Health Informatics Unit, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Jens Schneider
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Rawan AlSaad
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Hazrat Ali
- Faculty of Computing and Information Technology, Sohar University, Sohar, Oman
| | - Waleed Alomoush
- School of Information Technology, Skyline University College, Sharjah, United Arab Emirates
| | - Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Sarah Aziz
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
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14
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Rosamilia G, Lee KH, Roy S, Hart C, Huang Z. Impact of COVID-19 on nationwide pediatric complicated sinusitis trends throughout 2018-2022. Am J Otolaryngol 2024; 45:104187. [PMID: 38134847 DOI: 10.1016/j.amjoto.2023.104187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES To describe and analyze the trends of pediatric sinusitis cases from 2018 to 2022 across the country utilizing the Pediatric Hospital Information System (PHIS) database focusing on volumes, socioeconomics, and severity of cases. STUDY DESIGN Retrospective Cohort Study. METHODS A retrospective cohort study using the Pediatric Health Information System (PHIS) database, which consists of 50 children's hospitals was performed. Regions were defined according to PHIS guidelines. We evaluated percentage of sinusitis cases demographic and socioeconomic information and subgrouped by region throughout 2018-2022. RESULTS In all regions there were a greater number of sinusitis cases post-COVID compared to pre-COVID, with notable increases in major and extreme severity. The years 2020 and 2021 saw a decrease in total sinusitis cases in all locations. Both surgical intervention and severity of sinusitis were significant factors affecting length of stay. Age and severity were the most significant predictors regarding the odds of having sinus surgery. Age and insurance type were significant predictors of severity, with increasing age and government insurance associated with higher odds of major or extreme severity of sinusitis. CONCLUSIONS There appears to be a trend of both increased number and worsening severity of acute sinusitis cases in the post-COVID era compared to pre-COVID. There was a decrease in cases in 2020-2021 during the pandemic, consistent with trends of other communicable diseases.
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Affiliation(s)
- Gianna Rosamilia
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, Houston, TX, United States of America
| | - Kyung Hyun Lee
- Center for Clinical Research & Evidence-Based Medicine, Department of Pediatrics, University of Texas Health Science Center, Houston, TX, United States of America
| | - Soham Roy
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital Colorado, Denver, CO, United States of America
| | - Catherine Hart
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America
| | - Zhen Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, McGovern Medical School, Houston, TX, United States of America.
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15
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Morris RD. How denialist amplification spread COVID misinformation and undermined the credibility of public health science. J Public Health Policy 2024; 45:114-125. [PMID: 38388891 DOI: 10.1057/s41271-023-00451-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 02/24/2024]
Abstract
Denialist scientists played an outsized role in shaping public opinion and determining public health policy during the recent COVID pandemic. From early on, amplification of researchers who denied the threat of COVID shaped public opinion and undermined public health policy. The forces that amplify denialists include (1) Motivated amplifiers seeking to protect their own interests by supporting denialist scientists, (2) Conventional media outlets giving disproportionate time to denialist opinions, (3) Promoters of controversy seeking to gain traction in an 'attention economy,' and (4) Social media creating information silos in which denialists can become the dominant voice. Denialist amplification poses an existential threat to science relevant to public policy. It is incumbent on the scientific community to create a forum to accurately capture the collective perspective of the scientific community related to public health policy that is open to dissenting voices but prevents artificial amplification of denialists.
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16
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Dirajlal-Fargo S, Maison DP, Durieux JC, Andrukhiv A, Funderburg N, Ailstock K, Gerschenson M, Mccomsey GA. Altered mitochondrial respiration in peripheral blood mononuclear cells of post-acute sequelae of SARS-CoV-2 infection. Mitochondrion 2024; 75:101849. [PMID: 38341012 DOI: 10.1016/j.mito.2024.101849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/20/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
Peripheral blood mononuclear cells (PBMC) mitochondrial respiration was measured ex vivo from participants without a history of COVID (n = 19), with a history of COVID and full recovery (n = 20), and with PASC (n = 20). Mean mitochondrial basal respiration, ATP-linked respiration, maximal respiration, spare respiration capacity, ATP-linked respiration, and non-mitochondrial respiration were highest in COVID + PASC+ (p ≤ 0.04). Every unit increase in non-mitochondrial respiration, ATP-linked respiration, basal respiration, spare respiration capacity, and maximal respiration increased the predicted odds of PASC between 1 % and 6 %. Mitochondrial dysfunction in PBMCs may be contributing to the etiology of PASC.
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Affiliation(s)
- Sahera Dirajlal-Fargo
- Case Western Reserve University, Cleveland, OH, USA; Ann and Robert Lurie Children's Hospital, Chicago, IL, USA.
| | - David P Maison
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.
| | | | - Anastasia Andrukhiv
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.
| | - Nicholas Funderburg
- Division of Medical Laboratory Science, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA.
| | - Kate Ailstock
- Division of Medical Laboratory Science, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA.
| | - Mariana Gerschenson
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.
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17
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Boudreau C, Rhéaume A. Impact of the Work Environment on Nurse Outcomes: A Mediation Analysis. West J Nurs Res 2024; 46:210-218. [PMID: 38343035 PMCID: PMC10903131 DOI: 10.1177/01939459241230369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND The nursing workforce remains in a vulnerable state post pandemic as working conditions are difficult and exacerbated by a global nursing shortage. Identifying factors leading to turnover intentions are thus critical for health care system recovery. PURPOSE The purpose of this study was to examine the impact of nurses' work environment and the pandemic on missed nursing care, scope of practice, emotional exhaustion, and intent to leave. METHODS This study was a cross-sectional, self-reporting online survey, sent to hospital-based nurses in a Canadian province (n = 419). Mediation analysis was used to examine both direct and indirect effects of work environment and COVID-19 impact on nurse outcomes (emotional exhaustion and intent to leave) through missed care and scope of practice. RESULTS The results showed that 73% of nurses were considering leaving the profession. Several direct and indirect pathways predicted emotional exhaustion and intent to leave. A better work environment was related to both decreased emotional exhaustion and intent to leave. Nurses' scope of practice partially mediated the relationship between work environment and intent to leave. On the other hand, missed care did not mediate emotional exhaustion or intent to leave. CONCLUSIONS While considering the global nursing shortage, it is imperative to implement strategies to promote nurses' well-being and their retention within the health care system.
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Affiliation(s)
| | - Ann Rhéaume
- School of Nursing, Université de Moncton, Moncton, NB, Canada
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18
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Du M, Liu M, Wang Y, Qin C, Liu J. Global burden of sleep disturbances among older adults and the disparities by geographical regions and pandemic periods. SSM Popul Health 2024; 25:101588. [PMID: 38225953 PMCID: PMC10788304 DOI: 10.1016/j.ssmph.2023.101588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/23/2023] [Accepted: 12/18/2023] [Indexed: 01/17/2024] Open
Abstract
Sleep disturbances are highly prevalent during the COVID-19 pandemic, especially among older adults. We aimed to evaluate sleep heath during COVID-19 pandemic and assess the differences among geographical regions and pandemic periods. We searched three databases (PubMed, Embase, Web of Science) to find articles up to March 12, 2023. We included observational studies that reported the prevalence of sleep disturbances among adults aged 60 years or older in any setting. Two researchers independently reviewed the literature and retrieved the data. We used Der Simonian-Laird random effects meta-analyses to pool the data, followed by subgroup analysis, sensitivity analysis, and meta-regression. A total of 64 studies with 181,224 older adults during the pandemic were included. The prevalence of poor sleep quality, short sleep duration, long sleep duration, and insomnia symptoms were 47.12% (95% CI: 25.97%, 68.27%), 40.81% (95% CI: 18.49%, 63.12%), 31.61% (95% CI: 24.83%, 38.38%), and 21.15% (95% CI: 15.30%, 27.00%), respectively. The prevalence of sleep problems reported by self-constructed items was 26.97% (95% CI: 20.73%, 33.22%). When compared to America (64.13%), Europe (20.23%) and the Western Pacific (21.31%) showed a lower prevalence of sleep problems (all P < 0.0001). The prevalence of worsened sleep problems was 27.88% (95% CI: 11.94%, 43.82%). Compared to 2020 (15.14%), it increased to 47.42% in 2021 (P < 0.05). Eight studies on sleep disturbances among 672 older COVID-19 patients were included. The prevalence of sleep problems and insomnia symptoms among older COVID-19 patients were 41.58% (95% CI: 21.97%, 61.20%) and 41.56% (95% CI: 28.11%, 58.02%), respectively. A significant burden related to poor sleep has been observed among older adults worldwide over the past three years, with variations across different regions and time periods. It is important to make more efforts in prevention and intervention to identify the risk factors, treatment, and rehabilitation of sleep disturbances for healthy aging.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Yaping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Chenyuan Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
- Institute for Global Health and Development, Peking University, No.5, Yiheyuan Road, Haidian District, Beijing, 100871, China
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
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19
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Gonzalez C, Musso G, Louzan JR, Dominguez JM, Gomez C, Appendino G, Abaca A, Clemente L, Latasa D, Manago M, Lovesio C, Estenssoro E. Characteristics and risk factors associated with mortality during the first cycle of prone secondary to ARDS due to SARS-CoV-2 pneumonia. Med Intensiva 2024; 48:133-141. [PMID: 37714730 DOI: 10.1016/j.medine.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/07/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE To analyze characteristics, changes in oxygenation, and pulmonary mechanics, in mechanically ventilated patients with ARDS due to SARS-CoV-2 treated with prone position and evaluate the response to this maneuver. DESIGN Cohort study including patients with PaO2/FiO2 <150mmHg requiring prone position over 18 months. We classified patients according to PaO2/FiO2 changes from basal to 24h after the first prone cycle as: 1) no increase 2) increase <25%, 3) 25%-50% increase 4) increase >50%. SETTING 33-bed medical-surgical Intensive Care Unit (ICU) in Argentina. PATIENTS 273 patients. INTERVENTIONS None. MAIN VARIABLES OF INTEREST Epidemiological characteristics, respiratory mechanics and oxygenation were compared between survivors and non-survivors. Independent factors associated with in-hospital mortality were identified. RESULTS Baseline PaO2/FiO2 was 116 [97-135]mmHg (115 [94-136] in survivors vs. 117 [98-134] in non-survivors; p=0.50). After prone positioning, 22 patients (8%) had similar PaO2/FiO2 values; 46(16%) increased PaO2/FiO2 ≤25%; 55 (21%) increased it 25%-50%; and 150 (55%), >50%. Mortality was 86%, 87%, 72% and 50% respectively (p<0.001). Baseline PaO2/FiO2, <100mmHg did not imply that patients were refractory to prone position. Factors independently associated with mortality were age, percentage increase in PaO2/FiO2 after 24h being in prone, and number of prone cycles. CONCLUSIONS Older patients unable to improve PaO2/FiO2 after 24h in prone position and who require >1 cycle might early receive additional treatments for refractory hypoxemia. After the first 24h in the prone position, a low percentage of PaO2/FiO2 increase over baseline, beyond the initial value, was independently associated with higher mortality.
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Affiliation(s)
| | - Gabriel Musso
- Sanatorio Parque, Bv. Oroño 860, Rosario, Santa Fe, Argentina
| | | | | | - Celeste Gomez
- Sanatorio Parque, Bv. Oroño 860, Rosario, Santa Fe, Argentina
| | | | - Analía Abaca
- Sanatorio Parque, Bv. Oroño 860, Rosario, Santa Fe, Argentina
| | - Lucio Clemente
- Sanatorio Parque, Bv. Oroño 860, Rosario, Santa Fe, Argentina
| | - Diana Latasa
- Sanatorio Parque, Bv. Oroño 860, Rosario, Santa Fe, Argentina
| | - Martin Manago
- Sanatorio Parque, Bv. Oroño 860, Rosario, Santa Fe, Argentina
| | - Carlos Lovesio
- Sanatorio Parque, Bv. Oroño 860, Rosario, Santa Fe, Argentina
| | - Elisa Estenssoro
- Hospital Interzonal de Agudos General San Martín de La Plata, Av. 1 1850, La Plata, Argentina
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20
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Nimgaonkar I, Yoke LH, Roychoudhury P, Flaherty PW, Oshima MU, Weixler A, Gauthier J, Greninger AL, Mielcarek M, Boeckh M, Liu C, Hill JA. Outcomes in Hematopoietic Cell Transplant and Chimeric Antigen Receptor T Cell Therapy Recipients with Pre-Cellular Therapy SARS-CoV-2 Infection. Clin Infect Dis 2024:ciae116. [PMID: 38427848 DOI: 10.1093/cid/ciae116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/12/2024] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Hematopoietic cell transplant (HCT) or chimeric antigen receptor T cell (CAR-T) therapy recipients have high morbidity from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. There are limited data on outcomes from SARS-CoV-2 infection shortly before cellular therapy and uncertainty whether to delay therapy. METHODS We conducted a retrospective cohort study of patients with SARS-CoV-2 infection within 90 days prior to HCT or CAR-T therapy between January 2020 and November 2022. We characterized the kinetics of SARS-CoV-2 detection, clinical outcomes following cellular therapy, and impact on delays in cellular therapy. RESULTS We identified 37 patients (n=15 allogeneic HCT, n=11 autologous HCT, n=11 CAR-T therapy) with SARS-CoV-2 infections within 90 days of cellular therapy. Most infections (73%) occurred between March and November 2022, when Omicron strains were prevalent. Most patients had asymptomatic (27%) or mild (68%) coronavirus disease 2019 (COVID-19). SARS-CoV-2 positivity lasted a median of 20.0 days [IQR, 12.5-26.25]. The median time from first positive SARS-CoV-2 test to cellular therapy was 45 days [IQR, 37.75-70]; one patient tested positive on the day of infusion. After cellular therapy, no patients had recrudescent SARS-CoV-2 infection or COVID-19-related complications. Cellular therapy delays related to SARS-CoV-2 infection occurred in 70% of patients for a median of 37 days. Delays were more common after allogeneic (73%) and autologous (91%) HCT compared to CAR-T cell therapy (45%). CONCLUSIONS Patients with asymptomatic or mild COVID-19 may not require prolonged delays in cellular therapy in the context of contemporary circulating variants and availability of antiviral therapies.
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Affiliation(s)
- Ila Nimgaonkar
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - Leah H Yoke
- Department of Medicine, University of Washington, Seattle, WA, United States
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Pavitra Roychoudhury
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States
| | - Patrick W Flaherty
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Masumi Ueda Oshima
- Department of Medicine, University of Washington, Seattle, WA, United States
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Amelia Weixler
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States
| | - Jordan Gauthier
- Department of Medicine, University of Washington, Seattle, WA, United States
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Alexander L Greninger
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States
| | - Marco Mielcarek
- Department of Medicine, University of Washington, Seattle, WA, United States
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Michael Boeckh
- Department of Medicine, University of Washington, Seattle, WA, United States
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Catherine Liu
- Department of Medicine, University of Washington, Seattle, WA, United States
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Joshua A Hill
- Department of Medicine, University of Washington, Seattle, WA, United States
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
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21
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Shiva M. Seeking outcomes under tight budgets: A case for health impact bonds in Post- COVID times. Int J Health Plann Manage 2024; 39:343-362. [PMID: 37924311 DOI: 10.1002/hpm.3727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 10/14/2023] [Accepted: 10/19/2023] [Indexed: 11/06/2023] Open
Abstract
With global public debt at record levels, governments are facing unprecedented challenges in providing essential health services. This exploratory study aims to assess the relevance of Health Impact Bonds (HIBs) as a means of financing preventative health services during times of fiscal constraint and in the aftermath of the COVID pandemic. The study draws on a review of the literature on HIBs, along with a case study analysis of HIBs implemented in the UK. The findings of the study indicate that, although HIBs offer promise as an innovative funding tool for preventative health services in tight fiscal situations, certain challenges are limiting their broader adoption.
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Affiliation(s)
- Mehdi Shiva
- RAND Europe, Cambridge, UK
- Blavatnik School of Government, University of Oxford
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22
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Aerts R, Autier B, Gornicec M, Prattes J, Lagrou K, Gangneux JP, Hoenigl M. Point-of-care testing for viral-associated pulmonary aspergillosis. Expert Rev Mol Diagn 2024; 24:231-243. [PMID: 37688631 DOI: 10.1080/14737159.2023.2257597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/17/2023] [Accepted: 09/07/2023] [Indexed: 09/11/2023]
Abstract
INTRODUCTION Over the last years, severe respiratory viral infections, particularly those caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the influenza virus, have emerged as risk factor for viral-associated pulmonary aspergillosis (VAPA) among critically ill patients. Delays in diagnosis of VAPA are associated with increased mortality. Point-of-care-tests may play an important role in earlier diagnosis of VAPA and thus improve patient outcomes. AREAS COVERED The following review will give an update on point-of-care tests for VAPA, analyzing performances in respiratory and blood specimens. EXPERT OPINION Point-of-care tests have emerged, and particularly the IMMY Aspergillus galactomannan lateral flow assay (LFA) shows performances comparable to the galactomannan ELISA for diagnosis of VAPA. Notably, nearly all evaluations of POC tests for VAPA have been performed in COVID-19 patients, with very limited data in influenza patients. For early diagnosis of COVID associated pulmonary aspergillosis (CAPA), the LFA has shown promising performances in respiratory samples, particularly in bronchoalveolar lavage fluid, and may thereby help in improving patient outcomes. In contrast, serum LFA testing may not be useful for early diagnosis of disease, except in cases with invasive tracheobronchial aspergillosis.
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Affiliation(s)
- Robina Aerts
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven, Belgium
| | - Brice Autier
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France
- Centre Hospitalier Universitaire de Rennes, Laboratory of Parasitology and Mycology, European Excellence Center in Medical Mycology (ECMM-EC), National Reference Center on mycology and antifungals (LA-AspC Chronic aspergillosis and A. fumigatus resistance), Rennes, France
| | - Maximilian Gornicec
- Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - Juergen Prattes
- Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Medicine, Medical University of Graz, Graz, Austria
- Translational Medical Mycology Research Unit, Medical University of Graz, Graz, Austria
| | - Katrien Lagrou
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, KU Leuven, Leuven, Belgium
- Department of Laboratory Medicine, National Reference Center for Mycosis, University Hospitals Leuven, Leuven, Belgium
| | - Jean-Pierre Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, Rennes, France
- Centre Hospitalier Universitaire de Rennes, Laboratory of Parasitology and Mycology, European Excellence Center in Medical Mycology (ECMM-EC), National Reference Center on mycology and antifungals (LA-AspC Chronic aspergillosis and A. fumigatus resistance), Rennes, France
| | - Martin Hoenigl
- Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Medicine, Medical University of Graz, Graz, Austria
- Translational Medical Mycology Research Unit, Medical University of Graz, Graz, Austria
- BioTechMed, Graz, Austria
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23
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Pan WW, Young KZ, Johnson MW, Young BK. Workforce separation among ophthalmologists before and during the COVID-19 pandemic. Graefes Arch Clin Exp Ophthalmol 2024; 262:1005-1007. [PMID: 37728753 DOI: 10.1007/s00417-023-06228-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/17/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023] Open
Affiliation(s)
- Warren W Pan
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA
| | - Kelly Z Young
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Mark W Johnson
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA
| | - Benjamin K Young
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA.
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24
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Bell AJ, Afulani P, Compton S, Barringer S, Kaselitz E, Muzik M, Moyer CA. Understanding how COVID-19 affected black pregnant women early in the pandemic: A cross-sectional survey. Midwifery 2024; 130:103915. [PMID: 38184973 DOI: 10.1016/j.midw.2024.103915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 06/07/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
OBJECTIVE Previous research has shown that the COVID-19 pandemic significantly increased anxiety among pregnant women, and at the same time, COVID-19 has disproportionately affected communities of color in the United States. We sought to understand how self-identied Black pregnant women in the United States were affected in the early days of the COVID-19 pandemic. DESIGN Cross-sectional, online survey distributed via social media SETTING: Online PARTICIPANTS: Non-probability, convenience sample of self-identified Black pregnant women in the United States between April 3 and 24, 2020 who responded to an online inquiry seeking women who were pregnant at the outset of the COVID-19 pandemic. MEASUREMENTS AND FINDINGS An anonymous, self-administered, online survey of pregnant women was conducted, including both quantitative assessment of demographics, COVID-related anxiety, and pregnancy-related anxiety as well as open-ended prompts for qualitative assessment of the impact of COVID on prenatal care, birth plans, anxiety and overall experience of pregnancy. Quantitative data were analyzed using Stata 15.0, qualitative data were thematically analyzed using NVivo12.1. Results were compared using joint display methodology. Of 87 self-identified Black or African-American women who responded, the most common concerns related to fear of getting infected with COVID (89.7 %, N = 78) and concerns related to loss of job/income (67.8 %, N = 59). More than half (55.2 %, N = 48) reported either themselves or their family members working in essential services. Findings indicate that uncertainty, lack of support, perceived quality of care, and heightened anxiety worked together to define Black women's experiences of pregnancy in the early days of the COVID-19 pandemic in the U.S. While quantitative data did not explicitly capture reports of discrimination as impacting perceived quality of care, the qualitative data suggest a link between fears of discrimination, the need for self-advocacy, and heightened anxiety. KEY CONCLUSIONS Despite being a relatively well-educated sample of Black women from around the United States, many respondents spoke of the fears of discrimination, the need for self-advocacy, and heightened anxiety, reinforcing that discrimination and fear of discrimation for Black women in healthcare settings are pervasive, regardless of a woman's level of education or other socioeconomic status indicators. IMPLICATIONS FOR PRACTICE These findings suggest that in times of uncertainty, such as the early days of the COVID-19 pandemic, it is more important than ever to provide thoughtful, supportive care to pregnant women of color who are primed for negative experiences in the healthcare settting.
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Affiliation(s)
- April J Bell
- California Preterm Birth Initiative, Obstetrics, Gynecology & Reproductive Sciences, University of California, 490 Illinois Street, Floor 9, Box 2930, San Francisco, CA 94143, USA
| | - Patience Afulani
- Departments of Epidemiology & Biostatistics & Obstetrics, Gynecology, & Reproductive Sciences, Institute for Global Health Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, 550 16th St, 3rd Floor, San Francisco, CA 94158, USA
| | - Sarah Compton
- Department of Obstetrics & Gynecology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA; Global REACH, University of Michigan, 1111 E. Catherine Street, Ann Arbor, MI 48019, USA
| | - Sarah Barringer
- University of Michigan, 500 S. State Street, Ann Arbor, MI 48109, USA
| | - Elizabeth Kaselitz
- Global REACH, University of Michigan, 1111 E. Catherine Street, Ann Arbor, MI 48019, USA
| | - Maria Muzik
- Department of Obstetrics & Gynecology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA; Department of Psychiatry, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Cheryl A Moyer
- Department of Learning Health Sciences, University of Michigan Medical School, 1111 E. Catherine Street; 231 Victor Vaughan Building, Ann Arbor, MI 48109, USA.
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Hakim H, Driedger SM, Gagnon D, Chevrier J, Roch G, Dubé E, Witteman HO. Digital Gamification Tools to Enhance Vaccine Uptake: Scoping Review. JMIR Serious Games 2024; 12:e47257. [PMID: 38421688 PMCID: PMC10906656 DOI: 10.2196/47257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/22/2023] [Accepted: 01/02/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Gamification has been used successfully to promote various desired health behaviors. Previous studies have used gamification to achieve desired health behaviors or facilitate their learning about health. OBJECTIVE In this scoping review, we aimed to describe digital gamified tools that have been implemented or evaluated across various populations to encourage vaccination, as well as any reported effects of identified tools. METHODS We searched Medline, Embase, CINAHL, the Web of Science Core Collection, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Academic Search Premier, PsycInfo, Global Health, and ERIC for peer-reviewed papers describing digital gamified tools with or without evaluations. We also conducted web searches with Google to identify digital gamified tools lacking associated publications. We consulted 12 experts in the field of gamification and health behavior to identify any papers or tools we might have missed. We extracted data about the target population of the tools, the interventions themselves (eg, type of digital gamified tool platform, type of disease/vaccine, type and design of study), and any effects of evaluated tools, and we synthesized data narratively. RESULTS Of 1402 records, we included 28 (2%) peer-reviewed papers and 10 digital gamified tools lacking associated publications. The experts added 1 digital gamified tool that met the inclusion criteria. Our final data set therefore included 28 peer-reviewed papers and 11 digital gamified tools. Of the 28 peer-reviewed papers, 7 (25%) explained the development of the tool, 16 (57%) described evaluation, and 2 (7%) reported both development and evaluation of the tool. The 28 peer-reviewed papers reported on 25 different tools. Of these 25 digital gamified tools, 11 (44%) were web-based tools, 8 (32%) mobile (native mobile or mobile-enabled web) apps, and 6 (24%) virtual reality tools. Overall, tools that were evaluated showed increases in knowledge and intentions to receive vaccines, mixed effects on attitudes, and positive effects on beliefs. We did not observe discernible advantages of one type of digital gamified tool (web based, mobile, virtual reality) over the others. However, a few studies were randomized controlled trials, and publication bias may have led to such positive effects having a higher likelihood of appearing in the peer-reviewed literature. CONCLUSIONS Digital gamified tools appear to have potential for improving vaccine uptake by fostering positive beliefs and increasing vaccine-related knowledge and intentions. Encouraging comparative studies of different features or different types of digital gamified tools could advance the field by identifying features or types of tools that yield more positive effects across populations and contexts. Further work in this area should seek to inform the implementation of gamification for vaccine acceptance and promote effective health communication, thus yielding meaningful health and social impacts.
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Affiliation(s)
- Hina Hakim
- Department of Family and Emergency Medicine, Université Laval, Québec City, QC, Canada
| | - S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Dominique Gagnon
- Direction des risques biologiques, Institut national de santé publique du Québec, Quebec City, QC, Canada
| | - Julien Chevrier
- Bibliothèque Louise-Lalonde-Lamarre, Polytechnique Montréal, Montréal, QC, Canada
| | - Geneviève Roch
- Faculty of Nursing, Université Laval, Quebec City, QC, Canada
- Centre hospitalier universitaire (CHU) de Québec-Université Laval, Université Laval, Quebec City, QC, Canada
- VITAM Research Centre for Sustainable Health, Université Laval, Quebec City, QC, Canada
| | - Eve Dubé
- Direction des risques biologiques, Institut national de santé publique du Québec, Quebec City, QC, Canada
- Département d'anthropologie, Université Laval, Quebec City, QC, Canada
| | - Holly O Witteman
- Department of Family and Emergency Medicine, Université Laval, Québec City, QC, Canada
- Centre hospitalier universitaire (CHU) de Québec-Université Laval, Université Laval, Quebec City, QC, Canada
- VITAM Research Centre for Sustainable Health, Université Laval, Quebec City, QC, Canada
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26
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Rabin C. Longitudinal study of the role of COVID worry versus general anxiety in predicting vaccination and other COVID-preventive behaviors. Psychol Health 2024:1-12. [PMID: 38419472 DOI: 10.1080/08870446.2024.2323764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 02/21/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE The COVID-19 pandemic highlighted the critical role of public engagement in health protective behaviors (e.g. masking, vaccination) to reduce viral spread and impact. Future public health efforts may be facilitated by identifying factors that impact the likelihood of adopting these behaviors. This study evaluated whether COVID-specific worry and/or generalized anxiety predicted subsequent uptake of COVID-19 vaccination and engagement in other COVID-preventive behaviors. METHOD AND MEASURES Participants (N = 205) completed an online survey in July 2020, shortly after the onset of the pandemic, and a follow-up survey, over a year later, after vaccines were available to the public. RESULTS Findings indicate that those reporting greater COVID-worry on the initial survey were more likely to get vaccinated against COVID-19 by the follow-up survey and to report greater engagement in COVID-protective behaviors at both timepoints. By contrast, lower levels of generalized anxiety predicted greater likelihood of vaccination by follow-up and greater engagement in other COVID-protective behaviors on the initial survey. CONCLUSIONS These findings suggest that worry about a specific health threat may have a protective function, motivating protective behavior, whereas elevated levels of generalized anxiety appear to undermine health protective behavior and should be aggressively addressed.
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Affiliation(s)
- Carolyn Rabin
- Clinical Psychology Department, William James College, Newton, MA, USA
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27
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Nisa L, Leroyer H, Sandu K. Open airway surgery for post- COVID laryngotracheal stenosis. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08533-z. [PMID: 38407612 DOI: 10.1007/s00405-024-08533-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/05/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION This study reports our experience with open reconstructive surgery in patients with laryngotracheal stenosis (LTS) following prolonged intubation and/or tracheostomy in the context of COVID-19. METHODS All patients underwent a preoperative endoscopic airway assessment. Posterior glottic lesions were graded according to the Bogdasarian classification, subglottic-tracheal lesions according to the Cotton-Myers classification and postoperative complications reported by the Clavien-Dindo classification. We report postoperative outcomes and functional results in this patient subset. RESULTS We include 14 patients diagnosed to have post COVID LTS, one female and 13 males. This group was compared with a control group, diagnosed with LTS following prolonged intubation. In the COVID group, mean age of patients at the time of the airway surgery was 52.1 ± 16.8 years (range: 13.7-76.3). More than half the patients were multi-morbid with hypertension and obesity being the most common conditions. Eleven patients had multi-site stenoses. Open surgical interventions performed were tracheal resection and anastomosis, laryngotracheal reconstruction and extended cricotracheal resection, and postoperative complications were seen in 12 (85.6%) patients. 70% patients with pre-existing tracheostomy were decannulated. Oral swallowing was not tolerated in one-fifth of the patients and a significant number of them have poor voice quality. CONCLUSION Post-COVID pandemic, airway surgeons are seeing an increased number of patients with complex LTS, and we report significant postoperative complications in this patient subset. Decannulation rates, voice and swallowing results are poor in patients with glottic involvement as compared to isolated tracheal stenosis.
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Affiliation(s)
- Lluís Nisa
- Department of Otorhinolaryngology, Head and Neck Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Hajdi Leroyer
- Department of Otorhinolaryngology, Head and Neck Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Kishore Sandu
- Department of Otorhinolaryngology, Head and Neck Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
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Schwartz CE, Borowiec K, Rapkin BD. Reserve-building as a buffer for depression among individuals living with disability: a longitudinal study of current activities related to brain health. Front Psychol 2024; 15:1330437. [PMID: 38455115 PMCID: PMC10919219 DOI: 10.3389/fpsyg.2024.1330437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/19/2024] [Indexed: 03/09/2024] Open
Abstract
Aims This study examined whether reserve-building activities are associated with attenuated reported depression among people who were disabled from work due to a medical condition as compared to employed, retired, and unemployed participants. Methods This secondary analysis included 771 individuals who provided data at three time points: baseline (late Spring 2020), follow-up 1 (Spring 2021), and follow-up 2 (Fall 2021). The DeltaQuest Reserve-Building Measure assessed current activities related to brain health. An analysis of variance and Pearson correlation coefficients assessed group differences in reserve-building activity scores. Classification and regression tree (CART) modeling investigated factors associated with higher and lower reported depression by employment group. The random effects (RE) models tested two buffering hypotheses: (1) comparing all groups to the employed group and (2) examining within-group effects. Results Engaging in outdoor activities, exercise, and religious/spiritual activities was associated with reduced depression over time in the overall sample. While disabled participants endorsed lower levels of being Active in the World, Outdoor activities, and Exercise and higher levels of Inner Life and Passive Media Consumption than the other employment groups, more reserve-building activities distinguished depression levels in the disabled group's CART models compared to the others. Among the disabled, unemployed, and retired participants, engaging in any reserve-building activities was also associated with lower depression scores, which was distinct from the employed participants. In the RE models that used the employed group as the reference category, only the disabled group's level of depression was buffered by engaging in creative activities. In the within-group RE models, the disabled group's engagement in Religious/Spiritual, Outdoors, and Games was associated with substantially reduced within-group depression, which was different from the other employment groups. In contrast, reserve-building activities were not implicated at all as buffers for employed participants. Conclusion This study revealed a beneficial effect of reserve-building activities on buffering depression over time during the COVID-19 pandemic, particularly for disabled people. It documented that even if such individuals engaged in lesser amounts of such activities as compared to other employment groups, the buffering effect was substantial. Given the low-cost and accessible nature of reserve-building activities, it would be worthwhile to encourage such activities for disabled individuals.
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Affiliation(s)
- Carolyn E. Schwartz
- DeltaQuest Foundation, Inc., Concord, MA, United States
- Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, United States
| | - Katrina Borowiec
- DeltaQuest Foundation, Inc., Concord, MA, United States
- Department of Measurement, Evaluation, Statistics, and Assessment, Boston College Lynch School of Education and Human Development, Chestnut Hill, MA, United States
| | - Bruce D. Rapkin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
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Maybin J, Watters M, Rowley B, Walker C, Sharp G, Alvergne A. COVID-19 and abnormal uterine bleeding: potential associations and mechanisms. Clin Sci (Lond) 2024; 138:153-171. [PMID: 38372528 PMCID: PMC10876417 DOI: 10.1042/cs20220280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/16/2024] [Accepted: 01/29/2024] [Indexed: 02/20/2024]
Abstract
The impact of COVID-19 on menstruation has received a high level of public and media interest. Despite this, uncertainty exists about the advice that women and people who menstruate should receive in relation to the expected impact of SARS-CoV-2 infection, long COVID or COVID-19 vaccination on menstruation. Furthermore, the mechanisms leading to these reported menstrual changes are poorly understood. This review evaluates the published literature on COVID-19 and its impact on menstrual bleeding, discussing the strengths and limitations of these studies. We present evidence consistent with SARS-CoV-2 infection and long COVID having an association with changes in menstrual bleeding parameters and that the impact of COVID vaccination on menstruation appears less significant. An overview of menstrual physiology and known causes of abnormal uterine bleeding (AUB) is provided before discussing potential mechanisms which may underpin the menstrual disturbance reported with COVID-19, highlighting areas for future scientific study. Finally, consideration is given to the effect that menstruation may have on COVID-19, including the impact of the ovarian sex hormones on acute COVID-19 severity and susceptibility and reported variation in long COVID symptoms across the menstrual cycle. Understanding the current evidence and addressing gaps in our knowledge in this area are essential to inform public health policy, direct the treatment of menstrual disturbance and facilitate development of new therapies, which may reduce the severity of COVID-19 and improve quality of life for those experiencing long COVID.
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Affiliation(s)
- Jacqueline A. Maybin
- Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, U.K
| | - Marianne Watters
- Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, U.K
| | - Bethan Rowley
- Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, U.K
| | - Catherine A. Walker
- Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, U.K
| | | | - Alexandra Alvergne
- ISEM, Univ Montpellier, CNRS, IRD, Montpellier, France
- School of Anthropology and Museum Ethnography, Oxford, U.K
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Tabatabai T, Thompson H, Cheung K, Palmer S, Eckburg A, Loeffler BT, Mott SL, Liu V. Assessment of Effectiveness of COVID-Pandemic Scheduling Triage in an Academic Dermatology Clinic [JAAD-D-23-00022]. J Am Acad Dermatol 2024:S0190-9622(24)00388-8. [PMID: 38395227 DOI: 10.1016/j.jaad.2024.01.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 10/30/2023] [Accepted: 01/14/2024] [Indexed: 02/25/2024]
Affiliation(s)
- Taylor Tabatabai
- Department of Dermatology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 40024 PFP, Iowa City, Iowa 52242.
| | - Hannah Thompson
- Department of Dermatology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 40024 PFP, Iowa City, Iowa 52242
| | - Kevin Cheung
- Department of Dermatology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 40024 PFP, Iowa City, Iowa 52242; Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 40024 PFP, Iowa City, Iowa 52242
| | - Sam Palmer
- Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 40024 PFP, Iowa City, Iowa 52242
| | - Alexandra Eckburg
- Department of Dermatology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 40024 PFP, Iowa City, Iowa 52242
| | - Bradley T Loeffler
- University of Iowa Holden Comprehensive Cancer Center, 200 Hawkins Drive, Iowa City, Iowa 52242
| | - Sarah L Mott
- University of Iowa Holden Comprehensive Cancer Center, 200 Hawkins Drive, Iowa City, Iowa 52242
| | - Vincent Liu
- Department of Dermatology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 40024 PFP, Iowa City, Iowa 52242; Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 40024 PFP, Iowa City, Iowa 52242
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Visentin A, Gentile M. Editorial: Covid-19 therapies in patients with hematologic malignancies. Front Oncol 2024; 14:1382268. [PMID: 38440230 PMCID: PMC10910085 DOI: 10.3389/fonc.2024.1382268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 03/06/2024] Open
Affiliation(s)
- Andrea Visentin
- Hematology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Massimo Gentile
- Hematology Unit, Azienda Ospedaliera (AO) Cosenza, Cosenza, Italy
- Department of Pharmacy, Health and Nutritional Science, University of Calabria, Rende, Italy
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Choi NG, Marti CN, Choi BY. Mental Health Treatment Use, Perceived Treatment Need, and Reasons for Non-Use Among U.S. Adults with Serious Suicidal Thoughts During the COVID-19 Pandemic. Community Ment Health J 2024:10.1007/s10597-024-01249-8. [PMID: 38372825 DOI: 10.1007/s10597-024-01249-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/11/2024] [Indexed: 02/20/2024]
Abstract
Analyzing the 2021 National Survey on Drug Use and Health data with generalized linear models, we examined: (1) COVID pandemic-related and other correlates of mental health treatment use and unmet perceived treatment need among U.S. adults who experienced serious suicidal thoughts (N = 3,177); and (2) correlates of self-reported reasons for not receiving treatment. We found that 61% used any mental health treatment, and 48% of users and 37% of nonusers reported perceived treatment need. Significant correlates of treatment use were demographic factors, insurance, major depressive disorder, and illicit drug use disorder. Significant correlates of perceived treatment need were age 18-34, some college education, and major depressive episode. Perceived negative effect of the COVID pandemic on mental health was a significant factor for both treatment use and perceived need. The most frequent reasons for not getting treatment were the cost of treatment or lack of insurance and stigma-related concerns.
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Affiliation(s)
- Namkee G Choi
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA.
| | - C Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA
| | - Bryan Y Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine and BayHealth, Philadelphia, USA
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Cataldi JR, Suresh K, Brewer SE, Perreira C, Nederveld A, Skenadore A, Furniss A, Williams C, Severson R, Dempsey AF, O'Leary ST. Boot Camp Translation using Community-Engaged messaging for adolescent Vaccination: A Cluster-Randomized trial. Vaccine 2024; 42:1078-1086. [PMID: 38253469 DOI: 10.1016/j.vaccine.2024.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Routine vaccination coverage for adolescents living in the rural US is lower than adolescents living in urban areas. We sought to measure the effect of Boot Camp Translation (BCT), a community-based participatory intervention, on rural adolescent vaccination coverage. METHODS A cluster randomized controlled trial was performed September 2018-November 2021 involving 16 rural Colorado counties. Intervention county community members engaged in BCT to develop interventions to improve adolescent vaccination locally. Adolescent vaccination coverage was measured using the Colorado Immunization Information System. RESULTS For 11-12-year-olds, HPV initiation, HPV up-to-date, MenACWY, and Tdap vaccination coverage was lower post- versus pre-intervention in the control and intervention groups. For 11-12-year-olds in the intervention group, there was no significant difference post- versus pre-intervention in the odds of HPV vaccine initiation (adjusted ratio of odds ratios [aROR] = 0.93, 95 %: 0.85-1.02, p = 0.10) or up-to-date HPV vaccination (aROR: 1.10, 95 % CI: 0.98-1.23, p = 0.11) compared with the control group. Among 11-12-year-olds, the decrease in the proportion vaccinated with MenACWY and Tdap in the intervention group was significantly greater than the control group. Among 13-17-year-olds, there were significant increases in HPV initiation, HPV up-to-date, MenACWY, and Tdap vaccination coverage from pre- to post-intervention for both groups, with no significant differences between groups. CONCLUSION 11-12-year-old vaccination coverage decreased slightly from pre- to post-intervention while 13-17-year-old vaccination coverage increased. We saw no effect from the BCT intervention. Our findings about the effectiveness of BCT for improving vaccine uptake may not be generalizable because the study coincided with the COVID-19 pandemic. CLINICAL TRIAL REGISTRY This study was registered with ClinicalTrials.gov, NCT03955757.
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Affiliation(s)
- Jessica R Cataldi
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States.
| | - Krithika Suresh
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Sarah E Brewer
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Cathryn Perreira
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Andrea Nederveld
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Amanda Skenadore
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Anna Furniss
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Charnetta Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Rachel Severson
- Colorado Department of Public Health and Environment, Denver, CO, United States
| | - Amanda F Dempsey
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
| | - Sean T O'Leary
- ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
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Orser L, Squires JE, Musten A, Ho N, Lindsay J, Pai NP, O'Byrne P. Real world outcomes of distributing Lucira Check-It® COVID self-tests in Ontario, Canada: the GetaKit COVID study. BMC Public Health 2024; 24:485. [PMID: 38360568 PMCID: PMC10870641 DOI: 10.1186/s12889-024-17783-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND In Ontario, Canada we developed and implemented an online screening algorithm for the distribution of HIV self-tests, known as GetaKit. During the COVID pandemic, we adapted the GetaKit algorithm to screen for COVID based on population and infection data and distributed COVID rt-LAMP self-tests (using the Lucira Check-It®) to eligible participants. METHODS GetaKit/COVID was a prospective observational study that occurred over a 7-month period from September 2021 to April 2022. All potential participants completed an online registration and risk assessment, including demographic information, COVID symptoms and risk factors, and vaccination status. Bivariate comparisons were performed for three outcomes: results reporting status, vaccination status, and COVID diagnosis status. Data were analysed using Chi-Square for categorial covariates and Independent Samples T-Test and Mann-Whitney U test for continuous covariates. Bivariate logistic regression models were applied to examine associations between the covariates and outcomes. RESULTS During the study period, we distributed 6469 COVID self-tests to 4160 eligible participants; 46% identified as Black, Indigenous or a Person of Colour (BIPOC). Nearly 70% of participants reported their COVID self-test results; 304 of which were positive. Overall, 91% also reported being vaccinated against COVID. Statistical analysis found living with five or fewer people, having tested for COVID previously, and being fully vaccinated were positive factors in results reporting. For COVID vaccination, people from large urban centers, who identified their ethnicity as white, and who reported previous COVID testing were more likely to be fully vaccinated. Finally, being identified as a contact of someone who had tested positive for COVID and the presence of COVID-related symptoms were found to be positive factors in diagnosis. CONCLUSIONS While most participants who accessed this service were vaccinated against COVID and the majority of diagnoses were identified in participants who had symptoms of, or an exposure to, COVID, our program was able to appropriately link participants to recommended follow-up based on reported risks and results. These findings highlight the utility of online screening algorithms to provide health services, particularly for persons with historical barriers to healthcare access, such as BIPOC or lower-income groups.
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Affiliation(s)
- Lauren Orser
- Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
| | - Janet E Squires
- Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
| | - Alexandra Musten
- Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
| | - Nikki Ho
- Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
| | - Jennifer Lindsay
- Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada
| | - Nitika Pant Pai
- Department of Medicine, School of Population and Global Health, McGill University, 5252 Boulevard de Maisonneuve W., Montréal, QC, H4A 3S5, Canada
| | - Patrick O'Byrne
- Faculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada.
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Clothier HJ, Shetty AN, Mesfin Y, Mackie M, Pearce C, Buttery JP. What would have happened anyway? Population data source considerations when estimating background incident rates of adverse events following immunisation to inform vaccine safety. Vaccine 2024; 42:1108-1115. [PMID: 38262811 DOI: 10.1016/j.vaccine.2024.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Understanding background incident rates of adverse events following immunisation (AEFI) is essential to rapidly detect, evaluate, respond to, and communicate about vaccine safety concerns, especially for new vaccines. Creating estimates based on geographic specific population level data is increasingly important, as new AEFI presentations will be subject to the same local influences of population demography, exposures, health system variations and level of health care sought. METHODS We conducted a retrospective cohort analysis of hospital admissions, emergency department presentations and general practice consultations from 2015 to 2019-before introduction of COVID-19, Mpox or Shingrix vaccination-to estimate background incident rates for 37 conditions considered potential AEFI of special interest (AESI). Background incident rates per 100,000 population were calculated and presented as cases expected to occur coincidentally 1 day, 1 week and 6 weeks post-vaccination, by life-stage age-groups and presenting healthcare setting. We then assessed the proportional contribution of each data source to inform each AESI background rate estimate. RESULTS 16,437,156 episodes of the 37 AESI were identified. Hospital admissions predominantly informed 19 (51%) of AESI, including exclusively ADEM and CVST; 8 AESI (22%) by primary care, and 10 (27%) a mix. Four AESI (allergic urticaria, Bell's palsy, erythema multiform and sudden death) were better informed by emergency presentations than admissions, but conversely 11 AESI (30%) were not captured in ICD-10 coded emergency presentations at all. CONCLUSIONS Emergent safety concerns are inevitable in population-wide implementation of new vaccines, therefore understanding local background rates aids both safety signal detection as well as maintaining public confidence in vaccination. Hospital and primary care data sources can be interrogated to inform expected background incident rates of adverse events that may occur following vaccination. However, it is necessary to understand which data-source provides best intelligence according to nature of condition and presenting healthcare setting.
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Affiliation(s)
- Hazel J Clothier
- Health Informatics, Centre for Health Analytics, Melbourne Children's Campus, 50 Flemington Road, Parkville, Victoria, Australia; SAEFVIC, Infection and Immunity, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, Australia; Melbourne School of Population & Global Health, University of Melbourne, Grattan Street, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Grattan Street, Parkville, Victoria, Australia.
| | - Aishwarya N Shetty
- Health Informatics, Centre for Health Analytics, Melbourne Children's Campus, 50 Flemington Road, Parkville, Victoria, Australia; SAEFVIC, Infection and Immunity, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, Australia.
| | - Yonatan Mesfin
- SAEFVIC, Infection and Immunity, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, Australia
| | - Michael Mackie
- Victorian Agency for Health Information, Victorian Government Department of Health, 50 Lonsdale Street, Melbourne, Victoria, Australia.
| | | | - Jim P Buttery
- Health Informatics, Centre for Health Analytics, Melbourne Children's Campus, 50 Flemington Road, Parkville, Victoria, Australia; SAEFVIC, Infection and Immunity, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Grattan Street, Parkville, Victoria, Australia; Department of General Medicine, The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, Australia.
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Calcaterra V, Tagi VM, D'Auria E, Lai A, Zanelli S, Montanari C, Biganzoli EM, Marano G, Borghi E, Massa V, Riva A, Zuccotti G. Long-term effects of SARS-CoV-2 infection in hospitalized children: findings from an Italian single-center study. Ital J Pediatr 2024; 50:27. [PMID: 38355648 PMCID: PMC10865522 DOI: 10.1186/s13052-024-01596-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Limited evidence exists regarding the association between COVID-19 and Long COVID manifestations in children, particularly concerning variants of concern (VOCs). We aimed to characterize a cohort of pediatric patients hospitalized with confirmed acute SARS-CoV-2 and monitor them for Long COVID symptoms. Additionally, it seeks to explore any potential correlations between VOCs and clinical symptoms. METHODS We conducted a prospective study involving children hospitalized from November 2021 to March 2023, with confirmed acute SARS-CoV-2 infection. A telephone survey was conducted at 3-6-12 months after discharge. RESULTS We included 167 patients (77 F/90 M). Upon hospital admission, 95.5% of patients presented as symptomatic. Regarding patients for whom it was feasible to determine the SARS-CoV-2 variant (n = 51), the Delta variant was identified in 11 children (21.6%) and Omicron variant in the remaining 40 patients (78.4%: 27.5% BA.1 variant; 15% BA.2 variant; 57.5% BA.5 variant). 19 patients (16.5%) reported experiencing at least one symptom indicative of Long COVID (weight loss 31.6%, inappetence 26.3%, chronic cough 21.1%, fatigue 21.1%, and sleep disturbances, wheezing, abdominal pain and mood disorders 15.8%). In only 4 patients with Long COVID we could identified a specific SARS-CoV-2 variant (3 Omicron: 2 BA.1 and 1 BA.2; 1 Delta). CONCLUSIONS this study underscores that long COVID is a significant concern in the pediatric population. Our data reinforce the importance of continuously monitoring the impact of long-COVID in infants, children, and adolescents. A follow-up following SARS-CoV-2 infection is therefore advisable, with symptom investigation tailored to the patient's age.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, Via Aselli 2, 27100, Pavia, Italy.
- Pediatric Department, Buzzi Children's Hospital, 20154, Milano, Italy.
| | - Veronica Maria Tagi
- Pediatric Department, Buzzi Children's Hospital, 20154, Milano, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
| | - Enza D'Auria
- Pediatric Department, Buzzi Children's Hospital, 20154, Milano, Italy
| | - Alessia Lai
- Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
| | - Sara Zanelli
- Pediatric Department, Buzzi Children's Hospital, 20154, Milano, Italy
| | - Chiara Montanari
- Pediatric Department, Buzzi Children's Hospital, 20154, Milano, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
| | - Elia Maria Biganzoli
- Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
| | - Giuseppe Marano
- Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
| | - Elisa Borghi
- Department of Health Sciences, University of Milan, 20142, Milan, Italy
| | - Valentina Massa
- Department of Health Sciences, University of Milan, 20142, Milan, Italy
| | - Agostino Riva
- Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157, Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children's Hospital, 20154, Milano, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
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Msetfi RM, Kornbrot DE, Halbrook YJ. The association between the sense of control and depression during the COVID-19 pandemic: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1323306. [PMID: 38414499 PMCID: PMC10897004 DOI: 10.3389/fpsyt.2024.1323306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/09/2024] [Indexed: 02/29/2024] Open
Abstract
Introduction High levels of depression and low sense of control have been reported during the COVID-19 pandemic. The removal of typical freedoms through public health restrictions may have played an important role. The aim of this review was to examine data collected during the pandemic and (1) estimate the strength of the association between sense of control and depression, (2) examine whether the different types of control measures affected the strength of the association, and (3) whether this changed as a function of pandemic indicators. Methods We conducted a systematic review and meta-analysis of studies published in English between December 2019 and November 2022. A total of 993 articles were identified, of which 20 were included in the review and 16 in the meta-analysis after conducting a quality assessment using the standard NIH tool. Results The control-depression association gave a bias-independent pooled effect size of r = .41, and grew stronger over the 130 weeks covered by this review but did not change as a function of local COVID incidence rates. Subgroup analyses showed that external and overall control were more strongly related to depression than internal control. Discussion These findings emphasize that external factors are important to the sense of control and the importance of preserving the sense of control in situations where the removal of personal freedoms is necessary, such as public health emergencies.
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Affiliation(s)
| | - Diana E. Kornbrot
- Department of Psychology, Sport and Geography, University of Hertfordshire, Hatfield, United Kingdom
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Pradhan S, Rouster SD, Blackard JT, Dean GE, Sherman KE. Replication and Injury Associated With SARS-CoV-2 in Cultured Hepatocytes. Pathog Immun 2024; 8:59-73. [PMID: 38361525 PMCID: PMC10868721 DOI: 10.20411/pai.v8i2.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/18/2023] [Indexed: 02/17/2024] Open
Abstract
Background Liver dysfunction is one of the hallmarks of SARS-CoV-2 infection. The mechanism(s) of hepatic injury in SARS-CoV-2 infection remains controversial with some reporting viral replication and cellular injury and others suggesting lack of replication and injury due to non-cytopathogenic etiologies. To investigate this further, we evaluated SARS-CoV-2 replication in immortalized hepatic cell lines and primary hepatocytes, examined whether cell injury was associated with apoptotic pathways, and also determined the effect of the antiviral remdesivir on these processes. Methods Immortalized hepatocyte cell lines (HepG2 and Huh7.5), as well as primary human hepatocytes, were exposed to SARS-CoV-2 at a multiplicity of infection of 0.1 PFU/mL. Viral replication was evaluated by plaque assays, immunohistochemical staining for the viral spike protein, and caspase-3 expression evaluated with and without exposure to remdesivir. Results All hepatocyte cell lines and primary hepatocytes supported active replication of SARS-CoV-2. Significant cytopathic effect was observed by light microscopy, and caspase-3 staining supported activation of apoptotic pathways. Remdesivir abrogated infection in a dose-dependent fashion and was not independently associated with hepatocyte injury. Conclusion Hepatocytes appear to be highly permissive of SARS-CoV-2 replication which leads to rapid cell death associated with activation of apoptotic pathways. Viral replication and hepatocytes injury are abrogated with remdesivir. We conclude that active viral replication is most likely a key contributor to liver enzyme abnormalities observed in the setting of acute SARS-CoV-2 infection.
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Affiliation(s)
- Suman Pradhan
- Department of Molecular and Cellular Biosciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Susan D. Rouster
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jason T. Blackard
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Gary E. Dean
- Department of Molecular and Cellular Biosciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Kenneth E. Sherman
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Massachusetts General Hospital-Harvard Medical School, Boston, Massachusetts
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Schneider PS, Pantis M, Preiser C, Hagmann D, Barth GM, Renner TJ, Allgaier K. SARS-CoV-2 and Adolescent Psychiatric Emergencies at the Tübingen University Hospital: Analyzing Trends, Diagnoses, and Contributing Factors. Int J Environ Res Public Health 2024; 21:216. [PMID: 38397705 PMCID: PMC10888620 DOI: 10.3390/ijerph21020216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Psychiatric emergencies have increased in recent decades, particularly with the onset of the SARS-CoV-2 pandemic, and far too little is known about the backgrounds of these emergencies. In this study, we investigated the extent to which the number of psychiatric emergencies changed during and in the aftermath of the SARS-CoV-2 pandemic at the Child and Adolescent Psychiatry (CAP) Tübingen. We considered age and psychiatric diagnoses. Additionally, we evaluated the backgrounds of the emergencies. We applied a mixed- (quantitative and qualitative) methods approach to data on emergency presentations at the CAP Tübingen from the pre-SARS-CoV-2 pandemic period (October 2019-January 2020) to Restriction Phase 1 (October 2020-January 2021), Restriction Phase 2 (October 2021-January 2022), and endemic phase (October 2022-January 2023). The total number of emergencies and those with eating disorders and affective disorders increased, while obsessive-compulsive disorders, expansive disorders and anxiety disorders decreased. The patients presenting in the pre-SARS-CoV-2 pandemic period were younger than those in the subsequent periods. We content-coded the reasons behind the emergency presentations. We also identified four areas of stressors and personality characteristics associated with the emergency presentations. In light of the increasing number of psychiatric emergencies, the long-term aim should be to meet the growing demands and create options for prevention.
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Affiliation(s)
- Priska S. Schneider
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, 72076 Tübingen, Germany; (M.P.); (G.M.B.); (T.J.R.); (K.A.)
- German Center for Mental Health (DZPG) Partner Site, 72076 Tübingen, Germany
| | - Michelle Pantis
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, 72076 Tübingen, Germany; (M.P.); (G.M.B.); (T.J.R.); (K.A.)
- German Center for Mental Health (DZPG) Partner Site, 72076 Tübingen, Germany
| | - Christine Preiser
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital, 72074 Tübingen, Germany;
- Centre for Public Health and Health Services Research, University Hospital Tübingen, 72016 Tübingen, Germany
| | - Daniela Hagmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, 72076 Tübingen, Germany; (M.P.); (G.M.B.); (T.J.R.); (K.A.)
- German Center for Mental Health (DZPG) Partner Site, 72076 Tübingen, Germany
| | - Gottfried M. Barth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, 72076 Tübingen, Germany; (M.P.); (G.M.B.); (T.J.R.); (K.A.)
- German Center for Mental Health (DZPG) Partner Site, 72076 Tübingen, Germany
| | - Tobias J. Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, 72076 Tübingen, Germany; (M.P.); (G.M.B.); (T.J.R.); (K.A.)
- German Center for Mental Health (DZPG) Partner Site, 72076 Tübingen, Germany
- LEAD Graduate School and Research Network, University Tübingen, 72072 Tübingen, Germany
| | - Katharina Allgaier
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, 72076 Tübingen, Germany; (M.P.); (G.M.B.); (T.J.R.); (K.A.)
- German Center for Mental Health (DZPG) Partner Site, 72076 Tübingen, Germany
- LEAD Graduate School and Research Network, University Tübingen, 72072 Tübingen, Germany
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40
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Gold AI, Ryjova Y, Aviv EC, Corner GW, Rasmussen HF, Kim Y, Margolin G. Social contributions to meaning in life: the role of romantic relationship quality, parenting, and gender. Front Psychol 2024; 15:1349642. [PMID: 38390404 PMCID: PMC10881820 DOI: 10.3389/fpsyg.2024.1349642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction The present study tests the association between romantic relationship quality and number of children on meaning in life (i.e., sense of purpose, coherence, and significance) and considers interactions between these constructs and gender. Methods A survey was conducted approximately one year into the pandemic among 473 individuals in the United States. Results Models demonstrated that relationship quality and number of children are positively associated with meaning, though relationship quality was more strongly related to meaning for men than women. We showed that for women there was an equally positive link between relationship quality and meaning regardless of number of children. However, for men, the positive association between relationship quality and meaning was strongest for those with more than one child, decreased in magnitude for those with one child, and was no longer significant for men with more than one child. Discussion These findings provide empirical evidence that social relationships benefit meaning in life and underscore the complexity of these associations. Results have implications for theoretical perspectives on meaning in life, as well as for policies that encourage family wellbeing.
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Affiliation(s)
- Alaina I Gold
- Department of Psychology, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, United States
| | - Yana Ryjova
- Department of Psychology, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, United States
| | - Elizabeth C Aviv
- Department of Psychology, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, United States
| | - Geoffrey W Corner
- VA Puget Sound Health Care System, Veterans Health Administration, United States Department of Veterans Affairs, Seattle, WA, United States
| | - Hannah F Rasmussen
- Department of Psychology, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, United States
| | - Yehsong Kim
- Department of Psychology, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, United States
| | - Gayla Margolin
- Department of Psychology, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, United States
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41
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Albano D, Treglia G. Editorial: A year in review: discussions in nuclear medicine. Front Med (Lausanne) 2024; 11:1370082. [PMID: 38379559 PMCID: PMC10877022 DOI: 10.3389/fmed.2024.1370082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/25/2024] [Indexed: 02/22/2024] Open
Affiliation(s)
- Domenico Albano
- Division of Nuclear Medicine, Università degli Studi di Brescia and ASST Spedali Civili di Brescia, Brescia, Italy
| | - Giorgio Treglia
- Division of Nuclear Medicine, Ente Ospedaliero Cantonale, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Winklmeier S, Rübsamen H, Özdemir C, Wratil PR, Lupoli G, Stern M, Schneider C, Eisenhut K, Ho S, Wong HK, Taskin D, Petry M, Weigand M, Eichhorn P, Foesel BU, Mader S, Keppler OT, Kümpfel T, Meinl E. Intramuscular vaccination against SARS-CoV-2 transiently induces neutralizing IgG rather than IgA in the saliva. Front Immunol 2024; 15:1330864. [PMID: 38375482 PMCID: PMC10875124 DOI: 10.3389/fimmu.2024.1330864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/15/2024] [Indexed: 02/21/2024] Open
Abstract
The mucosal immunity is crucial for restricting SARS-CoV-2 at its entry site. Intramuscularly applied vaccines against SARS-CoV-2 stimulate high levels of neutralizing Abs in serum, but the impact of these intramuscular vaccinations on features of mucosal immunity is less clear. Here, we analyzed kinetic and functional properties of anti-SARS-CoV-2 Abs in the saliva after vaccination with BNT162b2. We analyzed a total of 24 healthy donors longitudinally for up to 16 months. We found that specific IgG appeared in the saliva after the second vaccination, declined thereafter and reappeared after the third vaccination. Adjusting serum and saliva for the same IgG concentration revealed a strong correlation between the reactivity in these two compartments. Reactivity to VoCs correlated strongly as seen by ELISAs against RBD variants and by live-virus neutralizing assays against replication-competent viruses. For further functional analysis, we purified IgG and IgA from serum and saliva. In vaccinated donors we found neutralizing activity towards authentic virus in the IgG, but not in the IgA fraction of the saliva. In contrast, IgA with neutralizing activity appeared in the saliva only after breakthrough infection. In serum, we found neutralizing activity in both the IgA and IgG fractions. Together, we show that intramuscular mRNA vaccination transiently induces a mucosal immunity that is mediated by IgG and thus differs from the mucosal immunity after infection. Waning of specific mucosal IgG might be linked to susceptibility for breakthrough infection.
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Affiliation(s)
- Stephan Winklmeier
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
| | - Heike Rübsamen
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
| | - Ceren Özdemir
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
| | - Paul R. Wratil
- Max von Pettenkofer Institute & Gene Center, Virology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Gaia Lupoli
- Max von Pettenkofer Institute & Gene Center, Virology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Marcel Stern
- Max von Pettenkofer Institute & Gene Center, Virology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Celine Schneider
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
| | - Katharina Eisenhut
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
| | - Samantha Ho
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
| | - Hoi Kiu Wong
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
| | - Damla Taskin
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
| | - Marvin Petry
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
| | - Michael Weigand
- Institute of Laboratory Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Peter Eichhorn
- Institute of Laboratory Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Bärbel U. Foesel
- Institute of Epidemiology, Helmholtz Munich, Neuherberg, Germany
| | - Simone Mader
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
| | - Oliver T. Keppler
- Max von Pettenkofer Institute & Gene Center, Virology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
| | - Edgar Meinl
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität München, Martinsried, Germany
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Kumar P, Parveen, Raj N, Kumar M, Fakhri KU, Kumar S, Khan AA, Alanazi AM, Solanki R, Harsha, Manzoor N, Kapur MK. Natural products from Streptomyces spp. as potential inhibitors of the major factors (holoRdRp and nsp13) for SARS-CoV-2 replication: an in silico approach. Arch Microbiol 2024; 206:88. [PMID: 38305873 DOI: 10.1007/s00203-023-03820-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 02/03/2024]
Abstract
The COVID-19 pandemic caused unprecedented damage to humanity, and while vaccines have been developed, they are not fully effective against the SARS-CoV-2 virus. Limited targeted drugs, such as Remdesivir and Paxlovid, are available against the virus. Hence, there is an urgent need to explore and develop new drugs to combat COVID-19. This study focuses on exploring microbial natural products from soil-isolated bacteria Streptomyces sp. strain 196 and RI.24 as a potential source of new targeted drugs against SARS-CoV-2. Molecular docking studies were performed on holoRdRp and nsp13, two key factors responsible for virus replication factor. Our in silico studies, K-252-C aglycone indolocarbazole alkaloid (K252C) and daunorubicin were found to have better binding affinities than the respective control drugs, with K252C exhibiting binding energy of - 9.1 kcal/mol with holoRdRp and - 9.2 kcal/mol with nsp13, and daunorubicin showing binding energy at - 8.1 kcal/mol with holoRdRp and - 9.3 kcal/mol with nsp13. ADMET analysis, MD simulation, and MM/GBSA studies indicated that K252C and daunorubicin have the potential to be developed as targeted drugs against SARS-CoV-2. The study concludes that K252C and daunorubicin are potential lead compounds that might suppress the inhibition of SARS-CoV-2 replication among the tested microbial compounds and could be developed as targeted drugs against COVID-19. In the future, further in vitro studies are required to validate these findings.
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Affiliation(s)
- Prateek Kumar
- Department of Zoology, University of Allahabad, Uttar Pradesh, Prayagraj, 211 002, India.
| | - Parveen
- Medical Mycology Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, 110025, India
| | - Nafis Raj
- Medical Mycology Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, 110025, India
| | - Munendra Kumar
- Department of Zoology, Rajiv Gandhi University, Doimukh, 791112, Arunachal Pradesh, India
| | - Khalid Umar Fakhri
- Department of Biosciences, Jamia Millia Islamia, New Delhi, 110025, India
| | - Sugandh Kumar
- School of Medicine, University of San Francisco California (UCSF), San Francisco, CA, 95115, USA
| | - Azmat Ali Khan
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Amer M Alanazi
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Renu Solanki
- Deen Dayal Upadhyaya College, University of Delhi, New Delhi, 110 078, India
| | - Harsha
- Microbial Technology Lab, Acharya Narendra Dev College, University of Delhi, New Delhi, 110 019, India
| | - Nikhat Manzoor
- Medical Mycology Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, 110025, India
| | - Monisha Khanna Kapur
- Microbial Technology Lab, Acharya Narendra Dev College, University of Delhi, New Delhi, 110 019, India.
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Ozer S. Social support, self-efficacy, self-esteem, and well-being during COVID-19 lockdown: A two-wave study of Danish students. Scand J Psychol 2024; 65:42-52. [PMID: 37489595 DOI: 10.1111/sjop.12952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/26/2023]
Abstract
Societal lockdown due to the COVID-19 pandemic has transformed everyday life across the globe, including requirements of social distancing that might limit the social support people derive from social interaction. Social support has proven to be a vital resource for well-being (i.e., perceived stress and satisfaction with life) and coping during societal challenges. The present study examined how social support is associated with perceived stress and life satisfaction through self-efficacy and self-esteem among Danish students (N = 204). These psychological constructs were examined both during and after lockdown, assessing the possible aversive psychological effects of the COVID-19 pandemic. Results did not yield any significant changes in either the mean scores of the constructs or the indirect effects model across the two time points. Moreover, the results indicate that social support derived from a significant person, family, and friends - but not student peers - is negatively linked with perceived stress and positively associated with life satisfaction through both self-efficacy and self-esteem. Although societal lockdown did not yield significant psychological impact, the results highlight the importance of social support among students, both during and after lockdown.
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Affiliation(s)
- Simon Ozer
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus C, Denmark
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Chakabva MS, Polina S, Brauner M, McGuire M, Brown Z, Akthar T, Todt M, Polina A, Nova FF. Comparison of Standard Versus Intermediate Prophylaxis Dose for Venous Thromboembolism Prophylaxis in Patients Hospitalized With COVID-19 Infection. Hosp Pharm 2024; 59:94-101. [PMID: 38223865 PMCID: PMC10786052 DOI: 10.1177/00185787231194997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Background: COVID-19 infection is associated with a high risk of venous thromboembolism (VTE) events. VTE prophylaxis reduces the risk of these events. The optimal dose of VTE prophylaxis however remains uncertain. Objectives: To compare the incidence of VTE in patients treated with either standard dose VTE versus intermediate dose VTE prophylaxis. Methods: In this retrospective cohort study, we analyzed data from 1786 adult patients admitted into the hospital with polymerase chain reaction confirmed COVID-19 infection between April 2020 to September 2021. For analysis, patients were divided into 2 cohorts: either standard dose prophylaxis treatment group (patients who received either unfractionated heparin 5000units 3 times a day or enoxaparin 30-40 mg daily subcutaneously) or intermediate dose VTE prophylaxis group (patients received either unfractionated heparin 7500 units 3 times daily or enoxaparin 30-40 mg twice a day subcutaneously). The primary outcome was incidence of VTE events described as either deep vein thrombosis (DVT) or pulmonary embolism (PE). Secondary outcome was bleeding events. Results: During the study period, 398 (22%) patients were primarily treated with standard dose VTE prophylaxis, whereas 1388 (78%) patients were treated with intermediate dose VTE prophylaxis. There was a significantly higher incidence of venous thromboembolism events noted in the standard dose prophylaxis treatment group when compared with the intermediate dose prophylaxis group (25/398 (6.3%) vs 35/1388 (2.5%) P < .001, [Odds Ratio 2.6197, 95% confidence interval = 1.5482-4.4327]). Multivariable-adjusted logistic regression, adjusting for age, obesity, and smoking, with the intermediate dose prophylaxis treatment group as the referent category revealed higher odds for incident venous thromboembolism events in the standard dose prophylaxis group. There was no statistically significant difference in bleeding events between the 2 treatment groups (9 (2.3%) for standard dose prophylaxis group vs 46 (3.3%) for intermediate dose prophylaxis group P = .26). Conclusions: Among patients hospitalized with COVID-19 infection, patients receiving intermediate dose VTE prophylaxis experienced lower incident rates of venous thromboembolism events compared to those receiving standard dose VTE prophylaxis without a statistically significant increase in the risk of bleeding events.
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Affiliation(s)
| | | | | | | | | | | | | | - Aws Polina
- Wayne State/Detroit Medical Center Internal Medicine Residency, Detroit, MI, USA
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46
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Warren J. Routine. Acad Emerg Med 2024; 31:198-199. [PMID: 37656896 DOI: 10.1111/acem.14801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/03/2023]
Abstract
Written a year and a half into the pandemic during a particularly difficult week, this poem explores the moral injury and emotional distress that emergency physicians encounter and must process daily. These repeated microtraumas throughout our day frequently contribute to depersonalization and it is important to recognize those factors that "break the routine" and help to improve physician well-being.
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Affiliation(s)
- Jonathan Warren
- Department of Emergency Medicine, Harbor-UCLA, Torrance, California, USA
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47
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Olbert E, Alhani N, Struhal W. Retrospective analysis of COVID-19 patients with Guillain-Barre, Miller-Fisher, and opsoclonus-myoclonus-ataxia syndromes-a case series. Wien Med Wochenschr 2024; 174:30-34. [PMID: 37523107 PMCID: PMC10810910 DOI: 10.1007/s10354-023-01018-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/23/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND In accordance with the rising number of SARS-CoV‑2 infections, reports of neurological complications have also increased. They include cerebrovascular diseases but also immunological diseases such as Guillain-Barre syndrome (GBS), Miller-Fisher syndrome (MFS), and opsoclonus-myoclonus-ataxia syndrome (OMAS). While GBS and MFS are typical postinfectious complications, OMAS has only recently been described in the context of COVID-19. GBS, MFS, and OMAS can occur as para- and postinfectious, with different underlying pathomechanisms depending on the time of neurological symptom onset. The study aimed to describe clinical features, time between infection and onset of neurological symptoms, and outcome for these diseases. METHODS All COVID-19 patients treated in the neurological ward between January 2020 and December 2022 were screened for GBS, MFS, and OMAS. The clinical features of all patients, with a particular focus on the time of onset of neurological symptoms, were analyzed. RESULTS This case series included 12 patients (7 GBS, 2 MFS, 3 OMAS). All GBS and one MFS patient received immunomodulatory treatment. Three patients (2 GBS, 1 OMAS) had a severe COVID-19 infection and received mechanical ventilation. In patients with OMAS, only one patient received treatment with intravenous immunoglobulin and cortisone. The remaining two patients, both with disease onset concurrent with SARS-COV‑2 infection, recovered swiftly without treatment. In all subgroups, patients with concurrent onset of neurological symptoms and COVID-19 infection showed a trend toward shorter disease duration. CONCLUSION All patient groups displayed a shorter disease duration if the onset of neurological symptoms occurred shortly after the COVID-19 diagnosis. In particular, both the OMAS patients with symptom onset concurrent with COVID-19 showed only abortive symptoms followed by a swift recovery. This observation would suggest different pathomechanisms for immune-mediated diseases depending on the time of onset after an infection.
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Affiliation(s)
- Elisabeth Olbert
- Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria.
- Department of Neurology, University Hospital Tulln, Alter Ziegelweg 10, 3430, Tulln an der Donau, Austria.
| | - Naela Alhani
- Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria
- Department of Neurology, University Hospital Tulln, Alter Ziegelweg 10, 3430, Tulln an der Donau, Austria
| | - Walter Struhal
- Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria
- Department of Neurology, University Hospital Tulln, Alter Ziegelweg 10, 3430, Tulln an der Donau, Austria
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Blin T, Parent C, Pichon G, Guillon A, Jouan Y, Allouchi H, Aubrey N, Boursin F, Domain R, Korkmaz B, Sécher T, Heuzé-Vourc'h N. The proteolytic airway environment associated with pneumonia acts as a barrier for treatment with anti-infective antibodies. Eur J Pharm Biopharm 2024; 195:114163. [PMID: 38086491 DOI: 10.1016/j.ejpb.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 01/29/2024]
Abstract
Like pneumonia, coronavirus disease 2019 (COVID-19) is characterized by a massive infiltration of innate immune cells (such as polymorphonuclear leukocytes) into the airways and alveolar spaces. These cells release proteases that may degrade therapeutic antibodies and thus limit their effectiveness. Here, we investigated the in vitro and ex vivo impact on anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) IgG1s and other IgG subclasses (IgG2 and IgG4) of the neutrophil elastase, proteinase 3 and cathepsin G (the three main neutrophil serine proteases) found in endotracheal aspirates from patients with severe COVID-19. Although the IgGs were sensitive to neutrophil serine proteases, IgG2 was most resistant to proteolytic degradation. The two anti-SARS CoV2 antibodies (casirivimab and imdevimab) were sensitive to the lung's proteolytic environment, although neutrophil serine protease inhibitors only partly limited the degradation. Overall, our results show that the pneumonia-associated imbalance between proteases and their inhibitors in the airways contributes to degradation of antiviral antibodies.
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Affiliation(s)
- Timothée Blin
- INSERM, Respiratory Disease Research Centre, U1100, F-37032 Tours, France; University of Tours, F-37032 Tours, France; Tours University Hospital (CHRU), Department of Pulmonary Medicine, Cystic Fibrosis Resource Center, F-37032 Tours, France
| | - Christelle Parent
- INSERM, Respiratory Disease Research Centre, U1100, F-37032 Tours, France; University of Tours, F-37032 Tours, France
| | - Gabrielle Pichon
- INSERM, Respiratory Disease Research Centre, U1100, F-37032 Tours, France; University of Tours, F-37032 Tours, France
| | - Antoine Guillon
- INSERM, Respiratory Disease Research Centre, U1100, F-37032 Tours, France; University of Tours, F-37032 Tours, France; Tours University Hospital (CHRU), Critical Care Department, F-37032 Tours, France
| | - Youenn Jouan
- INSERM, Respiratory Disease Research Centre, U1100, F-37032 Tours, France; University of Tours, F-37032 Tours, France; Tours University Hospital (CHRU), Cardiac Surgery Department, F-37032 Tours, France
| | - Hassan Allouchi
- INSERM, Respiratory Disease Research Centre, U1100, F-37032 Tours, France; University of Tours, F-37032 Tours, France; Tours University Hospital (CHRU), Pharmacy Department, F-37032 Tours, France
| | - Nicolas Aubrey
- University of Tours, F-37032 Tours, France; UMR INRA ISP 1282, BioMap Team, F-37032 Tours, France
| | - Fanny Boursin
- University of Tours, F-37032 Tours, France; UMR INRA ISP 1282, BioMap Team, F-37032 Tours, France
| | - Roxane Domain
- INSERM, Respiratory Disease Research Centre, U1100, F-37032 Tours, France; University of Tours, F-37032 Tours, France
| | - Baris Korkmaz
- INSERM, Respiratory Disease Research Centre, U1100, F-37032 Tours, France; University of Tours, F-37032 Tours, France
| | - Thomas Sécher
- INSERM, Respiratory Disease Research Centre, U1100, F-37032 Tours, France; University of Tours, F-37032 Tours, France
| | - Nathalie Heuzé-Vourc'h
- INSERM, Respiratory Disease Research Centre, U1100, F-37032 Tours, France; University of Tours, F-37032 Tours, France.
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Montoya A, Park P, Bynum J, Chang CH. Transfer Trauma Among Nursing Home Residents: Development of a Composite Measure. Gerontologist 2024; 64:gnad085. [PMID: 37392460 DOI: 10.1093/geront/gnad085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Nursing home (NH)-to-NH transfers place NH residents at risk for developing transfer trauma. We aimed to develop a composite measure of transfer trauma and apply it among those transferring before and during the pandemic. RESEARCH DESIGN AND METHODS Cross-sectional cohort analysis of long-stay NH residents with a NH-to-NH transfer. Minimum Data Set data (2018-2020) were used to create the cohorts. A composite measure of transfer trauma was developed (2018 cohort) and applied to the 2019 and 2020 cohorts. We analyzed resident characteristics and conducted logistic regression analyses to compare rates of transfer trauma between periods. RESULTS In 2018, 794 residents were transferred; 242 (30.5%) met the criteria for transfer trauma. In the 2019 and 2020, 750 residents (2019) and 795 (2020) were transferred. In 2019 cohort, 30.7% met the criteria for transfer trauma, and 21.9% in 2020 cohort. During the pandemic, a higher proportion of transferred residents left the facility before the first quarterly assessment. Among residents who stayed in NH for their quarterly assessment, after adjusting for demographic characteristics, residents in the 2020 cohort were less likely to experience transfer trauma than those in the 2019 cohort (adjusted odds ratio [AOR] = 0.64, 95% confidence interval [CI]: 0.51, 0.81). However, residents in 2020 cohort were two times more likely to die (AOR = 1.94, 95% CI: 1.15, 3.26) and 3 times more likely to discharge within 90 days after transfer (AOR = 2.86, 95% CI: 2.30, 3.56) compared with those in 2019 cohort. DISCUSSION AND IMPLICATIONS These findings highlight how common transfer trauma is after NH-to-NH transfer and the need for further research to mitigate negative outcomes associated with the transfer in this vulnerable population.
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Affiliation(s)
- Ana Montoya
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Pil Park
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Julie Bynum
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Chiang-Hua Chang
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
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Rowe AS, Hawkins B, McClam MD, Winters S, Balatow PB, Ryan M. Predictive value of methicillin-resistant staphylococcus aureus nasal swab in patients with COVID-19 pneumonia and secondary bacterial pneumonia. Diagn Microbiol Infect Dis 2024; 108:116134. [PMID: 37988933 DOI: 10.1016/j.diagmicrobio.2023.116134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To determine the performance measures of admission methicillin-resistant Staphylococcus aureus (MRSA) nasal swabs for MRSA bacterial pneumonia in patients co-infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS The study included patients admitted with SARS-CoV-2-positive nasopharyngeal specimens, MRSA nasal screens, and bacterial cultures to assess secondary MRSA pneumonia. RESULTS 293 patients and 662 microbiological cultures evaluated. Overall, the specificity (91.8% [95% CI 88.6% to 95%]) and negative predictive value (NPV 97.4% [95% CI 95.4% - 99.3%]) of MRSA nasal swabs was high. However, the sensitivity (46.2%; 95% CI 19.1% to 73.3%) and positive predictive value (PPV 20.7%; 95% CI 59.5 - 35.4%) were low. Those patients in the MRSA nasal swab negative group had a shorter median duration of linezolid therapy. CONCLUSIONS SARS-CoV-2 infection doesn't reduce the specificity or negative predictive value of MRSA nasal swabs for secondary MRSA pneumonia.
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Affiliation(s)
- A Shaun Rowe
- The University of Tennessee Health Science Center College of Pharmacy, Department of Clinical Pharmacy and Translational Science, Knoxville, Tennessee, USA.
| | - Brandon Hawkins
- The University of Tennessee Health Science Center College of Pharmacy, Department of Clinical Pharmacy and Translational Science, Knoxville, Tennessee, USA
| | - Megan Doyle McClam
- The University of Tennessee Medical Center, Department of Pulmonology and Critical Care, Knoxville, Tennessee, USA
| | - Shauna Winters
- The University of Tennessee Medical Center, Department of Pharmacy, Knoxville, Tennessee, USA
| | - Pearson Bray Balatow
- The University of Tennessee Health Science Center College of Pharmacy, Department of Clinical Pharmacy and Translational Science, Knoxville, Tennessee, USA
| | - MaryKathleen Ryan
- The University of Tennessee Health Science Center College of Pharmacy, Department of Clinical Pharmacy and Translational Science, Knoxville, Tennessee, USA
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