COVID-19: Impact on Public Health and Healthcare

A topical collection in Healthcare (ISSN 2227-9032). This collection belongs to the section "Coronaviruses (CoV) and COVID-19 Pandemic".

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Editors


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Guest Editor
Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
Interests: developing and evaluating evidence-based (theory-based) health behavior change interventions; health behavior research (HBR); obesity prevention; mental health promotion, especially stress coping; community-based participatory research (CBPR) and evaluation; integrative mind-body-spirit interventions, especially yoga/meditation
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Topical Collection Information

Dear Colleagues,

The COVID-19 pandemic has created a worldwide public health emergency and has had a significant impact on all dimensions of health, including physical, psychological, social, and financial. Therefore, this Special Issue of Healthcare aims to reflect the full breadth of the pandemic’s impact across different populations worldwide and cover all aspects of health. Possible topics include, but are not limited to:

  • Preventive strategies associated with COVID-19 to promote health behaviours, for instance, handwashing, mask-wearing behaviour, social distancing, and vaccine acceptability, screening, testing, and tracing. Theory-based health behaviour intervention studies are highly encouraged.
  • Effect of COVID-19 on job sectors, for example, changes in employment and labour force participation.
  • Effect on psychosocial health across different population groups, including general, healthcare workers, geriatric, young adults, etc.

Prof. Manoj Sharma
Dr. Kavita Batra
Guest Editors

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Keywords

  • COVID-19
  • Health Behaviour
  • Prevention
  • Impact
  • Healthcare
  • Screening
  • Treatment

Published Papers (90 papers)

2024

Jump to: 2023, 2022, 2021, 2020

11 pages, 238 KiB  
Article
Predictors of Depression in Elderly According to Gender during COVID-19: Using the Data of 2020 Community Health Survey
by Hye-Jung Jun and Kyoung-Mi Kim
Healthcare 2024, 12(5), 551; https://doi.org/10.3390/healthcare12050551 - 27 Feb 2024
Viewed by 554
Abstract
Background: This study aimed to examine factors influencing depression according to gender in people during COVID-19. Methods: This study was conducted on 61,147 elderly individuals over the age of 65 who participated in the 2020 Community Health Survey (CHS). Data analysis was conducted [...] Read more.
Background: This study aimed to examine factors influencing depression according to gender in people during COVID-19. Methods: This study was conducted on 61,147 elderly individuals over the age of 65 who participated in the 2020 Community Health Survey (CHS). Data analysis was conducted using SAS 9.4. Results: Elderly females had a higher perceived fear of COVID-19 than males. The common factors affecting depression in elderly individuals were age, monthly income, economic activity, stress, subjective health status, and social support. Among elderly women, changes in residential areas and daily life due to COVID-19 were identified as factors affecting depression. Conclusions: Therefore, during COVID-19, it was necessary to provide customized depression relief programs for the elderly, and it was necessary to find ways for them to positively perceive their health status and increase healthcare efficacy. In the future, it is necessary to pay attention to elderly women living in rural areas and make efforts to ensure that their daily lives are not interrupted by infectious diseases. Full article
9 pages, 2396 KiB  
Case Report
Spontaneous Coronary Artery Dissection as a Cause of Acute Myocardial Infarction in COVID-19 Patients: A Case Report and Review of the Literature
by Angeliki Papageorgiou, Athanasios Moulias, Athanasios Papageorgiou, Theodoros Karampitsakos, Anastasios Apostolos, Grigorios Tsigkas and Periklis Davlouros
Healthcare 2024, 12(2), 214; https://doi.org/10.3390/healthcare12020214 - 16 Jan 2024
Cited by 2 | Viewed by 831
Abstract
Patients with COVID-19 often experience significant cardiovascular complications, including heart failure, myocarditis, and acute coronary syndrome. We present the case of a male patient with severe COVID-19 pneumonia, complicated with inferior ST-segment elevation myocardial infarction (STEMI), which was attributed to spontaneous coronary artery [...] Read more.
Patients with COVID-19 often experience significant cardiovascular complications, including heart failure, myocarditis, and acute coronary syndrome. We present the case of a male patient with severe COVID-19 pneumonia, complicated with inferior ST-segment elevation myocardial infarction (STEMI), which was attributed to spontaneous coronary artery dissection (SCAD). We also make a review of the literature on case reports of patients with COVID-19 and acute myocardial infarction due to SCAD. Through these clinical cases, a potential correlation between SCAD and COVID-19 infection is implied. Endothelial dysfunction, thrombotic complications, and disturbance of the vascular tone are established COVID-19 sequelae, triggered either by direct viral injury or mediated by the cytokines’ storm. These abnormalities in the coronary vasculature and the vasa vasorum could result in SCAD. Moreover, disturbances of the vascular tone can cause coronary vasospasm, a reported precipitant of SCAD. Thus, SCAD should be considered in COVID-19 patients with acute coronary syndrome (ACS), and in the case of STEMI, an early angiographic evaluation, if feasible, should be performed rather than thrombolysis to avoid potential adverse events of the latter in the setting of SCAD. Full article
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2023

Jump to: 2024, 2022, 2021, 2020

8 pages, 197 KiB  
Brief Report
Gastrointestinal Manifestations Are Associated with Severe COVID-19 in Children
by Esra Betul Akkoyun, Bilal Ashraf, Natasha Hanners, Jeffrey Kahn and Zachary Most
Healthcare 2024, 12(1), 81; https://doi.org/10.3390/healthcare12010081 - 29 Dec 2023
Viewed by 854
Abstract
Purpose: Although less severe than in adults, children can experience a range of COVID-19 symptoms, from asymptomatic to life-threatening, including respiratory and gastrointestinal symptoms. Medical conditions may also increase the severity of the disease in infected children. Methods: This study was performed at [...] Read more.
Purpose: Although less severe than in adults, children can experience a range of COVID-19 symptoms, from asymptomatic to life-threatening, including respiratory and gastrointestinal symptoms. Medical conditions may also increase the severity of the disease in infected children. Methods: This study was performed at a single center, comparing cases and controls, and involving 253 pediatric patients who had been diagnosed with COVID-19. Two different outcomes were assessed. The first categorized symptomatic individuals who were hospitalized with COVID-19 (hospital) from those who were not (nonhospital). The second categorized admitted individuals who spent at least one day in the intensive care unit (ICU) from those who did not require intensive care (floor). Results: Ninety individuals (36%) had at least one underlying medical condition, the most common being pulmonary disorders, such as asthma (12%), followed by neurodevelopmental disorders (8%), gastrointestinal disorders (6%), and seizure disorders (6%). The hospital group was more likely to have a comorbidity, such as obstructive sleep apnea (OSA), diabetes mellitus, seizure disorder, hypertension, sickle cell disease, neurodevelopmental disorder, and immunocompromising conditions, including cancer, bone marrow transplant, and other immunodeficiencies, compared to the non-hospital group. Abdominal pain was more common in the hospital group. Shortness of breath (SOB) and diarrhea were significantly more common in the ICU group than in the floor group. Conclusions: Early identification of pediatric patients with severe COVID-19 is important to improve outcomes. In our single-center case–control study, we found that the presence of gastrointestinal symptoms on presentation was more commonly associated with severe COVID-19 in children. Full article
16 pages, 3860 KiB  
Article
Changes in the Impacts of COVID-19 over Time on Families with Older Adults Living on Remote Islands in Japan: A Study in Family Ethnographic Research
by Naohiro Hohashi, Mikio Watanabe, Minami Taniguchi and Shiho Araki
Healthcare 2023, 11(23), 3088; https://doi.org/10.3390/healthcare11233088 - 02 Dec 2023
Viewed by 844
Abstract
Coronavirus disease 2019 (COVID-19) affected not only individuals but also families. The purpose of this study was to clarify the temporal changes in the impact of the COVID-19 pandemic on entire families with older adults susceptible to infection living on small islands in [...] Read more.
Coronavirus disease 2019 (COVID-19) affected not only individuals but also families. The purpose of this study was to clarify the temporal changes in the impact of the COVID-19 pandemic on entire families with older adults susceptible to infection living on small islands in Japan over the duration of the pandemic. Family ethnographic research was conducted from 2021 to 2023, using the Concentric Sphere Family Environment Theory as the theoretical framework. Formal interviews were conducted with 20 families. In addition, data from informal interviews, participant observation and other sources were compiled into field notes. All data on the impact on the entire family were extracted and content analysis was conducted. Six categories (family internal environmental system, family system unit, micro system, macro system, supra system, and family chrono-environment system) and a total of 85 subcategories were extracted. The results show that COVID-19 exerted not only negative but also positive impacts on the entire family, and their temporal changes are clarified. The impact on families is believed to have been influenced by the family external environment, such as increases and decreases of infection cases or events that occurred outside the family. The knowledge acquired from these studies will help healthcare professionals in providing appropriate family support. Full article
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9 pages, 1236 KiB  
Article
Incidences for Fractures 2017–2021: What Do We Learn from the COVID-19 Pandemic?
by Ulrich Niemöller, Christian Tanislav and Karel Kostev
Healthcare 2023, 11(20), 2804; https://doi.org/10.3390/healthcare11202804 - 23 Oct 2023
Cited by 1 | Viewed by 749
Abstract
Purpose/Introduction: In the present study, we aimed to assess the long-term incidence of fractures and during the COVID-19 pandemic. Methods: The current cohort study included patients who had received an initial fracture diagnosis of any type documented anonymously in the Disease Analyzer database [...] Read more.
Purpose/Introduction: In the present study, we aimed to assess the long-term incidence of fractures and during the COVID-19 pandemic. Methods: The current cohort study included patients who had received an initial fracture diagnosis of any type documented anonymously in the Disease Analyzer database (IQVIA) between 2017 and 2021 by physicians in 941 general practices in Germany. We investigated the development of fracture incidence over this period. Results: A total of 196,211 patients had a fracture diagnosis between 2017 and 2021. The number of patients with fracture diagnosis was highest in 2019 (n = 50,084) and lowest in 2020 (n = 46,227). The mean age of patients increased from 60.8 years in 2017 to 63.3 years in 2021. Between 58% and 60% of patients were female. From 2017 to 2019, the number of fractures documented in the younger age categories remained constant. Between 2019 and 2020, an incidence decrease was documented in the younger age groups (age group 16–40 years: −17.17%; age group 41–60 years: −18.71%; age group 61–80 years: −6.43%). By contrast, a slight increase of 3.03% was identified in the age group >80 years of age. No relevant changes in fracture incidences were noted between 2020 and 2021. Incidence rates decreased for both sexes from 2019 to 2020 (female patients: −6.27%; male patients: −10.18%). In the youngest age group (16–40 years), the decrease observed in 2020 was due to lower incidences for fractures of the upper and lower extremities (−11.9%; −12.5%) and ribs (−50.0%). In the age group ≥80 years, fracture incidences increased for the upper extremity (+2.8%), lower extremity (+8.3%), and femur (+8.3%). Conclusions: The circumstances of the pandemic reduced the incidence of fractures in younger people, probably due to reduced recreational activities, while fracture incidence increased in older people, presumably as a result of lack of support. Full article
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11 pages, 283 KiB  
Article
Burnout and Intention to Change Profession among Romanian Dentists during COVID-19: A Cross Sectional Study Using the Maslach Burnout Inventory
by Ioana Silistraru, Anamaria Ciubară, Oana Olariu, Ioan-Adrian Ciureanu, Laura-Elisabeta Checheriță, Daniela Drugus, Radu Dănilă and Ștefan Roșca
Healthcare 2023, 11(19), 2667; https://doi.org/10.3390/healthcare11192667 - 01 Oct 2023
Cited by 1 | Viewed by 776
Abstract
This study aims to examine the relationship between burnout and dentists’ intentions to change careers during the COVID-19 pandemic. The MBI-Human Services Survey for Medical Personnel—MBI-HSS (MP) was used to measure burnout levels and investigate how they relate to dentists’ intentions to change [...] Read more.
This study aims to examine the relationship between burnout and dentists’ intentions to change careers during the COVID-19 pandemic. The MBI-Human Services Survey for Medical Personnel—MBI-HSS (MP) was used to measure burnout levels and investigate how they relate to dentists’ intentions to change their profession. The sample included 69 Romanian dentists, 56 of whom were women and 13 of whom were men. Self-reported questionnaires provided to the participants were used to collect the data. Female participants reported higher levels of emotional Exhaustion and Depersonalisation than males. However, there were no substantial differences in Personal Accomplishment levels between genders. As for the intentions to change careers, 41 expressed a clear intention to change their profession, 15 were still determining if they would choose the same speciality, and 28 indicated they would not choose the medical field. The study’s findings provide insight into how dentists’ thoughts about perceived burnout during the COVID-19 pandemic significantly influenced their attitudes regarding their career paths. The results suggest concerns regarding burnout in the dental field and emphasise the necessity for burnout interventions and support services, particularly during healthcare crises. Further research and interventions to mitigate burnout and promote well-being among dentists are needed to ensure the sustainability and quality of dental healthcare services in Romania. Full article
14 pages, 242 KiB  
Article
Experiences of Caring for Cohort-Isolated Patients among Nurses in Locked Psychiatric Units
by Hyeran An, Kyungmi Kim, Jongeun Lee and Sunhwa Won
Healthcare 2023, 11(19), 2650; https://doi.org/10.3390/healthcare11192650 - 28 Sep 2023
Viewed by 637
Abstract
The aim of this study was to gain an understanding of the experiences of caring for cohorts of patients isolated due to coronavirus disease (COVID-19) among nurses in locked psychiatric units. A phenomenological approach was used to analyze data collected from 10 nurses [...] Read more.
The aim of this study was to gain an understanding of the experiences of caring for cohorts of patients isolated due to coronavirus disease (COVID-19) among nurses in locked psychiatric units. A phenomenological approach was used to analyze data collected from 10 nurses with a minimum of one year of experience as a mental health nurse working in locked psychiatric units that were cohort-isolated due to COVID-19. Data collected using semi-structured one-to-one in-depth interviews were analyzed based on steps outlined by Colaizzi. Five themes and thirteen subthemes emerged. The five themes were as follows: “Challenges intensified by the nature of mental disorders”, “Concerns regarding limited mental health care”, “Escalating stress”, “Bolstered identity as a mental health nurse”, “Witnessing changes that have begun”. Environmental and institutional measures need to be implemented to identify the potential phenomena that may affect locked psychiatric units during an infectious disease epidemic and ensure the safety of health care professionals and patients from the infectious disease. Full article
18 pages, 1553 KiB  
Article
Areas of Concern and Support among the Austrian General Population: A Qualitative Content Analytic Mapping of the Shift between Winter 2020/21 and Spring 2022
by Afsaneh Gächter, Barbara Zauner, Katja Haider, Yvonne Schaffler, Thomas Probst, Christoph Pieh and Elke Humer
Healthcare 2023, 11(18), 2539; https://doi.org/10.3390/healthcare11182539 - 14 Sep 2023
Viewed by 737
Abstract
This study aimed to analyze areas of concern and support of the Austrian general population two years into the COVID-19 pandemic. A representative sample (N = 1031) of the Austrian general population was surveyed online between 19 April 2022 and 26 April 2022. [...] Read more.
This study aimed to analyze areas of concern and support of the Austrian general population two years into the COVID-19 pandemic. A representative sample (N = 1031) of the Austrian general population was surveyed online between 19 April 2022 and 26 April 2022. A qualitative study design was used to explore the factors of most considerable current concern (Question 1) and the most important sources of support (Question 2). The responses to the two open-ended questions were evaluated using a conventional content analysis, and categories were formed according to the frequency of the answers. The analysis revealed that inflation and finances (30% of participants) and the war in Ukraine (22%) were the greatest sources of concern, followed by mental health (11%), and physical health (11%). Factors such as social contacts within and outside the family were mentioned most frequently as sources of support (36% of participants), followed by recreational activities (23%) and attitudes and abilities (22%). Compared to data collected at the end of the first year of the pandemic (between 23 December 2020 and 4 January 2021), concern about one’s financial situation was now mentioned more frequently (30% vs. 8,5%). On the other hand, different types of pandemic-related concerns were mentioned less often. Social contacts and recreation were mentioned as the most important sources of support at both time points (46% and 36% of the participants). The results suggest that the economic concerns are lagging behind the restrictions imposed by the pandemic. In addition, the impending war in Ukraine seems to have a relevant impact on mental health in Austria. Further nuanced qualitative research, particularly involving vulnerable groups such as low-income individuals and the unemployed, is crucial. Full article
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14 pages, 1183 KiB  
Article
Characteristics of COVID-19 Patients Admitted to Intensive Care Unit in Multispecialty Hospital of Riyadh, Saudi Arabia: A Retrospective Study
by Mansour Almuqbil, Ali Ibrahim Almoteer, Alwaleed Mohammed Suwayyid, Abdulaziz Hussain Bakarman, Raed Fawaz Alrashed, Majed Alrobish, Fahad Alasalb, Abdulaziz Abdulrahman Alhusaynan, Mohammed Hadi Alnefaie, Abdullah Saud Altayar, Saad Ebrahim Alobid, Moneer E. Almadani, Ahmed Alshehri, Adel Alghamdi and Syed Mohammed Basheeruddin Asdaq
Healthcare 2023, 11(18), 2500; https://doi.org/10.3390/healthcare11182500 - 08 Sep 2023
Cited by 3 | Viewed by 973
Abstract
During the early stages of the COVID-19 pandemic, infection rates were high and symptoms were severe. Medical resources, including healthcare experts and hospital facilities, were put to the test to ensure their readiness to deal with this unique event. An intensive care unit [...] Read more.
During the early stages of the COVID-19 pandemic, infection rates were high and symptoms were severe. Medical resources, including healthcare experts and hospital facilities, were put to the test to ensure their readiness to deal with this unique event. An intensive care unit (ICU) is expected to be required by many hospitalized patients. Many hospitals worldwide lacked resources during the pandemic’s peak stages, particularly in critical care treatment. Because of this, there were issues with capacity, as well as an excessive influx of patients. Additionally, even though the research location provides medical care to a sizable population, there is a paucity of scientific data detailing the situation as it pertains to COVID-19 patients during the height of the outbreak. Therefore, this study aimed to identify and describe the features of COVID-19 patients hospitalized in the ICU of one of the multispecialty hospitals in Riyadh, Saudi Arabia. An observational retrospective study was conducted using a chart review of COVID-19 patients admitted to the ICU between March 2020 and December 2020. To characterize the patients, descriptive statistics were utilized. An exploratory multivariate regression analysis was carried out on the study cohort to investigate the factors that were shown to be predictors of death and intubation. Only 333 (29.33%) of the 1135 samples from the hospital’s medical records were used for the final analysis and interpretation. More than 76% of the patients in the study were male, with a mean BMI of 22.07 and an average age of around 49 years. The most frequent chronic condition found among the patients who participated in the study was diabetes (39.34%), followed by hypertension (31.53%). At the time of admission, 63 of the total 333 patients needed to have intubation performed. In total, 22 of the 333 patients died while undergoing therapy. People with both diabetes and hypertension had a 7.85-fold higher risk of death, whereas those with only diabetes or hypertension had a 5.43-fold and 4.21-fold higher risk of death, respectively. At admission, intubation was necessary for many male patients (49 out of 63). Most intubated patients had hypertension, diabetes, or both conditions. Only 13 of the 63 patients who had been intubated died, with the vast majority being extubated. Diabetes and hypertension were significant contributors to the severity of illness experienced by COVID-19 participants. The presence of multiple comorbidities had the highest risk for intubation and mortality among ICU-admitted patients. Although more intubated patients died, the fatality rate was lower than in other countries due to enhanced healthcare management at the ICU of the study center. However, large-scale trials are needed to determine how effective various strategies were in preventing ICU admission, intubation, and death rates. Full article
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11 pages, 482 KiB  
Article
Central Line Associated Bloodstream Infections in Critical Ill Patients during and before the COVID-19 Pandemic
by Sona Hlinkova, Eva Moraucikova, Anna Lesnakova, Agnieszka Strzelecka and Vladimir Littva
Healthcare 2023, 11(17), 2415; https://doi.org/10.3390/healthcare11172415 - 29 Aug 2023
Cited by 1 | Viewed by 1306
Abstract
(1) Background: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the rates of central line-associated bloodstream infections (CLABSI), its etiology, and risk factors in critically ill patients, because Slovakia was one of the countries experiencing a [...] Read more.
(1) Background: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the rates of central line-associated bloodstream infections (CLABSI), its etiology, and risk factors in critically ill patients, because Slovakia was one of the countries experiencing a high burden of COVID-19 infections, and hospitals faced greater challenges in preventing and managing CLABSI; (2) Methods: A retrospective analysis of CLABSI data from all patients admitted to adult respiratory intensive care units before and during COVID-19 pandemic was conducted. We followed the guidelines of the Center for Disease Control surveillance methodology for CLABSI. Data were analyzed using STATISTICA 13.1; (3) Results: We analyzed the data of 803 ICU patients hospitalized for 8385 bed days, with 7803 central line days. Forty-five CLABSI events were identified. The CLABSI rate significantly increased during the COVID-19 pandemic compared to before the COVID-19 pandemic (2.81 versus 7.47 events per 1000 central line days, (p < 0.001). The most frequently identified pathogens causing CLABSI were Gram-negative organisms (60.20%). The risk factors found to increase the probability of developing CLABSI were length of stay (OR = 1.080; 95% Cl: 1.057–1.103; p < 0.001) and COVID-19 (OR = 5.485; 95% Cl: 32.706–11.116; p < 0.001). (4) Conclusions: The COVID-19 pandemic was associated with increases in CLABSI in ICUs. These data underscore the need to increase efforts in providing surveillance of CLABSI and implementing infection prevention measures. Full article
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16 pages, 1032 KiB  
Article
Effects of a Noncontact Visit Program in the NICU for the Prevention of COVID-19
by Hye Young Ahn, Hee Jee Jo and Hyun Jeong Ko
Healthcare 2023, 11(15), 2152; https://doi.org/10.3390/healthcare11152152 - 28 Jul 2023
Viewed by 915
Abstract
Background: With the spread of COVID-19, neonatal intensive care units restricted visiting hours to prevent infection. As a result, mothers of high-risk newborns were restricted from making contact with their children. Various problems could be encountered for hospitalized children and mothers of high-risk [...] Read more.
Background: With the spread of COVID-19, neonatal intensive care units restricted visiting hours to prevent infection. As a result, mothers of high-risk newborns were restricted from making contact with their children. Various problems could be encountered for hospitalized children and mothers of high-risk newborns due to restrictions on visits in the neonatal intensive care unit. Therefore, during the pandemic, continuous nursing support for mothers of high-risk newborns was needed. Methods: In this study, a nonequivalent control group non-synchronized design was employed. The subjects of the study were 36 mothers of high-risk neonates (20 in the experimental group and 16 in the control group) in E University Hospital, D Metropolitan City, from July to September 2022. The experimental group received a 10 min program performed by a nurse from 7:00 p.m. to 9:00 p.m. three times per week. Results: There were significant differences in nurses’ support between the experimental and control groups (F = 25.594, p < 0.001), changes over time (F = 16.178, p < 0.001), and time–group interactions (F = 9.663, p = 0.003). Conclusions: It was interpreted that the real-time noncontact visitation program could transcend time and space for many mothers of high-risk newborn babies, who suffered psychologically due to restrictions and bans on visitations during the COVID-19 pandemic. Full article
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22 pages, 1794 KiB  
Article
COVID-19 Pandemic: Did Strict Mobility Restrictions Save Lives and Healthcare Costs in Maharashtra, India?
by Preshit Nemdas Ambade, Kednapa Thavorn and Smita Pakhale
Healthcare 2023, 11(14), 2112; https://doi.org/10.3390/healthcare11142112 - 24 Jul 2023
Cited by 1 | Viewed by 1024
Abstract
Introduction: Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown’s impact on COVID-19 cases and associated healthcare costs. Methods: Using daily case data for 84 days (9 [...] Read more.
Introduction: Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown’s impact on COVID-19 cases and associated healthcare costs. Methods: Using daily case data for 84 days (9 March–31 May 2020), we modeled the epidemic’s trajectory and predicted new cases for different phases of lockdown. We fitted log-linear models to estimate the growth rate, basic (R0), daily reproduction number (Re), and case doubling time. Based on pre-restriction and Phase 1 R0, we predicted new cases for the rest of the restriction phases, and we compared them with the actual number of cases during each phase. Furthermore, using the published and gray literature, we estimated the costs and savings of implementing these restrictions for the projected period, and we performed a sensitivity analysis. Results: The estimated median R0 during the different phases was 1.14 (95% CI: 0.85, 1.45) for pre-lockdown, 1.67 (95% CI: 1.50, 1.82) for phase 1 (strict mobility restrictions), 1.24 (95% CI: 1.12, 1.35) for phase 2 (extension of phase 1 with no restrictions on agricultural and essential services), 1.12 (95% CI: 1.01, 1.23) for phase 3 (extension of phase 2 with mobility relaxations in areas with few infections), and 1.05 (95% CI: 0.99, 1.123) for phase 4 (implementation of localized lockdowns in high-case-load areas with fewer restrictions on other areas), respectively. The corresponding doubling time rate for cases (in days) was 17.78 (95% CI: 5.61, −15.19), 3.87 (95% CI: 3.15, 5.00), 10.37 (95% CI: 7.10, 19.30), 20.31 (95% CI: 10.70, 212.50), and 45.56 (95% CI: 20.50, –204.52). For the projected period, the cases could have reached 631,819 without the lockdown, as the actual reported number of cases was 64,975. From a healthcare perspective, the estimated total value of averted cases was INR 194.73 billion (USD 2.60 billion), resulting in net cost savings of 84.05%. The Incremental Cost-Effectiveness Ratio (ICER) per Quality Adjusted Life Year (QALY) for implementing the lockdown, rather than observing the natural course of the pandemic, was INR 33,812.15 (USD 450.83). Conclusion: Maharashtra’s early public health response delayed the pandemic and averted new cases and deaths during the first wave of the pandemic. However, we recommend that such restrictions be carefully used while considering the local socio-economic realities in countries like India. Full article
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11 pages, 1670 KiB  
Article
Long-Term Impacts of COVID-19 Pneumonia on Quality of Life: A Single Institutional Pilot Study
by Athavudh Deesomchok, Chalerm Liwsrisakun, Warawut Chaiwong, Chaicharn Pothirat, Pilaiporn Duangjit, Chaiwat Bumroongkit, Theerakorn Theerakittikul, Atikun Limsukon, Pattraporn Tajarernmuang, Konlawij Trongtrakul and Nutchanok Niyatiwatchanchai
Healthcare 2023, 11(13), 1963; https://doi.org/10.3390/healthcare11131963 - 07 Jul 2023
Viewed by 736
Abstract
Many studies have demonstrated poor quality of life (QoL) at 3, 6, 12, and 24 months after coronavirus disease 2019 (COVID-19). However, these studies were limited due to cross-sectional design, a longer gap between visits, and lack of controls for comparison. Therefore, the [...] Read more.
Many studies have demonstrated poor quality of life (QoL) at 3, 6, 12, and 24 months after coronavirus disease 2019 (COVID-19). However, these studies were limited due to cross-sectional design, a longer gap between visits, and lack of controls for comparison. Therefore, the aim of our prospective study was to assess the impact of COVID-19 pneumonia on QoL in both physical and mental health. A prospective study was conducted on adult patients with COVID-19 pneumonia. We used the 36-Item Short Form Health Survey (SF-36) and Euro Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L), EQ visual analogue scale (EQ-VAS), and Hospital Anxiety and Depression Scale to collect data at months, 1, 3, 6, 9, and 12. Thirty-eight patients with COVID-19 pneumonia and twenty-five healthy subjects were completely followed up on all visits. All domains of SF-36, except bodily pain and EQ-5D-5L of the patients, were lower than controls. There was an improvement of EQ-VAS and SF-36 including physical functioning, social functioning, and role limitation (physical problems) domains throughout study period in the COVID-19 pneumonia group. Adult patients who recovered from COVID-19 pneumonia had lower QoL which improved over the one-year follow-up period. Full article
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18 pages, 1217 KiB  
Article
Topic Modeling Analysis of Diabetes-Related Health Information during the Coronavirus Disease Pandemic
by Soyoon Min and Jeongwon Han
Healthcare 2023, 11(13), 1871; https://doi.org/10.3390/healthcare11131871 - 27 Jun 2023
Viewed by 1155
Abstract
This study aimed to provide diabetes-related health information by analyzing queries posted in the diabetes-related online community required during the COVID-19 pandemic. A total of 9156 queries from the diabetes-related online community, dated between 1 December 2019 and 3 May 2022, were used [...] Read more.
This study aimed to provide diabetes-related health information by analyzing queries posted in the diabetes-related online community required during the COVID-19 pandemic. A total of 9156 queries from the diabetes-related online community, dated between 1 December 2019 and 3 May 2022, were used in the study. The collected data were preprocessed for bidirectional encoder representation from transformer topic modeling analysis. Topics were extracted using the class-based term frequency–inverse document frequency for nouns and verbs. From the extracted verbs, words with common definitions were subject to substitution and unification processes, which enabled the identification of multifrequent verb categories by noun topics. The following nine noun topics were extracted, in this order: dietary management, drug management, gestational and childhood diabetes, management of diabetic complications, use and cost of medical treatment, blood glucose management, exercise treatment, COVID-19 vaccine and complications, and diabetes in older adults. The top three verb categories by noun topics were permission, method, and possibility. This study provided baseline data that can be used by clinical nurses to deliver diabetes-related education and management based on information sought by patients. Full article
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10 pages, 242 KiB  
Review
Public Health Challenges in Saudi Arabia during the COVID-19 Pandemic: A Literature Review
by Haytham A. Sheerah, Yasir Almuzaini and Anas Khan
Healthcare 2023, 11(12), 1757; https://doi.org/10.3390/healthcare11121757 - 15 Jun 2023
Cited by 5 | Viewed by 2177
Abstract
Similar to most countries, Saudi Arabia faced several challenges during the novel coronavirus disease 2019 (COVID-19) pandemic, some of which were related to the religious position of the country. The main challenges included deficits in knowledge, attitudes, and practices toward COVID-19, the negative [...] Read more.
Similar to most countries, Saudi Arabia faced several challenges during the novel coronavirus disease 2019 (COVID-19) pandemic, some of which were related to the religious position of the country. The main challenges included deficits in knowledge, attitudes, and practices toward COVID-19, the negative psychological impacts of the pandemic on the general population and healthcare workers, vaccine hesitancy, the management of religious mass gatherings (e.g., Hajj and Umrah), and the imposition of travel regulations. In this article, we discuss these challenges based on evidence from studies involving Saudi Arabian populations. We outline the measures through which the Saudi authorities managed to minimize the negative impacts of these challenges in the context of international health regulations and recommendations. Full article
15 pages, 1455 KiB  
Article
Distinct Clinical Presentations and Outcomes of Hospitalized Adults with the SARS-CoV-2 Infection Occurring during the Omicron Variant Surge
by Jianli Niu, Myeongji Kim, Ayesha T. Jalal, Jessica E. Goldberg, Elsa M. Acevedo Martinez, Nathalie P. Suarez Moscoso, Heysu Rubio-Gomez, Daniel Mayer, Alvaro Visbal, Candice Sareli, Paula A. Eckardt and Aharon E. Sareli
Healthcare 2023, 11(12), 1703; https://doi.org/10.3390/healthcare11121703 - 10 Jun 2023
Cited by 1 | Viewed by 1029
Abstract
The COVID-19 Omicron variant has imposed a tremendous burden on healthcare services. We characterized the types of the Omicron variant-associated hospitalizations and their associations with clinical outcomes. Consecutive adults hospitalized with COVID-19 during the Omicron variant surge period of 1–14 January 2022, were [...] Read more.
The COVID-19 Omicron variant has imposed a tremendous burden on healthcare services. We characterized the types of the Omicron variant-associated hospitalizations and their associations with clinical outcomes. Consecutive adults hospitalized with COVID-19 during the Omicron variant surge period of 1–14 January 2022, were classified into one of three groups based on their clinical presentations on admission: Group 1—primary COVID-19; Group 2—extrapulmonary manifestations of COVID-19; and Group 3—incidental COVID-19. Of the 500 patients who were hospitalized, 51.4% fell into Group 1, 16.4% into Group 2, and 32.2% into Group 3. The patients in Groups 1 and 2 were older, with higher proportions of comorbidities than patients in Group 3. The Group 1 patients had the highest mortality rate (15.6%), followed by Group 2 (8.5%), and Group 3 (0.6%), with adjusted odds ratios (OR) of 22.65 (95% confidence interval [CI], 2.75–239.46; p = 0.004) and 10.95 (95% CI, 1.02–117.28; p = 0.048), respectively, compared to Group 3. Those in Group 1 showed a greater utilization of intensive care services (15.9%), followed by Group 2 (10.9%), and Group 3 (2.5%), with adjusted ORs of 7.95 (95% CI, 2.52–25.08; p < 0.001) and 5.07 (95% CI, 1.34–19.15; p = 0.017), respectively, compared to Group 3. The patients in Groups 1 and 2 had longer hospitalization stays than the patients in Group 3 (p < 0.001 and p = 0.002, respectively). Older age (≥65 years) was an independent factor associated with longer hospital stays (OR = 1.72, 95% CI, 1.07–2.77). These findings can help hospitals prioritize patient care and service planning for future SARS-CoV-2 variants. Full article
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17 pages, 928 KiB  
Article
Role of Natural Products in the Management of COVID-19: A Saudi Arabian Perspective
by Mansour Almuqbil, Sarah Alshaikh, Nura Alrumayh, Fay Alnahdi, Eiman Fallatah, Shahad Almutairi, Mohd Imran, Mehnaz Kamal, Mazen Almehmadi, Ahad Amer Alsaiari, Wafa Ali Abdulrhman Alqarni, Ali Mohammed Alasmari, Sara Alwarthan, Ali A. Rabaan, Moneer E. Almadani and Syed Mohammed Basheeruddin Asdaq
Healthcare 2023, 11(11), 1584; https://doi.org/10.3390/healthcare11111584 - 28 May 2023
Viewed by 1606
Abstract
The coronavirus disease of 2019 (COVID-19) pandemic has resulted in an unprecedented circumstance that has never previously occurred. This has caused the Saudi Arabian people to recognize the necessity of preventive measures and explore alternative systems, such as using natural products (NPs), for [...] Read more.
The coronavirus disease of 2019 (COVID-19) pandemic has resulted in an unprecedented circumstance that has never previously occurred. This has caused the Saudi Arabian people to recognize the necessity of preventive measures and explore alternative systems, such as using natural products (NPs), for treating their infection. Therefore, the specific objectives of this study were to explore the factors that influence the selection of NPs for COVID-19 management and to know the outcome of using NPs in COVID-19 infection management. This observational cross-sectional study was conducted in Saudi Arabia between February and April 2022. The validated pretested questionnaire was distributed among different regions of the country via a purposive snowball sampling procedure. Both descriptive statistics and stepwise regression analyses were carried out to evaluate the parameters related to the use of medicinal plants for the prevention of COVID-19 and the treatment of respiratory symptoms during the pandemic. The data obtained were statistically analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, NY, USA). Of the 677 participants, 65% reported using NPs for themselves or family members during COVID-19. Utilizing NPs is always given priority by a significant (p < 0.001) percentage of survey respondents. Further, a highly significant (p < 0.001) percentage of participants felt that using NPs reduced their COVID-19 symptoms without having any remarkable (p < 0.001) adverse effects. Family and friends (59%) were the most frequent sources of information about utilizing NPs, followed by personal experience (41%). Honey (62.7%) and ginger (53.8%) were the most utilized NP among participants. Moreover, black seeds, garlic and turmeric were used by 40.5%, 37.7% and 26.3% of the surveyors, respectively. Those who used NPs before COVID-19 were 72.9% more likely to use them during COVID-19. NPs are more likely to be used by 75% of people who live in the central part of the country and whose families prefer it. This is true even if other factors are considered, such as the practice of using NPs along with traditional therapies and the fact that some participants’ families prefer it. Our findings show that NPs were commonly used to treat COVID-19 infection among Saudi Arabian residents. Close friends and family members mainly encouraged the use of NPs. Overall, the use of NPs was high among those who participated in our study; such practices are strongly impacted by society. It is essential to promote extensive studies to improve the recognition and accessibility of these products. Authorities should also educate the people about the benefits and risks of using commonly used NPs, especially those reported in this study. Full article
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13 pages, 276 KiB  
Article
Effectiveness of a Smoking Cessation Program during the COVID-19 Pandemic
by Aleksandra Kruk, Celina Czerwińska, Justyna Dolna-Michno, Elżbieta Broniatowska and Emanuel Kolanko
Healthcare 2023, 11(11), 1536; https://doi.org/10.3390/healthcare11111536 - 24 May 2023
Viewed by 1818
Abstract
The coronavirus disease-2019 pandemic has caused major obstacles for effective smoking cessation programs by significantly limiting access to healthcare. This cross-sectional analysis aimed to assess the effectiveness of a self-developed smoking cessation program during the pandemic. The program was based on remote lectures, [...] Read more.
The coronavirus disease-2019 pandemic has caused major obstacles for effective smoking cessation programs by significantly limiting access to healthcare. This cross-sectional analysis aimed to assess the effectiveness of a self-developed smoking cessation program during the pandemic. The program was based on remote lectures, educational interventions, and hybrid services provided by an outpatient clinic. We assessed 337 participants enrolled to the program between January 2019 and February 2022. Data on demographic characteristics, medical history, and smoking status at baseline and after at least 1-year follow-up were collected from medical records and a standardized self-developed questionnaire. Participants were classified into two groups according to their current smoking status. The smoking cessation rate at 1 year was 37% (95% confidence interval [CI]: 31–42%). Major predictors of smoking cessation were the place of residence, ability to refrain from smoking during severe illness, and the number of cigarettes smoked per day. The proportion of participants with high levels of nicotine dependence at baseline was 40.8% (95% CI: 34.5–47.5%) vs. 29.1% (95% CI: 23.4–35.5%) after the program. In the group that did not quit smoking, there were more participants who smoked within 5 min after waking up than before the program (40.4% [95% CI: 34.0–47.1%] vs. 25.4% [95% CI: 19.9–31.6%]). Effective smoking cessation interventions can be performed using remote counseling and education. Full article
19 pages, 2152 KiB  
Article
The Pattern of Injuries in the Emergency Room during the COVID-19 Pandemic
by Yunhyung Choi and Duk Hee Lee
Healthcare 2023, 11(10), 1483; https://doi.org/10.3390/healthcare11101483 - 19 May 2023
Cited by 1 | Viewed by 916
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has obviously caused a remarkable change in patients’ emergency department (ED) visits; however, data from multicenter studies are lacking. We aimed to present a comprehensive analysis of injury-related ED visits in Republic of Korea before and [...] Read more.
Background: The coronavirus disease 2019 (COVID-19) pandemic has obviously caused a remarkable change in patients’ emergency department (ED) visits; however, data from multicenter studies are lacking. We aimed to present a comprehensive analysis of injury-related ED visits in Republic of Korea before and during the COVID-19 pandemic. Materials and Methods: Data from 23 tertiary hospitals based on Emergency Department-based Injury In-depth Surveillance were used for this retrospective cross-sectional study. A total of 541,515 ED visits (age ≥ 20 years) between 1 January 2018 and 31 December 2020 were included, and the trend of injuries related to motor vehicular accidents, falls, self-harm and suicide, assault, and poisoning were compared between the pre-COVID-19 time period and during the COVID-19 pandemic. Results: In the first year of the COVID-19 period, a decline in the number of ED visits was observed (41,275, 21%) compared to the previous year. Injuries caused by motor vehicles (36,332 in 2019 vs. 27,144 in 2020), falls and slips (61,286 in 2019 vs. 49,156 in 2020), assaults (10,528 in 2019 vs. 8067 in 2020), and poisonings (7859 in 2019 vs. 7167 in 2020) decreased, whereas self-harm and suicide (8917 in 2019 vs. 8911 in 2020) remained unchanged. The hospitalization (16.6% in 2019 vs. 18.8% in 2020) and ED mortality rate (0.6% in 2019 vs. 0.8% in 2020) also increased. Conclusion: The COVID-19 pandemic led to a decline in the overall number of trauma patients seeking medical care; however, the proportion of patients requiring hospitalization or intensive care unit admission increased, indicating more severe injuries among those who did seek care. Suicide attempt rates remained unchanged, highlighting the need for targeted care and support for vulnerable patients. During the pandemic, EDs had to continue to provide care to patients with medical emergencies unrelated to COVID-19, which requires a delicate and adaptable approach to ED operations. To manage the increased stress and workload caused by the pandemic, increased resources and support for healthcare workers were needed. Full article
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14 pages, 3228 KiB  
Article
The Role of Vaccination and Face Mask Wearing on COVID-19 Infection and Hospitalization: A Cross-Sectional Study of the MENA Region
by Ahmed Hamimes, Mohamed Lounis, Hani Amir Aouissi, Rabih Roufayel, Abdelhak Lakehal, Hafid Bouzekri, Haewon Byeon, Mostefa Ababsa and Christian Napoli
Healthcare 2023, 11(9), 1257; https://doi.org/10.3390/healthcare11091257 - 28 Apr 2023
Cited by 3 | Viewed by 1618
Abstract
Since the emergence of the Coronavirus disease (COVID-19) pandemic, the disease has affected more than 675 million people worldwide, including more than 6.87 million deaths. To mitigate the effects of this pandemic, many countries established control measures to contain its spread. Their riposte [...] Read more.
Since the emergence of the Coronavirus disease (COVID-19) pandemic, the disease has affected more than 675 million people worldwide, including more than 6.87 million deaths. To mitigate the effects of this pandemic, many countries established control measures to contain its spread. Their riposte was based on a combination of pharmaceutical (vaccination) and non-pharmaceutical (such as facemask wearing, social distancing, and quarantine) measures. In this way, cross-sectional research was conducted in Algeria from 23 December 2021 to 12 March 2022 to investigate the effectiveness of preventative interventions in lowering COVID-19 infection and severity. More specifically, we investigated the link between mask-wearing and infection on one side, and the relationship between vaccination and the risk of hospitalization on the other. For this purpose, we used binary logistic regression modeling that allows learning the role of mask-wearing and vaccination in a heterogeneous society with respect to compliance with barrier measures. This study determined that wearing a mask is equally important for people of all ages. Further, findings revealed that the risk of infection was 0.79 times lower among those who were using masks (odds ratio (OR) = 0.79; confidence interval (CI) 95% = 0.668–0.936; p-value = 0.006). At the same time, vaccination is a necessary preventive measure as the risk of hospitalization increases with age. Compared with those who did not get vaccinated, those who got vaccinated were 0.429 times less likely to end up in the hospital (OR = 0.429; CI95% = 0.273–0.676; p < 0.0001). The model performance demonstrates significant relationships between the dependent and independent variables, with the absence of over-dispersion in both studied models, such as the Akaike Information Criterion (AIC) scores. These findings emphasize the significance of preventative measures and immunization in the battle against the COVID-19 pandemic. Full article
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10 pages, 235 KiB  
Article
Changes in Injury Pattern and Outcomes of Trauma Patients after COVID-19 Pandemic: A Retrospective Cohort Study
by Myungjin Jang, Mina Lee, Giljae Lee, Jungnam Lee, Kangkook Choi and Byungchul Yu
Healthcare 2023, 11(8), 1074; https://doi.org/10.3390/healthcare11081074 - 10 Apr 2023
Cited by 4 | Viewed by 1188
Abstract
The COVID-19 pandemic, starting in 2020, changed the daily activities of people in the world and it might also affect patterns of major trauma. This study aimed to compare the epidemiology and outcomes of trauma patients before and after the COVID-19 outbreak. This [...] Read more.
The COVID-19 pandemic, starting in 2020, changed the daily activities of people in the world and it might also affect patterns of major trauma. This study aimed to compare the epidemiology and outcomes of trauma patients before and after the COVID-19 outbreak. This was a retrospective study, conducted in a single regional trauma center in Korea, and patients were grouped as pre- and post-COVID-19 and compared in terms of demographics, clinical characteristics, and clinical outcomes. A total of 4585 patients were included in the study and the mean age was 57.60 ± 18.55 and 59.06 ± 18.73 years in the pre- and post-COVID-19 groups, respectively. The rate of elderly patients (age ≥ 65) significantly increased in the post-COVID-19 group. In terms of injury patterns, self-harm was significantly increased after COVID-19 (2.6% vs. 3.5%, p = 0.021). Mortality, hospital length of stay, 24 h, and transfusion volume were not significantly different. Among the major complications, acute kidney injury, surgical wound infection, pneumonia, and sepsis were significantly different between the groups. This study revealed changes in the age of patients, injury patterns and severity, and major complication rates after the COVID-19 outbreak. Full article
16 pages, 324 KiB  
Article
Impact of COVID-19 on Portuguese Dental Students: A Cohort Study
by Rodrigo Melo dos Santos Gonçalves, Gustavo Vicentis Oliveira Fernandes, Juliana Campos Hasse Fernandes, Mariana Seabra and Andreia Figueiredo
Healthcare 2023, 11(6), 818; https://doi.org/10.3390/healthcare11060818 - 10 Mar 2023
Cited by 2 | Viewed by 1367
Abstract
Introduction: The goal of this study was to assess the impact of COVID-19 on Portuguese dental students on their depression, anxiety, temporomandibular dysfunction, academic degree, and oral behaviors. Methods: The target of this population study was to enroll third-, fourth-, and fifth-year students [...] Read more.
Introduction: The goal of this study was to assess the impact of COVID-19 on Portuguese dental students on their depression, anxiety, temporomandibular dysfunction, academic degree, and oral behaviors. Methods: The target of this population study was to enroll third-, fourth-, and fifth-year students of the Integrated Master’s degree in Dental Medicine at the Universidade Católica Portuguesa—Faculty of Dental Medicine (Viseu, Portugal) in the academic year 2021–2022. Temporomandibular disorders (TMD) symptoms, oral behaviors, anxiety, and depression were assessed using validated questionnaires. The variables under study were (a) age, gender, marital status, academic level, academic degree, medication, and any existing pathologies; (b) questions related to taste changes or thoughts that would indicate (or not) worsening psychological conditions (anxiety and depression). After data collection (Google Forms®), data were transferred to an Excel file and entered into SPSS® software. A chi-square test allowed the independence between ordinal or nominal variables. The Spearman correlation test was used to analyze the relationship between variables in the study (significant if p ≤ 0.05). Results: 98.2% of the students answered the questionnaire. TMD had a prevalence of 35%, and anxiety and depression a prevalence of 29% and 24%, respectively. The results showed that the female gender was the most affected by psychological and temporomandibular disorders. Statistically significant correlations were identified between variables, such as gender and anxiety, TDM, and depression (respectively, p = 0.0001, p = 0.014, and p = 0.026); between TDM and anxiety and depression (respectively, p = 0.001 and p < 0.001); and between performing oral behaviors and TMD, anxiety, and depression (respectively, p = 0.0001, p = 0.0001, and p = 0.006). The variables, such as age and academic degree, did not establish a statistically significant relationship with TMD, oral behaviors, and the two psychological conditions. Conclusions: It was possible to conclude that there was a moderate prevalence of TMD, anxiety, and depression in the period studied. Moreover, a statistically significant relationship was found between TMD, anxiety, and depression with gender and frequency of OBs; however, no significant association was found for TMD, anxiety, and depression with the age of students and with the academic degree. Full article
23 pages, 2142 KiB  
Article
Exploration of Sex and Age-Based Associations in Clinical Characteristics, Predictors of Severity, and Duration of Stay among COVID-19 Patients at the University Hospital of Saudi Arabia
by Rasha Assad Assiri, Asmatanzeem Bepari, Waseemoddin Patel, Syed Arif Hussain, Shaik Kalimulla Niazi, Asma Alshangiti, Safia Ali Alshangiti, Mary Anne Wong Cordero and Shazima Sheereen
Healthcare 2023, 11(5), 751; https://doi.org/10.3390/healthcare11050751 - 03 Mar 2023
Cited by 3 | Viewed by 9760
Abstract
COVID-19 infection has a spectrum of variable clinical severity between populations because of their characteristic demographic features, co-morbidities, and immune system reactions. This pandemic tested the healthcare system’s preparedness, which depends on predictors of severity and factors related to the duration of hospital [...] Read more.
COVID-19 infection has a spectrum of variable clinical severity between populations because of their characteristic demographic features, co-morbidities, and immune system reactions. This pandemic tested the healthcare system’s preparedness, which depends on predictors of severity and factors related to the duration of hospital stays. Therefore, we carried out a single-center, retrospective cohort study in a tertiary academic hospital to investigate these clinical features and predictors of severe disease and study the different factors that affect hospital stay. We utilized medical records from March 2020 to July 2021, which included 443 confirmed (positive RT-PCR) cases. The data were explained using descriptive statistics and analyzed via multivariate models. Among the patients, 65.4% were female and 34.5% were male, with a mean age of 45.7 years (SD ± 17.2). We presented seven age groups with ranges of 10 years and noticed that patients aged 30–39 years old comprised 23.02% of the records, while patients aged 70 and above comprised 10%. Nearly 47% were diagnosed as having mild, 25% as moderate, 18% as asymptomatic, and 11% as having a severe case of COVID-19 disease. Diabetes was the most common co-morbidity factor in 27.6% of patients, followed by hypertension (26.4%). Our population’s predictors of severity included pneumonia, identified on a chest X-ray, and co-morbid conditions such as cardiovascular disease, stroke, ICU stay, and mechanical ventilation. The median length of hospital stay was six days. It was significantly longer in patients with a severe disease and who were administered systemic intravenous steroids. An empirical assessment of various clinical parameters could assist in effectively measuring the disease progression and follow-up with patients. Full article
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20 pages, 1166 KiB  
Article
COVID-19 Vaccine Acceptance Behavior among Hispanics/Latinxs in Nevada: A Theory-Based Analysis
by Tara Marie Nerida, Manoj Sharma, Brian Labus, Erika Marquez and Chia-Liang Dai
Healthcare 2023, 11(5), 688; https://doi.org/10.3390/healthcare11050688 - 26 Feb 2023
Viewed by 1456
Abstract
Hesitancy toward the COVID-19 vaccine has hindered its rapid uptake among the Hispanic and Latinx populations. The study aimed to use the Multi-Theory Model (MTM) for health behavior change to explain the intention of initiating and sustaining the behavior of COVID-19 vaccination among [...] Read more.
Hesitancy toward the COVID-19 vaccine has hindered its rapid uptake among the Hispanic and Latinx populations. The study aimed to use the Multi-Theory Model (MTM) for health behavior change to explain the intention of initiating and sustaining the behavior of COVID-19 vaccination among the Hispanic and Latinx populations that expressed and did not express hesitancy towards the vaccine in Nevada. Using a quantitative cross-sectional and survey-based research study design, data were collected using a 50-item questionnaire and analyzed using multiple linear regression modeling. Of 231 respondents, participatory dialogue (b = 0.113, p < 0.001; b = 0.072, p < 0.001) and behavioral confidence (b = 0.358, p < 0.001; b = 0.206, p < 0.001) displayed significant associations with the initiation of COVID-19 vaccine acceptance among vaccine-hesitant and non-vaccine-hesitant individuals. Emotional transformation (b = 0.087, p < 0.001; b = 0.177, p < 0.001) displayed a significant association with the sustenance of COVID-19 vaccine acceptance among vaccine-hesitant and non-vaccine-hesitant individuals. Results from this study provide evidence that the MTM is a useful tool in predicting COVID-19 vaccine acceptance behavior among Hispanics and Latinxs in Nevada, and it should be used in intervention designs and messaging to promote vaccine uptake. Full article
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20 pages, 1219 KiB  
Article
Factors Affecting Preventive Behaviors for Safety and Health at Work during the COVID-19 Pandemic among Thai Construction Workers
by Samsiya Khaday, Kai-Way Li and Halimoh Dorloh
Healthcare 2023, 11(3), 426; https://doi.org/10.3390/healthcare11030426 - 02 Feb 2023
Cited by 3 | Viewed by 1705
Abstract
Occupational health and safety risks are of major concerns in construction industry. The COVID-19 outbreak provides an additional risk that could drastically affect the safety risks and health of construction workers. Understanding the factors that affect the health and safety of construction workers [...] Read more.
Occupational health and safety risks are of major concerns in construction industry. The COVID-19 outbreak provides an additional risk that could drastically affect the safety risks and health of construction workers. Understanding the factors that affect the health and safety of construction workers is significant in reducing risky behaviors and enhancing worker preventive behaviors. Via integrating the Protection Motivation Theory (PMT) and the extended Theory of Planned Behavior (TPB), this study investigates the factors that affect preventive behaviors among construction workers during the COVID-19 pandemic in Bangkok, Thailand. A total of 610 Thai construction workers participated in an online questionnaire survey, which consisted of nine factors with 43 questions. Structure equation modeling (SEM) was adopted to analyze the causal relationships among the latent variable. The SEM results indicated that organizational support and knowledge about COVID-19 had significant (p < 0.0001) direct influences on perceived vulnerability and perceived severity. In addition, perceived vulnerability and perceived severity had significant direct influences on perceived behavioral control. Perceived severity had significant (p < 0.0001) direct influence on attitude towards behavior. Moreover, perceived behavioral control and attitude towards behavior had significant (p < 0.0001) direct influence on intention to follow the preventive measure. Furthermore, the intention to follow the preventive measure had significant (p < 0.0001) direct influences on the COVID-19 preventive behavior. Of note, organizational support and knowledge about COVID-19 had significant (p < 0.0001) indirect influence on COVID-19 preventive behavior. The findings of this study may assist project managers/supervisors and authorities in the construction industry in understanding the challenge during COVID-19 and possible similar epidemics in the future. In addition, conducting effective strategies would improve construction industry safety and promote preventive behaviors among construction workers. Full article
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13 pages, 2095 KiB  
Brief Report
The State of Play on COVID-19 Vaccination in Pregnant and Breastfeeding Women: Recommendations, Legal Protection, Ethical Issues and Controversies in Italy
by Roberto Scendoni, Piergiorgio Fedeli and Mariano Cingolani
Healthcare 2023, 11(3), 328; https://doi.org/10.3390/healthcare11030328 - 22 Jan 2023
Cited by 7 | Viewed by 1617
Abstract
To date, extensive research has been conducted on vaccination against COVID-19 during pregnancy to verify the safety and efficacy of the vaccines, despite the fact that pregnant women were excluded from the initial clinical trials. The ever-increasing number of scientific publications has confirmed [...] Read more.
To date, extensive research has been conducted on vaccination against COVID-19 during pregnancy to verify the safety and efficacy of the vaccines, despite the fact that pregnant women were excluded from the initial clinical trials. The ever-increasing number of scientific publications has confirmed the absence of biological mechanisms associating mRNA vaccines with adverse effects in pregnancy and breastfeeding, although few studies have been carried out on their effect on fertility. While the Italian legal system provides for maternity protection measures and indemnity for vaccination damages pursuant to law no. 210/1992, it is not exempt from controversy. This contribution describes the state of play on COVID-19 vaccination in pregnant and lactating women, including: current recommendations for pregnant and lactating women; ethical issues related to vaccination hesitancy among pregnant women; the legislative paradox whereby sanctions may be imposed on women in certain professional categories who refuse vaccination because they are pregnant; and the possible legal consequences in the event of harm to the unborn child due to vaccination. All of this is considered in accordance with the principles of medical ethics, taking into account the national legislation. Full article
11 pages, 301 KiB  
Article
Impact of COVID-19 Restrictions in Childbirth and Puerperium: A Cross-Sectional Study
by María Suárez-Cortés, María de los Ángeles Castaño-Molina, Antonio Jesús Ramos-Morcillo, Alonso Molina-Rodriguez, Ismael Jiménez-Ruiz, María Jesús Hernández-López, Francisco David Harillo-Acevedo and César Carrillo-García
Healthcare 2023, 11(2), 249; https://doi.org/10.3390/healthcare11020249 - 13 Jan 2023
Cited by 1 | Viewed by 1398
Abstract
Introduction (1): The COVID-19 pandemic led to changes in healthcare during pregnancy, childbirth and puerperium. The objective of this study was to know the impact of visit restrictions, PCR performance and use of masks on delivery and puerperium care. Methods (2): A descriptive [...] Read more.
Introduction (1): The COVID-19 pandemic led to changes in healthcare during pregnancy, childbirth and puerperium. The objective of this study was to know the impact of visit restrictions, PCR performance and use of masks on delivery and puerperium care. Methods (2): A descriptive cross-sectional study was carried out. A survey was used to assess the impact of COVID-19-related measures on women who had given birth in hospitals in the Region of Murcia, Spain, between March 2020 and February 2022. Results (3): The final sample size was 434 women. The average scores were 4.27 for dimension 1 (Visit restrictions), 4.15 for dimension 2 (PCR testing) and 3.98 for dimension 3 (Mask use). More specifically, we found that the restriction of visits was considered a positive measure for the establishment of the mother–newborn bond (mean score 4.37) and that the use of masks at the time of delivery should have been made more flexible (mean score 4.7). Conclusions (4): The policy of restricting hospital visits during the pandemic caused by COVID-19 has been considered beneficial by mothers, who expressed that they did not feel lonely during their hospital stay. Full article

2022

Jump to: 2024, 2023, 2021, 2020

15 pages, 627 KiB  
Article
Comparison of the Psychological Impact of COVID-19 on Self-Employed Private Healthcare Workers with Respect to Employed Public Healthcare Workers: Three-Wave Study during the COVID-19 Pandemic in Spain
by Manuel Pabón-Carrasco, Samuel Vilar-Palomo, María Luisa Gonzalez-Elena, Rocío Romero-Castillo, José Antonio Ponce-Blandon and Aurora Castro-Méndez
Healthcare 2023, 11(1), 134; https://doi.org/10.3390/healthcare11010134 - 31 Dec 2022
Cited by 1 | Viewed by 1334
Abstract
(1) Background: Coronavirus disease, also called COVID-19, is a worldwide pandemic with a major impact on all aspects of the individual (health status, psychological, and economic aspects, among others). The perception of health professionals in this situation has been influenced by their economic [...] Read more.
(1) Background: Coronavirus disease, also called COVID-19, is a worldwide pandemic with a major impact on all aspects of the individual (health status, psychological, and economic aspects, among others). The perception of health professionals in this situation has been influenced by their economic and psychosocial situations. On the economic level, self-employed workers have no state subsidies, with the added disadvantage of not having sufficient means to cope with contagion. This could potentially have an impact on their health and indirectly on their family members, creating additional stress. The aim of this study was to determine whether there are differences in the level of anxiety of health professionals working in private practice compared to healthcare workers working in public institutions during the first three waves of COVID-19. (2) Methods: A cohort study on 517 subjects comparing anxiety between a group of health workers and a group of health professionals working in the public sector at three key moments during the pandemic was performed. (3) Results: Statistically significant differences were found between self-employed private health professionals compared to those working as public health workers. The perception of impact was worse in the self-employed; however, a higher level of anxiety was evident in public employees in all assessed domains (cognitive, physiological, and motor, p = 0.001). (4) Conclusions: There were significant changes when comparing the first phase between both groups; employed public healthcare workers manifested a sense of lower risk of COVID-19 contagion than privately employed professionals, who had a higher level of anxiety. In the second and third waves, negative feelings improved for both groups, and the fear of showing anxiety to the patient decreased over the course of the waves. Full article
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11 pages, 271 KiB  
Article
A Survey of Living Conditions and Psychological Distress in Japanese University Freshmen during the COVID-19 Pandemic
by Yoko Iio, Yukihiro Mori, Yuka Aoyama, Hana Kozai, Mamoru Tanaka, Makoto Aoike, Hatsumi Kawamura, Manato Seguchi, Masato Tsurudome and Morihiro Ito
Healthcare 2023, 11(1), 94; https://doi.org/10.3390/healthcare11010094 - 28 Dec 2022
Cited by 2 | Viewed by 1420
Abstract
Since the novel coronavirus disease 2019 (COVID-19) pandemic, educational institutions have implemented measures such as school closures, raising concerns regarding the increase in psychological distress among university students. The purpose of this study is to identify factors that have influenced psychological distress among [...] Read more.
Since the novel coronavirus disease 2019 (COVID-19) pandemic, educational institutions have implemented measures such as school closures, raising concerns regarding the increase in psychological distress among university students. The purpose of this study is to identify factors that have influenced psychological distress among college freshmen during the COVID-19 pandemic. A questionnaire survey was conducted at the conclusion of the sixth wave of COVID-19 in Japan. Psychological distress was measured using the six-item Kessler Psychological Distress Scale (K6). Factors affecting psychological distress were calculated using regression analysis. Of the 2536 participants, 1841 (72.6%) reported having no psychological distress, while 695 (27.4%) reported having psychological distress. Factors that were identified to contribute to psychological distress were lack of sleep, weight gain or loss, worsening of interpersonal relationships, and physical symptoms and illnesses. A willingness to join an athletic club and having an environment in which it is easy to discuss worries and anxieties with others were factors that were identified to hinder psychological distress. It is necessary for universities to offer enhanced supports for physical and interpersonal activities. Additionally, it is imperative to encourage students to look after their physical health and to actively utilize university-based consultation systems. Full article
15 pages, 314 KiB  
Article
Giving Birth in Unpredictable Conditions: Association between Parents’ COVID-19 Related Concerns, Family Functioning, Dyadic Coping, Perceived Social Support and Depressive Symptoms
by Theano Kokkinaki, Katerina Koutra, Olga Michopoulou, Nicole Anagnostatou, Lina Chaziraki, Panagiota Kokarida and Eleftheria Hatzidaki
Healthcare 2022, 10(12), 2550; https://doi.org/10.3390/healthcare10122550 - 16 Dec 2022
Cited by 4 | Viewed by 1436
Abstract
Background: The way postpartum parents’ COVID-19-related concerns are associated with the family environment, support resources and depressive symptoms areunder-investigated. Methods: Two hundred and forty-three new parents (132 mothers, 111 fathers) completed self-report questionnaires within an 8-week period after birth. Parental concerns for COVID-19-related [...] Read more.
Background: The way postpartum parents’ COVID-19-related concerns are associated with the family environment, support resources and depressive symptoms areunder-investigated. Methods: Two hundred and forty-three new parents (132 mothers, 111 fathers) completed self-report questionnaires within an 8-week period after birth. Parental concerns for COVID-19-related life changes were assessed with the COVID-19 Questionnaire, perceived social support with the Multidimensional Scale of Perceived Social Support, perceived family functioning with the Family Adaptability and Cohesion Evaluation Scales IV Package, dyadic coping behaviors with the Dyadic Coping Inventory and maternal/paternal postnatal depression with the Edinburgh Postnatal Depression Scale. Results: (a) Higher levels of COVID-19-related concerns about daily life were associated with lower levels of family communication, satisfaction and increased depressive symptomatology in both parents, and with lower levels of family functioning in mothers; (b) Maternal health care COVID-19-related concerns were linked with lower levels of family communication, lower perceived social support and with an increase in maternal depressive symptoms; and (c) COVID-19-related concerns about neonate hospitalization were associated with increased maternal depressive symptoms. Conclusion: Τhese findings suggest that COVID-19-related concerns had a common negative effect on both postpartum mothers’ and fathers’ mental health and on certain aspects of family functioning. Full article
12 pages, 298 KiB  
Article
Epidemiological Context and Risk Factors Associated with the Evolution of the Coronavirus Disease (COVID-19): A Retrospective Cohort Study
by Leyla Hadef, Brahim Hamad, Salma Hamad, Amira Laouini and Nouri Ben Ali
Healthcare 2022, 10(11), 2139; https://doi.org/10.3390/healthcare10112139 - 27 Oct 2022
Cited by 1 | Viewed by 1134
Abstract
Since its initial appearance in December 2019, COVID-19 has posed a serious challenge to healthcare authorities worldwide. The purpose of the current study was to identify the epidemiological context associated with the respiratory illness propagated by the spread of COVID-19 and outline various [...] Read more.
Since its initial appearance in December 2019, COVID-19 has posed a serious challenge to healthcare authorities worldwide. The purpose of the current study was to identify the epidemiological context associated with the respiratory illness propagated by the spread of COVID-19 and outline various risk factors related to its evolution in the province of Debila (Southeastern Algeria). A retrospective analysis was carried out for a cohort of 612 COVID-19 patients admitted to hospitals between March 2020 and February 2022. The results were analyzed using descriptive statistics. Further, logistic regression analysis was employed to perform the odds ratio. In gendered comparison, males were found to have a higher rate of incidence and mortality compared to females. In terms of age, individuals with advanced ages of 60 years or over were typically correlated with higher rates of incidence and mortality in comparison toindividuals below this age. Furthermore, the current research indicated that peri-urban areas were less affected that the urban regions, which had relatively significant incidence and mortality rates. The summer season was marked with the highest incidence and mortality rate in comparison with other seasons. Patients who were hospitalized, were the age of 60 or over, or characterized by comorbidity, were mainly associated with death evolution (odds ratio [OR] = 8.695; p = 0.000), (OR = 6.192; p = 0.000), and (OR = 2.538; p = 0.000), respectively. The study identifies an important relationship between the sanitary status of patients, hospitalization, over-age categories, and the case severity of the COVID-19 patient. Full article
8 pages, 1512 KiB  
Article
Close Contacts, Infected Cases, and the Trends of SARS-CoV-2 Omicron Epidemic in Shenzhen, China
by Furong Li, Fengchao Liang, Bin Zhu, Xinxin Han, Shenying Fang, Jie Huang, Xuan Zou and Dongfeng Gu
Healthcare 2022, 10(11), 2126; https://doi.org/10.3390/healthcare10112126 - 26 Oct 2022
Cited by 1 | Viewed by 1621
Abstract
(1) The overall trends of the number of daily close contacts and infected cases as well as their association during an epidemic of Omicron Variant of SARS-CoV-2 have been poorly described. (2) Methods: This study was to describe the trends during the epidemic [...] Read more.
(1) The overall trends of the number of daily close contacts and infected cases as well as their association during an epidemic of Omicron Variant of SARS-CoV-2 have been poorly described. (2) Methods: This study was to describe the trends during the epidemic of the Omicron variant of SARS-CoV-2 in Shenzhen, China, including the number of close contacts and infected cases as well as their ratios by days and stages (five stages). (3) Results: A total of 1128 infected cases and 80,288 close contacts were identified in Shenzhen from 13 February 2022 to 1 April 2022. Before the citywide lockdown (14 March), the number of daily close contacts and infected cases gradually increased. However, the numbers showed a decrease after the lockdown was imposed. The ratio of daily close contacts to daily infected cases ranged from 20.2:1 to 63.4:1 and reached the lowest during the lockdown period. The growth rate of daily close contacts was consistent with those of infected cases observed 6 days later to some extent. (4) Conclusions: The Omicron variant epidemic was promptly contained by tracing close contacts and taking subsequent quarantine measures. Full article
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10 pages, 254 KiB  
Article
Joint Effect of Diabetes Mellitus and Hypertension on COVID-19 in-Hospital Mortality Stratified by Age Group and Other Comorbidities: A Cohort Retrospective Study Using Hospital-Based Data in Sleman, Yogyakarta
by Yampa Eksa Daidella Ghilari, Arik Iskandar, Bayu Satria Wiratama and Anggoro Budi Hartopo
Healthcare 2022, 10(10), 2103; https://doi.org/10.3390/healthcare10102103 - 20 Oct 2022
Cited by 1 | Viewed by 1393
Abstract
The joint effect of diabetes mellitus and hypertension on COVID-19 has rarely been evaluated but had potential as a major risk factor. This study aims to investigate the joint effect between diabetes mellitus and hypertension on in-hospital mortality among COVID-19 patients in Yogyakarta [...] Read more.
The joint effect of diabetes mellitus and hypertension on COVID-19 has rarely been evaluated but had potential as a major risk factor. This study aims to investigate the joint effect between diabetes mellitus and hypertension on in-hospital mortality among COVID-19 patients in Yogyakarta stratified by age groups and other comorbidities status. Methods: This cohort retrospective study collected data from two major hospitals in the Sleman district and a total of 2779 hospitalized COVID-19 patients were included in this study. The study outcome was COVID-19 in-hospital mortality (deceased or discharged alive) and the main risk factors were diabetes mellitus (DM) and hypertension (HT). The multiple logistic regression model was utilized to estimate adjusted odds ratio (AOR) and calculate the joint effect. Results: COVID-19 patients who have both DM and hypertension were three times (AOR: 3.21; 95% CI: 2.45–4.19) more likely to have in-hospital mortality than those without both comorbidities. The highest risk of in-hospital mortality was found in COVID-19 patients without other comorbidities (other than DM and HT) and younger age (age 0–40 years), with AOR equal to 22.40 (95% CI: 6.61–75.99). Conclusions: This study identified a joint effect between diabetes mellitus and hypertension which increases the risk of in-hospital mortality among COVID-19 patients. Targeted public health, clinical, and health education intervention should be carried out on individuals with diabetes mellitus and/or hypertension. Full article
10 pages, 570 KiB  
Case Report
Non-Communicable Diseases and Transitioning Health System in the Democratic People’s Republic of Korea during COVID-19 Lockdown
by Jin-Won Noh, Kyoung-Beom Kim, Ha-Eun Jang, Min-Hee Heo, Young-Jin Kim and Jiho Cha
Healthcare 2022, 10(10), 2095; https://doi.org/10.3390/healthcare10102095 - 20 Oct 2022
Viewed by 1696
Abstract
While there are increasing concerns on COVID-19 situation in Democratic People’s Republic of Korea (DPRK, or North Korea), little is known about North Korea’s health system function for Non-Communicable Diseases. Given the scarcity of available evidence, a scoping review was conducted in peer [...] Read more.
While there are increasing concerns on COVID-19 situation in Democratic People’s Republic of Korea (DPRK, or North Korea), little is known about North Korea’s health system function for Non-Communicable Diseases. Given the scarcity of available evidence, a scoping review was conducted in peer review articles from MEDLINE, SCOPUS, and Web of Science, and policy literatures from Rodongshinmun, state-run media in North Korea to analyze the North Korea health system and COVID-19 pandemic. The transition to a market economy is expected to deepen the gap between the rich and the poor over access to health care, causing a new type of health inequality in North Korea. COVID-19 lockdown intensified the DPRK’s economic predicament exacerbating shortage of health financing on non-communicable diseases. The case study of mixed evidence from scoping review indicates that NCDs prevention and management are not functional in the transitioning health system under chronic economic crisis and isolation. This study indicates that NCDs prevention and management are not functional in the transitioning health system under chronic economic crisis and isolation. The destabilized markets under COVID-19 lockdown intensified the DPRK’s economic predicament and exacerbated the chronic shortage of health financing especially to NCDs. Full article
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10 pages, 260 KiB  
Article
Self-Reported Sleep during the COVID Lockdown in a Sample of UK University Students and Staff
by John H. Foster and Sandra Rankin
Healthcare 2022, 10(10), 2083; https://doi.org/10.3390/healthcare10102083 - 19 Oct 2022
Cited by 2 | Viewed by 1798
Abstract
The link between disturbed sleep and the extended lockdown period resulting from COVID-19 is well established. Data from an online survey of 2341 of university students (n = 1972, 84.2%) and staff were reported. Overall (n = 1710, 73.1%) were female and the [...] Read more.
The link between disturbed sleep and the extended lockdown period resulting from COVID-19 is well established. Data from an online survey of 2341 of university students (n = 1972, 84.2%) and staff were reported. Overall (n = 1710, 73.1%) were female and the mean age for the sample was 29.26 (SD = 12.86). 1799 (76.8%) provided self-reported data from the Nottingham Health Profile (NHP) Sleep Subscale that allowed sleep to be compared prior to the lockdown period and during the lockdown period. Sociodemographic data which included, gender, age, whether an individual was a student or member of the university staff, ethnicity, caring responsibilities, and highest educational level were collected. Other data included, the NHP Sleep Sub-scale, change in alcohol consumption during the lockdown period, routine behaviours during the lockdown period, self-efficacy and health and wellbeing. There was a significant deterioration in NHP Sleep scores (p < 0.001) and all areas of sleep that were assessed significantly deteriorated during the lockdown period. These included indicators of sleep quality, sleep latency, sleep duration, sleep disturbance and increased use of sleep medication. Following a multinomial logit regression with change of NHP sleep scores entered as the dependent variable there were several significant predictors. Women had greater sleep dysfunction than men. Increased alcohol consumption, lower educational status and a deterioration in health and well-being scores were associated with greater sleep dysfunction. Not having a designated area to work in and not putting on clothes and make-up were both associated with greater sleep dysfunction during the lockdown period. These findings confirm the importance of taking steps to maintain sleep hygiene during extended lockdown periods. Full article
22 pages, 3855 KiB  
Article
“Pandemic Fatigue! It’s Been Going On since March 2020”: A Photovoice Study of the Experiences of BIPOC Older Adults and Frontline Healthcare Workers during the Pandemic
by Angela U. Ekwonye, Abigail Malek, Tenzin Chonyi, Stephanie Nguyen, Valerie Ponce-Diaz, Lisa Lau Haller, Iqra Farah and Mary Hearst
Healthcare 2022, 10(10), 1967; https://doi.org/10.3390/healthcare10101967 - 08 Oct 2022
Cited by 1 | Viewed by 1914
Abstract
The coronavirus disease 2019 (COVID-19) pandemic intensified the stressful and already difficult circumstances of communities of color. Yet, there is no current photovoice research highlighting the lived experiences of these communities from two perspectives—the older adults (OAs) and the frontline healthcare workers (FLHWs). [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic intensified the stressful and already difficult circumstances of communities of color. Yet, there is no current photovoice research highlighting the lived experiences of these communities from two perspectives—the older adults (OAs) and the frontline healthcare workers (FLHWs). This qualitative study used photovoice to visually portray the struggles of Black, Indigenous, and persons of color (BIPOC) OAs (n = 7) and younger FLHWs (n = 5) who worked with older adults during the pandemic and how they coped and recovered from the challenges of the pandemic. The investigators conducted a three-day training of ten research assistants (RAs) who were paired with either an OA or an FLHW for the photovoice sessions conducted in four stages. Upon examination of the narratives, focus group transcriptions, and photo stories, it became clear that participants faced different challenges during the pandemic, such as the fear of COVID-19 exposure, struggles to adopt COVID-19 mitigation strategies, workplace challenges, and social isolation. Amid this crisis of suffering, isolation, and sadness, participants employed two major strategies to deal with the challenges of the pandemic: positive reappraisal and self-care practices. The findings have implications for clinical social workers, mental health counselors, faith communities, nurse managers and administrators, and policymakers. Full article
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10 pages, 2068 KiB  
Article
Profile of Patients with Cardiovascular Diseases during the Pandemic in a Cardiology Clinic of a COVID-19 Support Hospital
by Andrei Cârstea, Adrian Mită, Mircea-Cătălin Forțofoiu, Irina Paula Doica, Doina Cârstea, Ileana-Diana Diaconu, Anca Abu Alhija Barău, Liviu Martin, Maria Monalisa Filip, Andreea Loredana Golli and Maria Forțofoiu
Healthcare 2022, 10(10), 1887; https://doi.org/10.3390/healthcare10101887 - 27 Sep 2022
Cited by 1 | Viewed by 1261
Abstract
Background: During the pandemic, our hospital became a COVID support hospital and consequently the cardiology clinic had restricted activity; thus, it received only suspect and/or patients confirmed positive with the various COVID-19 strains that were associated with a chronic/flaring cardiovascular pathology. Methods: Two [...] Read more.
Background: During the pandemic, our hospital became a COVID support hospital and consequently the cardiology clinic had restricted activity; thus, it received only suspect and/or patients confirmed positive with the various COVID-19 strains that were associated with a chronic/flaring cardiovascular pathology. Methods: Two batches of patients admitted during a one-year period were compared in the cardiology clinic over two different periods of time: BATCH I (1 April 2019 to 31 March 2020), in a non-COVID context (BATCH I N-COV) and BATCH II (1 July 2020 to 30 June 2021) comprising patients that presented with respiratory infection of SARS-CoV-2 (BATCH II COV-2), associated with chronic and/or acute cardiovascular condition. To determine the profile of the patients admitted in our clinic, we observed the following parameters: age, type of cardiac condition, and admission mode (for the N-COV group). Results: The data obtained as absolute numbers and as percentages in relation to the total number of admissions were presented in separate tables and graphs for both of the studied groups. Conclusions: The SARS-CoV-2 pandemic, in its almost two years of evolution, has divided the medical world in two main categories: COVID and non-COVID. Admission of the patients with chronic, but non-COVID cardiac conditions, in our case, dropped to almost one-quarter when we compared the two absolute admission numbers: 1382 in the year prior to pandemic compared with only 356 in the pandemic year. We believe that the number of deaths due to SARS-CoV-2 infection was infinitely higher than the reported ones and uncountable, in as much as COVID-19 did not kill only the infected patients, but it has also yielded a very large number of collateral victims among chronic patients who had no contact with the disease, but were unable to be admitted and treated for chronic heart disease. Full article
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14 pages, 294 KiB  
Article
A Study on the COVID-19 Preventive Behaviors of Automobile Manufacturing Workers in South Korea
by Ji-Hye Kim, Hye-Young Song, Jin-Hee Park, Purum Kang and Hyun-Ju Lee
Healthcare 2022, 10(10), 1826; https://doi.org/10.3390/healthcare10101826 - 21 Sep 2022
Viewed by 1288
Abstract
The present study used a cross-sectional, descriptive survey design to investigate the influencing factors of COVID-19-related infection prevention behaviors of workers in the automobile manufacturing sector. An online survey was conducted on 157 workers in the automobile manufacturing sector of a company in [...] Read more.
The present study used a cross-sectional, descriptive survey design to investigate the influencing factors of COVID-19-related infection prevention behaviors of workers in the automobile manufacturing sector. An online survey was conducted on 157 workers in the automobile manufacturing sector of a company in Korea. We analyzed the collected data using SPSS to test whether there were significant differences in COVID-19 risk perception, crisis communication, health literacy, and infection prevention behaviors according to the general characteristics of the participants. An independent sample t-test and a one-way analysis of variance (ANOVA) were performed. A Pearson’s correlation analysis was performed to identify the correlations among COVID-19 risk perception, crisis communication, health literacy, and infection prevention behaviors. Multiple regression analysis was performed to identify the influencing factors of COVID-19 infection prevention behaviors. The regression model was found to be significant, and the employment period at current job, COVID-19 prevention education, source of information, COVID-19 risk perception, crisis communication, and health literacy were also found to be significant. Among the demographic variables, employment period at current job of 5–10 years showed a higher level of infection prevention behaviors than that of <5 years. Moreover, the level of infection prevention behaviors was also significantly higher when COVID-19-related information was acquired through the KDCA/health center. Higher COVID-19 risk perception, crisis communication, and health literacy were associated with significantly higher levels of infection prevention behaviors. Therefore, based on the results, health managers need to develop programs and educate and improve information comprehension and crisis communication skills in order to promote workers’ infection prevention behaviors of emerging infectious diseases in an era of global change. Full article
9 pages, 539 KiB  
Article
A Study on the Relationship between Depression Change Types and Suicide Ideation before and after COVID-19
by Sunghee Kim, Hye-Gyeong Son, Seoyoon Lee, Hayoung Park and Kyu-Hyoung Jeong
Healthcare 2022, 10(9), 1610; https://doi.org/10.3390/healthcare10091610 - 24 Aug 2022
Cited by 5 | Viewed by 1540
Abstract
Background: The purpose of this study is to explore and categorize changes in depression, and investigate the relationship between suicidal ideations before and after the COVID-19 pandemic. Methods: In this study, data from the Korea Welfare Panel Study (KoWePS) was used and included [...] Read more.
Background: The purpose of this study is to explore and categorize changes in depression, and investigate the relationship between suicidal ideations before and after the COVID-19 pandemic. Methods: In this study, data from the Korea Welfare Panel Study (KoWePS) was used and included 8692 adults, 19 years of age or older, who could estimate the change in depression from 2017 (12th) to 2021 (16th) for final analysis. Depression change was classified into two types, ‘low-level ascending’ type (n = 7809, 80.9%), and ‘increasing after reduction’ type (n = 883, 10.2%). The Firth Method was used to examine the relationship between depression change types and suicidal ideation. Results: The lower the equivalized annual income and the lower the educational level, and the likelihood of belonging to the ‘increasing after reduction’ type, compared to the ‘low-level ascending’ type, the greater the probability of having suicidal ideation. Conclusion: The significant impact of socioeconomic status (income and educational background) on suicidal ideation indicates the need to consider how epidemics affect inequality in society. This study is expected to provide a deeper understanding of depression, as well as to establish a foundation for long-term prevention of the rapid increase in suicide rates after COVID-19. Full article
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10 pages, 840 KiB  
Article
Changes in Emergency Department Case Severity and Length of Stay before and after COVID-19 Outbreak in Korea
by Yong-Seok Kim, In-Byung Kim, Seon-Rye Kim and Byung-Jun Cho
Healthcare 2022, 10(8), 1540; https://doi.org/10.3390/healthcare10081540 - 14 Aug 2022
Cited by 4 | Viewed by 1634
Abstract
Severe patients visited regional emergency centers more frequently during the COVID-19 period, and disposition status warranting admission to the intensive care unit or resulting in death was more common during the COVID-19 period. This study was conducted to compare the characteristics and severity [...] Read more.
Severe patients visited regional emergency centers more frequently during the COVID-19 period, and disposition status warranting admission to the intensive care unit or resulting in death was more common during the COVID-19 period. This study was conducted to compare the characteristics and severity of patients, and emergency department length of stay before and after the COVID-19 outbreak. Subjects were 75,409 patients who visited the regional emergency medical center from 1 February 2019 to 19 January 2020 and from 1 February 2020 to 19 January 2021. Data was analyzed using the SPSS/WIN 22.0 program. The significance level was p < 0.05. The chi-square test and t-test were used for variables, and Cramer V was used for correlation. We found that the total number of patients visiting the emergency room decreased by 37.6% after COVID-19, but emergency department length of stay among severely ill patients increased by 203.7%. Additionally, the utilization rate of 119 ambulances and relatively more severe patients increased by 9.0% and by 2.1%. More studies about emergency department designs and operational programs should be conducted for better action not only during regular periods but also during periods of pandemic. Full article
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15 pages, 2774 KiB  
Article
Substantial Impairment of Quality of Life during COVID-19 Pandemic in Patients with Advanced Rectal Cancer
by Irene Dennison, Claudia Schweizer, Tim Fitz, Daniel Blasko, Christopher Sörgel, Annett Kallies, Linda Schmidt, Rainer Fietkau and Luitpold Valentin Distel
Healthcare 2022, 10(8), 1513; https://doi.org/10.3390/healthcare10081513 - 11 Aug 2022
Cited by 4 | Viewed by 1231
Abstract
The aim of this study was to analyze the quality of life of patients with advanced rectal cancer before and during the COVID-19 pandemic and to determine whether the pandemic affected patients’ quality of life. The study included 389 patients and was performed [...] Read more.
The aim of this study was to analyze the quality of life of patients with advanced rectal cancer before and during the COVID-19 pandemic and to determine whether the pandemic affected patients’ quality of life. The study included 389 patients and was performed from May 2010 to June 2021. The fifteen months from March 2020 to June 2021 were categorized as the COVID-19 period. Patients were surveyed using the QLQ-C30 and QLQ-CR38 questionnaires. The questionnaires were used at different phases of radiochemotherapy: prior to RCT (day 1), during RCT (day 14), at the end of RCT (day 35), and prior to mesorectal surgery (day 70). Scores were formed from the questions. In addition, scores were analyzed for different age groups (<64 and >64) and sexes (female and male). Overall, patients reported lower functional scores and higher symptom scores during the pandemic than before the pandemic. Although it had been expected that older and younger patients would differ clearly, there were only minor differences. The comparison between the two sexes showed very different scores, with female patients having lower functional scores and higher symptom scores than male patients before and especially during COVID-19. In conclusion, age does not play a major role in quality of life, but sex does play an important role in perception of functioning and symptoms. COVID-19 also had a major impact on patients’ lives, as it was a very isolating and stressful time for everyone, especially cancer patients, which was reflected in worsening scores. Full article
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13 pages, 296 KiB  
Review
Assessment of the Functional Capacity and Preparedness of the Haitian Healthcare System to Fight against the COVID-19 Pandemic: A Narrative Review
by Josemyrne Ashley Faure, Chia-Wen Wang, Chi-Hsin Sally Chen and Chang-Chuan Chan
Healthcare 2022, 10(8), 1428; https://doi.org/10.3390/healthcare10081428 - 29 Jul 2022
Cited by 2 | Viewed by 2098
Abstract
Low-income countries, such as Haiti, are facing challenges in fighting the COVID-19 pandemic due to resource shortages and fragile healthcare systems. This study assessed the functional capacity and preparedness of the Haitian healthcare system regarding the COVID-19 pandemic. It employed a narrative review [...] Read more.
Low-income countries, such as Haiti, are facing challenges in fighting the COVID-19 pandemic due to resource shortages and fragile healthcare systems. This study assessed the functional capacity and preparedness of the Haitian healthcare system regarding the COVID-19 pandemic. It employed a narrative review approach to analyze secondary data and used the Donabedian model and the global health security index as the theoretical frameworks to evaluate preparedness. The findings reveal that Haiti faces challenges in tackling the COVID-19 pandemic due to a lack of biosafety and biosecurity regulations, inadequate laboratory systems for COVID-19 testing, and shortages of human resources and personal protective equipment. Moreover, poverty remains widespread, and people lack access to clean water and sanitation services, resulting in a high risk of COVID-19 infection. Furthermore, a lack of communication, rumors, the circulation of fake news regarding COVID-19, and stigmatization cause distrust and reduce the number of people seeking healthcare services. Haiti faces challenges with respect to tackling the pandemic. The Haitian government can strengthen and improve the capacity of the healthcare system to fight against the COVID-19 pandemic and infectious diseases emerging in the future. Full article
26 pages, 671 KiB  
Article
The Importance of Behavioral and Native Factors on COVID-19 Infection and Severity: Insights from a Preliminary Cross-Sectional Study
by Hani Amir Aouissi, Mohamed Seif Allah Kechebar, Mostefa Ababsa, Rabih Roufayel, Bilel Neji, Alexandru-Ionut Petrisor, Ahmed Hamimes, Loïc Epelboin and Norio Ohmagari
Healthcare 2022, 10(7), 1341; https://doi.org/10.3390/healthcare10071341 - 19 Jul 2022
Cited by 22 | Viewed by 3441
Abstract
The COVID-19 pandemic has had a major impact on a global scale. Understanding the innate and lifestyle-related factors influencing the rate and severity of COVID-19 is important for making evidence-based recommendations. This cross-sectional study aims at establishing a potential relationship between human characteristics [...] Read more.
The COVID-19 pandemic has had a major impact on a global scale. Understanding the innate and lifestyle-related factors influencing the rate and severity of COVID-19 is important for making evidence-based recommendations. This cross-sectional study aims at establishing a potential relationship between human characteristics and vulnerability/resistance to SARS-CoV-2. We hypothesize that the impact of the virus is not the same due to cultural and ethnic differences. A cross-sectional study was performed using an online questionnaire. The methodology included the development of a multi-language survey, expert evaluation, and data analysis. Data were collected using a 13-item pre-tested questionnaire based on a literature review between 9 December 2020 and 21 July 2021. Data were statistically analyzed using logistic regression. For a total of 1125 respondents, 332 (29.5%) were COVID-19 positive; among them, 130 (11.5%) required home-based treatment, and 14 (1.2%) intensive care. The significant and most influential factors on infection included age, physical activity, and health status (p < 0.05), i.e., better physical activity and better health status significantly reduced the possibility of infection, while older age significantly increased it. The severity of infection was negatively associated with the acceptance (adherence and respect) of preventive measures and positively associated with tobacco (p < 0.05), i.e., smoking regularly significantly increases the severity of COVID-19 infection. This suggests the importance of behavioral factors compared to innate ones. Apparently, individual behavior is mainly responsible for the spread of the virus. Therefore, adopting a healthy lifestyle and scrupulously observing preventive measures, including vaccination, would greatly limit the probability of infection and prevent the development of severe COVID-19. Full article
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9 pages, 737 KiB  
Article
Long-Acting Injectable Antipsychotics (LAIs) Prescribing Trends during the COVID-19 Pandemic in Romania
by Ana A. Miron, Petru I. Ifteni, Andreea Teodorescu and Paula S. Petric
Healthcare 2022, 10(7), 1265; https://doi.org/10.3390/healthcare10071265 - 07 Jul 2022
Cited by 7 | Viewed by 1573
Abstract
Long acting injectable antipsychotics (LAIs) are considered the ideal treatment for schizophrenia, especially for young patients with high rates of non-adherence. In the current COVID-19 pandemic, it has been reported that the administration of LAIs decreased in some areas. The aim of this [...] Read more.
Long acting injectable antipsychotics (LAIs) are considered the ideal treatment for schizophrenia, especially for young patients with high rates of non-adherence. In the current COVID-19 pandemic, it has been reported that the administration of LAIs decreased in some areas. The aim of this study was to evaluate the impact of COVID-19 pandemic on the initiation of LAIs. This is a retrospective mirror- image study covering a total period of 24 months: 12 months before and 12 months after the declaration of COVID-19 pandemic on March 11, 2020. During the study period, out of 218 patients admitted with schizophrenia, only 15 (1.3%) received LAIs at discharge. There was a 48.3% reduction in LAIs initiation compared to the pre-pandemic period (29 LAIs initiations in 2019 from 224 admissions). Despite the 27% reduction in the total number of admissions (1500 in 2019 vs. 1100 in 2020), the number of admissions with schizophrenia remained almost the same (224 in 2019 vs. 218 in 2020). COVID-19 pandemic brought an important challenge in the treatment of patients with schizophrenia, especially in the initiation of LAIs. This could have an important impact on the relapse rate in the next period. Full article
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16 pages, 994 KiB  
Article
The Moderated Mediating Effect of Hope, Self-Efficacy and Resilience in the Relationship between Post-Traumatic Growth and Mental Health during the COVID-19 Pandemic
by Donatella Di Corrado, Benedetta Muzii, Paola Magnano, Marinella Coco, Rosamaria La Paglia and Nelson Mauro Maldonato
Healthcare 2022, 10(6), 1091; https://doi.org/10.3390/healthcare10061091 - 12 Jun 2022
Cited by 7 | Viewed by 2800
Abstract
As a major life trauma, COVID-19 had negative impacts on psychological well-being. The aim of this study was to test and verify the mediation of resilience, hope and self-efficacy and to analyze the moderating effect of gender and COVID-19 contagion on the association [...] Read more.
As a major life trauma, COVID-19 had negative impacts on psychological well-being. The aim of this study was to test and verify the mediation of resilience, hope and self-efficacy and to analyze the moderating effect of gender and COVID-19 contagion on the association between symptoms of anxiety, stress and depression, and post-traumatic growth among adults during COVID-19. A cross-sectional study was conducted via an online survey with self-administered questionnaires. The Depression, Anxiety, and Stress Scale, the Post-traumatic Growth Inventory, the Resilience Scale, the General Self-Efficacy Scale, and the Comprehensive State Hope Scale were used. A total of 493 (n = 262 female and n = 231 male) participated in the survey (Mage = 33.40 years, SD = 13.41, range = 20 to 60). A multiple mediation model was used to verify the mediating effect of resilience, hope and self-efficacy on the relationship between symptoms of anxiety, stress and depression, and PTG. A moderated mediation model was examined to find and test the moderated effects of gender and COVID-19 contagion on the mediation model. Results showed the indirect effects of anxiety (β = 0.340 (0.120); 95% CI [from 0.128 to 0.587]) and depression (β = 0.222 (0.095); 95% CI [0.048, 0.429]) on PTG trough resilience and hope. Symptoms of anxiety, stress and depression, and self-efficacy were significantly highest in females. Moreover, males and participants with COVID-19 contagion had significantly higher levels of resilience and post-traumatic growth. These findings suggest that hope and resilience, as protective factors, could be an important key to developing an intervention strategy to enhance and improve psychological health during a crisis. Full article
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10 pages, 562 KiB  
Article
COVID-19 Vaccines and Restrictions: Concerns and Opinions among Individuals in Saudi Arabia
by Abdulkarim M. Meraya, Riyadh M. Salami, Saad S. Alqahtani, Osama A. Madkhali, Abdulrahman M. Hijri, Fouad A. Qassadi and Ayman M. Albarrati
Healthcare 2022, 10(5), 816; https://doi.org/10.3390/healthcare10050816 - 28 Apr 2022
Cited by 5 | Viewed by 2352
Abstract
(1) Background: Recent studies in Saudi Arabia have indicated that a small proportion of the population is hesitant to receive COVID-19 vaccines due to uncertainty about their safety. The objective of this study was therefore to examine concerns about COVID-19 vaccines in Saudi [...] Read more.
(1) Background: Recent studies in Saudi Arabia have indicated that a small proportion of the population is hesitant to receive COVID-19 vaccines due to uncertainty about their safety. The objective of this study was therefore to examine concerns about COVID-19 vaccines in Saudi Arabia; (2) Methods: This cross-sectional study surveyed Saudi residents aged 14 years and older. The online questionnaire consisted of the following sections: (1) demographics; (2) knowledge about COVID-19 vaccines and sources of information; (3) COVID-19 vaccines worry scale; and (4) opinions about restrictions placed on unvaccinated individuals in Saudi Arabia. An adjusted regression model was computed to examine the relationships between demographic factors and worry about COVID-19 vaccines. All analyses were stratified by age, with those aged 19 years and above considered adults and those aged younger than 19 years considered as adolescents; (3) Results: A total of 1002 respondents completed the survey. Of the study sample, 870 were aged ≥19 years and 132 were aged <19 years. Of the adults in the study sample, 52% either agreed or strongly agreed with the statement, “I am worried about the potential side effects of COVID-19 vaccinations in children”. Among adults, females demonstrated higher levels of worry about COVID-19 vaccines than males (β = 1.142; p = 0.004) in the adjusted analyses. A high percentage of the participants either disagreed or strongly disagreed with allowing unvaccinated individuals to enter malls, schools, universities or to live freely without restrictions; (4) Conclusions: A high proportion of individuals in Saudi Arabia are concerned about possible side effects of COVID-19 vaccines, and many believe that unvaccinated individuals should not be restricted from participating in public life. It is therefore crucial to provide easily accessible information on the safety of COVID-19 vaccines in order to accelerate vaccination and minimize hesitancy regarding any future vaccinations that may be necessary. Full article
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11 pages, 443 KiB  
Article
Association between Frequency of Going Out and Psychological Condition among Community-Dwelling Older Adults after the COVID-19 Pandemic in Japan
by Suguru Shimokihara, Michio Maruta, Yasuaki Akasaki, Yuriko Ikeda, Gwanghee Han, Taishiro Kamasaki, Keiichiro Tokuda, Yuma Hidaka, Yoshihiko Akasaki and Takayuki Tabira
Healthcare 2022, 10(3), 439; https://doi.org/10.3390/healthcare10030439 - 25 Feb 2022
Cited by 6 | Viewed by 1852
Abstract
Background: The psychological condition and frequency of going out (FGO) of community-dwelling older adults after the spread of COVID-19 will provide insights for supporting the daily lives of community-dwelling older adults. Going out is defined as moving from one’s own home to a [...] Read more.
Background: The psychological condition and frequency of going out (FGO) of community-dwelling older adults after the spread of COVID-19 will provide insights for supporting the daily lives of community-dwelling older adults. Going out is defined as moving from one’s own home to a place or region beyond one’s own home and is considered to reflect the daily and social life of community-dwelling older adults. This study investigates the relationship between the FGO and current psychological condition after the second wave of COVID-19 in community-dwelling older adults in Japan. Methods: This study adopted a self-administered questionnaire by mail. A total of 493 members of CO-OP Kagoshima were included in the analysis and divided into two groups according to the change in FGO. Multiple logistic regression analysis was conducted after a bivariate analysis to investigate the relationship between the FGO and psychological condition. Results: Significant differences were noted between the groups with decreased FGO and those with increased/unchanged FGO in general and pandemic-related psychological condition. Multiple logistic regression analysis showed a significant relationship between FGO and psychological condition, such as mental fatigue, not smiling as much as before, and anxiousness to go outside. Conclusion: Community-dwelling older adults may have experienced a decrease in the frequency of going out and a detrimental effect on their psychological condition after the COVID-19 pandemic. This finding may inform strategies to identify priorities for psychological approaches altered by COVID-19 to prevent confinement and stress in older adults. Full article
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13 pages, 279 KiB  
Article
Care Home and Home Care Staff’s Learning during the COVID-19 Pandemic and Beliefs about Subsequent Changes in the Future: A Survey Study in Sweden, Italy, Germany and the United Kingdom
by Agneta Malmgren Fänge, Jonas Christensen, Tamara Backhouse, Andrea Kenkmann, Anne Killett, Oliver Fisher, Carlos Chiatti and Connie Lethin
Healthcare 2022, 10(2), 306; https://doi.org/10.3390/healthcare10020306 - 05 Feb 2022
Cited by 3 | Viewed by 2338
Abstract
The aim of this study was to compare perceptions of learning from the COVID-19 pandemic and beliefs in subsequent changes for the future, among care home and home care staff, in four European countries. A 29-item on-line questionnaire was designed in English and [...] Read more.
The aim of this study was to compare perceptions of learning from the COVID-19 pandemic and beliefs in subsequent changes for the future, among care home and home care staff, in four European countries. A 29-item on-line questionnaire was designed in English and later translated into Swedish, Italian, and German on the impact of the pandemic on stress and anxiety. Anonymous data from care staff respondents was collected in four countries between 7 October 2020 and 17 December 2010: Sweden (n = 212), Italy (n = 103), Germany (n = 120), and the United Kingdom (n = 167). While care staff in all countries reported learning in multiple areas of care practice, Italy reported the highest levels of learning and the most agreement that changes will occur in the future due to the pandemic. Conversely, care staff in Germany reported low levels of learning and reported the least agreement for change in the future. While the pandemic has strained care home and home care staff practices, our study indicates that much learning of new skills and knowledge has taken place within the workforce. Our study has demonstrated the potential of cross-border collaborations and experiences for enhancing knowledge acquisition in relation to societal challenges and needs. The results could be built upon to improve future health care and care service practices. Full article

2021

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17 pages, 704 KiB  
Article
Association between Perceived Trusted of COVID-19 Information Sources and Mental Health during the Early Stage of the Pandemic in Bangladesh
by Muhammad Mainuddin Patwary, Mondira Bardhan, Matthew H. E. M. Browning, Asma Safia Disha, Md. Zahidul Haque, Sharif Mutasim Billah, Md. Pervez Kabir, Md. Riad Hossain, Md. Ashraful Alam, Faysal Kabir Shuvo and Ahmad Salman
Healthcare 2022, 10(1), 24; https://doi.org/10.3390/healthcare10010024 - 24 Dec 2021
Cited by 11 | Viewed by 3776
Abstract
Unverified information concerning COVID-19 can affect mental health. Understanding perceived trust in information sources and associated mental health outcomes during the COVID-19 pandemic is vital to ensure ongoing media coverage of the crisis does not exacerbate mental health impacts. A number of studies [...] Read more.
Unverified information concerning COVID-19 can affect mental health. Understanding perceived trust in information sources and associated mental health outcomes during the COVID-19 pandemic is vital to ensure ongoing media coverage of the crisis does not exacerbate mental health impacts. A number of studies have been conducted in other parts of the world to determine associations between information exposure relating to COVID-19 and mental health. However, the mechanism by which trust in information sources may affect mental health is not fully explained in the developing country context. To address this issue, the present study examined associations between perceived trust in three sources of information concerning COVID-19 and anxiety/stress with the mediating effects of COVID-19 stress in Bangladesh. An online cross-sectional study was conducted with 744 Bangladeshi adults between 17 April and 1 May 2020. Perceived trust in traditional, social, and health media for COVID-19 information, demographics, frontline service status, COVID-19-related stressors, anxiety (GAD-7), and stress (PSS-4) were assessed via self-report. Linear regression tested for associations between perceived trust and mental health. Mediation analyses investigated whether COVID-19-related stressors affected perceived trust and mental health associations. In fully adjusted models, more trust in social media was associated with more anxiety (B = 0.03, CI = 0.27–0.97) and stress (B = 0.01, CI = −0.34–0.47), while more trust in traditional media was associated with more anxiety (B = 0.09, CI = 0.17–2.26) but less stress (B = −0.08, CI = −0.89–0.03). Mediation analyses showed that COVID-19-related stressors partially explained associations between perceived trust and anxiety. These findings suggest that trusting social media to provide accurate COVID-19 information may exacerbate poor mental health. These findings also indicate that trusting traditional media (i.e., television, radio, and the newspaper) may have stress-buffering effects. We recommend that responsible authorities call attention to concerns about the trustworthiness of social media as well as broadcast positive and authentic news in traditional media outcomes based on these results. Full article
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11 pages, 4712 KiB  
Article
A Local Survey of COVID-19: Vaccine Potential Acceptance Rate among Personnel in a Level 1 Trauma Center without Severe COVID-19 Cases
by André Nohl, Heithem Ben Abdallah, Veronika Weichert, Sascha Zeiger, Tobias Ohmann and Marcel Dudda
Healthcare 2021, 9(12), 1616; https://doi.org/10.3390/healthcare9121616 - 23 Nov 2021
Cited by 3 | Viewed by 1793
Abstract
Background: Healthcare workers (HCWs) in hospitals are at high risk during the COVID-19 pandemic. Healthcare workers’ infection risk could be amplified during the ongoing pandemic due to various factors, including continuous exposure to patients and inadequate infection control training. Despite the risk healthcare [...] Read more.
Background: Healthcare workers (HCWs) in hospitals are at high risk during the COVID-19 pandemic. Healthcare workers’ infection risk could be amplified during the ongoing pandemic due to various factors, including continuous exposure to patients and inadequate infection control training. Despite the risk healthcare workers face, vaccine hesitancy remains a global challenge. Differences in acceptance rates have ranged from less than 55% (in Russia) to nearly 90% (in China). In order to improve our knowledge of vaccine acceptance and its variation in rates, an evaluation is warranted. A survey was thus administered to healthcare workers. Methods: This survey aimed to address vaccination acceptance among employees in an urban level 1 trauma hospital. It was conducted through a developed and structured questionnaire that was randomly distributed online among the staff (age ≥18 years) to receive their feedback. Results: Among 285 participants (out of 995 employees), 69% were female, and 83.5% were overaged more than 30 years of age. The two largest groups were nurses (32%) and doctors (22%). The majority of respondents reported that they would “like to be vaccinated” (77.4%) and that they trusted the COVID-19 vaccine (62%). Moreover, 67.8% also reported that they felt the vaccination was effective. They reported that vaccination was a method to prevent the spread of COVID-19 (85.15%) and was a way to protect individuals with weak immune systems (78.2%). More importantly, the participants were concerned about other people (80.1%) and believed the vaccine would protect others. On the other hand, the result showed that the majority of participants (95.3%) chose to be vaccinated once everyone else was vaccinated, “I don’t need to get vaccinated”. Results showed that the majority of participants that chose “I don’t need to get vaccinated” did so after everyone else was vaccinated. Our results show that COVID-19 vaccination intention in a level 1 trauma hospital was associated with older age males who are more confident, and also share a collective responsibility, are less complacent, and have fewer constraints. Conclusion: Acceptance of the COVID-19 vaccine is relatively low among healthcare workers (HCWs). Differences in vaccine acceptance have been noted between different categories of HCWs and genders. Therefore, addressing barriers to vaccination acceptance among these HCWs is essential to avoid reluctance to receive the vaccination, but it will be challenging. Full article
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11 pages, 273 KiB  
Article
Survival of COVID-19 with Multimorbidity Patients
by E. Bustos-Vázquez, E. Padilla-González, D. Reyes-Gómez, M. C. Carmona-Ramos, J. A. Monroy-Vargas, A. E. Benítez-Herrera and G. Meléndez-Mier
Healthcare 2021, 9(11), 1423; https://doi.org/10.3390/healthcare9111423 - 22 Oct 2021
Cited by 2 | Viewed by 1795
Abstract
Background: The outbreak of SARS-CoV-2 abruptly disseminated in early 2020, overcoming the capacity of health systems to respond the pandemic. It was not until the vaccines were launched worldwide that an increase in survival was observed. The objectives of this study were to [...] Read more.
Background: The outbreak of SARS-CoV-2 abruptly disseminated in early 2020, overcoming the capacity of health systems to respond the pandemic. It was not until the vaccines were launched worldwide that an increase in survival was observed. The objectives of this study were to analyse the characteristics of survivors and their relationship with comorbidities. We had access to a database containing information on 16,747 hospitalized patients from Mexico, all infected with SARS-CoV-2, as part of a regular follow-up. The descriptive analysis looked for clusters of either success or failure. We categorized the samples into no comorbidities, or one and up to five coexisting with the infection. We performed a logistic regression test to ascertain what factors were more influential in survival. The main variable of interest was survival associated with multimorbidity factors. The database hosted information on hospitalized patients from Mexico between March 2020 through to April 2021. Categories 2 and 3 had the largest number of patients. Survival rates were higher in categories 0 (64.8%), 1 (57.5%) and 2 (51.6%). In total, 1741 (10.5%) patients were allocated to an ICU unit. Mechanical ventilators were used on 1415 patients, corresponding to 8.76%. Survival was recorded in 9575 patients, accounting for 57.2% of the sample population. Patients without comorbidities, younger people and women were more likely to survive. Full article
13 pages, 1103 KiB  
Article
Exploring and Monitoring the Reasons for Hesitation with COVID-19 Vaccine Based on Social-Platform Text and Classification Algorithms
by Jingfang Liu, Shuangjinhua Lu and Caiying Lu
Healthcare 2021, 9(10), 1353; https://doi.org/10.3390/healthcare9101353 - 12 Oct 2021
Cited by 9 | Viewed by 2679
Abstract
(1) Background: The COVID-19 pandemic is globally rampant, and it is the common goal of all countries to eliminate hesitation in taking the COVID-19 vaccine and achieve herd immunity as soon as possible. However, people are generally more hesitant about the COVID-19 vaccine [...] Read more.
(1) Background: The COVID-19 pandemic is globally rampant, and it is the common goal of all countries to eliminate hesitation in taking the COVID-19 vaccine and achieve herd immunity as soon as possible. However, people are generally more hesitant about the COVID-19 vaccine than about other conventional vaccines, and exploring the specific reasons for hesitation with the COVID-19 vaccine is crucial. (2) Methods: this paper selected text data from a social platform to conduct qualitative analysis of the text to structure COVID-19 vaccine hesitancy reasons, and then conducted semiautomatic quantitative content analysis of the text through a supervised machine-learning method to classify them. (3) Results: on the basis of a large number of studies and news reports on vaccine hesitancy, we structured 12 types of the COVID-19 vaccine hesitancy reasons. Then, in the experiment, we conducted comparative analysis of three classifiers: support vector machine (SVM), logistic regression (LR), and naive Bayes classifier (NBC). Results show that the SVM classification model with TF-IDF and SMOTE had the best performance. (4) Conclusions: our study structured 12 types of COVID-19 vaccine hesitancy reasons through qualitative analysis, filling in the gaps of previous studies. At the same time, this work provides public health institutions with a monitoring tool to support efforts to mitigate and eliminate COVID-19 vaccine hesitancy. Full article
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13 pages, 744 KiB  
Article
A Theory-Based Analysis of COVID-19 Vaccine Hesitancy among African Americans in the United States: A Recent Evidence
by Manoj Sharma, Kavita Batra and Ravi Batra
Healthcare 2021, 9(10), 1273; https://doi.org/10.3390/healthcare9101273 - 27 Sep 2021
Cited by 23 | Viewed by 6735
Abstract
African Americans have been disproportionately vaccinated at lower rates, which warrants the development of theory-based interventions to reduce vaccine hesitancy in this group. The fourth-generation theories, e.g., multi-theory model (MTM) of health behavior change, are vital in developing behavioral interventions. Therefore, the current [...] Read more.
African Americans have been disproportionately vaccinated at lower rates, which warrants the development of theory-based interventions to reduce vaccine hesitancy in this group. The fourth-generation theories, e.g., multi-theory model (MTM) of health behavior change, are vital in developing behavioral interventions. Therefore, the current study aims to determine recent trends in COVID-19 vaccination rates and to test the MTM model in predicting the initiation of COVID-19 vaccines among vaccine-hesitant Blacks. A sample of 428 unvaccinated African Americans were recruited through a web-based survey using a 28-item psychometric valid questionnaire. Chi-square, independent-samples-t-test or Welch’s t test, and Pearson’s correlation tests were utilized for the analyses. Hierarchical regression modelling was performed to determine the increment in variation accounted for through addition of predictors over a set of models. Nearly 48% of unvaccinated Blacks reported being vaccine-hesitant. The vaccine-hesitant group was relatively younger (40.5 years ± 15.8 vs. 46.2 years ± 17.4, p < 0.001), were Republicans (22.1% vs. 10.0%, p < 0.001), lived in the North-East region (26.0% vs. 11.4%, p < 0.001) and had religious affiliations other than Christianity (21.2% vs. 13.6%, p = 0.04). The mean scores of perceived advantages ((9.01 ± 3.10 vs. 7.07 ± 3.60, p < 0.001) and behavioral confidence (8.84 ± 3.76 vs. 5.67 ± 4.09, p < 0.001) were higher among vaccine non-hesitant group as opposed to the hesitant ones. In a final regression model, all MTM constructs) predicted nearly 65% of variance in initiating COVID-19 vaccination behavior among the vaccine-hesitant group (adjusted R2 = 0.649, F = 32.944, p < 0.001). With each unit increment in MTM constructs (e.g., participatory dialogue and behavior confidence), the initiation of COVID-19 vaccination among vaccine-hesitant Blacks increased by 0.106 and 0.166 units, respectively. Based on the findings of this study a m-health educational intervention to promote COVID-19 vaccine uptake behavior among Blacks is proposed. Full article
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9 pages, 1258 KiB  
Article
Modeling-Based Estimate of the Vaccination Rate, Lockdown Rules and COVID-19
by Chinlin Guo and Wei-Chiao Chang
Healthcare 2021, 9(10), 1245; https://doi.org/10.3390/healthcare9101245 - 22 Sep 2021
Cited by 2 | Viewed by 1570
Abstract
COVID-19 has become a severe infectious disease and has caused high morbidity and mortality worldwide. Restriction rules such as quarantine and city lockdown have been implemented to mitigate the spread of infection, leading to significant economic impacts. Fortunately, development and inoculation of COVID-19 [...] Read more.
COVID-19 has become a severe infectious disease and has caused high morbidity and mortality worldwide. Restriction rules such as quarantine and city lockdown have been implemented to mitigate the spread of infection, leading to significant economic impacts. Fortunately, development and inoculation of COVID-19 vaccines are being conducted on an unprecedented scale. The effectiveness of vaccines raises a hope that city lockdown might not be necessary in the presence of ongoing vaccination, thereby minimizing economic loss. The question, however, is how fast and what type of vaccines should be inoculated to control the disease without limiting economic activity. Here, we set up a simulation scenario of COVID-19 outbreak in a modest city with a population of 2.5 million. The basic reproduction number (R0) was ranging from 1.0 to 5.5. Vaccination rates at 1000/day, 10,000/day and 100,000/day with two types of vaccine (effectiveness v = 51% and 89%) were given. The results indicated that R0 was a critical factor. Neither high vaccination rate (10,000 persons/day) nor high-end vaccine (v = 89%) could control the disease when the scenario was at R0 = 5.5. Unless an extremely high vaccination rate was given (>4% of the entire population/per day), no significant difference was found between two types of vaccine. With the population scaled to 25 million, the required vaccination rate was >1,000,000/day, a quite unrealistic number. Nevertheless, with a slight reduction of R0 from 5 to 3.5, a significant impact of vaccine inoculation on disease control was observed. Thus, our study raised the importance of estimating transmission dynamics of COVID-19 in a city before determining the subsequent policy. Full article
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16 pages, 4033 KiB  
Article
Early Spatiotemporal Patterns and Population Characteristics of the COVID-19 Pandemic in Southeast Asia
by Mingjian Zhu, Jirapat Kleepbua, Zhou Guan, Sien Ping Chew, Joanna Weihui Tan, Jian Shen, Natthjija Latthitham, Jianxiong Hu, Jia Xian Law and Lanjuan Li
Healthcare 2021, 9(9), 1220; https://doi.org/10.3390/healthcare9091220 - 16 Sep 2021
Cited by 8 | Viewed by 3507
Abstract
This observational study aims to investigate the early disease patterns of coronavirus disease 2019 (COVID-19) in Southeast Asia, consequently providing historical experience for further interventions. Data were extracted from official websites of the WHO and health authorities of relevant countries. A total of [...] Read more.
This observational study aims to investigate the early disease patterns of coronavirus disease 2019 (COVID-19) in Southeast Asia, consequently providing historical experience for further interventions. Data were extracted from official websites of the WHO and health authorities of relevant countries. A total of 1346 confirmed cases of COVID-19, with 217 recoveries and 18 deaths, were reported in Southeast Asia as of 16 March 2020. The basic reproductive number (R0) of COVID-19 in the region was estimated as 2.51 (95% CI:2.31 to 2.73), and there were significant geographical variations at the subregional level. Early transmission dynamics were examined with an exponential regression model: y = 0.30e0.13x (p < 0.01, R2 = 0.96), which could help predict short-term incidence. Country-level disease burden was positively correlated with Human Development Index (r = 0.86, p < 0.01). A potential early shift in spatial diffusion patterns and a spatiotemporal cluster occurring in Malaysia and Singapore were detected. Demographic analyses of 925 confirmed cases indicated a median age of 44 years and a sex ratio (male/female) of 1.25. Age may play a significant role in both susceptibilities and outcomes. The COVID-19 situation in Southeast Asia is challenging and unevenly geographically distributed. Hence, enhanced real-time surveillance and more efficient resource allocation are urgently needed. Full article
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14 pages, 14039 KiB  
Article
A Report Card on Prevention Efforts of COVID-19 Deaths in US
by Ramalingam Shanmugam, Lawrence Fulton, Zo Ramamonjiarivelo, José Betancourt, Brad Beauvais, Clemens Scott Kruse and Matthew S. Brooks
Healthcare 2021, 9(9), 1175; https://doi.org/10.3390/healthcare9091175 - 07 Sep 2021
Cited by 1 | Viewed by 1716
Abstract
COVID-19 (otherwise known as coronavirus disease 2019) is a life-threatening pandemic that has been combatted in various ways by the government, public health officials, and health care providers. These interventions have been met with varying levels of success. Ultimately, we question if the [...] Read more.
COVID-19 (otherwise known as coronavirus disease 2019) is a life-threatening pandemic that has been combatted in various ways by the government, public health officials, and health care providers. These interventions have been met with varying levels of success. Ultimately, we question if the preventive efforts have reduced COVID-19 deaths in the United States. To address this question, we analyze data pertaining to COVID-19 deaths drawn from the Centers for Disease Control and Prevention (CDC). For this purpose, we employ incidence rate restricted Poisson (IRRP) as an underlying analysis methodology and evaluate all preventive efforts utilized to attempt to reduce COVID-19 deaths. Interpretations of analytic results and graphical visualizations are used to emphasize our various findings. Much needed modifications of the public health policies with respect to dealing with any future pandemics are compiled, critically assessed, and discussed. Full article
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9 pages, 914 KiB  
Article
The Role of Resilience for Migrants and Refugees’ Mental Health in Times of COVID-19
by Sara Solà-Sales, Natalia Pérez-González, Julie Van Hoey, Isabel Iborra-Marmolejo, María José Beneyto-Arrojo and Carmen Moret-Tatay
Healthcare 2021, 9(9), 1131; https://doi.org/10.3390/healthcare9091131 - 30 Aug 2021
Cited by 16 | Viewed by 3930
Abstract
Migrants and refugees need international protection, particularly during a crisis such as the current health pandemic. The aim of this research was to examine the mental health and attitudes towards COVID-19 in migrants and refugees compared to the general Spanish population. Moreover, the [...] Read more.
Migrants and refugees need international protection, particularly during a crisis such as the current health pandemic. The aim of this research was to examine the mental health and attitudes towards COVID-19 in migrants and refugees compared to the general Spanish population. Moreover, the nature of resilience was examined as a mixed component though life experiences. For this proposal, an interview was carried out in a sample of 245 participants who volunteered to participate in the study. The sample was divided into Spanish non-migrants, Spanish migrants, non-Spanish migrants and refugees. Attitudes towards COVID-19, resilience (based on BRCS) and mental health (based on DASS-21) were measured. The results obtained can be described as follows: (i) Migrant participants indicated worse mental health than non-migrants, and within the migrant group, refugees presented worse scores; (ii) No differences were found in attitudes towards COVID-19 in any of the subgroups; (iii) A moderating effect of group was found for the relationship between resilience and mental health but not between resilience and fear of COVID-19. These results might be of great interest in making visible the vulnerability of migrants and specifically refugees, and the proposal of intervention programs based on resilience training. Full article
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21 pages, 10238 KiB  
Article
Associations between Personality Traits, Intolerance of Uncertainty, Coping Strategies, and Stress in Italian Frontline and Non-Frontline HCWs during the COVID-19 Pandemic—A Multi-Group Path-Analysis
by Ramona Bongelli, Carla Canestrari, Alessandra Fermani, Morena Muzi, Ilaria Riccioni, Alessia Bertolazzi and Roberto Burro
Healthcare 2021, 9(8), 1086; https://doi.org/10.3390/healthcare9081086 - 23 Aug 2021
Cited by 19 | Viewed by 4372
Abstract
The COVID-19 pandemic represented a very difficult physical and psychological challenge for the general population and even more for healthcare workers (HCWs). The main aim of the present study is to test whether there were significant differences between frontline and non-frontline Italian HCWs [...] Read more.
The COVID-19 pandemic represented a very difficult physical and psychological challenge for the general population and even more for healthcare workers (HCWs). The main aim of the present study is to test whether there were significant differences between frontline and non-frontline Italian HCWs concerning (a) personality traits, intolerance of uncertainty, coping strategies and perceived stress, and (b) the models of their associations. A total of 682 Italian HCWs completed a self-report questionnaire: 280 employed in COVID-19 wards and 402 in other wards. The analysis of variance omnibus test revealed significant differences between the two groups only for perceived stress, which was higher among the frontline. The multi-group path analysis revealed significant differences in the structure of the associations between the two groups of HCWs, specifically concerning the relations between: personality traits and intolerance of uncertainty; intolerance of uncertainty and coping strategies. Regarding the relation between coping strategies and stress no difference was identified between the two groups. In both of them, emotionally focused coping was negatively related with perceived stress, whereas dysfunctional coping was positively related with stress. These results could be useful in planning actions aiming to reduce stress and improve the effectiveness of HCWs’ interventions. Training programs aimed to provide HCWs with a skillset to tackle uncertain and stressful circumstances could represent an appropriate support to develop a preventive approach during outbreaks. Full article
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11 pages, 347 KiB  
Article
COVID-19 Vaccine Literacy of Family Carers for Their Older Parents in Japan
by Hiroko Costantini
Healthcare 2021, 9(8), 1038; https://doi.org/10.3390/healthcare9081038 - 12 Aug 2021
Cited by 18 | Viewed by 3473
Abstract
In super-ageing Japan, COVID-19 vaccinations were starting to reach older people as of June 2021, which raises the issue of vaccine literacy. This study focuses on family members who work and also care for their older parents, as they are at risk of [...] Read more.
In super-ageing Japan, COVID-19 vaccinations were starting to reach older people as of June 2021, which raises the issue of vaccine literacy. This study focuses on family members who work and also care for their older parents, as they are at risk of COVID-19 and also risk transmitting COVID-19 to the parents they care for and potentially influencing their parents’ vaccine uptake. Such family carers are central to the approach in Japan to achieving a sustainable and resilient society in response to ageing. Contrasting family carers’ COVID-19 vaccine literacy with their overall health literacy provides insights into their preparedness for COVID-19 vaccinations. The purpose of this study is to understand how vaccine literacy, compared to health literacy, varies across family carers and the sources of information they use. Through a cross-sectional online survey, family carers’ vaccine literacy, health literacy and their sources of information, including mass media, social media, health and care professionals, family, colleagues, friends, and others, were assessed. The participants’ (n = 292) mean age was 53, with 44% women, and an average of 8.3 h per week caring for their parents. Notwithstanding the increased risks from COVID-19 with age, COVID-19 vaccine literacy relative to health literacy for older family carers is lower on average, higher with increased provision of care, and more variable, resulting in a substantial proportion of older family carers with relatively low vaccine literacy. At this stage of vaccine rollout in Japan, family carers’ sources of information to inform COVID-19 vaccine literacy is distinct, including more national and local mass media versus less health and care professionals and informal networks, which indicates the importance of tailored health communication strategies to enhance vaccine literacy Full article
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10 pages, 629 KiB  
Article
Characteristics of COVID-19-Related Free Telephone Consultations by Public Health Nurses in Japan: A Retrospective Study
by Yuka Sumikawa, Chikako Honda, Kyoko Yoshioka-Maeda and Noriko Yamamoto-Mitani
Healthcare 2021, 9(8), 1022; https://doi.org/10.3390/healthcare9081022 - 09 Aug 2021
Cited by 4 | Viewed by 1938
Abstract
This study aimed to (1) describe the characteristics of community residents who used coronavirus disease 2019 (COVID-19)-related telephone consultation systems by public health nurses (PHNs) and (2) analyze the concerns they had during the first wave of COVID-19 in Japan. Among 1126 telephone [...] Read more.
This study aimed to (1) describe the characteristics of community residents who used coronavirus disease 2019 (COVID-19)-related telephone consultation systems by public health nurses (PHNs) and (2) analyze the concerns they had during the first wave of COVID-19 in Japan. Among 1126 telephone consultations, PHNs recorded telephone consultations between 25 March, and 30 April, 2020, in City A, Japan. We analyzed 1017 consultations involving 799 (79%) community residents (resident group) and 218 (21%) organizational representatives (organization group) located in City A. Half of the consultations were made during midmorning, and most of the consultations were regarding COVID-19 symptoms. Among the resident group, visiting a primary care doctor was the most common recommendation by the PHNs; there was no difference in provision of consultation by sex. Health- and welfare-related organizations mainly consulted PHNs about “having COVID-19-related symptoms” and “undergoing PCR testing,” and PHNs’ recommended them to visit a primary care doctor and coordinate PCR testing. The results suggest that public health centers should provide more helpful information on COVID-19 that accurately reflects the concerns of the population. Full article
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13 pages, 763 KiB  
Article
Perceptions and Preventive Practices Regarding COVID-19 Pandemic Outbreak and Oral Health Care Perceptions during the Lockdown: A Cross-Sectional Survey from Saudi Arabia
by Abdullah Alassaf, Basim Almulhim, Sara Ayid Alghamdi and Sreekanth Kumar Mallineni
Healthcare 2021, 9(8), 959; https://doi.org/10.3390/healthcare9080959 - 29 Jul 2021
Cited by 10 | Viewed by 2712
Abstract
Aims: The study aimed to evaluate perceptions and preventive practices regarding the COVID-19 pandemic and oral health care perceptions during the lockdown in the Saudi Arabian population. Materials and Method: This cross-sectional study was performed by collecting the data from individuals belonging to [...] Read more.
Aims: The study aimed to evaluate perceptions and preventive practices regarding the COVID-19 pandemic and oral health care perceptions during the lockdown in the Saudi Arabian population. Materials and Method: This cross-sectional study was performed by collecting the data from individuals belonging to various parts of the Saudi Arabian Population through an online self-reported questionnaire. The questionnaire had two main parts: first comprised of demographic data include the region of residence, gender, nationality, age, the number of family members, monthly income of the family, and the second was further divided into three sections of perception (P), practice (PRA) and oral health care practice (D) questions. All these (P, PRA, and D) were analyzed by comparing all of the demographic characteristics. Statistical analysis was performed using SPSS IBM (version 21.0), and statistical significance was set at a 5% level. Results: Overall, 2013 participants (54% males and 46% females) contributed to the Saudi Arabia study. Only 5% of non-Saudis live in Saudi Arabia were participated in the study, while the majority of participants were of 21–40 years age group (45%), 59% of having more than five family members, and 60% of them had ≤10 K Suadi riyal monthly income respectively. The majority of the participants were from Riyadh (33.7%) and Asir (25.1%) in the study. Overall, 89.5% of the participants were aware of the COVID-19 global pandemic. The majority of the participants (55%) from Saudi Arabia utilized the Ministry of Health website, a source of information regarding COVID-19. However, 56.5% of the participants had COVID-19 related perception, and 74.3% followed an appropriate preventive practice. Approximately 60% had good oral health practice. The study participants showed mixed opinions on perceptions regarding COVID-19, preventive practice, and oral health practices. Conclusion: The present study suggested that the Saudi Arabian population has good attention to COVID-19, but preventive practice and oral health perception need better awareness to control this novel virus spread. The Ministry of Health website utilized as a significant source of information among the Saudi Arabian population regarding COVID-19. Full article
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11 pages, 1453 KiB  
Article
The Effect of Post-Graduate Year Training on the Self-Efficacy and Emotional Traits of Physicians Facing the COVID-19 Pandemic
by Chih-Hung Chen, Ya-Hui Cheng, Yuan-Chi Shen, Chia-Te Kung, Peng-Chen Chien and Ching-Hua Hsieh
Healthcare 2021, 9(7), 912; https://doi.org/10.3390/healthcare9070912 - 19 Jul 2021
Viewed by 2319
Abstract
Background: Taiwan implemented the post-graduate year (PGY) training to reform the medical education system to provide holistic medical care after severe acute respiratory syndrome in 2003. In late 2019, COVID-19 quickly spread across the globe and became a pandemic crisis. This study aimed [...] Read more.
Background: Taiwan implemented the post-graduate year (PGY) training to reform the medical education system to provide holistic medical care after severe acute respiratory syndrome in 2003. In late 2019, COVID-19 quickly spread across the globe and became a pandemic crisis. This study aimed to investigate whether the establishment of the PGY training had positive effects on the self-efficacy and emotional traits of medical workers. Methods: One hundred and ten physicians, including PGY, residents, and visiting staff, were investigated using the General Self-Efficacy Scale (GSES) and Emotional Trait and State Scale (ETSS), and their feedback and suggestions were collected. An exploratory factor analysis was done to reduce the factor dimensions using the varimax rotation method, which was reduced to four factors: “the ability to cope with ease”, “proactive ability”, “negative emotion”, and “positive emotion”. A comparison with and without PGY training when facing the COVID-19 pandemic was conducted. Results: Those who had received PGY training (n = 77) were younger, had a lower grade of seniority, and had less practical experience than those who had not received PGY (n = 33). Those who had received PGY training had significantly higher scores for the factors “ability to cope with ease”, “proactive ability”, and “positive emotion” than those who had not received PGY training. Conclusion: The study revealed that PGY training may have had positive effects on the personal self-efficacy and emotional traits of physicians coping with the COVID-19 pandemic. Full article
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16 pages, 810 KiB  
Article
Testing the Multi-Theory Model (MTM) to Predict the Use of New Technology for Social Connectedness in the COVID-19 Pandemic
by Manoj Sharma, Kavita Batra and Jason Flatt
Healthcare 2021, 9(7), 838; https://doi.org/10.3390/healthcare9070838 - 01 Jul 2021
Cited by 10 | Viewed by 4057
Abstract
Loneliness or social isolation, recently described as a “behavioral epidemic,” remains a long-standing public health issue, which has worsened during the COVID-19 pandemic. The use of technology has been suggested to enhance social connectedness and to decrease the negative health outcomes associated with [...] Read more.
Loneliness or social isolation, recently described as a “behavioral epidemic,” remains a long-standing public health issue, which has worsened during the COVID-19 pandemic. The use of technology has been suggested to enhance social connectedness and to decrease the negative health outcomes associated with social isolation. However, till today, no theory-based studies were performed to examine the determinants of technology use. Therefore, the current study aims to test theory-based determinants in explaining the adoption of new technology in a nationally representative sample during the COVID-19 pandemic (n = 382). A psychometrically reliable and valid instrument based on the multi-theory model (MTM) of health behavior change was administered electronically using a cross-sectional study design. A total of 47.1% of the respondents reported high levels of social isolation, and 40.6% did not use any new technology. Among technology users (59.4%), the three initiation constructs participatory dialogue (b = 0.054, p < 0.05), behavioral confidence (b = 0.184, p < 0.001), and changes in the physical environment (b= 0.053, p < 0.05) were significant and accounted for 38.3% of the variance in the initiation of new technologies. Concerning sustenance in technology users, all three constructs emotional transformation (b = 0.115, p < 0.001), practice for change (b = 0.086, p < 0.001), and changes in the social environment (b = 0.061, p < 0.001) were significant and accounted for 42.6% of the variance in maintaining the use of new technology. MTM offers a powerful framework to design health promotion interventions encouraging the use of new technologies to foster greater social connectedness amid the COVID-19 pandemic and beyond it. Full article
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11 pages, 271 KiB  
Article
Concerns, Knowledge, and Practices of Dentists in Mexico Regarding Infection Control during the Coronavirus Disease Pandemic: A Cross-Sectional Study
by José F. Gómez-Clavel, Miguel A. Morales-Pérez, Gabriela Argumedo, Cynthia G. Trejo-Iriarte and Alejandro García-Muñoz
Healthcare 2021, 9(6), 731; https://doi.org/10.3390/healthcare9060731 - 14 Jun 2021
Cited by 4 | Viewed by 2347
Abstract
Dentists are highly exposed and vulnerable during the coronavirus disease (COVID-19) pandemic, as physical proximity to patients is necessary for effective dental examination and treatment. The objective of this study was to describe the concerns, knowledge, and infection control practices of dentists in [...] Read more.
Dentists are highly exposed and vulnerable during the coronavirus disease (COVID-19) pandemic, as physical proximity to patients is necessary for effective dental examination and treatment. The objective of this study was to describe the concerns, knowledge, and infection control practices of dentists in Mexico during the COVID-19 pandemic. In this cross-sectional study conducted from 22 May 2020 to 8 July 2020, an anonymous survey was distributed to dentists, which covered information regarding dentists’ sociodemographic and professional characteristics, clinical practices during the pandemic, and perceptions regarding the application of infection prevention and control guidance for dental settings during the COVID-19 pandemic. Out of 703 respondents, 73.1% (n = 514) were women and 53.6% (n = 377) were dentists with 1–10 years of experience. Regarding the statements issued by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), the responses for 11 survey items had total agreement rates >90% (high frequency); seven and nine items had moderate and low frequency of total agreement, respectively. Most dentists in this study agreed with the WHO and CDC statements and were concerned regarding the possibility of infection, despite using the protective gear. Full article
11 pages, 238 KiB  
Article
Face Mask Usage among Young Polish People during the COVID-19 Epidemic—An Evolving Scenario
by Radomir Reszke, Marta Szepietowska, Piotr K. Krajewski, Łukasz Matusiak, Rafał Białynicki-Birula and Jacek C. Szepietowski
Healthcare 2021, 9(6), 638; https://doi.org/10.3390/healthcare9060638 - 27 May 2021
Cited by 5 | Viewed by 3247
Abstract
The usage of face masks has been mandated in many countries in an attempt to diminish the spread of SARS-CoV-2. In this cross-sectional study, we aimed to determine face mask-wearing behaviors and practices in 1173 young Polish people during the second wave of [...] Read more.
The usage of face masks has been mandated in many countries in an attempt to diminish the spread of SARS-CoV-2. In this cross-sectional study, we aimed to determine face mask-wearing behaviors and practices in 1173 young Polish people during the second wave of the COVID-19 epidemic in October 2020. The majority of respondents (97.4%) declared that they wore face masks in areas/situations where it is mandatory. The most common types of utilized face masks were cloth masks (47.7%) and surgical masks (47%), followed by respirators (N95/FFP3) (3.2%) and half-face elastomeric respirators (0.9%). Over 38% reported frequently disinfecting their face masks, especially females. Respondents reporting personal atopic predisposition (64.5% vs. 72.1%; p = 0.02) or sensitive skin (65.5% vs. 74.3%; p = 0.005) declared multiple use of face masks less commonly than other individuals. Individuals suffering from facial skin lesions declared disinfecting face masks more commonly (40.8% vs. 34.9%; p = 0.04). Overall, the self-declared utilization of face masks among young people in Poland has improved since the beginning of the epidemic as compared with our previous study. Until the mass vaccination of the public is achieved and government policy is changed, face mask use remains a valuable tool to decrease the transmission of SARS-CoV-2. Full article
10 pages, 239 KiB  
Article
Knowledge, Protective Behaviors and Risk Perception of COVID-19 among Dental Students in India: A Cross-Sectional Analysis
by Kavita Batra, Yashashri Urankar, Ravi Batra, Aaron F. Gomes, Meru S and Pragati Kaurani
Healthcare 2021, 9(5), 574; https://doi.org/10.3390/healthcare9050574 - 13 May 2021
Cited by 31 | Viewed by 3840
Abstract
Objective: This study’s objective was to examine the knowledge, performance in practicing protective behaviors, and risk perception of Coronavirus disease-19 (COVID-19) among dental students of India. Methods: A web-based cross-sectional survey was conducted from 10–30 August 2020, involving 381 dental students that were [...] Read more.
Objective: This study’s objective was to examine the knowledge, performance in practicing protective behaviors, and risk perception of Coronavirus disease-19 (COVID-19) among dental students of India. Methods: A web-based cross-sectional survey was conducted from 10–30 August 2020, involving 381 dental students that were enrolled at the Uttaranchal Dental and Medical Research Institute in India. A web-based structured questionnaire assessed the COVID-19 related knowledge, protective behaviors, and risk perception performance. The independent-samples-t and analysis of variance tests were used to analyze the differences in knowledge, protective behaviors, and perception across the groups. Results: Of the dental students surveyed, 83% had adequate knowledge of COVID-19, and nearly 80% followed appropriate practices regarding COVID-19. The COVID-19 related risk perception was higher among females as compared to males. COVID-19 related knowledge was significantly correlated with preventive behaviors (r = 0.18; p < 0·01) and risk perception (r = 0.10; p < 0.05). We found a high score of COVID-19 related knowledge and precautionary behaviors and moderate risk perception among students. Conclusions: Knowledge and protective behaviors towards infectious diseases, such as COVID-19, have clinical applications in developing educational and formal training programs to promote adherence to the infection control practices among dental students. Clinical significance: The findings of this study will inform policymakers to emphasize on effective risk communication. Dental institutions can incorporate infection control modules in the current curriculum, thereby making future dental professionals capable of performing effective infection control management in the clinical settings. This is critical in improving their knowledge of infection control practices to minimize the risk of nosocomial infections. Full article
10 pages, 244 KiB  
Article
Work-Related Stressors among the Healthcare Professionals in the Fever Clinic Centers for Individuals with Symptoms of COVID-19
by Saad Alyahya and Fouad AboGazalah
Healthcare 2021, 9(5), 548; https://doi.org/10.3390/healthcare9050548 - 08 May 2021
Cited by 10 | Viewed by 3083
Abstract
Work-related stress can affect the quality of healthcare during the COVID-19 pandemic. This study aimed to assess the relationship between selected work-related stressors and stress levels among healthcare professionals providing preventive and curative services to people with COVID-19 symptoms in the Fever Clinics [...] Read more.
Work-related stress can affect the quality of healthcare during the COVID-19 pandemic. This study aimed to assess the relationship between selected work-related stressors and stress levels among healthcare professionals providing preventive and curative services to people with COVID-19 symptoms in the Fever Clinics in Saudi Arabia. A systematic random sampling using an online questionnaire approach was used to select healthcare professionals in the Fever Clinics in Saudi Arabia during September 2020. Participants were asked to fill out a questionnaire including data on their sociodemographic and occupational characteristics, role conflict and ambiguity, social support, and stress. The results showed that role conflict and ambiguity were significant risk factors for stress, and social support was negatively associated with stress levels. Additionally, younger and non-Saudi healthcare professionals exhibited higher stress levels than their older and Saudi counterparts. In conclusion, role conflict, ambiguity, and social support can predict the risk of stress among healthcare professionals in the Fever Clinics in Saudi Arabia. Full article
16 pages, 681 KiB  
Review
Analysis of Facilitators and Barriers to the Delivery of Routine Care during the COVID-19 Global Pandemic: A Systematic Review
by Cristian Lieneck, Brooke Herzog and Raven Krips
Healthcare 2021, 9(5), 528; https://doi.org/10.3390/healthcare9050528 - 01 May 2021
Cited by 13 | Viewed by 2509
Abstract
The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to [...] Read more.
The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues. Full article
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9 pages, 392 KiB  
Article
Student Health Implications of School Closures during the COVID-19 Pandemic: New Evidence on the Association of e-Learning, Outdoor Exercise, and Myopia
by Ji Liu, Baihuiyu Li, Qiaoyi Chen and Jingxia Dang
Healthcare 2021, 9(5), 500; https://doi.org/10.3390/healthcare9050500 - 23 Apr 2021
Cited by 32 | Viewed by 4895
Abstract
The coronavirus disease 2019 (COVID-19) pandemic forced many education systems to consider alternative remote e-learning modalities, which have consequential behavioral and health implications for youth. In particular, increased e-learning engagement with digital screens and reduction in outdoor activities are two likely channels posing [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic forced many education systems to consider alternative remote e-learning modalities, which have consequential behavioral and health implications for youth. In particular, increased e-learning engagement with digital screens and reduction in outdoor activities are two likely channels posing adverse risks for myopia development. This study investigated the association between e-learning screen use, outdoor activity, lighting condition, and myopia development among school-age children in China, during the first wave of the COVID-19 pandemic. Data were collected from 3405 school-age children attending primary, lower-secondary, and upper-secondary schools in China. Univariate parametric and nonparametric tests, and multivariate logistic regression analysis were used. Findings show that each diopter hour increase in daily e-learning screen use is significantly associated with progression of myopia symptoms (OR: 1.074, 95% CI: 1.058–1.089; p < 0.001), whereas engaging in outdoor exercise four to six times per week (OR: 0.745, 95% CI: 0.568–0.977; p = 0.034) and one to three times per week (OR: 0.829, 95% CI: 0.686–0.991; p = 0.048) is associated with a lower likelihood of myopia progression than none at all. In addition, we found that indoor lighting that is either “too dim” (OR: 1.686, 95% CI: 1.226–2.319; p = 0.001) or “too bright” (OR: 1.529, 95% CI: 1.007–2.366; p = 0.036) is significantly associated higher likelihood of myopic symptoms. Findings in this study uncover the less observable vision consequences of the COVID-19 pandemic on youths through digital online learning and highlight the importance of considering appropriate mitigation strategies to deal with this emerging public health challenge. Full article
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15 pages, 2466 KiB  
Article
Older Adults’ Avoidance of Public Transportation after the Outbreak of COVID-19: Korean Subway Evidence
by Byungjin Park and Joonmo Cho
Healthcare 2021, 9(4), 448; https://doi.org/10.3390/healthcare9040448 - 11 Apr 2021
Cited by 18 | Viewed by 3152
Abstract
With the spread of the coronavirus worldwide, nations have implemented policies restricting the movement of people to minimize the possibility of infection. Although voluntary restriction is a key factor in reducing mobility, it has only been emphasized in terms of the effect of [...] Read more.
With the spread of the coronavirus worldwide, nations have implemented policies restricting the movement of people to minimize the possibility of infection. Although voluntary restriction is a key factor in reducing mobility, it has only been emphasized in terms of the effect of governments’ mobility restriction measures. This research aimed to analyze voluntary mass transportation use after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak by age group to explore how the perception of the risk of infection affected the public transit system. Mass transportation big data of Seoul Metro transportation use in the capital city of Korea was employed for panel analyses. The analysis results showed that in the period with both the highest and lowest number of infections of SARS-CoV-2, users aged 65 years and over reduced their subway use more than people aged between 20 and 64. This study also found that the decrease in subway use caused by the sharp increase of coronavirus disease 2019 (COVID-19) cases was the most prominent among people aged 65 years and over. The results imply that the elders’ avoidance of public transportation affected their daily lives, consumption, and production activities, as well as their mobility. Full article
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9 pages, 233 KiB  
Article
The Psychological Symptoms of College Student in China during the Lockdown of COVID-19 Epidemic
by Yin Li, Linbo Qin, Yaobin Shi and Jun Han
Healthcare 2021, 9(4), 447; https://doi.org/10.3390/healthcare9040447 - 11 Apr 2021
Cited by 8 | Viewed by 2236
Abstract
The COVID-19 epidemic has had a huge impact on the mental state of human beings due to its high infection and fatality rates in early 2020. In this paper, a cross-sectional online survey was designed to understand the mental state of college students [...] Read more.
The COVID-19 epidemic has had a huge impact on the mental state of human beings due to its high infection and fatality rates in early 2020. In this paper, a cross-sectional online survey was designed to understand the mental state of college students in a university located in Wuhan city during the lockdown. Out of 1168 respondents, above 50% participants had obvious fear and anxiety symptoms; anxiety and fear were 61.64% and 58.39%, respectively. Conformity (49.49%), invulnerability (26.11%), insensitivity (21.49%) and rebelliousness (12.41%) symptoms also appeared. Meanwhile, it was revealed that the senior students experienced more anxiety than the freshmen. Moreover, it was found that the psychological symptoms (except for the insensitivity symptom) had no significant difference in gender, residence and annual household income after the one-way analysis of variance. Full article
17 pages, 3240 KiB  
Article
Development of a Novel Design and Subsequent Fabrication of an Automated Touchless Hand Sanitizer Dispenser to Reduce the Spread of Contagious Diseases
by Arnab Das, Adittya Barua, Md. Ajwad Mohimin, Jainal Abedin, Mayeen Uddin Khandaker and Kholoud S. Al-mugren
Healthcare 2021, 9(4), 445; https://doi.org/10.3390/healthcare9040445 - 10 Apr 2021
Cited by 17 | Viewed by 16159
Abstract
Background: The use of a touchless automated hand sanitizer dispenser may play a key role to reduce contagious diseases. The key problem of the conventional ultrasonic and infra-red-based dispensers is their malfunctioning due to the interference of sunlight, vehicle sound, etc. when deployed [...] Read more.
Background: The use of a touchless automated hand sanitizer dispenser may play a key role to reduce contagious diseases. The key problem of the conventional ultrasonic and infra-red-based dispensers is their malfunctioning due to the interference of sunlight, vehicle sound, etc. when deployed in busy public places. To overcome such limitations, this study introduced a laser-based sensing device to dispense sanitizer in an automated touchless process. Method: The dispensing system is based on an Arduino circuit breadboard where an ATmega328p microcontroller was pre-installed. To sense the proximity, a light-dependent resistor (LDR) is used where the laser light is to be blocked after the placement of human hands, hence produced a sharp decrease in the LDR sensor value. Once the LDR sensor value exceeds the lower threshold, the pump is actuated by the microcontroller, and the sanitizer dispenses through the nozzle. Results and discussion: A novel design and subsequent fabrication of a low-cost, touchless, automated sanitizer dispenser to be used in public places, was demonstrated. The overall performance of the manufactured device was analyzed based on the cost and power consumption, and environmental factors by deploying it in busy public places as well as in indoor environment in major cities in Bangladesh, and found to be more efficient and cost-effective compared to other dispensers available in the market. A comprehensive discussion on this unique design compared to the conventional ultrasonic and infra-red based dispensers, is presented to show its suitability over the commercial ones. The guidelines of the World Health Organization are followed for the preparation of sanitizer liquid. A clear demonstration of the circuitry connections is presented herein, which facilitates the interested individual to manufacture a cost-effective dispenser device in a relatively short time and use it accordingly. Conclusion: This study reveals that the LDR-based automated hand sanitizer dispenser system is a novel concept, and it is cost-effective compared to the conventional ones. The presented device is expected to play a key role in contactless hand disinfection in public places, and reduce the spread of infectious diseases in society. Full article
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10 pages, 2826 KiB  
Article
Application of Artificial Intelligence in COVID-19 Pandemic: Bibliometric Analysis
by Md. Mohaimenul Islam, Tahmina Nasrin Poly, Belal Alsinglawi, Li-Fong Lin, Shuo-Chen Chien, Ju-Chi Liu and Wen-Shan Jian
Healthcare 2021, 9(4), 441; https://doi.org/10.3390/healthcare9040441 - 09 Apr 2021
Cited by 31 | Viewed by 4782
Abstract
The application of artificial intelligence (AI) to health has increased, including to COVID-19. This study aimed to provide a clear overview of COVID-19-related AI publication trends using longitudinal bibliometric analysis. A systematic literature search was conducted on the Web of Science for English [...] Read more.
The application of artificial intelligence (AI) to health has increased, including to COVID-19. This study aimed to provide a clear overview of COVID-19-related AI publication trends using longitudinal bibliometric analysis. A systematic literature search was conducted on the Web of Science for English language peer-reviewed articles related to AI application to COVID-19. A search strategy was developed to collect relevant articles and extracted bibliographic information (e.g., country, research area, sources, and author). VOSviewer (Leiden University) and Bibliometrix (R package) were used to visualize the co-occurrence networks of authors, sources, countries, institutions, global collaborations, citations, co-citations, and keywords. We included 729 research articles on the application of AI to COVID-19 published between 2020 and 2021. PLOS One (33/729, 4.52%), Chaos Solution Fractals (29/729, 3.97%), and Journal of Medical Internet Research (29/729, 3.97%) were the most common journals publishing these articles. The Republic of China (190/729, 26.06%), the USA (173/729, 23.73%), and India (92/729, 12.62%) were the most prolific countries of origin. The Huazhong University of Science and Technology, Wuhan University, and the Chinese Academy of Sciences were the most productive institutions. This is the first study to show a comprehensive picture of the global efforts to address COVID-19 using AI. The findings of this study also provide insights and research directions for academic researchers, policymakers, and healthcare practitioners who wish to collaborate in these domains in the future. Full article
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10 pages, 1163 KiB  
Project Report
An Experimental Education Project for Consultations of Older Adults during the Pandemic and Healthcare Lockdown
by Agnieszka Neumann-Podczaska, Mikołaj Seostianin, Konrad Madejczyk, Piotr Merks, Urszula Religioni, Zofia Tomczak, Sławomir Tobis, Daniela Claudia Moga, Melody Ryan and Katarzyna Wieczorowska-Tobis
Healthcare 2021, 9(4), 425; https://doi.org/10.3390/healthcare9040425 - 06 Apr 2021
Cited by 10 | Viewed by 2422
Abstract
Objective: To develop a mentor-supervised, interprofessional, geriatric telemedicine experiential education project in response to the COVID-19 pandemic. Method: Medical and pharmacy students collaborated via remote consultations to address the coexistence of multimorbidity and polypharmacy in geriatric patients. In-depth interviews of students and patients [...] Read more.
Objective: To develop a mentor-supervised, interprofessional, geriatric telemedicine experiential education project in response to the COVID-19 pandemic. Method: Medical and pharmacy students collaborated via remote consultations to address the coexistence of multimorbidity and polypharmacy in geriatric patients. In-depth interviews of students and patients as well as Likert scale-based telephonic survey were performed for a comprehensive evaluation of the project’s significance. Results: To date, 49 consultations have been conducted. Remote consultations performed by medical and pharmacy students working collaboratively were beneficial for both students, participants. Conclusions and Practice Implications: This experimental education project provided students with authentic challenges while simultaneously delivering care to the older adults who are susceptible to disruption of care associated with the pandemic. Further development and expanded implementation of such approaches may be a post-pandemic practice to provide more accessible care for senior patients while incorporating interprofessional education. Full article
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8 pages, 234 KiB  
Article
The ICF Classification as a Simple Tool to Aid in the Assessment of Healthcare Services in a Non-COVID-19 Hospital during the COVID-19 Pandemic
by Mateusz Lucki, Agnieszka Wareńczak, Ewa Chlebuś, Przemysław Daroszewski and Przemysław Lisiński
Healthcare 2021, 9(4), 398; https://doi.org/10.3390/healthcare9040398 - 01 Apr 2021
Cited by 5 | Viewed by 1646
Abstract
The COVID-19 pandemic has had a significant impact on the operation of medical facilities. In this period, they have seen increased absence of medical staff from work, a decrease in the number of hospitalizations and in the value of healthcare services provided. We [...] Read more.
The COVID-19 pandemic has had a significant impact on the operation of medical facilities. In this period, they have seen increased absence of medical staff from work, a decrease in the number of hospitalizations and in the value of healthcare services provided. We assess the impact of this pandemic on the operation of a non-COVID-19 orthopedic and rehabilitation hospital using International Classification of Functioning, Disability and Health (ICF) categories. The authors analyzed these parameters in relation to the operation of a non-COVID-19 orthopedic, rehabilitation and rheumatological hospital in Q1 2020 compared to Q1 2019. For the analysis, the categories and qualifiers of the ICF were used, allowing for a simple and easily readable data analysis. In March 2020, in comparison to March 2019, the average working time of medical workers (p < 0.001) and the number of hospitalizations (p < 0.034) decreased significantly. In April 2020, compared to April 2019, the average working time of medical workers (<0.001) and the number of hospitalizations (0.002) also decreased significantly. In addition, in April 2020, the percentage value of the contracted services provided decreased significantly (p = 0.017), which was not observed in March of that year. The COVID-19 pandemic has affected the operation of a non-COVID-19 hospital, causing an increase in staff absences from work, a decrease in the number of hospitalizations and a decrease in the value of the revenue generated from health services provided. The ICF is a useful tool for the evaluation of a hospital’s healthcare services. Full article
13 pages, 514 KiB  
Article
Prevention and Control of COVID-19 Pandemic on International Cruise Ships: The Legal Controversies
by Xiaohan Zhang and Chao Wang
Healthcare 2021, 9(3), 281; https://doi.org/10.3390/healthcare9030281 - 04 Mar 2021
Cited by 9 | Viewed by 3938
Abstract
During the COVID-19 pandemic in 2020, a number of international cruise ships were infected, thereby resulting in serious public health and human rights problems. Multiple difficulties were encountered in the prevention and control of the coronavirus disease onboard ships, while rule-based international cooperation [...] Read more.
During the COVID-19 pandemic in 2020, a number of international cruise ships were infected, thereby resulting in serious public health and human rights problems. Multiple difficulties were encountered in the prevention and control of the coronavirus disease onboard ships, while rule-based international cooperation in this regard appeared inefficient and ineffective. By applying interdisciplinary methodologies, including empirical research of law, policy science, and health studies, this research reviewed the legal difficulties in the prevention and control of COVID-19 on international cruise ships and sought solutions from a policy-making and strategic perspective. We found that, apart from the inherent nature of cruise ships such as crowded semi-enclosed areas, shared sanitary facilities and limited medical resources, there are also nonnegligible legal reasons affecting the effectiveness of containment measures on board. In particular, there is ambiguity and even inconsistency of relevant international norms and domestic regulations, and some of the key rules are neither mandatory nor enforceable. We conclude by suggesting that rule-based international cooperation on this issue must be strengthened with respect to information sharing and management, a more effective supervisory mechanism, clarification of key rules over jurisdiction and distributions of obligations among the port states, flag states, nationality states, and cruise ship companies. Full article
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17 pages, 1805 KiB  
Article
Forecasting COVID-19 Confirmed Cases Using Empirical Data Analysis in Korea
by Da Hye Lee, Youn Su Kim, Young Youp Koh, Kwang Yoon Song and In Hong Chang
Healthcare 2021, 9(3), 254; https://doi.org/10.3390/healthcare9030254 - 01 Mar 2021
Cited by 11 | Viewed by 2467
Abstract
From November to December 2020, the third wave of COVID-19 cases in Korea is ongoing. The government increased Seoul’s social distancing to the 2.5 level, and the number of confirmed cases is increasing daily. Due to a shortage of hospital beds, treatment is [...] Read more.
From November to December 2020, the third wave of COVID-19 cases in Korea is ongoing. The government increased Seoul’s social distancing to the 2.5 level, and the number of confirmed cases is increasing daily. Due to a shortage of hospital beds, treatment is difficult. Furthermore, gatherings at the end of the year and the beginning of next year are expected to worsen the effects. The purpose of this paper is to emphasize the importance of prediction timing rather than prediction of the number of confirmed cases. Thus, in this study, five groups were set according to minimum, maximum, and high variability. Through empirical data analysis, the groups were subdivided into a total of 19 cases. The cumulative number of COVID-19 confirmed cases is predicted using the auto regressive integrated moving average (ARIMA) model and compared with the actual number of confirmed cases. Through group and case-by-case prediction, forecasts can accurately determine decreasing and increasing trends. To prevent further spread of COVID-19, urgent and strong government restrictions are needed. This study will help the government and the Korea Disease Control and Prevention Agency (KDCA) to respond systematically to a future surge in confirmed cases. Full article
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18 pages, 3003 KiB  
Article
Assessing the Psychological Impact of COVID-19 among College Students: An Evidence of 15 Countries
by Kavita Batra, Manoj Sharma, Ravi Batra, Tejinder Pal Singh and Nena Schvaneveldt
Healthcare 2021, 9(2), 222; https://doi.org/10.3390/healthcare9020222 - 17 Feb 2021
Cited by 109 | Viewed by 12045
Abstract
Mental health issues among college students is a leading public health concern, which seems to have been exacerbating during the COVID-19 pandemic. While previous estimates related to psychological burden among college students are available, quantitative synthesis of available data still needs to be [...] Read more.
Mental health issues among college students is a leading public health concern, which seems to have been exacerbating during the COVID-19 pandemic. While previous estimates related to psychological burden among college students are available, quantitative synthesis of available data still needs to be performed. Therefore, this meta-analysis endeavors to present collective evidence discussing the psychological impact of COVID-19 among college students. Bibliographical library databases, including Embase, Medline, CINAHL, Scopus, and PsycINFO, were systematically searched for relevant studies. Titles, abstracts, and full articles were screened, and two reviewers extracted data. Heterogeneity was assessed by I2 statistic. The random-effects model was utilized to obtain the pooled estimates of psychological indicators among college students. Location, gender, level of severity, and quality scores were used as moderator variables for subgroup analyses. Funnel plot and Egger linear regression test was used to assess publication bias. Twenty-seven studies constituting 90,879 college students met the inclusion criteria. The results indicated 39.4% anxiety (95% CI: 28.6, 51.3; I2 = 99.8%; p-value < 0.0001) and 31.2% depression (95% CI: 19.7, 45.6; I2= 99.8%, p < 0.0001) among college students. The pooled prevalence of stress (26.0%), post-traumatic stress disorder (29.8%), and impaired sleep quality (50.5%) were also reported. College students bear a disproportionate burden of mental health problems worldwide, with females having higher anxiety and depression levels than males. This study‘’s findings underscore the need to develop appropriate public health interventions to address college students’ emotional and psychosocial needs. The policies should be reflective of demographic and socioeconomic differentials. Full article
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11 pages, 369 KiB  
Article
Assessment of Awareness and Knowledge on Novel Coronavirus (COVID-19) Pandemic among Seafarers
by Gopi Battineni, Getu Gamo Sagaro, Nalini Chintalapudi, Marzio Di Canio and Francesco Amenta
Healthcare 2021, 9(2), 120; https://doi.org/10.3390/healthcare9020120 - 25 Jan 2021
Cited by 21 | Viewed by 5082
Abstract
Background: The ongoing pandemic due to the novel coronavirus (COVID-19) is becoming a serious global threat. Experts suggest that the infection can be controlled by immediate prevention measures. Sailing is one of the occupational categories more vulnerable to this virus outbreak due [...] Read more.
Background: The ongoing pandemic due to the novel coronavirus (COVID-19) is becoming a serious global threat. Experts suggest that the infection can be controlled by immediate prevention measures. Sailing is one of the occupational categories more vulnerable to this virus outbreak due to the proximity of the working conditions. Objective: Awareness and knowledge assessments of seafarers towards the current epidemic is mandatory to understand the effectiveness and success of the infection control measures adopted by shipping companies. Methods: In this study, we presented an online questionnaire survey to determine the knowledge levels of COVID-19 among seafarers. The data were collected by self-reported survey, and analysis was done by the analysis of variance (ANOVA). The t-test was used to understand the knowledge attitude differences to COVID-19 among different occupational groups of seafarers, and the p-value ≤ of 0.05 was considered statistically significant. Results: Among 1,458 responses received, 92.82% had a college or university degree. The results reported that the mean COVID-19 knowledge score was 5.82 (standard deviation = 0.51, range 0–6), and the overall correct percentage was 97%. There was a statistically significant difference between age groups (F (4, 1453) = 5.44, p < 0.001) and educational groups (F (4, 1453) = 1.52, p < 0.001). The knowledge score was not significantly different across the educational status of the participants (F (2, 1455) = 1.52, p = 0.220). Conclusions: The present study highlighted good knowledge and behaviours among sailors about COVID-19. However, shipping companies need to come up with new campaigns to hold optimistic practices and suitable guidelines on ships, including cruise boats, to keep sea workers always alert and collaborative in mitigating the spread of COVID-19. Full article
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10 pages, 455 KiB  
Article
Determinants of Behavioral Changes Since COVID-19 among Middle School Students
by Jaewon Lee, Jennifer Allen, Hyejung Lim and Gyuhyun Choi
Healthcare 2021, 9(1), 75; https://doi.org/10.3390/healthcare9010075 - 14 Jan 2021
Cited by 9 | Viewed by 3583
Abstract
Middle school students are of particular interest when examining the impact of the COVID-19 pandemic because they are in a formative period for socioemotional development, and because they are not as mature as adults, making them more vulnerable to the effects of the [...] Read more.
Middle school students are of particular interest when examining the impact of the COVID-19 pandemic because they are in a formative period for socioemotional development, and because they are not as mature as adults, making them more vulnerable to the effects of the current pandemic. This study seeks to examine determinants of protective behavior changes since COVID-19 among middle school students. Participants were recruited through an official online flatform used by public schools. The final sample included 328 middle school students in South Korea. A multiple linear regression was conducted to explore what factors influence protective behavior changes since COVID-19. Gender and health status were associated with protective behavior changes since COVID-19. Family satisfaction was positively associated with protective behavior changes. Levels of sanitation since COVID-19 and perceptions regarding the risk of COVID-19 were significantly related to protective behavior changes. This study suggests to consider three factors–individual, family, and environmental—in order to prevent middle school students from contracting and spreading the virus. Full article
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15 pages, 274 KiB  
Article
Explaining Handwashing Behavior in a Sample of College Students during COVID-19 Pandemic Using the Multi-Theory Model (MTM) of Health Behavior Change: A Single Institutional Cross-Sectional Survey
by Manoj Sharma, Kavita Batra, Robert E. Davis and Amanda H. Wilkerson
Healthcare 2021, 9(1), 55; https://doi.org/10.3390/healthcare9010055 - 06 Jan 2021
Cited by 33 | Viewed by 5120
Abstract
Amidst the COVID-19 pandemic, handwashing offers a simple and effective hygienic measure for disease prevention. Reportedly, a significant proportion of college students did not follow handwashing recommendations provided by the Centers for Disease Control and Prevention (CDC) in the pre-COVID era. The purpose [...] Read more.
Amidst the COVID-19 pandemic, handwashing offers a simple and effective hygienic measure for disease prevention. Reportedly, a significant proportion of college students did not follow handwashing recommendations provided by the Centers for Disease Control and Prevention (CDC) in the pre-COVID era. The purpose of this cross-sectional study was to explore and explain the handwashing behavior among college students during the COVID-19 pandemic using a contemporary fourth-generation multi-theory model (MTM) of health behavior change. Data were collected from 713 college students at a large public university in the Southern U.S. in October 2020 using a validated 36-item survey. Statistical analyses included independent samples t-tests, Pearson correlation, and hierarchical regression modeling. Among students not following handwashing recommendations, the constructs of participatory dialogue (β = 0.152; p < 0.05) and behavioral confidence (β = 0.474; p < 0.0001) were statistically significant and accounted for 27.2% of the variance in the likelihood of initiation of the behavior. Additionally, the constructs of emotional transformation (β = 0.330; p < 0.0001), practice for change (β = 0.296; p < 0.0001), and changes in the social environment (β = 0.180; p < 0.05) were statistically significant and accounted for 45.1% of the variance in the likelihood of sustaining handwashing behavior. This study highlights the applicability and usability of the MTM in designing and testing behavior change interventions and media messaging in campaigns targeting college students. Full article
8 pages, 867 KiB  
Article
Lack of Antibodies to SARS-CoV-2 among Blood Donors during COVID-19 Lockdown: A Study from Saudi Arabia
by Thamir A. Alandijany, Sherif A. El-Kafrawy, Abrar A. Al-Ghamdi, Fadi S. Qashqari, Arwa A. Faizo, Ahmed M. Tolah, Ahmed M. Hassan, Sayed S. Sohrab, Salwa I. Hindawi, Maha A. Badawi and Esam I. Azhar
Healthcare 2021, 9(1), 51; https://doi.org/10.3390/healthcare9010051 - 05 Jan 2021
Cited by 12 | Viewed by 3216
Abstract
In response to the coronavirus disease 2019 (COVID-19), Saudi Arabia have imposed timely restrictions to minimize the infection spread, lower the risk for vulnerable groups, and reduce the pressure on healthcare services. The effectiveness of these measures has not been assessed comprehensively and, [...] Read more.
In response to the coronavirus disease 2019 (COVID-19), Saudi Arabia have imposed timely restrictions to minimize the infection spread, lower the risk for vulnerable groups, and reduce the pressure on healthcare services. The effectiveness of these measures has not been assessed comprehensively and, thereby, remains uncertain. Besides monitoring the number of COVID-19 cases diagnosed by molecular assays, the seroprevalence can serve as an indicator for the incidence rate among the general population. This study aimed to evaluate seroprevalence status of all healthy blood donors who attended one of the main largest hospital located in the western region of Saudi Arabia from 1 January to 31 May 2020. The study period covered two months prior to reporting the first COVID-19 case in the country on 2 March 2020. Importantly, it covered the period when “lock-down type” measures have been enforced. Samples were subjected to in-house enzyme-linked immunosorbent assay (ELISA), chemiluminescence immunoassay (CLIA), and microneutralization (MN). The sero statuses of all samples were confirmed negative, demonstrating the lack of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among blood donors during COVID-19 lockdown period. This study supports the hypothesis that COVID-19 restrictions have potential for limiting the extent of the infection. Full article
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9 pages, 1144 KiB  
Article
Postponed Dental Visits during the COVID-19 Pandemic and their Correlates. Evidence from the Nationally Representative COVID-19 Snapshot Monitoring in Germany (COSMO)
by André Hajek, Freia De Bock, Lena Huebl, Benedikt Kretzler and Hans-Helmut König
Healthcare 2021, 9(1), 50; https://doi.org/10.3390/healthcare9010050 - 05 Jan 2021
Cited by 23 | Viewed by 3376
Abstract
(1) Background: The COVID-19 pandemic is accompanied by various societal and economic challenges. Furthermore, it is associated with major health challenges. Oral health is a key component of health. Therefore, both curative and preventive dental visits are important during pandemics. Since there is [...] Read more.
(1) Background: The COVID-19 pandemic is accompanied by various societal and economic challenges. Furthermore, it is associated with major health challenges. Oral health is a key component of health. Therefore, both curative and preventive dental visits are important during pandemics. Since there is a lack of nationally representative studies focusing on postponed dental visits and their correlates during the COVID-19 pandemic, we aimed to fill this gap in knowledge; (2) Methods: Cross-sectional data (wave 17) were collected from a nationally representative online-survey (COVID-19 Snapshot Monitoring in Germany (COSMO)) conducted in July 2020. The analytical sample consisted of 974 individuals (average age was 45.9 years (SD: 16.5, from 18 to 74 years)). The outcome measure was postponed dental visits since March 2020 (yes; no) due to the COVID-19 pandemic. Furthermore, the type of postponed dental visits was recorded (check-up/regular dental examination; pain/dental complaints; planned therapy); (3) Results: 22% of participants reported to have postponed dental visits due to the COVID-19 pandemic since March 2020, whereas 78% of individuals did not report postponed visits (“no, attended as planned”: 29.2%; “no, examining pending”: 44.9%; “no, other reasons”: 3.9%). Among individuals who reported postponed dental visits, 72% postponed a “check-up/regular dental examination”, whereas 8.4% postponed a dental visit despite “pain/dental complaints” and 19.6% postponed “planned therapy”. Furthermore, multiple logistic regressions showed that the likelihood of postponed dental visits was positively associated with being younger (aged 65 and older, OR: 0.43, 95% CI: 0.22–0.85; compared to individuals 18 to 29 years), and higher affect regarding COVID-19 (OR: 1.36, 95% CI: 1.13–1.64); (4) Conclusions: Our study showed that more than one out of five individuals postponed a dental visit—particularly check-ups and regular dental examination—due to the COVID-19 pandemic since March 2020. Several correlates of these postponed visits have been identified. This may help identify and address individuals at risk for deterioration of oral health amplified by postponed dental visits. Full article
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10 pages, 1899 KiB  
Article
A Direct Method for RT-PCR Detection of SARS-CoV-2 in Clinical Samples
by Sherif A. El-Kafrawy, Mai M. El-Daly, Ahmed M. Hassan, Reham M. Kaki, Adel M. Abuzenadah, Mohammad A. Kamal and Esam I. Azhar
Healthcare 2021, 9(1), 37; https://doi.org/10.3390/healthcare9010037 - 04 Jan 2021
Cited by 11 | Viewed by 4001
Abstract
Introduction: the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic of acute respiratory disease (COVID-19). SARS-CoV-2 is a positive-strand RNA virus and its genomic characterization has played a vital role in the design of appropriate diagnostics tests. [...] Read more.
Introduction: the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic of acute respiratory disease (COVID-19). SARS-CoV-2 is a positive-strand RNA virus and its genomic characterization has played a vital role in the design of appropriate diagnostics tests. The current RT-PCR protocol for SARS-CoV-2 detects two regions of the viral genome, requiring RNA extraction and several hours. There is a need for fast, simple, and cost-effective detection strategies. Methods: we optimized a protocol for direct RT-PCR detection of SARS-CoV-2 without the need for nucleic acid extraction. Nasopharyngeal samples were diluted to 1:3 using diethyl pyrocarbonate (DEPC)-treated water. The diluted samples were incubated at 95 °C for 5 min in a thermal cycler, followed by a cooling step at 4 °C for 5 min. Samples then underwent reverse transcription real-time RT-PCR in the E and RdRp genes. Results: our direct detection protocol showed 100% concordance with the standard protocol with an average Ct value difference of 4.38 for the E region and 3.85 for the RdRp region. Conclusion: the direct PCR technique was found to be a reliable and sensitive method that can be used to reduce the time and cost of the assay by removing the need for RNA extraction. It enables the use of the assay in research, diagnostics, and screening for COVID-19 in regions with fewer economic resources, where supplies are more limited allowing for wider use for screening. Full article
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9 pages, 1053 KiB  
Article
Impact of the COVID-19 Pandemic on Manual Therapy Service Utilization within the Australian Private Healthcare Setting
by Reidar P. Lystad, Benjamin T. Brown, Michael S. Swain and Roger M. Engel
Healthcare 2020, 8(4), 558; https://doi.org/10.3390/healthcare8040558 - 13 Dec 2020
Cited by 15 | Viewed by 3716
Abstract
The COVID-19 pandemic has impacted a wide range of health services. This study aimed to quantify the impact of the COVID-19 pandemic on manual therapy service utilization within the Australian private healthcare setting during the first half of 2020. Quarterly data regarding the [...] Read more.
The COVID-19 pandemic has impacted a wide range of health services. This study aimed to quantify the impact of the COVID-19 pandemic on manual therapy service utilization within the Australian private healthcare setting during the first half of 2020. Quarterly data regarding the number and total cost of services provided were extracted for each manual therapy profession (i.e., chiropractic, osteopathy, and physiotherapy) for the period January 2015 to June 2020 from the Australian Prudential Regulation Authority. Time series forecasting methods were used to estimate absolute and relative differences between the forecasted and observed values of service utilization. An estimated 1.3 million (13.2%) fewer manual therapy services, with a total cost of AUD 84 million, were provided within the Australian private healthcare setting during the first half of 2020. Reduction in service utilization was considerably larger in the second quarter (21.7%) than in the first quarter (5.7%), and was larger in physiotherapy (20.6%) and osteopathy (12.7%) than in chiropractic (5.2%). The impact varied across states and territories, with the largest reductions in service utilization observed in New South Wales (17.5%), Australian Capital Territory (16.3%), and Victoria (16.2%). The COVID-19 pandemic has had a profound impact on manual therapy service utilization in Australia. The magnitude of the decline in service utilization varied considerably across professions and locations. The long-term consequences of this decline in manual therapy utilization remain to be determined. Full article
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10 pages, 215 KiB  
Article
COVID-19 and Psychological Health of Female Saudi Arabian Population: A Cross-Sectional Study
by Syed Mohammed Basheeruddin Asdaq, Sara Abdulrahman Alajlan, Yahya Mohzari, Mohammed Asad, Ahmad Alamer, Ahmed A. Alrashed, Naira Nayeem and Sreeharsha Nagaraja
Healthcare 2020, 8(4), 542; https://doi.org/10.3390/healthcare8040542 - 09 Dec 2020
Cited by 9 | Viewed by 2393
Abstract
The influence of the COVID-19 pandemic is unprecedented on physical and mental health. This study aimed to determine the impact of the COVID-19 event on mental health among Saudi Arabian females of Riyadh by a cross-sectional study design. The samples of the study [...] Read more.
The influence of the COVID-19 pandemic is unprecedented on physical and mental health. This study aimed to determine the impact of the COVID-19 event on mental health among Saudi Arabian females of Riyadh by a cross-sectional study design. The samples of the study were recruited using convenience and snowball sampling methods. The questionnaire is composed of items related to sociodemographic profile, general mental status, negative attitude scale, impact of event (COVID-19 pandemic) scale (R) and negative health impact. The data obtained were analyzed using multivariate regression analysis. Out of the 797 samples (34.58 ± 12.89 years), 457 (57.34%) belonged to an age group of ≥25 years. The average BMI of the participants was 26.73 (kg/m2). Significantly (p = 0.000), a large proportion of the participants were overweight and unemployed. Age group (>25 years) have more odds for abnormal mental status (OR; 1.592), development of negative attitudes (OR; 1.986), the intense impact of COVID-19 events (OR; 1.444) and susceptibility to attain negative health impacts (OR; 1.574). High body weight is another risk factor for altered mental status, negative attitude and developing impact of COVID-19 quickly. Overall, the COVID-19 pandemic was directly associated with stress (53%), anxiety (63%) and depression (44%) in our sample population. There is an urgent need for psychological counseling for the distressed population. Full article
10 pages, 688 KiB  
Article
Echocardiography Abnormal Findings and Laboratory Operations during the COVID-19 Pandemic at a High Volume Center in New York City
by Li Pang, Eric P. Stahl, Kana Fujikura, Michelle Chen, Weijia Li, Ming Zhang, Jeffrey M. Levsky, Mark I. Travin, Edwin C. Ho, Ythan Goldberg and Cynthia C. Taub
Healthcare 2020, 8(4), 534; https://doi.org/10.3390/healthcare8040534 - 03 Dec 2020
Cited by 3 | Viewed by 2100
Abstract
(1) Background: This study sought to explore how the novel coronavirus (COVID-19) pandemic affected the echocardiography (TTE) laboratory operations at a high volume medical center in New York City. Changes in cardiac imaging study volume, turn-around time, and abnormal findings were analyzed and [...] Read more.
(1) Background: This study sought to explore how the novel coronavirus (COVID-19) pandemic affected the echocardiography (TTE) laboratory operations at a high volume medical center in New York City. Changes in cardiac imaging study volume, turn-around time, and abnormal findings were analyzed and compared to a pre-pandemic period. (2) Methods: Volume of all cardiac imaging studies and TTE reports between 11 March 2020 to 5 May 2020 and the same calendar period in 2019 were retrospectively identified and compared. (3) Results: During the pandemic, our center experienced a 46.72% reduction in TTEs, 82.47% reduction in transesophageal echocardiograms, 83.16% reduction in stress echo, 70.32% reduction in nuclear tests, 46.25% reduction in calcium score, 73.91% reduction in coronary computed tomography angiography, and 87.23% reduction in cardiac magnetic resonance imaging. TTE findings were overall similar between 2020 and 2019 (all p ≥ 0.05), except for a significantly higher right ventricular systolic pressure in 2020 (39.8 ± 14.2 vs. 34.6 ± 11.2 mmHg, p = 0.012). (4) Conclusions: Despite encountering an influx of critically ill patients, our hospital center experienced a reduction in the number of cardiac imaging studies, which likely represents a change in both patient mindset and physician management approach. Full article
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9 pages, 230 KiB  
Article
Clinical Characteristics of the COVID-19 Patients with Pneumonia Detected by Computerized Tomography but Negative for Infiltration by X-ray
by Dilaram Acharya, Jungi Park, Yebong Lee, In Suk Hamm, Dong Seok Lee, Seong-Su Moon and Kwan Lee
Healthcare 2020, 8(4), 518; https://doi.org/10.3390/healthcare8040518 - 29 Nov 2020
Cited by 2 | Viewed by 2621
Abstract
Coronavirus Disease 2019 (COVID-19) has rapidly spread to all corners of the globe. Different diagnostic tools, such as Chest X-ray (CXR), lung ultrasound (LUS), and computerized tomography (CT), have been used to detect active pneumonic lesions associated with COVID-19 with their varying degrees [...] Read more.
Coronavirus Disease 2019 (COVID-19) has rapidly spread to all corners of the globe. Different diagnostic tools, such as Chest X-ray (CXR), lung ultrasound (LUS), and computerized tomography (CT), have been used to detect active pneumonic lesions associated with COVID-19 with their varying degrees of sensitivity and specificity. This study was undertaken to investigate the clinical characteristics of COVID-19 patients with a pneumonic lung lesion detected by CT that is not detected by CXR. A total of 156 COVID-19 patients hospitalized at three nationally designated South Korean hospitals with no active lesion detected by CXR but on clinical suspicion of pneumonia underwent the CT examination and were enrolled. Medical records, which included demographic and clinical features, including comorbidity, symptoms, radiological, and laboratory findings on admission, were reviewed and analyzed. The risk factors of pneumonia detected by CT for patients without an active lesion detected by CXR were investigated. Of the 156 patients without an active lesion detected by CXR, 35 (22.44%) patients were found to have pneumonia by CT. The patients with pneumonia defined by CT were older than those without (64.1 years vs. 41.2 years). Comorbidities such as hypertension, diabetes, cardiovascular disease, preexisting stroke, and dementia were more common among patients with pneumonia defined by CT than those without. Serum albumin level, C-reactive protein (CRP), stroke, and age ≥ 70 years were significantly associated with pneumonia defined by CT after adjustment for age. In multivariable regression analysis, serum albumin level (adjusted odds ratio (AOR) = 0.123, 95% CI = (0.035–0.429)) and preexisting stroke (AOR = 11.447, 95% CI = (1.168–112.220)) significantly and independently predicted pneumonia detection by CT. Our results suggest that CT scans should be performed on COVID-19 patients negative for a pneumonic lung lesion by CXR who are suspected to be pneumonic on clinical grounds. In addition, older patients with a lower albumin level and a preexisting stroke should be checked for the presence of pneumonia despite a negative CXR finding for an active lesion. Full article
24 pages, 484 KiB  
Review
Maternal Coronavirus Infections and Neonates Born to Mothers with SARS-CoV-2: A Systematic Review
by Waldemar Naves do Amaral, Carolina Leão de Moraes, Ana Paula dos Santos Rodrigues, Matias Noll, Jalsi Tacon Arruda and Carolina Rodrigues Mendonça
Healthcare 2020, 8(4), 511; https://doi.org/10.3390/healthcare8040511 - 24 Nov 2020
Cited by 44 | Viewed by 6004
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is continuously affecting the lives of all people. Understanding the impact of COVID-19 on pregnancy in terms of morbidity, mortality, and perinatal maternal and fetal outcomes is essential to propose strategies for prevention and infection control. Here, [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic is continuously affecting the lives of all people. Understanding the impact of COVID-19 on pregnancy in terms of morbidity, mortality, and perinatal maternal and fetal outcomes is essential to propose strategies for prevention and infection control. Here, we conducted a systematic review to investigate pregnant women infected with COVID-19 in terms of signs and symptoms, type of delivery, comorbidities, maternal and neonatal outcomes, and the possibility of vertical transmission. A search on Embase and PubMed databases was performed on 31 October 2020. Observational studies and case reports on pregnant women infected with COVID-19 were included without language restrictions. The 70 selected studies included a total of 1457 pregnant women diagnosed with COVID-19 in the first, second, and third trimesters of pregnancy. The most common signs and symptoms were fever, cough, and nausea. The most frequent comorbidities were obesity, hypertensive disorders, and gestational diabetes. Among maternal and fetal outcomes, premature birth (n = 64), maternal death (n = 15), intrauterine fetal death or neonatal death (n = 16), cases of intrauterine fetal distress (n = 28), miscarriage (n = 7), decreased fetal movements (n = 19), and severe neonatal asphyxia (n = 5) were the most frequent. Thirty-nine newborns tested positive for SARS-CoV-2. Additionally, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA was detected in the placenta (n = 13) and breast milk (n = 6). This review indicates that COVID-19 during pregnancy can result in maternal, fetal, and neonatal complications. In addition, SARS-CoV-2 viral exposure of neonates during pregnancy and delivery cannot be ruled out. Thus, we highlight the need for long-term follow-up of newborns from mothers diagnosed with COVID-19 to establish the full implications of SARS-CoV-2 infection in these children. Full article
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11 pages, 283 KiB  
Article
Predictors of Staying at Home during the COVID-19 Pandemic and Social Lockdown based on Protection Motivation Theory: A Cross-Sectional Study in Japan
by Tsuyoshi Okuhara, Hiroko Okada and Takahiro Kiuchi
Healthcare 2020, 8(4), 475; https://doi.org/10.3390/healthcare8040475 - 11 Nov 2020
Cited by 44 | Viewed by 5268
Abstract
During the COVID-19 pandemic, a social lockdown should be put in place and individuals should stay at home. Behavioral change is the only way to prevent the pandemic and overwhelmed healthcare systems until vaccines are available. We aimed to examine the psychological factors [...] Read more.
During the COVID-19 pandemic, a social lockdown should be put in place and individuals should stay at home. Behavioral change is the only way to prevent the pandemic and overwhelmed healthcare systems until vaccines are available. We aimed to examine the psychological factors that predict staying at home during the COVID-19 pandemic and social lockdown. A total of 1980 participants in Japan completed a survey for this study from 9 to 11 May 2020, when the state of emergency covered all prefectures in the country. Self-reported behavior in terms of staying at home, the perceived severity of the pandemic, vulnerability to the pandemic, response efficacy, and self-efficacy based on protection motivation theory were assessed. Multiple regression analysis showed that perceived severity (standardized β = 0.11, p < 0.001) and self-efficacy (standardized β = 0.32, p < 0.001) significantly predicted greater levels of staying at home, after controlling for socio-demographics. However, perceived vulnerability and response efficacy did not. To encourage people to stay at home during the pandemic and social lockdown, increasing the perceived severity of infection by COVID-19 and self-efficacy in terms of exercising restraint with respect to going out may consequently encourage people to stay at home. Full article
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