Coping with stress during the COVID-19 pandemic in the oldest-old population

The aim of the study is to investigate psychosocial factors that are associated with positive and negative coping with stress, as well as with worries about and perceived threat by COVID-19 to enable us to provide adequate support for oldest-old individuals. A paper–pencil-based survey assessed COVID-19 worries and perceived threat, depression, anxiety, somatization, social support, loneliness, resilience, positive and negative coping in a sample of n = 197 oldest-old individuals (78–100 years). Linear multivariate and binary logistic regression analyses were conducted. Individuals with high levels of resilience were more likely to feel self-efficient when coping with stress. High levels of depression, anxiety and loneliness were associated with feeling more helpless when coping with stress. However, oldest-old individuals who felt lonely also experienced situations where they felt competent in stress coping. Being male and experiencing high levels of social support was more likely associated with high levels of worries due to COVID-19. Increased age and higher levels of depression were associated with lower levels of perceived personal threat, whereas higher somatization scores were more likely associated with higher perceived personal threat. Findings suggest that mental health factors may shape the way oldest-old individuals cope with pandemic-related stress. Resilience might be an important factor to take into account when targeting an improvement in positive coping with stress. Oldest-old individuals who have higher levels of depression, anxiety and feel lonely may be supported by adapting their coping skill repertoire to reduce the feeling of helplessness when coping with stress.     

COVID-19, stigma,and people with disabilities: A mental health perspective

Discrimination is an age-old ‘illness’ irrespective of its context. Stigma is a common factor that has been associated with disability and coronavirus disease 2019. The public health impact of stigma on differently-abled people during this pandemic is not known and it is a poorly investigated and neglected area. It is important to address the current research need in the concerned area and its implications for public health policymaking and changes in practices that it requires. Together we can win the war against pandemics if we reduce the mental distancing in all perspectives.     

COVID-19 pandemic management and the rheumatology patient

We discuss the evidence behind mask use, including evidence for homemade masks, social distancing, and the local coronavirus disease-2019 (COVID-19) epidemics in countries that initially employed more limited public health interventions. Given the absence of data for specific interventions in the rheumatic disease population, we reviewed the evidence available for the general population. The risk of poor outcomes with COVID-19 in patients with rheumatic diseases is a potential concern given the immunosuppression associated with these conditions and disease-modifying anti-rheumatic drug therapy, as well as advancing age and many of the comorbidities present in such patients. Infection prevention is key, for both individual patients and their community. Given the data collected from the general population, we recommend ongoing proper mask use, social distancing, and hand hygiene for patients with rheumatic diseases and encourage providers to counsel these patients in prevention strategies and attempt to dispel abundant misinformation.     

E-health literacy of nursing students and investigation of factors affecting e-health literacy during COVID-19 pandemic process: A cross-sectional study

The lack of knowledge on health literacy affects all segments of society, particularly health workers.The objectives were to identify nursing students’ means of accessing information during the coronavirus disease 2019 pandemic, their level of health literacy, and the factors that affect it.This cross-sectional study was conducted in Turkey among 398 nursing students of Çukurova University and Van Yüzüncü Yil University between June 1 and June 30, 2020. As a data collection tool, E-Health Literacy Scale was used, with students’ characteristics and personal information form related to Internet use. These forms were converted to the online format. The survey link was sent to the students’ smartphones and/or e-mails to ask them to participate.Majority of participants were Van Yüzüncü Yil University nursing students (63.8%). E-SYO score average of all students was found to be 29.42 ± 4.39 (min = 14, max = 40); it was is found be at a good level. They used the Internet as the first source of information about coronavirus disease 2019 (65.1%).Among the participants, 65.8% stated that it was important to access the health resource on the Internet and 19.1% of the participants thought that it was very important. It was found that Internet use was being used for >3 times a day (72.9%). The age, class, gender, family type, income level, high school from which they graduated from, and their working status significantly were statistically affecting their health literacy (P < .05). The health literacy scale scores were significant and higher than those who did not know the concept of health literacy, and those who perceived Internet skills well and very well than those who perceived them poorly (P < .05).Nursing students were found to have good average health literacy averages. Improving the health literacy is important for making individuals healthier.     

Heterogeneity in presentation of hyperglycaemia during COVID-19 pandemic: A proposed classification

Diabetes and hyperglycemia occurring during COVID-19 era have implications for COVID-19 related morbidity/mortality. In this brief review, we have attempted to categorise and classify such heterogenous hyperglycemic states. During COVID-19 pandemic broadly two types of hyperglycemia were seen: one in patients without COVID-19 infection and second in patients with COVID-19 infection. Patients not inflicted with COVID-19 infection and diagnosed with either type 2 diabetes mellitus (T2DM) or type 1 diabetes mellitus (T1DM) show more severe hyperglycemia and more ketoacidosis, respectively. In former, it could be attributed to weight gain, decreased exercise, stress and in both type of diabetes, due to delayed diagnosis during lockdown and pandemic. In patients with COVID-19 and associated pneumonia, altered glucose metabolism leading to hyperglycemia could be due to corticosteroids, cytokine storm, damage to pancreatic beta cells, or combination of these factors. Some of these patients present with diabetic ketoacidosis, hyperglycemic hyperosmolar state or both. We have provided a framework for categorisation of hyperglycemic states, which could be consolidated/revised in future based on new research data.     

Impacts of the COVID-19 pandemic on rural America

Despite considerable social scientific attention to the impacts of the COVID-19 pandemic on urbanized areas, very little research has examined its impact on rural populations. Yet rural communities—which make up tens of millions of people from diverse backgrounds in the United States—are among the nation’s most vulnerable populations and may be less resilient to the effects of such a large-scale exogenous shock. We address this critical knowledge gap with data from a new survey designed to assess the impacts of the pandemic on health-related and economic dimensions of rural well-being in the North American West. Notably, we find that the effects of the COVID-19 pandemic on rural populations have been severe, with significant negative impacts on unemployment, overall life satisfaction, mental health, and economic outlook. Further, we find that these impacts have been generally consistent across age, ethnicity, education, and sex. We discuss how these findings constitute the beginning of a much larger interdisciplinary COVID-19 research effort that integrates rural areas and pushes beyond the predominant focus on cities and nation-states.

The COVID-19 pandemic has generated worldwide social and economic upheaval, with the United States experiencing disproportionately high levels of infection and economic fallout. While it has become increasingly clear that these impacts fall unevenly along lines of race, class, gender, and disability (1), research has focused much less attention on the role of rurality, despite it being a potentially critical axis along which the pandemic’s effects may vary (2). Thus, most research—and, by extension, national news coverage—has tended to highlight urban centers, resulting in limited information about how the COVID-19 pandemic is affecting rural regions.As social scientists piece together empirical evidence to describe the COVID-19 pandemic’s macrolevel impacts across the entire country, the urban bias of data and research overlooks 46 million rural people (3–7). If left unaddressed, this gap in knowledge could result in the creation of ill-informed long-term recovery policies which are intended to serve the entire country but are ineffective for those living in rural areas.These gaps in research are compounded by the fact that many rural communities may be uniquely vulnerable to the pandemic’s physical and economic impacts, and will require recovery plans which will look very different from those designed for urban areas. Rural regions tend to have higher levels of poverty (8), fewer job opportunities (9), and heightened vulnerability to labor market shocks (10) relative to urban areas. Further, they broadly lack access to healthcare (11), now see a heightened reliance on telehealth (12), tend to have older and health-compromised populations (13, 14), face serious barriers to enrollment in clinical trials (15), and have far more limited access to COVID-19 testing (16).As such, scholars, policy makers, and practitioners cannot straightforwardly and uniformly apply prevailing urban-centric data and findings to rural populations. Not only does this limit a fuller understanding of the disaster itself, but it obscures the need for a more accurate and evidenced-based recovery process that is tailored to the social structural makeup of rural America.The shortage of rural research on COVID-19 is due to a lack of publicly available, fine-grained data on rural regions. For example, although government statistics on unemployment are available for rural areas, standard errors can be quite large, and data are often suppressed for privacy, limiting the types of questions that can be reliably answered (17). When primary data collection does occur, it is often hindered by methodological difficulties stemming from the remoteness of rural areas (18).To overcome this difficulty, we launched an original data collection effort in June of 2020 in the most sparsely populated rural region of the United States—the North American West. Due to its unique social, political, and economic attributes (19), this large region is likely to have been heavily impacted by the pandemic, making it suitable for assessing how the pandemic has impacted rural well-being in the United States. Further, the geographical reach of this region makes up a substantial portion of the rural contiguous United States, inclusive of Arizona, California, Colorado, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming (Fig. 1).Open in a separate windowFig. 1.(Left) Map of rural counties included in the survey sample frame highlighted in orange. (Top Right) COVID-19 daily case rate per 100,000 people in 2020 across the United States (20). The highlighted bars indicate the period of time when the survey was fielded. (Bottom Right) COVID-19 daily case rate per 100,000 people in 2020 in rural western counties (20). The highlighted bars indicate the period of time when the survey was fielded.In this paper, we use newly collected rural data to examine how—and to what extent—the COVID-19 pandemic has impacted rural well-being. Importantly, we test this question through two essential dimensions of well-being: first, health-related well-being, measured by the level of direct experience with the virus and perceived impacts to overall life and physical and mental health; and second, economic well-being, including formal and informal work, perceived financial impacts, and perceptions of local economic health (21).Finally, although often presumed a monolith, rural America is home to diverse populations. In addition to the epoch-spanning tenure of Indigenous communities and the long-established predominately Black communities in the rural South (22), rural America has grown increasingly racially and ethnically diverse in recent decades (23, 24), with particular population growth among Latino/Latinas (25, 26). Rural communities also fall along a broad spectrum of economic profiles, ranging from deeply impoverished to some of the wealthiest enclaves in the country (27), and are variously reliant upon natural resource extraction (28), manufacturing activities such as meatpacking (10), and natural amenity development (29). Because of this diversity, and the persistent, well-documented social and economic inequalities seen in the rural United States along the lines of gender, age, education, and ethnicity (30, 31), we not only examine well-being across the entire population but also compare results between male and female, ages, levels of education, and Latino/Latina and non-Latino/Latina in both a bivariate and multivariable context.     

Factors affecting the mental health of medical students during the COVID-19 pandemic: A cross-sectional study

The coronavirus disease 2019 outbreak has impacted many educational institutions by imposing restrictions on offline or in-person lessons. Many students were stressed by “the loss of everyday life” due to the pandemic, and it is important to examine the impact of this loss on adolescents’ mental health. This study aimed to investigate the factors that affect students’ mental health during the pandemic from various perspectives. A total of 166 medical students participated in this study. Participants completed questionnaires about their demographics, life stress, mental health, and stress factors during in-person and online lecture days. Participants were divided into 2 groups, those with low and high mental health. The researchers compared independent variables between the groups using the χ² test or Fisher’s exact test. Multiple logistic regression analysis was performed, with mental health as the dependent variable. The multiple logistic regression analysis indicated that increased time spent online was significantly associated with mental health (P < .05). Human relations and the inability to meet/talk with friends trended toward a significant association with mental health (P < .1). The students who were not stressed about the increased time spent online were at a risk of low mental health. The students who appreciated interacting with others experienced more stress during the lockdown. To reduce students’ stress on online days, teachers should devise a lecture style with frequent breaks and introduce active learning. The findings of this study will contribute to addressing students’ low mental health and reducing their stress during the coronavirus disease 2019 pandemic.     

Teledentistry during COVID-19 pandemic

Background and aimsDentistry involves close face-to-face interaction with patients, hence during the COVID-19 pandemic, it has mostly been suspended. Teledentistry can offer an innovative solution to resume dental practice during this pandemic. In this review, we provide a brief overview of applications of teledentistry.MethodsArticles on teledentistry, relevant to this review, were searched and consulted from PubMed, Google Scholar, and Cochrane database.ResultsTeledentistry is the remote facilitating of dental treatment, guidance, and education via the use of information technology instead of direct face-to-face contact with patients. Teleconsultation, telediagnosis, teletriage, and telemonitoring are subunits of teledentistry that have important functions relevant to dental practice. There are many challenges for acceptance of teledentistry by the dentists as well as patients, which need to be addressed urgently.ConclusionTeledentistry can offer a novel solution to resume dental practice during the current pandemic, hence, the need of the hour is to incorporate teledentistry into routine dental practice. If not fully replace, at least teledentistry can complement the existing compromised dental system during the current pandemic.     

The positive impact of social media on health behavior towards the COVID-19 pandemic in Bangladesh: A web-based cross-sectional study

BackgroundHealth information has a profound impact on developing awareness and ultimately preventing the burden of coronavirus disease-2019 (COVID-19) pandemic, but study in Bangladesh is lacking.AimsTherefore, this study was conducted to investigate the impact of information from social media and television in developing health awareness among people amid the COVID-19 pandemic.MethodsData was collected during December 10, 2020 to February 10, 2021 from 1808 people. Data was collected by using questionnaire about information source and their impact on COVID-19 related health measures. Pearson's correlation analyses was conducted.ResultsFemale (52%, 937 of 1808) was the most prevalent sex and the mean age was 24 ± 3.9 years. Most of the social media users were students (63%, 1131 of 1808). Social media (53%, 959 of 1808) and television (44%, 800 of 1808) were the most popular sources and Facebook (66.5%, 1203 of 1808) was the most common source of getting health information. About 87% people received health information on social media and television. Users of social media had about 3 times more likelihood to follow the health rules. About 80% participants who used social media followed the health measures after 0–28 days of getting the information. The strongest correlation was found between social distancing and the information on television (r = 0.943).ConclusionStrong correlation of health information was present among the participants in building awareness about taking preventive measures. This is the first study to describe the positive influence of information amid COVID-19 in Bangladesh.     

COVID-19 pandemic: Pathophysiology and manifestations from the gastrointestinal tract

The pandemic of coronavirus disease 2019(COVID-19), caused by a newly identified β-coronavirus(SARS-CoV-2) has emerged as a dire health problem, causing a massive crisis for global health. Primary method of transmission was firstly thought to be animal to human transmission. However, it has been observed that the virus is transmitted from human to human via respiratory droplets. Interestingly, SARS-CoV-2 ribonucleic acid(RNA) has been isolated from patient stools, suggesting a possible gastrointestinal(GI) involvement. Most commonly reported clinical manifestations are fever, fatigue and dry cough. Interestingly, a small percentage of patients experience GI symptoms with the most common being anorexia, diarrhea, nausea and vomiting. The presence of viral RNA in stools is also common and fecal tests can be positive even after negative respiratory samples. The exact incidence of digestive symptoms is a matter of debate. The distribution of Angiotensin converting enzyme type 2 receptors in multiple organs in the body provides a possible explanation for the digestive symptoms' mechanism. Cases with solely GI symptoms have been reported in both adults and children. Viral RNA has also been detected in stool and blood samples, indicating the possibility of liver damage, which has been reported in COVID-19 patients. The presence of chronic liver disease appears to be a risk factor for severe complications and a poorer prognosis, however data from these cases is lacking. The aim of this review is firstly, to briefly update what is known about the origin and the transmission of SARS-CoV-2, but mainly to focus on the manifestations of the GI tract and their pathophysiological background, so that physicians on the one hand, not to underestimate or disregard digestive symptoms due to the small number of patients exhibiting exclusively this symptomatology and on the other, to have SARS-CoV-2 on their mind when the gastroenteritis type symptoms predominate.     

Effect of pandemic on DOTS treatment during COVID-19 lockdown- A cross-sectional study

BackgroundTuberculosis (TB) is still the most common infectious disease globally, affecting 1.5 million people per year. Prior to COVID-19 outbreak, India was struggling with a rampant attack of Tuberculosis. With the surge of COVID-19 implementation of all national health programs including NTEP was disrupted. Prioritization of services, the challenges to reaching all types of communities and the role of stigmatization, and the possibility of increased disease transmission were few problems in the implementation of DOTS during the lockdown.AimTo assess effect of pandemic on DOTS treatment during COVID-19 lockdown.MethodsA cross-sectional study was conducted among 254 tuberculosis patients who were under DOTS during Covid-19 lockdown in Belagavi district. Participants who were on DOTS during 2019–2021 period.ResultOf 254 participants, only 5 (2.0%) were supervised while taking drugs, 67 (26.4%) of subject's empty blister packs were taken back by health personnel and 106 (41.7%) participants were regularly followed up for treatment by health department. The variables like gender, literacy status, socioeconomic status, and occupation were all significantly associated with hampered access to DOTS during the lockdown period at p < 0.05.ConclusionThis study concluded that the participants had hampered accessibilities to DOTS during lockdown.     

Changes in Medicaid enrollment during the COVID-19 pandemic across 6 states

The coronavirus disease 2019 public health emergency (PHE) caused extensive job loss and loss of employer-sponsored insurance. State Medicaid programs experienced a related increase in enrollment during the PHE. However, the composition of enrollment and enrollee changes during the pandemic is unknown. This study examined changes in Medicaid enrollment and population characteristics during the PHE. A retrospective study documenting changes in Medicaid new enrollment and disenrollment, and enrollee characteristics between March and October 2020 compared to the same time in 2019 using full-state Medicaid populations from 6 states of a wide geographical region. The primary outcomes were Medicaid enrollment and disenrollment during the PHE. New enrollment included persons enrolled in Medicaid between March and October 2020 who were not enrolled in January or February, 2020. Disenrollment included persons who were enrolled in March of 2020 but not enrolled in October 2020. The study included 8.50 million Medicaid enrollees in 2020 and 8.46 million in 2019. Overall, enrollment increased by 13.0% (1.19 million) in the selected states during the PHE compared to 2019. New enrollment accounted for 24.9% of the relative increase, while the remaining 75.1% was due to disenrollment. A larger proportion of new enrollment in 2020 was among adults aged 27 to 44 (28.3% vs 23.6%), Hispanics (34.3% vs 32.5%) and in the financial needy (44.0% vs 39.0%) category compared to 2019. Disenrollment included a larger proportion of older adults (26.1% vs 8.1%) and non-Hispanics (70.3% vs 66.4%) than in 2019. Medicaid enrollment grew considerably during the PHE, and most enrollment growth was attributed to decreases in disenrollment rather than increases in new enrollment. Our results highlight the impact of coronavirus disease 2019 on state health programs and can guide federal and state budgetary planning once the PHE ends.     

Precautionary behaviours of individuals with multimorbidity during the COVID-19 pandemic

Studies show that older individuals with multimorbidity are more susceptible to develop a more severe case of COVID-19 when infected by the virus. These individuals are more likely to be admitted to Intensive Care Units and to die from COVID-19-related conditions than younger individuals or those without multimorbidity. This research aimed to assess whether there are differences in terms of precautionary behaviours between individuals aged 50 + with multimorbidity and their counterparts without multimorbidity residing in 25 European countries plus Israel. We used data from the SHARE-COVID19 questionnaire on the socio-demographic and economic characteristics, multimorbidity, and precautionary behaviours of individuals. SHARE wave 8 and 7 databases were also used to fully identify individuals with multimorbidity. Our results showed that individuals with multimorbidity were more likely to exhibit precautionary behaviours than their counterparts without multimorbidity when gender, age, education, financial distress and countries were included as controls. Additionally, we found that women, more educated individuals and those experiencing more financial distress adopt more protective behaviours than their counterparts. Our results also indicate that the prevalence of precautionary behaviours is higher in Spain and Italy and lower in Denmark, Finland and Sweden. To guarantee the adoption of preventive actions against COVID-19, public health messaging and actions must continue to be disseminated among middle and older aged persons with multimorbidity, and more awareness campaigns should be targeted at men and less educated individuals but also at persons experiencing less financial distress, particularly in countries where people engaged in fewer precautionary behaviours.     

A correlation study between meteorological parameters and COVID-19 pandemic in Mumbai,India

Background and aimsMeteorological parameters play a major role in the transmission of infectious diseases such as COVID-19. In this study, we aim to analyze the correlation between meteorological parameters and COVID-19 pandemic in the financial capital of India, Mumbai.MethodsIn this research, we collected data from April 27 till July 25, 2020 (90 days). A Spearman rank correlation test along with two-tailed p test and an Artificial Neural Network (ANN) technique have been used to predict the associations of COVID-19 with meteorological parameters.ResultsA significant correlation of COVID-19 was found with temperature (T_min), dew point (DP_max), relative humidity (RH_max, RH_avg, RH_min) and surface pressure (P_max, P_avg, P_min). The parameters which showed significant correlation were then taken for the modeling and prediction of COVID-19 infections using Artificial Neural Network technique.ConclusionsIt was found that the relative humidity and pressure parameters had the most influencing effect out of all other significant parameters (obtained from Spearman’s method) on the active number of COVID-19 cases. The finding in this study might be useful for the public, local authorities, and the Ministry of Health, Govt. of India to combat COVID-19.