A qualitative study exploring how youth use TikTok to learn about mental health and mental health services in British Columbia, Canada

Aims: Youth are increasingly seeking health information through online platforms, such as websites, social media, and online forums. TikTok emerged as a popular platform for disseminating and consuming health information during the COVID-19 pandemic. As such, this study aimed to explore how youth used TikTok to access information about mental health and mental health services during the pandemic. Method(s): Twenty-one interviews were conducted over Zoom with youth (ages 12-24) who lived in British Columbia, Canada and had accessed TikTok for mental health information during the pandemic. Interviews were audio-recorded, transcribed verbatim, and analysed thematically using an inductive approach. Result(s): Youth described TikTok as a safe place to talk about mental health and share personal experiences. This helped youth feel less alone with their struggles and facilitated conversations about mental health with friends, family, and service providers. Participants also described how mental health content on TikTok helped them be more mindful of their own mental health and the different resources and coping strategies available and encouraged them to seek services. For those hesitant or unable to access services, TikTok provided immediate support. Youth appreciated the ease of accessing this information, given the platform's engaging and digestible format (i.e., short videos) and predictive nature of its algorithm. However, participants expressed concerns with the spread of misinformation and the lack of verifiable information on the platform. Conclusion(s): TikTok is as a practical platform to disseminate mental health information to youth. However, efforts to establish strategies for preventing and reporting misinformation are warranted.

Participation in COVID-19 clinical trials, willingness to participate, and trust in sources of information among persons with and without cancer in Puerto Rico

Introduction: Cancer patients have a high risk of severe COVID-19 and complications from it. Although the COVID-19 pandemic has led to an increase in the conduction of clinical trials (CTs), there is a scarcity of data on CT participation among cancer patients. We aimed to describe the level of participation in a COVID-19 CT, willingness to participate, as well as trust in sources of information for CTs among persons with and without a previous cancer diagnosis in Puerto Rico. Method(s): Data collected from November 2021 to March 2022 from two cross-sectional studies were merged and used for analysis. Informed consent, telephone, face-to-face, and online interviews were conducted among participants >=18 years old living in Puerto Rico (n=987). Descriptive statistics and bivariate analysis (Fisher's exact text and chi-squared test) was done to describe the outcomes of interest, overall and by cancer status. Result(s): Mean age of participants was 41+/-15.5 years. Most participants were women (71.3%), with an educational level greater than high school (89.5%) and with an annual family income below $20,000 (75.1%). Overall, 4.4% of participants (n=43) reported history of cancer diagnosis. Only 1.8% of the population reported to have participated in a COVID-19 CT to receive either a treatment or vaccine;stratifying by cancer, none of the cancer patients had participated in a COVID-19 CT, and only 1.9% of non-cancer patients participated. While 37.0% of the participants indicated being very willing to sign up for a CT assessing COVID-19 treatment, willingness was higher in cancer patients (55.8%) than among participants without cancer (36.1%). Regarding trust in sources of information for CTs, the level of trust ("a great deal/a fair amount") was higher for their physicians (87.6%), researchers (87.0%), the National Institute of Health (86.7%), their local clinics (82.9%), and a university hospital (82.7%), while it was lower for a pharmaceutical company (64.0%), and for friend, relative, or community leader (37.6%);no differences were observed by cancer status. Conclusion(s): While participation in COVID-19 CTs was extremely low in the study population, the willingness to participate was higher among cancer patients. Education on CTs and their availability are necessary to increase participation in this understudied group. Such efforts will enhance the representation of Hispanic and vulnerable populations, such as cancer patients, on COVID-19 CTs, and thus proper generalizability of study findings in the future.

Interpreting High Sensitivity Troponins in Various Acute Clinical Settings - Increased Significance to the Present.Day Cardiologist

High-sensitivity cardiac troponins expedite the evaluation of patients with chest pain in the emergency department. The utility of troponins extends beyond the acute coronary syndromes to accurate the diagnosis of myocardial injury. Troponins are best friends for physicians;however, they are a double-edged sword if not interpreted appropriately. Misdiagnosis is harmful with regard to patient outcomes. The present review focuses on the recent updates in the understanding and interpretation of high-sensitivity troponins in various acute clinical settings. Common mistakes and gray zones in the interpretation of troponins, the concept of myocardial injury versus infarction, newer entities like myocardial infarction (MI) with Nonobstructive Coronary Arteries, recent controversies over the definition of periprocedural MI, complementary role of imaging in the diagnosis of myocardial injury and the role of troponins in the current COVID-19 pandemic are discussed.Copyright © 2022 Saudi Center for Organ Transplantation.

Sexual health and contraceptives in the young people of the XXI century

Youth is a key period of life to ensure future well-being, especially in relation to sexuality. The general objective is to analyze the sexual education of young people today regarding sexual practices and to study the use of contraceptive methods. Material(s) and Method(s): It is a cross-sectional, observational study of cases. Designed a digital questionnaire made with Google consisting of 26 items and 3 blocks: social-demographic data, female sexuality and sexual health. Data analysis the statistical program SPSS 25.0. Result(s): The sample obtained: 1320 women. Social-demographic data: ages between 15 and 29 years and 58.3% of the women had a partner. The most frequent sexual orientation: 77% heterosexual. Female sexuality: for 63.9% of women, sex is an important part of their relationships and 43.3% consider themselves attractive people. The most rejected practices: anal sex, during menstruation or with the light on. 4.7% do not feel prepared to require their sexual partner to use a condom. 9.7% are not able to request sexual practices that they want. 6.2% state that they do not avoid any practice despite the fact that some of them cause discomfort. During the Covid-19 situation, the frequency of sexual relations decreases by 49% and the absent practices of viral transmission via online increase. Regarding sexual education, we observe that the majority have been provided by friends, that is, unqualified personnel. The most explained topics are focused on the traditional aspects of sexual health and human development, therefore it is an education that is not of quality, data confirmed by 58% of women. The contraceptive methods most used by women are condoms and oral contraceptives, whose main purpose is the prevention of pregnancy and sexually transmitted infections (condoms). Its use can have negative connotations such as decreased sexual desire, excitement, sensitivity and orgasm disorders. Conclusion(s): Currently, young women perceive sexuality more and more naturally, talking about it without fear or censorship. Sex educators are mostly not qualified personnel. The SARS-CoV2 (Covid-19) situation increases the number of sexual practices online, decreasing it. The contraceptive methods most used by women are condoms and oral contraceptives.Copyright © 2023

Alcohol consumption among adolescents during the COVID-19 pandemic, ConVid Adolescents - Behavior Research

Objective: To describe the prevalence of alcohol consumption before and during the COVID-19 pandemic and to analyze the factors associated with this behavior during the period of social distancing among Brazilian adolescents. Method(s): Cross-sectional study using data from the ConVid Adolescents survey, carried out via the Internet between June and September 2020. The prevalence of alcohol consumption before and during the pandemic, as well as association with sociodemographic variables, mental health, and lifestyle were estimated. A logistic regression model was used to assess associated factors. Result(s): 9,470 adolescents were evaluated. Alcohol consumption decreased from 17.70% (95%CI 16.64-18.85) before the pandemic to 12.80% (95%CI 11.85-13.76) during the pandemic. Alcohol consumption was associated with the age group of 16 and 17 years (OR=2.9;95%CI 1.08-1.53), place of residence in the South (OR=1.82;95%CI 1.46-2.27) and Southeast regions (OR=1.33;95%CI 1.05-1.69), having three or more close friends (OR=1.78;95%CI 1.25-2.53), reporting worsening sleep problems during the pandemic (OR=1.59;95%CI 1.20-2.11), feeling sad sometimes (OR=1,83;95%CI 1,40-2,38) and always (OR=2.27;95%CI 1.70-3.05), feeling always irritated (OR=1,60;95%CI 1,14-2,25), being a smoker (OR=13,74;95%CI 8.63-21.87) and a passive smoker (OR=1.76;95%CI 1.42-2.19). Strict adherence to social distancing was associated with lower alcohol consumption (OR=0.40;95%CI 0.32-0.49). Conclusion(s): The COVID-19 pandemic led to a decrease in consumption of alcoholic beverages by Brazilian adolescents, which was influenced by sociodemographic and mental health factors, adherence to social restriction measures and lifestyle in this period. Managers, educators, family and the society must be involved in the articulation of Public Policies to prevent alcohol consumption.Copyright © 2023 A Epidemio e uma publicacao da Associacao Brasileira de Saude Coletiva-ABRASCO.

Should COVID-19 pandemic mitigations in the myeloma clinic continue? A summary of patient opinions

Introduction: The COVID-19 pandemic necessitated multiple changes to the format of myeloma clinics to minimise the risk of infection among patients and staff. These included changing in-person clinic appointments to telephone appointments when there was no medical need for face-to- face review and instituting a courier service for delivery of oral or self-administered medications. As COVID-19 restrictions relaxed, we sought to investigate the acceptability of these changes to our patients and to determine which, if any, of the new arrangements should continue. Method(s): Patients who attended the Myeloma Clinic at The Royal Marsden Hospital, both in-person and by telephone, on four separate dates in August and September 2022 were asked to complete a questionnaire to provide their opinions using a combination of multiple-choice, Likert scale and free-text questions. These covered the main domains of change outlined above along with questions about blood test location and attendance with family and friends. Result(s): Questionnaires were returned by 59 patients, 11 relating to in-person appointments and 48 to telephone appointments. 86.0% of patients were in favour of continuing the option of telephone appointments, with many highlighting their convenience and the avoidance of long travel and waiting times, with some also mentioning their COVID-19 security. However, a number of patients expressed concerns including communication difficulties, the inability to effectively assess physical health with an examination and a lack of reassurance. Furthermore, those who attended in-person appointments felt they were very COVID-secure, assigning them a mean of score of 4.5, where 1 was very insecure and 5 very secure. Several suggested that the optimum schedule would include regular telephone appointments with occasional in-person meetings. Interestingly, only 25.5% of patients wanted a video calling option. Patients were also very positive about receiving medications by courier, with 94.1% of patients receiving their medications within two working days of their clinic appointment. 81.8% of patients expressed a wish for this option to continue, highlighting the increased convenience and reduction in waiting times. Conclusion(s): These results suggest that changes made to the Myeloma Clinic in response to the COVID-19 pandemic have improved the patient experience. A mixture of telephone and in-person appointments may be preferable for this cohort of patients, many of whom require regular appointments for chemotherapy approval but are medically stable, and whose frailty makes long travel and waiting times challenging. These findings have implications for the planning of myeloma clinics across the UK.

Psychosocial factors associated with the risk of developing psychosis in a Mexican general population sample

Epidemiological evidence has linked an array of sociodemographic and psychosocial factors with an increased risk of developing psychosis However, research in samples from low- and middle-income countries is still scarce. This study used a Mexican sample to explore (i) sociodemographic and psychosocial differences between individuals who screened positive for Clinical High-Risk for psychosis (CHRpositive group) and those who did not (Non-CHR group), and (ii) sociodemographic and psychosocial factors associated with screening positive for CHR. The sample consisted of 822 individuals from the general population. Findings showed that participants in the CHRpositive group were younger, had a lower educational level, and reported more mental health problems than the Non-CHR group. The CHR-positive group had a greater prevalence of medium/high risk associated with cannabis use, a higher prevalence of adverse experiences as well as higher levels of childhood maltreatment, poorer family functioning, and more COVID-related distress than the Non-CHR group. Findings of multivariate analysis showed that the variables associated with screening positive for CHR were: having an unhealthy family functioning, a higher risk associated with cannabis use, a lower level of education, having experienced a major natural disaster, violent or unexpected death of a relative or friend, higher levels of childhood maltreatment, and higher COVID-related distress. An older age was a protective factor for screening positive for CHR. Overall, the findings highlight the importance of examining potential psychosocial contributors to psychosis vulnerability across different sociocultural contexts to delineate risk and protective processes relevant to specific populations and better target preventive intervention efforts.

Eye Sight - A Bull's Eye Target of COVID-19

Aim: To determine the effect of COVID-19 on eye sight due to increase screen time in undergraduate students of medical school. Study design: Cross-sectional study. Place and duration of study: This survey was carried out from October 2022 to December 2022 in Army Medical College Rawalpindi. Questionnaires were filled in person and also online-based platform was used to distribute the e-questionnaire, developed using the Google Form. The participants were asked to share the e-questionnaire with their friends using Facebook and Messenger. Method(s): Participants were selected for the study using non-probability consecutive sampling. College students of 20-25 years were included in the study. Sample size was 400 according to a study done internationally. Participants with comorbidities (cataract, glaucoma) were excluded from study. Participants having (trouble concentrating on things such as reading the newspaper, books or watching television) were included in the study. Digital eye strain was calculated using validated computer vision syndrome (CVS-Q) questionnaire to measure the symptoms such as eye fatigue, headache, blurred vision, double vision, itching eyes, dryness, tears, eye redness and pain, excessive blinking, feeling of a foreign body, burning or irritation, difficulty in focusing for near vision, feeling of sight worsening, and sensitivity to light. Qualitative data was analyzed using Chi square test. Results A total number of 470 responses were recorded, out of which 257 (54.7%) were males and 213(45.3%) were females. In our study, the most common symptom was headache, affecting 58.1% of the population before COVID 19 which has increased to 83.2% and the P value is less than 0.001.Theother symptoms which also showed P value less than 0.001 were blurred vision while using digital device, irritated or burning eyes, dry eyes and sensitivity to bright light. Conclusion The practical implication of the study is to create awareness among general population about COVID, that eye sight is Bull`s Target to be affected by it and simple preventing measures can be taken. The purpose of this study is to limelight the importance that during COVID 19 lockdown the excessive use of digital devices and their cons on the ocular health among future health care workers.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

Understanding Patient Experiences with Overactive Bladder

INTRODUCTION AND OBJECTIVE: Overactive bladder (OAB) is highly prevalent, affecting millions of Americans, and poses a significant symptom burden. The purpose of this study was to understand patient experiences with OAB and the impact of these experiences on OAB treatment. METHOD(S): People with symptoms of OAB were recruited from a tertiary care clinic and from an online health research portal to complete semi-structured interviews regarding their OAB experiences. The interviews were recorded, transcribed, coded, and inductively analyzed to identify emerging themes. RESULT(S): We performed 19 interviews and identified several key themes central to the patient experience, including symptom impact and severity, knowledge, stigma, self-efficacy, and regret. We considered these themes along the following stages of the patient's OAB journey. Symptom Development and Awareness: The routine of self-care is insidious and normalized, making realization of a lifestyle that is centered around voiding less obvious to patients, leading to a delay of care-seeking. Participants noted restrictions on all aspects of life. Adjectives used to describe symptom impact included "annoyance, depression, humiliation and desperation." Care-Seeking: Participants expressed coping behaviors during onset and gradual worsening of symptoms, however many recounted a "sentinel event" that heightened their severity perception and served as a cue to action. Routine primary care visit screenings and friend recommendations were additional cues to action. Reasons for careseeking delay included lack of OAB knowledge, stigma, and embarrassment. Experiences with Therapy: Participants recognized that treatment outcomes depended on their engagement. Some individuals regretted their lack of self-advocacy and self-efficacy. Participants highlighted internal barriers (forgetfulness, doubting treatment effectiveness) and external barriers (comorbidities, COVID- 19) to therapy adherence. Among those with high self-efficacy, fear of treatment failure, calendar tools, and social support networks facilitated treatment compliance (Figure 1). CONCLUSION(S): Living with OAB affects patients physically, mentally, and socially. Gaining a better understanding of OAB experiences can help physicians tailor their practice to meet patients' needs.

The Perceived Impact of the Covid-19 Pandemic on Medical Students' Future Careers

Purpose of study The COVID-19 pandemic disrupted medical education on multiple levels, and medical students have been forced to adjust to distance learning, altered clinical opportunities, and standardized testing inconsistencies. We sought to identify the effects of these dramatic deviations on medical students' career plans. Methods used We conducted a cross-sectional online survey of Johns Hopkins medical students between 7/13/2020 and 9/9/ 2020 in order to assess the implications of the COVID-19 pandemic on students' career decisions. The survey items were developed to cover topics ranging from physical and emotional well-being during the pandemic, as well as perceptions of the effects on career development. Respondents rated statements according to a 5-point Likert scale, with a score of 1 representing 'strongly disagree', 2 'somewhat disagree', 3 'neutral', 4 'somewhat agree', and 5 'strongly agree'. Descriptive statistics were calculated for all variables. Summary of results Of the 585 eligible medical students, we had a final sample of 76 responses (13% response rate). Twenty-five (25/71, 35%) of those who responded had friends or family members who had been diagnosed with COVID-19. Students felt neutral regarding having more time to explore research projects (Mean +/- SD;3.06 +/- 1.18) and hobbies (3.43 +/- 1.28), as well as more time to spend with friends or family members (3.34 +/- 1.37). Most survey respondents somewhat disagreed that they considered quitting medical school during the pandemic (1.55 +/- 1.10). Students somewhat agreed that they view the field of medicine more positively since the onset of the COVID-19 pandemic (3.60 +/- 1.09). Respondents somewhat agreed that they would be unable to explore other specialties and find their best fit (3.55 +/- 1.32), but they felt neutral regarding level of competitiveness for their desired field (2.71 +/- 1.08). We found that the minority (4/66, 6%) of students had considered changing their specialty. Students felt neutral in terms of their Step 1 (3.25 +/- 1.05) or Step 2 (2.81 +/- 1.02) score deterring them from future career opportunities. Conclusions The majority of medical students have experienced barriers in their career pathway as a direct cause of COVID-19 restrictions on medical education, including the ability to explore different specialties to discover their best fit or find a chance to network with mentors. However, despite these obstacles, most students remain committed to medicine.

Student Perspective of Team Dynamics before and after a Disaster Response Course

Purpose of Study We need to understand the COVID-19 pandemic impact on healthcare students. Loma Linda University requires an annual Critical Incident Response Course for graduating students about the importance of interprofessional teamwork in a disaster response. We surveyed students about the pandemic impact on their lives. Methods Used This is a mixed methods multidisciplinary cohort study of healthcare students (n=442). The 2020 course consisted of asynchronous content (eight hours) and a synchronous virtual meeting (two hours) focusing on triage, disaster simulation, and interprofessional teamwork. Students completed a pre/post survey on the COVID-19 pandemic response. We report both descriptive statistics and qualitative results from two independent coders. Summary of Results Respondents included Medicine (n=149), Nursing Undergraduate (n=169), Nursing Graduate (n=16), Pharmacy (n=45), Dentistry (n=58), Other (n=5). Inter-rater reliability for coded answers exceeded, k=0.827 (Cohen's kappa analysis). Students reported observing examples of efficient teamwork (77%) compared to 42% reporting inefficiencies. The most common efficiency was Mutual Support/ Collaboration (50%) and the least reported was Team Structure (6%). Most common inefficiency was communication (41%) and the least was adaptability (4%). Students believed their profession will be different after COVID-19 (76%). The most reported anticipated change was Disaster Preparedness/ Infection control (59%). Post-coursework survey showed 55% reported a stronger understanding of their profession's impact on disaster management. Individuals reported changing behavior during the pandemic (84%). The biggest change was in sleep: 15% reported a decrease and 41% reported an increase, followed by connecting with people (21% decrease, 39% increase). The biggest unmet need was Money (27%). The most helpful resources were Friends/Family (89%) and Social Media (43%). 34% volunteered or worked at an essential workplace. Conclusions Healthcare students reported that communication, mutual support, and understanding one's interprofessional contribution are the core of fighting a pandemic. Healthcare students have unique challenges and resource requirements during a pandemic.

Why Do People Buy Prescription Medicines Online? A Qualitative Interview Study

Introduction: Many people in the United Kingdom (UK) are turning to the internet to obtain prescription medicines. This introduces a significant public health risk and patient safety concerns, for example because the internet is a source of fake medicines. According to an estimate by the UK government, 1 in 10 people in the UK bought a fake medical product online in 2021 (1). To help address this problem, it is important to understand why people buy prescription medicines online in the first place. Aim(s): This qualitative study aimed to identify why people in the UK purchase medicines online, including their perceptions of risks posed by the availability of fake medicines online. The focus was on prescription-only medicines (POMs). Method(s): Semi-structured interviews were conducted with adults based in the UK who had previously purchased medicines online. Purposive sampling was adopted to achieve diversity regarding participants' experiences and demography. The interviews were conducted online using Microsoft Teams. The recruitment process started in April- 2021 and ended in May-2022. The recruitment was continued until no new codes were identified (data saturation was reached). Interview transcripts were analysed using thematic analysis with the Theory of Planned Behaviour (TPB) acting as a framework to develop the coding of themes (2). Result(s): Twenty participants (12 female, 8 male) were interviewed. Participant age groups were 18-29 (n = 4), 30-39 (n = 4), 40-49 (n = 5), 50-59 (n=4), and >=70 (n = 3). Participants had bought various types of POMs (e.g., antibiotics, and high-risk controlled medicines). Participants demonstrated awareness of the presence of fake medicines online, and they understood risks associated with them. The factors that influenced participants to buy medicines online were grouped into themes including advantages (Avoiding long waiting times;Bypassing gatekeepers;Medicines availability;Lower costs;Convenient process;Privacy) and disadvantages (Medicines safety concerns;Medicines quality concerns;Higher costs;Online payment risks;Lack of accountability;Engage in an illegal behaviour) of purchasing medicines online, the social influencing factors (Interactions with healthcare providers;Other consumers' reviews and experiences;Words of mouth by friends;Influencers' endorsement), the barriers (General barriers;Website specific barriers) and facilitators (Facilitators offered by the illegal sellers of medicines;Facilitators offered by various internet platforms;COVID-19 outbreak as facilitating condition;Consumer personability) of the purchase as well as factors that lead consumers to trust (Website features;Product appearance;Positive previous purchase experience) the online sellers of medicines. Conclusion(s): The in-depth insight into what could drive people in the UK to buy medicines online could enable the development of effective and evidence-based public awareness campaigns that warn consumers about the risks of buying fake medicines from online sources. The findings could also help researchers to design other interventions to prevent people from buying POMs online. A limitation of this study is that although the interviews were in-depth and data saturation was reached, the findings may not be generalisable as this was a qualitative study. However, the TPB which informed the analysis has well-established guidelines to develop a questionnaire, for a future quantitative study.

Patients' and Pharmacists' Experiences of a Community Pharmacy-Based Diabetes Care Plan

Introduction: The traditional view of healthcare professionals as the main decision-makers has changed, recognising the importance of people managing their own conditions (1). An evidence-informed Community Pharmacy-Based Diabetes Care Plan (2) provided personcentred care for adults living with type 2 diabetes in Lagos, Nigeria. Due to the Covid-19 pandemic, community pharmacists (n =20) had monthly remote consultations with patients (n =89) over six months, supporting patients in setting and reviewing their own goals. Aim(s): Part of a larger evaluation, this paper aims to describe patients' and pharmacists' experiences, acceptability and contextual barriers and facilitators to the care plan. Method(s): An invitation for all participants to participate in study interviews during months 4-6 of the care plan was sent via the pharmacists. The researcher contacted participants that sent their consent or consent to contact form in remotely. Semi-structured telephone interviews were conducted with consent. Participants' reasons for enrolling, participation experiences, barriers and facilitators were explored. Interviews were conducted in English, audio-recorded and transcribed verbatim. Transcripts were thematically analysed, aided by NVivo12. At study completion, all patients were provided with a post-study questionnaire (PSQ). Result(s): Seventy patients completed the PSQ. Of these, 88% were satisfied with the service on a 10-point satisfaction scale (1= very dissatisfied and 10= very satisfied). All respondents stated that the care plan helped them manage their conditions better. Based on their experience with the care plan, all respondents indicated they were likely or much more likely to recommend the care plan to friends and family if they need similar care. Interviews lasting 14-42 minutes were conducted with 10 pharmacists and 15 patients. Seven themes emerged from the data: reasons for agreeing to participate;perception of pharmacy (premises and profession);remote consultations - a new way of working;service delivery and care coordination;acceptability of the care plan;types of goals, goal attainment and patients' satisfaction;and facilitators, barriers, and recommendations to the care plan. The care plan was perceived as valuable, and it improved patients' confidence regarding diabetes management. Key benefits of the care plan were patients' empowerment, including better self-care and addition to therapeutics. Monthly online (majority) meetings between the pharmacists and patients maintained patients' engagement with the care plan and allowed improvements in goal achievements and better follow-up across the pharmacies. The remote consultations were perceived as innovative and useful, though a few patients were seen face to face in particular circumstances. Identified barriers included time and technology. Patients were satisfied and passionate about the new service, and pharmacists were excited about the opportunities to provide person-centred care in their pharmacies. Conclusion(s): This study is the first mixed-methods evaluation of a person-centred goal-setting intervention for people living with diabetes in Lagos, Nigeria. It showed that the care plan was acceptable and useful to patients and pharmacists. It supports the importance of personalised care in diabetes management. A key limitation was selection bias-only those who expressed interest were interviewed. No follow-up on non-participants was done because the research team had no access to patients' contact details.

COVID-19-Induced Post-Traumatic Stress Symptoms in Palliative Medicine Professionals (Sci218)

Outcomes: 1. Define the factors contributing to increased PTSD incidence due to COVID-19 among hospice and palliative medicine professionals. 2. Implement measures to screen and proactively mitigate workplace related factors associated with increased risk of PTSD in pandemic- and potentially non-pandemic-related situations. The COVID-19 pandemic has affected more than 557 million people globally. In order to assess its psychological effect on healthcare workers in hospice and palliative medicine, a survey was solicited to AAHPM members. Participation was voluntary and anonymous, with all responses kept in confidence. The survey consisted of three parts: demographics, attitudes/sentiments relating to COVID-19, and the DSM-IV-TR Post-Traumatic Stress Disorder (PTSD) Checklist-Specific (PCL-S). The PCL-S has clinical and research utility to screen for PTSD in response to a specific stressor, in this case COVID-19. A total of 323 AAHPM members participated, of which 290 (89.8%) completed the PCL-S. Utilizing the most conservative and reliable scoring method for the PCL-S, 16.6% (48/290) met diagnostic criteria for symptomatic PTSD. Demographic factors including age, relationship status, child status, years of experience, geographical location, and gender did not affect odds of PTSD symptomology, yet non-male gender was associated with higher PCL-S scores (3.2 +/- 1.5;p = 0.38). Attitudes surrounding the use and perceived efficacy of telemedicine did not impact the incidence of PTSD. Those providing critical care services (33/156;21.2%) were at greater risk of symptomatic PTSD than those not providing critical care services to COVID-19 patients (15/135;11.1%;RR = 1.9[1.08-3.35];p=0.026). Furthermore, PCL-S scores increased as a function of the number of patients where critical care (but not non-critical care) was provided (p=0.0006). Increased workload (p=0.009) and having to perform new job duties (p=0.004) as a result of COVID-19 were also associated with symptomatic PTSD. Personal stress was also a contributory factor;the risk of symptomatic PTSD was higher among respondents reporting a friend, family member, or colleague's death from COVID-19 (23.8% vs. 13.1%;RR = 1.82[1.08-3.05]). As COVID-19 continues to impact us all, understanding factors affecting the mental health of an integral part of the healthcare workforce is crucial.Copyright © 2023

Changes in the dynamics of food acquisition in homes of students of the University of Antioquia in times of pandemic.

Background: Confinement due Colombia's coronavirus pandemic caused impoverishment in many households, food shortage, and an increased food insecurity, which before the pandemic was at 54.2%. Related to these antecedents, comprehension of food acquisition dynamics was investigated throughout Universidad de Antioquia's students' households within the time of the pandemic. Method(s): A transversal descriptive study of 133 online surveys was applied. Result(s): The confinement changed how families obtained their provisions. Shopping through deliveries increased in 40.6%. Money for food decreased in 30.1% of households. Situations identified as obstacles for provisioning were fear of Coronavirus infection, deprovisioning, obligatory confinement imposed by the government, and higher prices. Nevertheless, 73.7% of households were satisfied with their provisioning methods. Conclusion(s): Confinement contributed to more dependent and solidary means of food acquisition (support from friends and neighbors), and decrease in the autonomy (self-bought).Copyright © 2022 Sociedad Espanola de Nutricion Comunitaria. All rights reserved.

Patterns of Self-medication During the COVID-19 Pandemic in a Colombian population.

Introduction: Self-medication is considered one of the most relevant problems for public health, since it is described as the voluntary use of drugs by the patient. Since the beginning of the health crisis caused by the COVID-19 pandemic, it has been evident that this practice has increased considerably, especially in the adult population. Objective(s): To evaluate the different patterns that influence self-medication during the COVID-19 pandemic. Method(s): A survey was conducted among the population of two vicinities of Bogota and the statistical program SPSS was used for data analysis to identify the main practices that increase the risks derived from self-medication, the most used drugs and their adverse effects. Socioeconomic factors related to self-medication were evaluated. A comparative study was carried out to observe their behavior before and during the pandemic. Additionally, the influence of the people who are part of the family and social environment on self-medication was evaluated. Result(s): The total number of surveys carried out was 301. The average age was 44.18 years. It was found that before the pandemic there was a higher frequency of self-medication of analgesics (49.1 %) and anti-influenza drugs (19.5 %), and during the pandemic it was of non-steroidal anti-inflammatory drugs (4.43 %), home remedies (6.69 %) and antibiotics (30.38 %). In addition, it was found that those who had the greatest influence on self-medication were family members (23.9 %), friends or acquaintances (17.3 %) and the pharmaceutical chemist (5.0 %). Conclusion(s): It is evident that during the COVID-19 pandemic self-medication is higher than in the pre-pandemic era, increasing the risk of adverse events and compromised patient safety.Copyright © 2023, Editorial Ciencias Medicas. All rights reserved.

Caregiver Involvement and Concerns with Care of Residents of Assisted Living before and during the COVID-19 Pandemic.

INTRODUCTION: Family/friend caregivers play an essential role in promoting the physical and mental health of older adults in need of care - especially during the COVID-19 pandemic and especially in assisted living (AL) homes, where resident care needs are similarly complex as in long-term care homes but fewer staffing resources and services are available. However, little research is available on caregiver involvement and concerns with care of AL residents prior to and during waves 1 and 2 of the COVID-19 pandemic. This study addressed this important knowledge gap. METHODS: This prospective cohort study used baseline and follow-up online surveys with primary caregivers to AL residents in Western Canada who were 65 years or older and had lived in the AL home for at least 3 months before Mar 1, 2020. Surveys assessed the following outcomes in the 3 months prior to and during waves 1 and 2 of the pandemic: sociodemographics, 5 ways of visiting or communicating with residents, involvement in 16 care tasks, concerns with 9 resident physical/mental health conditions, perceived lack of resident access to 7 care services, and whether caregivers felt well informed and involved with resident care. RESULTS: Based on 386 caregiver responses, in-person visits dropped significantly in wave 1 of the pandemic and so did caregiver involvement in nearly all care tasks. While these rates increased in wave 2, most did not return to pre-pandemic levels. Correspondingly, caregiver concerns (already high before the pandemic) substantially increased in wave 1 and stayed high in wave 2. These were particularly elevated among caregivers who did not feel well informed/involved with resident care. CONCLUSIONS: Restricted in-person visiting disrupted resident care and was associated with worse perceptions of resident health and well-being. Continued caregiver involvement in resident care and communication with caregivers even during lockdowns is key to mitigating these issues.

An evolving engagement programme for patients with photodermatoses

We previously reported on our experience of an in-person Scottish Photobiology Service (SPS) patient engagement event in 2019 and of its utility in defining what matters to patients with photosensitivity. We identified key issues with delays in referral from primary care, lack of availability of peer support and a need for disease-specific information to raise awareness of photosensitivity for family and employers. Through a follow- up workshop, we identified a workstream of activities planning to address these issues, which were modified by the subsequent COVID-19 pandemic. However, we successfully moved our programme to a virtual platform, and we report on our progress. Twice-yearly virtual TEAMS patient engagement half-day events, attended by patients and staff, provided patients with a forum to discuss with each other issues that they have identified as being important to them. These ranged from the isolation, anxiety and embarrassment associated with photosensitivity, dealing with friends who do not understand their condition, through to coping mechanisms and practicalities, such as sourcing sun protective clothing, dealing with sports activities and photoprotective measures in schools. The virtual events have received extremely positive feedback both in terms of content and utility for patients, as well as the convenience of the virtual format. To supplement these activities, we have also distributed twice-yearly SPS newsletters since 2020, initiated at the start of the COVID-19 pandemic, to ensure our patients knew we were there for them, despite the challenges of the pandemic and, again, this was most positively received. Regarding delays in referral from primary care, patient feedback indicated that this was mainly due to not being taken seriously, possibly due to a lack of understanding of photosensitivity in community care. We are addressing this by developing a 'photosensitivity red flag' poster for distribution throughout primary care in Scotland to raise awareness of the symptoms to look out for in photosensitivity conditions. Finally, we have also embarked on creating a series of diseasespecific podcasts. These involve an informal discussion between a patient with photosensitivity and a consultant photodermatologist, with a mediator present, to raise awareness of the true impact of a range of photodermatoses on many aspects of life. We demonstrate this ongoing programme of diverse patient engagement and educational activities in photodermatology, to highlight the model of a multifaceted hybrid approach to provide additional support for patients with photodermatoses. Acknowledgments: we wish to acknowledge all our SPS patients, their families and staff for their invaluable contributions.

Addiction Treatment Facilities under Special Circumstances/Settings

Background: There has been a rampant increase in substance abuse in Kashmir valley for the last few years. Department of Psychiatry SKIMS Medical College Srinagar has extended its services to cater to the needs of the substance users in the valley even during the COVID -19 pandemic. In 2021, de-addiction services were also started among prison inmates of central jail Srinagar. This was the first of its kind of services provided in the valley. The management of substance users with Hepatitis infections had also been challenging. Purpose(s): To describe the management of substance users under special circumstances(COVID-19), special settings(Central Jail Srinagar), high-risk groups(substance users with blood-borne infections). Method(s): Semi-structured proformas were used to collect data from special groups of participants a) those who were seeking treatment during COVID-19 times from the De-addiction center, SKIMS Medical College b) Prison in-mates on treatment for substance-use disorders c) substance users who are hepatitis B and/or positive. This included Socio-demographic details, clinical profile, the pattern of substance use, coping strategies, and treatment seeking. Preliminary Findings: More than 25 percent of the prison in-mates are substance dependent and relapse rate is very high. Psychiatric comorbidity like mood disorders and or personality disorders are present among most of the prison-inmates. During COVID-19 times, 90% patients reported average to very high level of importance and value given to their own health and health of family and friends and focussed on treatment of their illness(85%). Substance users with blood-borne infections were associated with highrisk behavior in the form of needle-sharing. Conclusion(s): The findings provide a voice that there is a need for backup plans that cater to the needs of substance users during in-evitable circumstances like the COVID-19 pandemic. Policymakers should focus on prison mental health for the functioning of a better society. Substance users with blood-borne infections should be rigorously treated to prevent them from taking the shape of an epidemic.

Providing Educational Resources during the Pandemic for Advanced Breast Cancer Patients

Significance and Background: Metastatic Breast Cancer (MBC) or Advanced Breast Cancer (ABC) is multifaceted and requires high levels of support and resource utilization. The ABC Program at MD Anderson Cancer Center began in 2014 with a goal to increase the quantity and quality of life for patients living with MBC. It offers emotional support, personalized visits with a nurse practitioner navigator, access to clinical trials, specialty clinics, tailored patient education and innovative care projects. Prior to COVID-19, the ABC Program held a 90-minute quarterly town hall series featuring 2-3 presenters and topics of patient interest. In response to COVID-19, it pivoted to a weekly virtual 60-minute educational series called "ABCs of Healthy Living in Challenging Times" that is for patients with breast cancer, caregivers, faculty, staff, community members and advocates. Purpose(s): To address COVID-19 social-distancing related isolation and changes to healthcare, build community, empower patients, and educate on diverse topics including patient services, treatment, symptom management and quality of life. Interventions and Evaluation: The series was facilitated by a nurse practitioner navigator via Zoom. A distribution list created from town hall meetings was the basis for the series' notices and has grown by referrals, word of mouth and marketing opportunities;it began with less than 150 people and has grown to more than 550 people. The facilitator offered a format where the attendees and speakers could interact visually and verbally with each other. From 4/2020 to 6/2022, 104 webinars were held for 2,546 attendees for an average of 24 attendees each week. Topics covered were side effect management/quality of life/healthy lifestyle (26%), patient education/empowerment (18%), treatment (19%), clinical trials/research (11%), quality of life related to COVID-19 (8%), COVID-19 (7%), innovation projects (4%), palliative/end of life care (7%), and financial/disability concerns (3%). The series was evaluated using the Qualtrics survey software (n=53). Respondents said that the series has positively influenced their interactions with healthcare providers (65%), how patients with MBC think about their cancer experiences (65%) and provided an opportunity to connect with others like themselves (65%). Respondents stated actions taken based on the series: shared the information with family/friends (77%), joined or remained in a support group (34%), spoke with a provider for information and services (32%), requested an appointment with the ABC Program or other specialty clinics (26%), started a new healthy behavior (21%), joined a clinical trial (11%), or started using a patient reported outcome tool (9%). The series served mostly patients living with MBC (70%), established patients at MD Anderson (38%) or patients at MD Anderson as well as a community cancer center (17%). Most respondents indicated that they attended about half of the time, usually or always (60%) and are very or completely satisfied with the series (92%). Demographics of the respondents were White (77%), Black (13%), Asian (4%) and Hispanic (16%). Discussion(s): The ABC Program pivoted to COVID-19 by offering services virtually. The virtual series has allowed for more digestible patient education, varied presentations, and participation for those living outside of Houston, TX. Peer support and continuing education are imperative dynamics for patients to use their voice to impact their overall quality of life. The series has impacted attendees with a change in behavior when speaking with their clinical team, awareness and utilization of support resources, and starting healthy behaviors. While the series was created in response to demands of COVID-19, it effectively addressed psychosocial and educational needs and overall quality of life of MBC patients. The series was an easy intervention to initiate with lasting changes relative to the effort and resources required.