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5.
J Alzheimers Dis ; 80(4): 1713-1721, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33646163

RESUMEN

BACKGROUND: From March 2020, the support and care systems for caregivers and people with dementia (PWD) were suspended or dramatically changed due to the lockdown during the world pandemic of COVID-19. Thus, these changes in living conditions have had deleterious consequences on the behavior of PWD and subsequently on their caregivers' mental health, the two being linked. OBJECTIVE: Our study aimed to examine changes in behavior among PWD and to look for associations between the evolution of behavioral and psychological symptoms of dementia (BPSD) and caregivers' mental health in the context of COVID-19. METHODS: The study was conducted among caregivers of PWD living at home in France. Caregivers were interviewed via an anonymous cross-sectional online survey during the first lockdown between April 15 and June 15, 2020. RESULTS: Three hundred and eighty-nine caregivers accompanying a relative living at home participated in the study; 43.3%of the PWD presented a worsening of BPSD during the lockdown. With multivariate logistic regressions, a significant association was observed between "more BPSD" and burden, anxiety and depression, between "BPSD equivalent" and anxiety and depression, and between "emerging BPSD" and only depression. CONCLUSION: The lockdown seems to have an impact on behavioral disorders in PWD and these disorders are associated with poorer mental health of caregivers. Our findings suggest attention should be given to caregivers of PWD who have BPSD before lockdown and the need for continued consultations and professional help in case of new lockdowns.


Asunto(s)
/psicología , Cuidadores/psicología , Control de Enfermedades Transmisibles , Demencia/psicología , Trastornos Mentales/psicología , Salud Mental , Anciano , Anciano de 80 o más Años , Cuidadores/tendencias , Control de Enfermedades Transmisibles/tendencias , Estudios Transversales , Demencia/epidemiología , Femenino , Francia/epidemiología , Humanos , Masculino , Trastornos Mentales/epidemiología , Salud Mental/tendencias , Persona de Mediana Edad , Encuestas y Cuestionarios
6.
J Alzheimers Dis ; 80(4): 1395-1399, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33646169

RESUMEN

The rapid emergence of COVID-19 has had far-reaching effects across all sectors of health and social care, but none more so than for residential long-term care homes. Mortality rates of older people with dementia in residential long-term care homes have been exponentially higher than the general public. Morbidity rates are also higher in these homes with the effects of government-imposed COVID-19 public health directives (e.g., strict social distancing), which have led most residential long-term care homes to adopt strict 'no visitor' and lockdown policies out of concern for their residents' physical safety. This tragic toll of the COVID-19 pandemic highlights profound stigma-related inequities. Societal assumptions that people living with dementia have no purpose or meaning and perpetuate a deep pernicious fear of, and disregard for, persons with dementia. This has enabled discriminatory practices such as segregation and confinement to residential long-term care settings that are sorely understaffed and lack a supportive, relational, and enriching environment. With a sense of moral urgency to address this crisis, we forged alliances across the globe to form Reimagining Dementia: A Creative Coalition for Justice. We are committed to shifting the culture of dementia care from centralized control, safety, isolation, and punitive interventions to a culture of inclusion, creativity, justice, and respect. Drawing on the emancipatory power of the imagination with the arts (e.g., theatre, improvisation, music), and grounded in authentic partnerships with persons living with dementia, we aim to advance this culture shift through education, advocacy, and innovation at every level of society.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/tendencias , Demencia/epidemiología , Demencia/terapia , Cuidados a Largo Plazo/tendencias , /psicología , Control de Enfermedades Transmisibles/métodos , Demencia/psicología , Hogares para Ancianos/tendencias , Humanos , Cuidados a Largo Plazo/métodos , Casas de Salud/tendencias
7.
Sci Data ; 8(1): 94, 2021 03 25.
Artículo en Inglés | MEDLINE | ID: mdl-33767205

RESUMEN

The Coronavirus disease 2019 (COVID-19) global pandemic has transformed almost every facet of human society throughout the world. Against an emerging, highly transmissible disease, governments worldwide have implemented non-pharmaceutical interventions (NPIs) to slow the spread of the virus. Examples of such interventions include community actions, such as school closures or restrictions on mass gatherings, individual actions including mask wearing and self-quarantine, and environmental actions such as cleaning public facilities. We present the Worldwide Non-pharmaceutical Interventions Tracker for COVID-19 (WNTRAC), a comprehensive dataset consisting of over 6,000 NPIs implemented worldwide since the start of the pandemic. WNTRAC covers NPIs implemented across 261 countries and territories, and classifies NPIs into a taxonomy of 16 NPI types. NPIs are automatically extracted daily from Wikipedia articles using natural language processing techniques and then manually validated to ensure accuracy and veracity. We hope that the dataset will prove valuable for policymakers, public health leaders, and researchers in modeling and analysis efforts to control the spread of COVID-19.


Asunto(s)
Inteligencia Artificial , /terapia , Control de Enfermedades Transmisibles/tendencias , Salud Global , Humanos
8.
Nat Med ; 27(3): 396-400, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33723454

RESUMEN

Fourteen months into the SARS-CoV-2 pandemic, we identify key lessons in the global and national responses to the pandemic. The World Health Organization has played a pivotal technical, normative and coordinating role, but has been constrained by its lack of authority over sovereign member states. Many governments also mistakenly attempted to manage COVID-19 like influenza, resulting in repeated lockdowns, high excess morbidity and mortality, and poor economic recovery. Despite the incredible speed of the development and approval of effective and safe vaccines, the emergence of new SARS-CoV-2 variants means that all countries will have to rely on a globally coordinated public health effort for several years to defeat this pandemic.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles , Salud Global , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/tendencias , Salud Global/historia , Salud Global/tendencias , Gobierno , Historia del Siglo XXI , Humanos , Pandemias/historia , Salud Pública/historia , Salud Pública/métodos , Salud Pública/tendencias , Administración en Salud Pública/métodos , Administración en Salud Pública/normas , Administración en Salud Pública/tendencias , /fisiología
9.
PLoS One ; 16(3): e0248066, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33690701

RESUMEN

This research note introduces a new global dataset, the Citizenship, Migration and Mobility in a Pandemic (CMMP). The dataset features systematic information on border closures and domestic lockdowns in response to the COVID-19 outbreak in 211 countries and territories worldwide from 1 March to 1 June 2020. It documents the evolution of the types and scope of international travel bans and exceptions to them, as well as internal measures including limitations of non-essential movement and curfews in 27 countries. CMMP can be used to study causes and effects of policy restrictions to migration and mobility during the COVID-19 pandemic. The dataset is available through Cadmus and will be regularly updated until the last pandemic-related restriction has been lifted or become long-term.


Asunto(s)
/psicología , Migración Humana/estadística & datos numéricos , Viaje/tendencias , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/tendencias , Brotes de Enfermedades/prevención & control , Humanos , Pandemias/estadística & datos numéricos , Viaje/estadística & datos numéricos
11.
Evol Psychol ; 19(1): 14747049211000714, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33752457

RESUMEN

It is puzzling why countries do not all implement stringent behavioral control measures to prevent the spread of COVID-19 even though preventive behaviors have been proven to be the only effective means to stop the pandemic. We provide a novel evolutionary life history explanation whereby pathogenic and parasitic prevalence represents intrinsic rather than extrinsic mortality risk that drives slower life history strategies and the related disease control motivation in all animals but especially humans. Our theory was tested and supported based on publicly available data involving over 150 countries. Countries having a higher historical prevalence of infectious diseases are found to adopt slower life history strategies that are related to prompter COVID-19 containment actions by the government and greater compliance by the population. Findings could afford governments novel insight into the design of more effective COVID-19 strategies that are based on enhancing a sense of control, vigilance, and compliance in the general population.


Asunto(s)
Control de la Conducta , Control de Enfermedades Transmisibles , Infecciones , Rasgos de la Historia de Vida , Conducta de Reducción del Riesgo , Control de la Conducta/legislación & jurisprudencia , Control de la Conducta/métodos , Control de la Conducta/psicología , /prevención & control , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/tendencias , Conducta Cooperativa , Salud Global , Regulación Gubernamental , Humanos , Infecciones/epidemiología , Infecciones/psicología , Infecciones/transmisión , Prevalencia
12.
Epilepsy Behav ; 116: 107800, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33571838

RESUMEN

OBJECTIVE: To evaluate the impact of the coronavirus disease 2019 (COVID-19) measures on the lives and psychosocial well-being of persons with epilepsy (PWE) during the third trimester of the COVID-19 pandemic. METHODS: A structured questionnaire investigating different aspects of the lives and psychosocial well-being of PWE during the COVID-19 pandemic was developed. Persons with epilepsy were invited via social media to anonymously respond to a secure web-based online questionnaire (www.icpcovid.com). Responses were collected between July 26th and December 3rd, 2020. Hospital anxiety and depression scales (HADS) were used to screen respondents for depression (HADS-D) and anxiety (HADS-A). RESULTS: Responses of 407 PWE were included in the analysis; 304 (74.7%) respondents were female and 245 (60.2%) living in Europe, 157 (38.6%) in South America, and 5 (1.2%) in Canada. Seventy-six (18.7%) reported a decrease of income during the COVID-19 lockdown, and 122 (30.0%) experienced difficulties in obtaining anti-seizure medication (ASM), mostly (72/122, 59.0%) due to unavailability. Seizure frequency increased in 122 (30.0%); 295 (72.5%) screened positive for anxiety, and 159 (39.1%) for depression. Hundred eighty-eight (46.2%) reported reluctance to seek medical care; 27.3% believed that epilepsy was associated with an increased risk of COVID-19 disease. Forty-six (74.2%) of 62 PWE who were followed up by telephone or video consult were satisfied with this consult. Fifty-five respondents, most (89.1%) of whom were from Europe, had also participated in a previous survey during the early months of the pandemic. In this subgroup, although there was no difference in prevalence of a positive screening for depression or anxiety, mean scores on HADS-A and HADS-D increased from 6.65 ±â€¯3.99 to 7.27 ±â€¯4.01 (p = 0.418), and from 5.84 ±â€¯4.43 to 6.60 ±â€¯4.45 (p = 0.371), respectively. CONCLUSIONS: The COVID-19 pandemic continues to impact the psychosocial and somatic well-being of PWE. To minimize this impact, ensuring uninterrupted access to ASM is essential. Teleconsultations are valid alternatives for continued follow-up, but should include attention to psychosocial well-being. Persons with epilepsy should be more actively informed that epilepsy is not a risk factor for developing (more severe) COVID-19 disease.


Asunto(s)
/epidemiología , Epilepsia/epidemiología , Epilepsia/psicología , Internacionalidad , Encuestas y Cuestionarios , Adulto , Ansiedad/epidemiología , Ansiedad/psicología , Ansiedad/terapia , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/tendencias , Prestación de Atención de Salud/métodos , Prestación de Atención de Salud/tendencias , Epilepsia/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Consulta Remota/métodos , Consulta Remota/tendencias , Factores de Riesgo , Convulsiones/epidemiología , Convulsiones/psicología , Convulsiones/terapia
13.
BMC Med ; 19(1): 20, 2021 02 05.
Artículo en Inglés | MEDLINE | ID: mdl-33541357

RESUMEN

BACKGROUND: There is little information on care-seeking patterns for sexual assault and domestic violence during the COVID-19 pandemic. The objective of this study was to examine the changes in emergency department (ED) admissions for sexual assault and domestic violence since the COVID-19 pandemic was declared. METHODS: Observational ED admissions data from The Ottawa Hospital were analyzed from March 4 to May 5 (62 days) in 2020 (COVID-19 period) and compared to the same period in 2018 (pre-COVID-19). Total and mean weekly admissions were calculated for all-cause ED admissions and for sexual and domestic violence cases. A Poisson regression (without offset term) was used to calculate the weekly case count ratio and 95% confidence intervals (CI) between the two time periods. Case characteristics were compared using chi-square tests, and percent differences were calculated. RESULTS: Compared to pre-COVID-19, total ED admissions dropped by 1111.22 cases per week (32.9% reduction), and the Sexual Assault and Domestic Violence Program cases dropped 4.66 cases per week. The weekly case count ratio for sexual assault cases was 0.47 (95% CI 0.79-0.27), equivalent of 53.49% reduction in cases, and 0.52 (95% CI 0.93-0.29), equivalent to a 48.45% reduction in physical assault cases. The characteristics of presenting cases were similar by age (median 25 years), sex (88.57% female), assault type (57.14% sexual assault, 48.57% physical assault), and location (31.43% patient's home, 40.00% assailant's home). There was a significant increase in psychological abuse (11.69% vs 28.57%) and assaults occurring outdoors (5.19% vs 22.86%). CONCLUSION: This study found a decrease in ED admissions for sexual assault and domestic violence during COVID-19, despite societal conditions that elevate risk of violence. Trends in care-seeking and assault patterns will require ongoing monitoring to inform the provision of optimal support for individuals experiencing violence, particularly as countries begin to re-open or lock-down again.


Asunto(s)
/epidemiología , Violencia Doméstica/tendencias , Servicio de Urgencia en Hospital/tendencias , Pandemias , Aceptación de la Atención de Salud , Delitos Sexuales/tendencias , Adulto , Control de Enfermedades Transmisibles/tendencias , Violencia Doméstica/psicología , Femenino , Humanos , Masculino , Ontario/epidemiología , Aceptación de la Atención de Salud/psicología , Delitos Sexuales/psicología , Adulto Joven
14.
Stroke ; 52(4): 1362-1369, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33626900

RESUMEN

BACKGROUND AND PURPOSE: In France, the entire population was put under a total lockdown from March 17 to May 11, 2020 during the peak of the coronavirus disease 2019 (COVID-19) pandemic. Whether the lockdown had consequences on the management of medical emergencies such as stroke and transient ischemic attack (TIA) has yet to be fully evaluated. This article describes hospitalization rates for acute stroke in 2 French regions that experienced contrasting rates of COVID-19 infection, before, during, and after the nationwide lockdown (January to June 2020). METHODS: All patients admitted for acute stroke/TIA into all public and private hospitals of the 2 study regions were included. Data were retrieved from the National Hospitalization Database (PMSI). In the most affected region (Grand-Est), the hospitalization rates observed in April 2020 were compared with the rates in the same period in the least affected region (Occitanie) and in the 3 prior years (2017-2019). RESULTS: There was a significant decline in hospitalization rates for stroke/TIA within the region most affected by COVID-19 during the month of April 2020 compared with previous years, while no significant change was seen in the least affected region. After lockdown, we observed a fast rebound in the rate of hospitalization for stroke/TIA in the most affected region, contrasting with a slower rebound in the least affected region. In both regions, patients with COVID-19 stroke more frequently had ischemic stroke, a nonsignificant greater prevalence of diabetes, they were less frequently admitted to stroke units, and mortality was higher than in patients without COVID-19. CONCLUSIONS: Our results demonstrates a significant drop in stroke/TIA hospitalizations and a fast recovery after the end of the French lockdown in the most affected region, while the least affected region saw a nonsignificant drop in stroke/TIA hospitalizations and a slow recovery. These results and recommendations could be used by the health authorities to prepare for future challenges.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/tendencias , Hospitalización/tendencias , Pandemias , Accidente Cerebrovascular/epidemiología , Anciano , Anciano de 80 o más Años , Control de Enfermedades Transmisibles/métodos , Femenino , Francia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Accidente Cerebrovascular/terapia
15.
Clin Neurol Neurosurg ; 202: 106488, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33460984

RESUMEN

OBJECTIVE: Myasthenia gravis (MG) is characterized by fluctuating muscle weakness due to immune mediated damage of acetylcholine receptor (AchR). COVID-19 infection, mental stress and non-availability of drugs following lockdown may worsen myasthenic symptoms. We report the impact of COVID 19, and lockdown on the physical and mental health, and quality of sleep in a cohort of MG. METHODS: Thirty-eight MG patients were telephonically interviewed 2months after the declaration of lockdown in India. The difficulty in procuring drugs, complications, and worsening in the MG Foundation of America (MGFA) stage were noted. The patients were enquired about MG Quality of Life 15 (MGQOL15), MG Activity of Daily Living (MGADL), Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) using a prefixed questionnaire. Their pre-COVID parameters were retrieved from our earlier trial data, which was completed 4months back. The scores of the above mentioned parameters before and after COVID were compared. RESULTS: Their median age was 45 years, and the median duration of treatment for MG was 4.5years. Eleven (28.9 %) patients were hypertensive and 3(7.9 %) diabetic. All were on prednisolone and 18(47.4 %) received azathioprine. None developed COVID, but three had other infections. Two patients needed hospitalization because of wrong medication in one and severe anxiety-insomnia in another. Following COVID19 and lockdown, MG patients had worsening in MGQOL15, MGADL, HADS and PSQI scores. Pittsburgh Sleep Quality Index score correlated with MGQOL15 and dose of acetylcholine esterase inhibitors. CONCLUSION: COVID-19 and lockdown were associated with anxiety, depression, poor MGQOL and sleep especially in severe MG patients.


Asunto(s)
/epidemiología , Miastenia Gravis/epidemiología , Miastenia Gravis/psicología , Pandemias , Cuarentena/psicología , Actividades Cotidianas/psicología , Adolescente , Adulto , Anciano , Estudios de Cohortes , Control de Enfermedades Transmisibles/tendencias , Femenino , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Calidad de Vida/psicología , Cuarentena/tendencias , Autoinforme , Adulto Joven
16.
Epilepsy Behav ; 116: 107785, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33515934

RESUMEN

The coronavirus disease 2019 (COVID-19) outbreak started in Wuhan, China, in late 2019 and rapidly spread globally. Vaccines have recently been developed and are being administered in some countries, but their widespread use is not yet sufficient; the battle against COVID-19 is protracted and people need to adapt to living under the influence of this disease. Epilepsy is a common chronic neurological condition characterized by spontaneous recurrence of unprovoked seizures. Various effects of COVID-19 on epilepsy have been studied in recent months. As clinicians, we need to keep up with daily updates in the evidence regarding interactions between COVID-19 and epilepsy. This review article summarizes the current evidence. Prospective studies on epilepsy and COVID-19 remain lacking. Most articles have comprised case reports, case series, retrospective studies, and recommendations/opinions that do not include data. However, summarizing these articles can identify the demands for research into COVID-19 and epilepsy by clarifying what is known and what remains unclear from current research.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/métodos , Epilepsia/epidemiología , Convulsiones/epidemiología , Anticonvulsivantes/uso terapéutico , Control de Enfermedades Transmisibles/tendencias , Epilepsia/tratamiento farmacológico , Humanos , Estudios Prospectivos , Recurrencia , Estudios Retrospectivos , Convulsiones/tratamiento farmacológico
18.
Diabetes Metab Syndr ; 15(1): 205-211, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33387854

RESUMEN

BACKGROUND AND AIMS: Potential role of health literacy in determining adherence to COVID-19 preventive behavior, pharmacological, and lifestyle management among diagnosed patients of chronic diseases during nationwide lockdown is inadequately investigated. METHODS: A cross-sectional study was conducted from May-August 2020 among diagnosed patients of chronic diseases residing in a COVID-19 hotspot of urban Jodhpur, Rajasthan, and availing health services from primary care facility. Telephonic interviews of participants were conducted to determine their health literacy using HLS-EU-Q47 questionnaire, adherence to COVID-19 preventive behaviour as per World Health Organization recommendations, and compliance to prescribed pharmacological and physical activity recommendations for chronic disease. RESULTS: All the 605 diagnosed patients of chronic diseases availing services from primary care facility were contacted for the study, yielding response rate of 68% with 412 agreeing to participate. Insufficient health literacy was observed for 65.8% participants. Only about half of participants had scored above median for COVID-19 awareness (55.1%) and preventive behavior (45.1%). Health literacy was observed to be significant predictor of COVID-19 awareness [aOR: 3.53 (95% CI: 1.81-6.88)]; COVID-19 preventive behavior [aOR: 2.06, 95%CI; 1.14-3.69] and compliance to pharmacological management [aOR: 3.05; 95% CI: 1.47-6.35] but not for physical activity. CONCLUSION: COVID-19 awareness, preventive behavior, and compliance to pharmacological management is associated with health literacy among patients of chronic disease availing services from primary health facility. Focusing on health literacy could thus be an essential strategic intervention yielding long term benefits.


Asunto(s)
/epidemiología , Alfabetización en Salud/tendencias , Cooperación del Paciente , Atención Primaria de Salud/tendencias , Cuarentena/tendencias , Población Urbana/tendencias , Adolescente , Adulto , /psicología , Enfermedad Crónica , Control de Enfermedades Transmisibles/tendencias , Estudios Transversales , Femenino , Instituciones de Salud/tendencias , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Cooperación del Paciente/psicología , Sistema de Registros , Encuestas y Cuestionarios , Adulto Joven
19.
Acta Neurol Scand ; 143(4): 349-354, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33421104

RESUMEN

OBJECTIVES: The aim of the present study was to investigate how the initial phase of the COVID-19 pandemic affected the hospital stroke management and research in Norway. MATERIALS AND METHODS: All neurological departments with a Stroke Unit in Norway (n = 17) were invited to participate in a questionnaire survey. The study focused on the first lockdown period, and all questions were thus answered in regard to the period between 12 March and 15 April 2020. RESULTS: The responder rate was 94% (16/17). Eighty-one % (13/16) reported that the pandemic affected their department, and 63% (10/16) changed their stroke care pathways. The number of new acute admissions in terms of both strokes and stroke mimics decreased at all 16 departments. Fewer patients received thrombolysis and endovascular treatment, and multidisciplinary stroke rehabilitation services were less available. The mandatory 3 months of follow-up of stroke patients was postponed at 73% of the hospitals. All departments conducting stroke research reported a stop in ongoing projects. CONCLUSION: In Norway, hospital-based stroke care and research were impacted during the initial phase of the COVID-19 pandemic, with likely repercussions for patient care and outcomes. In the future, stroke departments will require contingency plans in order to protect the entire stroke treatment chain.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/métodos , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/epidemiología , Encuestas y Cuestionarios , /prevención & control , Control de Enfermedades Transmisibles/tendencias , Estudios de Seguimiento , Hospitalización/tendencias , Humanos , Noruega/epidemiología , Pandemias/prevención & control , Accidente Cerebrovascular/terapia , Rehabilitación de Accidente Cerebrovascular/tendencias
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