Calidad de vida relacionada con la salud y los estados de ánimo en estudiantes de instituciones educativas de Antioquia, Colombia / Quality of life related to the health and mood states of students in educational institutions from Antioquia, Colombia / Qualidade de vida relacionada à saúde e ao humor em estudantes de instituições de ensino em Antioquia, Colômbia

Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.

Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.

Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.

Representação social da Covid-19 para a população de uma cidade de pequeno porte / Social representation of Covid-19 for the population of a small-sized city / Representación social del Covid-19 para la población de un pequeño pueblo

Objetivo: analisar a representação social da Covid-19 para a população geral de uma cidade de pequeno porte do Estado do Rio de Janeiro. Método: estudo qualitativo, apoiado na abordagem estrutural das representações sociais. Participaram 100 usuários de serviços de saúde. Os dados foram coletados por questionário sociodemográfico de evocações livres de palavras e roteiro de entrevista semiestruturada. Os dados foram analisados com o auxílio dos softwares Excel, EVOC 2005 e análise de conteúdo temático-categorial para contextualização das evocações respectivamente. Resultados: os termos do possível núcleo central foram: morte, sofrimento, cuidados, ansiedade-angústia e vacina. Na primeira periferia: medo e prevenção. À segunda periferia: informação-desinformação; desgoverno; ter-fé e proteção. A zona de contrate: doença; isolamento-social; dificuldades; catástrofe-mundial; desemprego e pandemia. Considerações finais: marcaram essa representação os impactos psicossociais negativos resultantes da desestruturação da vida e das mortes ocasionadas pela nova doença, no entanto o grupo aderiu as medidas de cuidados de proteção.

Objective: to analyze the social representation of Covid-19 among the general population of a small-sized city in the State of Rio de Janeiro. Method: Qualitative study, based on the structural approach of social representations. One hundred healthcare service users participated. Data were collected through a sociodemographic questionnaire, free word evocation, and a semi-structured interview guide. The data were analyzed using Excel software, EVOC 2005, and thematic-categorical content analysis for contextualization of the evocations, respectively. Results: the terms of the possible central core were: death, suffering, care, anxiety-distress, and vaccine. In the first periphery: fear and prevention. In the second periphery: information-misinformation; mismanagement; having faith and protection. The contrast zone: disease; social isolation; difficulties; global catastrophe; unemployment; and pandemic. Final considerations: this representation was marked by the negative psychosocial impacts resulting from the disruption of life and the deaths caused by the new disease; however, the group adhered to protective care measures.

Objetivo: analizar la representación social del Covid-19 para la población general de una pequeña ciudad del Estado de Río de Janeiro. Método: estudio cualitativo, basado en el enfoque estructural de las representaciones sociales. Participaron 100 usuarios de servicios de salud. Los datos se recolectaron mediante un cuestionario sociodemográfico con evocación libre de palabras y una guía de entrevista semiestructurada. Los datos fueron analizados utilizando lo software Excel y EVOC 2005 y análisis de contenido temático-categórico para contextualizar las evocaciones respectivamente. Resultados: los términos del posible núcleo central eran: muerte, sufrimiento, cuidados, ansiedad-angustia y vacuna. En la primera periferia: miedo y prevención. En la segunda periferia: información-desinformación; desgobierno; tener fe y protección. La zona de contraste: enfermedad; aislamiento-social; dificultades; catástrofe-mundial; desempleo y pandemia. Consideraciones finales: esta representación se caracterizó por los impactos psicosociales negativos derivados de la desestructuración de la vida y de las muertes causada por la nueva enfermedad, sin embargo, el grupo adhirió a las medidas de protección.

Efeitos do treinamento físico supervisionado na ansiedade, estresse e depressão após a Covid-19 / Effects of supervised physical training on anxiety, stress and depression after Covid-19 / Efectos del entrenamiento físico supervisado en la ansiedad, el estrés y la depresión después de la Covid-19

Objetivo: avaliar ansiedade, estresse e depressão antes e após o treinamento físico em acometidos pela Covid-19. Método: estudo quase-experimental realizado em Goiânia com pacientes que tiveram Covid-19 moderada a grave, após internação. Investigou-se ansiedade, estresse e depressão por meio da DASS-21. Os participantes realizaram dezoito sessões de treinamento físico, três vezes/semana composto por exercícios aeróbios, resistidos e de flexibilidade. Utilizou-se teste Shapiro Wilk para distribuição e os testes t pareado e Wilcoxon com nível de significância de p<0,05 para comparações. Resultado: participaram dezessete indivíduos com 55,59(±5,20) anos, predominantemente mulheres (64,7%), média de dezessete dias internados, maioria obesos (52,9%) com alguma doença prévia à Covid-19 (76,5%). Houve redução da ansiedade (mediana de 9,0 para 2,0 [p=0,001]), estresse de 10,0 para 2,0 (p=0,001) e depressão de 6,0 para 2,0 (p<0,001) após treinamento físico. Conclusão: o treinamento físico foi eficaz para melhora da ansiedade, estresse e depressão após dezoito sessões.

Objective: to assess anxiety, stress and depression before and after physical training in people affected by Covid-19. Method: a quasi-experimental study carried out in Goiania with patients who had moderate to severe Covid-19 after hospitalization. Anxiety, stress and depression were investigated using the DASS-21. The participants underwent eighteen physical training sessions, three times a week, consisting of aerobic, resistance and flexibility exercises. The Shapiro Wilk test was used for distribution and the paired t-test and Wilcoxon test with a significance level of p<0.05 were used for comparisons. Results: seventeen individuals took part, aged 55.59 (±5.20) years, predominantly women (64.7%), an average of seventeen days in hospital, the majority obese (52.9%) with some illness prior to Covid-19 (76.5%). There was a reduction in anxiety (median from 9.0 to 2.0 [p=0.001]), stress from 10.0 to 2.0 (p=0.001) and depression from 6.0 to 2.0 (p<0.001) after physical training. Conclusion: physical training was effective in improving anxiety, stress and depression after eighteen sessions.

Objetivo: evaluar la ansiedad, el estrés y la depresión antes y después del entrenamiento físico en afectados por la Covid-19. Método: estudio cuasi-experimental realizado en Goiânia con pacientes que tuvieron Covid-19 moderada a grave, tras hospitalización. Se investigó la ansiedad, el estrés y la depresión mediante el DASS-21. Los participantes realizaron dieciocho sesiones de entrenamiento físico, tres veces por semana compuesto por ejercicios aeróbicos, de resistencia y de flexibilidad. Se utilizó la prueba Shapiro Wilk para distribución y las pruebas t pareada y Wilcoxon con nivel de significancia de p<0,05 para comparaciones. Resultado: participaron diecisiete individuos con 55,59 (±5,20) años, predominantemente mujeres (64,7%), media de diecisiete días hospitalizados, mayoría obesos (52,9%) con alguna enfermedad previa a la Covid-19 (76,5%). Hubo reducción de la ansiedad (mediana de 9,0 a 2,0 [p=0,001]), estrés de 10,0 a 2,0 (p=0,001) y depresión de 6,0 a 2,0 (p<0,001) tras el entrenamiento físico. Conclusión: el entrenamiento físico fue eficaz para mejorar la ansiedad, el estrés y la depresión después de dieciocho sesiones.

A experiência de profissionais da saúde de um Centro de Saúde Escola do estado de São Paulo na pandemia da Covid-19 / The experience of health professionals from the Centro de Saúde Escola in the state of São Paulo during the Covid-19 pandemic

Em 2020, a Atenção Primária à Saúde do Sistema Único de Saúde cumpriu função de protagonista no combate à Covid-19 como primeiro acesso aos serviços de saúde, que foi considerada Emergência de Saúde Pública e doença pandêmica, exigindo desses serviços e dos profissionais uma reorganização, com fortalecimento do trabalho em equipe para garantir cuidado integral e de qualidade à população. Objetivo: compreender a experiência de profissionais da saúde da Atenção Primária na pandemia. Métodos: estudo qualitativo na abordagem compreensiva, decorrente de projeto maior e aprovado com o Parecer Consubstanciado. Coleta de dados: entre agosto de 2021 e fevereiro de 2022, por entrevistas individuais, síncronas, pela plataforma Google Meet; gravadas pela própria plataforma, transcritas e analisadas segundo referencial metodológico de Bardin, vertente temática. Das unidades de significação originaram categorias e temas propostos. Resultados: cinco categorias: reorganização do processo de trabalho da unidade de saúde; sentimentos demonstrados por profissionais e população; conflito população-profissionais da saúde na adesão à vacinação influenciada pela mídia; indicadores do processo de trabalho durante a pandemia; e (des)conhecimento. Três temas foram identificados: Processo de trabalho da equipe multidisciplinar da unidade de saúde durante a pandemia de 2020 e 2021; Enfrentamento/sentimento dos profissionais e pacientes; Mídia influenciando comportamento da população. Considerações finais: as contribuições do estudo corroboram para desenvolver alternativas para melhorar o cuidado ao paciente; proporcionar condições de apoio aos profissionais, tornando-se necessário que a unidade de saúde forneça suporte psicológico aos profissionais e que os gestores considerem as vivências dos trabalhadores para fortalecer o trabalho em equipe.

In 2020, Primary Health Care (PHC) of the Sistema Único de Saúde (SUS) played a leading role in the fight against Covid-19 as the first access to health services. Covid-19 was considered a Public Health Emergency and a pandemic disease, which required all services and health professionals to reorganize and strengthen teamwork to ensure comprehensive and quality care for the population. Objective: to understand the experience of health professionals working in Primary Care in the Covid-19 pandemic. Methods: qualitative study with a comprehensive approach, resulting from a larger project approved with Embodied Opinion number 4,731,629. Data collection: took place from August 2021 to February 2022, through individual interviews, synchronous, through the Google Meet platform. These were recorded by the platform itself, transcribed and analyzed according to Bardin's Content Analysis methodological framework, thematic approach. From the units of meaning originated the proposed categories and themes. Results: five categories: reorganization of the health unit's work process; feelings shown by professionals and population; conflict population-health professionals in adherence to vaccination influenced by the media; Indicators of the work process during the pandemic and (lack of) knowledge. Three themes were identified: The work process of the health unit's multidisciplinary team during the 2020 and 2021 pandemic; The coping/feeling of professionals and patients; Media influencing population behavior. The study's contributions support the development of alternatives to improve patient care; provide support conditions for professionals. Final considerations: the study's contributions support the development of alternatives to improve patient care; provide support conditions for professionals, making it necessary for the health unit to provide psychological support to professionals and for managers to consider the experiences of workers to strengthen teamwork.

Estresse percebido e sofrimento psíquico em gestoresde saúde na pandemia da Covid-19 / Perceived stress and psychic suffering in healthmanagers in the Covid-19 pandemic

Objetivo: analisar o nível de estresse percebido e sofrimento psíquico em gestores de saúde na pandemia da Covid-19. Método: estudo descritivo, transversal com abordagem quantitativa. A coleta ocorreu de abril a setembro de 2021, com 40 gestores de serviço de saúde. Utilizou-se para a coleta de dados um instrumento para caracterização sociodemográfica e ocupacional e as escalas "Perceived Stress Scale-14" e "Self Reporting Questionnaire" para avaliação do estresse percebido e sofrimento psíquico. Os dados coletados foram analisados no Statistical Package for the Social Sciences versão 22.0. O presente estudo faz parte de um projeto intitulado "Trabalhadores dos Serviços de Saúde Frente à Pandemia de Covid-19", aprovado pelo Comitê de Ética em Pesquisa sob CAAE número 35260620.9.0000.5231. Resultados: a maioria dos profissionais eram do sexo feminino (90%, N=36), casados (70%, N=28), com filhos (80%, N=32), com média de idade de 45 anos e com pós--graduação (47,5%, N=19). A média dos escores relacionados ao estresse percebido foi 31,13 pontos (DP=3,77) sendo o mínimo 24 e máximo de 42 pontos. Com relação ao sofrimento psíquico, (40%, N=16) os gestores apresentaram prováveis casos de transtornos. A prática de atividades físicas e de lazer (p<0,05) tem papel importante na diminuição do estresse percebido e do sofrimento psíquico. Conclusão: os gestores em saúde apresentaram, durante a pandemia, estresse e sofrimento psíquico, resultados esses que devem ser considerados para promoção de autocuidado aos gestores de saúde, enfatizando a necessidade da realização de atividades físicas e de lazer.

Objective: to analyze the level of perceived stress and psychological suffering in health managers during the Covid-19 pandemic. Method: descriptive, cross-sectional study with a quantitative approach. The collection took place from April to September 2021, with 40 health service managers. An instrument for socio-demographic and occupational characterization and the "Perceived Stress Scale-14" and "Self Reporting Questionnaire" scales were used for the assessment of perceived stress and psychic suffering. The collected data were analyzed using the Statistical Package for the Social Sciences version 22.0. The present study is part of a project entitled "Health Service Workers in the Face of the Covid-19 Pandemic", approved by the Research Ethics Committee under CAAE number 35260620.9.0000.5231. Results: most professionals were female (90%, N=36), married (70%, N=28), with children (80%, N=32), with a mean age of 45 years and with a postgraduate degree. -graduation (47.5%, N=19). The average score related to perceived stress was 31.13 points (SD=3.77), with a minimum of 24 and a maximum of 42 points. With regard to psychic suffering, (40%, N=16) the managers presented probable cases of disorders. The practice of physical and leisure activities (p<0.05) plays an important role in reducing perceived stress and psychological distress. Conclusion: health managers presented, during the pandemic, stress and psychic suffering, results that should be considered for promoting self-care to health managers, emphasizing the need to carry out physical and leisure activities.Keywords: Health manager; Occupational stress; Covid-19; Coronavirus infections.

Estudio cualitativo sobre información, confianza y acceso a la vacunación contra COVID-19 en adolescentes en un centro de salud de Buenos Aires / Qualitative study on information, trust in and access to COVID-19 vaccines among adolescents at a healthcare center in Buenos Aires

Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.

Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.

Changes in Mental Health Among Adolescents in South Korea Before and After COVID-19: An Interrupted Time Series Analysis From 2015 to 2022.

PURPOSE: This study aimed to examine changes in mental health among adolescents by comparing data from the period following the onset of the COVID-19 pandemic with the period before the pandemic. METHODS: We estimated the annual prevalence of stress perception, depressive symptoms, and suicidal ideation among middle and high school students using data from the Korean Youth Health Behavior Survey spanning from 2015 to 2022. We then compared mental health status across 2 periods-pre-COVID-19 (2015-2019) and during COVID-19 (2020-2022)-employing an interrupted time series analysis. We adjusted for covariates, such as household economic status, residence type, self-rated health, and history of hospitalization, due to violence. RESULTS: We analyzed data from 472,385 adolescents (242,819 boys and 230,016 girls). Stress perception, depressive symptoms, and suicidal ideation showed an increasing trend during the pre-COVID-19 period, followed by a decrease in the first year of the pandemic and an increasing trend in the second and third years. Boys experienced a faster increase in stress and depressive symptoms during the second and third years of the pandemic compared with the pre-COVID-19 period, whereas girls showed trends similar to those observed before the pandemic. Middle school students experienced a more rapid increase in these indicators than high school students during the second and third years. DISCUSSION: Adolescents' mental health initially improved in the first year of COVID-19 but worsened during the second and third years of the pandemic. This suggests a need for intervention policies and programs to support adolescent mental health.

[Post-COVID-19 condition-Clinical phenotyping in practice]. / Post-COVID-19-Zustand ­ klinische Phänotypisierung in der Praxis.

BACKGROUND: The high number and clinical heterogeneity of neurological impairments in patients with a post-COVID-19 condition (PCC) poses a challenge for outpatient care. OBJECTIVE: Our aim was to evaluate the applicability of the proposed subtypes according to the guidelines "Long/Post-COVID" (30 May 2024) and their phenotyping using clinical and neuropsychological findings from our post-COVID outpatient clinic. METHODS: The evaluation was based on cross-sectional neurological and psychological test examinations of the patients, which were carried out using standardized questionnaires and test batteries. In addition, a detailed anamnesis of the current symptoms and a retrospective survey of the acute symptoms up to 4 weeks after the confirmed infection was conducted. The subtypes were classified according to the abovementioned guidelines based on the medical history and selected patient questionnaires, to which we added a 5th subtype with reference to the previous guidelines "Long/Post-COVID" (as of 5 March 2023). RESULTS: A total of 157 patients were included between August 2020 and March 2022. The presentation was at a median of 9.4 months (interquartile range, IQR = 5.3) after infection, with a mean age of 49.9 years (IQR = 17.2) and more women (68%) presenting, with a total hospitalization rate of 26%. Subtype 1 (postintensive care syndrome) showed the highest proportion of men, highest body mass index (BMI) scores and the highest rates of subjective complaints of word-finding difficulties (70%). Subtype 2 (secondary diseases) was dominated by cognitive impairment and had the highest depression scores. Subtype 3 (fatigue and exercise-induced insufficiency) was the most common, had the most symptoms and most severe subjective fatigue and the largest proportion of women. Subtype 4 (exacerbation) mainly showed affective symptoms. Subtype 5 (complaints without relevance to everyday life) had the lowest scores for depression, fatigue and BMI. Neurological and psychological conditions were frequently pre-existing in all groups. DISCUSSION: The management of PCC can be improved at various levels. A standardized subtype classification enables early individually tailored treatment concepts. Patients at risk should be identified at the primary care level and informed about risk factors and prevention strategies. Regular monitoring of cardiovascular risk factors and physical activity are essential for PCC treatment. In the case of cognitive deficits and concurrent affective symptoms, psychotherapeutic support and drug treatment with selective serotonin reuptake inhibitors (SSRI) should be provided at an early stage.

Substance Use Emergency Department Visits Among Youths With Chronic Conditions During COVID-19.

Importance: Pediatric emergency department (ED) visits for substance use (SU) increased during COVID-19. Better understanding of trends associated with SU ED visits among youths with a chronic medical condition (CMC) is needed to target SU screening, prevention, and intervention efforts in this population. Objective: To describe trends in pediatric SU ED visits before and during COVID-19 among youths in the US with and without CMCs and by race and ethnicity. Design, Setting, and Participants: In this cohort study, data were obtained from 47 US children's hospital EDs in the Pediatric Health Information System (PHIS) between March 1, 2018, and March 1, 2022. The cohort included patients aged 10 to 18 years. Data analysis occurred from November 2022 to February 2023. Exposures: ED visit occurrence before or during the COVID-19 pandemic and with or without the presence of a CMC. CMCs included chronic conditions (CCs) and complex CCs (CCCs). Main Outcomes and Measures: The primary outcome was the number of visits for an SU diagnosis based on diagnostic codes for youths with and without CMCs. Trends were assessed using logistic regression, adjusting for covariates and center effect. Results: The sample included 3 722 553 ED visits from March 1, 2018, to March 1, 2022 (1 932 258 aged 14-18 years [51.9%]; 1 969 718 female [52.9%]; 961 121 Hispanic [25.8%]; 977 097 non-Hispanic Black [26.2%]; 1 473 656 non-Hispanic White [39.6%]). Of all visits, 1 016 913 (27.3%) were youths with CCs and 367 934 (9.9%) were youths with CCCs. Youth SU ED visits increased for all groups during COVID-19. The SU ED visits increased by 23% for youths with CCs (21 357 visits [4.0%] to 23 606 visits [4.9%]), by 26% for youths with CCCs (3594 visits [1.9%] to 4244 visits [2.4%]), and by 50% for youths without CCs (4997 visits [0.4%] to 5607 visits [0.6%]). Furthermore, compared with youths without CCs, youths with CCs had consistently larger odds of SU than the other groups before COVID-19 (adjusted odds ratio, 9.74; 99% CI, 9.35-10.15) and during COVID-19 (adjusted odds ratio, 8.58; 99% CI, 8.25-8.92). The interaction between race and ethnicity and CMCs was significant (P for interaction < .001). Conclusions and Relevance: The findings of this cohort study suggest that providing SU services to all youths during times of societal crises is critical, but particularly for youths with CMCs who experience higher potential health impacts from SU given their medical concerns.

The Impact of Mindfulness-Based Counseling on the Mental Health of Women With a History of COVID-19 During Pregnancy: A Quasi-Experimental Study.

INTRODUCTION: With the spread of COVID-19, certain population groups, including pregnant women, were more susceptible than others. This disease can lead to postpartum complications, including mental disorders, in mothers. Few studies have investigated the impact of mindfulness-based interventions on mental health, and the most effective counseling approach to promote mental health has not been identified. OBJECTIVE: This study aimed to determine the impact of online mindfulness-based counseling on improving mental health among women with a history of COVID-19 during pregnancy in Iran. METHODS: The present study was a quasi-experimental design conducted on 100 women with a history of coronavirus infection during pregnancy referred to the Mother's Clinic of Yahya Nejad and Ayatollah Rouhani Educational-Treatment Hospital, affiliated with Babol University of Medical Sciences, Iran, via convenience sampling. The women were randomly assigned to the intervention (mindfulness-based counseling) and control groups. The intervention group received eight 45-min weekly mindfulness-based counseling sessions over 8 weeks. Data were collected via a demographic information questionnaire and the Goldberg General Health Questionnaire before and after the intervention, which were completed by both groups. Independent t-tests and analysis of covariances (ANCOVAs) were used to compare the outcomes of the two groups. RESULTS: After controlling for confounding variables, the mean mental health scores before and after counseling were 29.42 ± 4.49 and 19.80 ± 3.88, respectively, in the intervention group and 26.26 ± 2.29 and 25.92 ± 2.15, respectively, in the control group. The mean mental health score in the intervention group was significantly lower than that in the control group (F = 266.7, p < 0.001). The mean scores for somatic symptoms (F = 89.30, p < 0.001), depression symptoms (F = 142.71, p < 0.001), anxiety and insomnia symptoms (F = 120.56, p < 0.001), and social dysfunction scores (F = 127.77, p < 0.001) were significantly different between the two groups after counseling. CONCLUSION: The findings indicated that online mindfulness-based counseling positively affects mental health and its domains during the postpartum period. However, further randomized clinical trials are needed before a definitive conclusion can be drawn. TRIAL REGISTRATION: We were not allowed to register according to the law of our country.

Perception, use of social media, and its impact on the mental health of Indian adolescents: A qualitative study.

BACKGROUND: Mental illness is a health challenge faced by adolescents that has grown worse after the Coronavirus disease 2019 pandemic. Research on social media and young people's mental health has recently increased, and numerous studies have examined whether frequent use of social media is linked to issues such as anxiety, stress, depression, eating disorders, insomnia, frustration, feeling alone, and externalizing problems among adolescents. This influence of social media on adolescents' lives is clear, with many platforms like Facebook, Instagram, and YouTube playing an important role in daily interactions and self-expression. Even though social media offers numerous benefits, such as connectivity and information sharing, excessive usage can have detrimental effects on mental health, particularly among adolescents. AIM: To study the impact of social media on the mental wellbeing of adolescents, and the associated potential dangers in India. METHODS: A total of 204 adolescents aged 14 years to 23 years were included in the study. This study explored the intricate relationship between social media usage and adolescent mental health in India. The study employs a cross-sectional survey design to capture a snapshot of adolescent mental health and social media usage patterns. Data collection involved administering structured questionnaires and the analysis utilized quantitative methods, including descriptive statistics. RESULTS: Excessive use of social media is correlated with increased stress, anxiety, and depression. Adolescents engage in compulsive behaviors such as scrolling in the middle of the night, which negatively impacts their mental and physical health, and leads to significant sleep disruption. Findings from the study aim to provide insights into the current state of adolescent mental health and inform strategies to promote positive wellbeing in the Indian population. CONCLUSION: The study underscores the need for further research to better understand the complex interplay between social media and adolescent mental health, and need for effective strategies to combat online harassment.

Erratum: COVID-19: ramifications of the pandemic on mental health and substance abuse.

[This corrects the article DOI: 10.3389/fpubh.2024.1401734.].

The impact of negative COVID-19 experiences on cancer survivors' health-related quality of life and psychological distress: a moderated mediation model.

Introduction: Cancer survivors experienced poorer health-related quality of life (HRQoL) and greater psychological distress during the COVID-19 pandemic than those without cancer. However, the underlying mechanisms that may explain how negative experiences during the pandemic are associated with distress and HRQoL remain unknown. We examined whether psychosocial risk factors (i.e., healthcare disruption, disruption to daily activities and social interaction [DDASI], and financial hardship) mediated the relationship between negative COVID-19-related experiences and cancer survivors' HRQoL and psychological distress (i.e., depressive symptoms, and anxiety) and whether the mediating effects were moderated by psychosocial protective factors (i.e., stress management ability and social support). Methods: A total of 9,651 cancer survivors completed a questionnaire assessing negative COVID-19-related experiences, psychosocial and practical experiences, and HRQoL. Conditional process analysis was used to evaluate the proposed moderated mediation models. Results: Participants had a mean age of 63.8 years (SD = 12.3) and were mostly non-Hispanic White (82.3%). DDASI and financial hardship mediated the relationship between negative COVID-19-related experiences and cancer survivor's HRQoL and psychological distress. Stress management ability buffered the indirect effect of DDASI on cancer survivors' HRQoL and psychological distress. Social support buffered the indirect effect of financial hardship on HRQoL and depressive symptoms. Conclusion: Financial resources and social interactions may buffer negative effects of major disruptions such as the COVID-19 pandemic. Future studies should assess the longitudinal impact of these associations.

FOLLOW-UP OF PATIENTS WITH POST COVID-19 CONDITION AFTER A MULTIDISCIPLINARY TEAM ASSESSMENT: A PILOT STUDY.

Objective: To follow up patients with post-COVID-19 condition (PCC) 6 months after a multidisciplinary team assessment in specialist care regarding symptoms of pain, anxiety, depression, fatigue and cognition, level of activity, physical activity and sick leave. Methods: A prospective pilot study conducted in a clinical setting of patients (n = 22) with PCC referred from primary healthcare to a specialist clinic for a 2 day-multidisciplinary team assessment followed by a subsequent rehabilitation plan. Data were collected through questionnaires filled in prior to the team assessment and 6 months later. Results: Fifteen of the initial 22 patients participated in the follow-up. No statistically significant improvements were seen in any of the questionnaires after 6 months. However, 76.9% of the participants perceived the intervention as being helpful. This differed between the genders, where all the women 100% (n = 8) perceived it as being helpful, compared with 40% (n = 2) of the men (p = 0.012). Conclusions: Based on these findings, the benefit of a multidisciplinary team assessment of PCC is not fully convincing. However, since the participants themselves perceived the intervention as being helpful, the team assessment seems to be of some value. Further studies with larger populations would be of interest.

Most people who become ill with COVID-19 experience mild symptoms and recover within days or weeks. However, minor symptoms last from weeks to months and include fatigue, attention disorder, headache, dyspnea, anxiety, pain, anosmia, etc. This clinical state has been denoted as "post-COVID-19 condition" (PCC). It has been recommended that complex cases of PCC are to be assessed by a multidisciplinary team regarding treatment and rehabilitation. The efficiency of this recommendation has not yet been proven. This pilot study aimed to follow up patients with PCC six months after a multidisciplinary team assessment in specialist care regarding symptoms of pain, anxiety, depression, fatigue and cognition, level of activity, physical activity and sick leave through questionnaires. The results showed no statistically significant improvements in any of the questionnaires after six months. The majority of the participants perceived the team assessment as being helpful. Since the assessment seemed to be of some value, there is a need for further studies with larger populations.

Preventive health behaviour differences across racial groups during the early stages of COVID-19.

Background: Throughout the COVID-19 pandemic, the practice of preventative health behaviours had been used disparately across different racial groups. This study seeks to identify any differences in preventative health behaviours across racial groups, controlling for other socio-demographic factors. Methods: A US national survey study was electronically conducted from July through November 2020, to measure racial/ethnic differences in health preventive behaviours about COVID-19. We performed 2-part regression models to assess whether preventive health behaviours differed by race and ethnicity. Specifically, we employed generalized logistic regressions for investigating the predictors of the use of complementary or alternative medicine (CAM), or stay-at-home strategy, then performed ordinal logistic regression to examine the predictors of social distancing, face mask wearing, and hand hygiene strategy practice. Results: The results show that non-White respondents were more likely to practice social distancing, mask wearing, and hand hygiene strategy to prevent COVID-19, compared to their White counterparts. Additionally, the findings indicate that individuals who experienced COVID-19-related racial abuse or depression had a higher likelihood of practicing preventive health behaviours. Discussion: We found ethnicity can be a predictor of health preventive behaviours, in accordance with previous research. The causes of these disparities will require further investigation in order to be addressed.

1-year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study.

Background: In patients with coronavirus disease 2019 (COVID-19) requiring supplemental oxygen, dexamethasone reduces acute severity and improves survival, but longer-term effects are unknown. We hypothesised that systemic corticosteroid administration during acute COVID-19 would be associated with improved health-related quality of life (HRQoL) 1 year after discharge. Methods: Adults admitted to hospital between February 2020 and March 2021 for COVID-19 and meeting current guideline recommendations for dexamethasone treatment were included using two prospective UK cohort studies (Post-hospitalisation COVID-19 and the International Severe Acute Respiratory and emerging Infection Consortium). HRQoL, assessed by the EuroQol-Five Dimensions-Five Levels utility index (EQ-5D-5L UI), pre-hospital and 1 year after discharge were compared between those receiving corticosteroids or not after propensity weighting for treatment. Secondary outcomes included patient-reported recovery, physical and mental health status, and measures of organ impairment. Sensitivity analyses were undertaken to account for survival and selection bias. Findings: Of the 1888 participants included in the primary analysis, 1149 received corticosteroids. There was no between-group difference in EQ-5D-5L UI at 1 year (mean difference 0.004, 95% CI -0.026-0.034). A similar reduction in EQ-5D-5L UI was seen at 1 year between corticosteroid exposed and nonexposed groups (mean±sd change -0.12±0.22 versus -0.11±0.22). Overall, there were no differences in secondary outcome measures. After sensitivity analyses modelled using a cohort of 109 318 patients admitted to hospital with COVID-19, EQ-5D-5L UI at 1 year remained similar between the two groups. Interpretation: Systemic corticosteroids for acute COVID-19 have no impact on the large reduction in HRQoL 1 year after hospital discharge. Treatments to address the persistent reduction in HRQoL are urgently needed.

[Prevalence and underdiagnosis of burn out syndrome in critical services in the context of the COVID-19 pandemic] / Prevalencia y subdiagnóstico del síndrome de burn out en servicios criticos en el contexto de la pandemia COVID-19.

Introduction: The importance of knowing the impact of work on people's health has increased after the COVID-19 pandemic. Burn Out (BO) syndrome arises from the tension emerging from the conflictive interaction between the worker and his or her employment. The objective was to describe the prevalence and frequency of diagnosis of BO in the health human resources of critical services of the Bahía Blanca Municipal Hospital in the context of the COVID-19 pandemic.Methods: Descriptive, cross-sectional study. The study population was the medical and nursing staff of the Intensive Care (IT), Emergency Medicine (SMU) and Clinic services who worked with COVID-19 during 2021. The Maslach Burnout Inventory (MBI) questionnaire was used and complementary closed questions to identify, among these cases, those that were diagnosed and treated by the institution.Results: Of the 219 workers, 55.3% (121/219) were nurses. In the SMU, 25% (24/96) of respondents had BO, followed by 20.4% (11/54) in Clinic and 8.7% (6/69) in IT (p value=0.004). Only 5.5% (12/219) of the total were diagnosed with BO by the institution and of this group, two people (0.9%) had previously consulted for characteristic symptoms.Discussion: A high prevalence of BO and a marked underdiagnosis were evident at the institutional level during the pandemic. Although the IT Service had the highest demand for attention, it was the one that presented the lowest BO values in relation to other services.

Introducción: La importancia del conocimiento del impacto del trabajo en la salud de las personas se ha acrecentado tras la pandemia por COVID-19. El síndrome de Burn Out (BO) nace de la tensión emergente de la interacción conflictiva entre el trabajador y su empleo. El objetivo fue describir la prevalencia y frecuencia de diagnóstico del BO en el recurso humano en salud de servicios críticos del Hospital Municipal de Bahía Blanca en el contexto de la pandemia COVID-19. Métodos: Estudio descriptivo, de corte transversal. La población de estudio fue el personal médico y de enfermería de los servicios de Terapia intensiva (TI), Médico de Urgencias (SMU) y Clínica que trabajaron con COVID-19 durante el 2021. Se empleó el cuestionario Maslach Burnout Inventory (MBI) y preguntas cerradas complementarias para identificar, entre estos casos, aquellos que fueron diagnosticados y tratados por la institución. Resultados: De los 219 trabajadores, el 55,3% (121/219) fueron enfermeros. En el SMU el 25% (24/96) de encuestados tenía BO, seguido por un 20,4% (11/54) en Clínica y un 8.7% (6/69) en TI (valor p=0.004). Sólo el 5,5% (12/219) del total fue diagnosticado con BO por la institución y de este grupo, dos personas (0,9%) habían consultado previamente por síntomas característicos. Discusión: Se evidenció una elevada prevalencia de BO y un marcado sub-diagnóstico a nivel institucional durante la pandemia. A pesar de que el Servicio de TI tuvo la mayor demanda de atención, fue el que presentó los valores más bajos de BO en relación a otros servicios.

Health care providers' perceptions of burnout and moral distress during the COVID-19 pandemic: A qualitative study from Saskatchewan, Canada.

OBJECTIVES: This study sought to describe feelings and perceptions of burnout and moral distress experienced by health care providers in the Canadian province of Saskatchewan during the COVID-19 pandemic. METHODS: This study was part of a larger mixed methods project, and we here report on the qualitative results relating to burnout and moral distress experienced by medical doctors, registered nurses and respiratory therapists. We used an exploratory, qualitative descriptive design involving one-one-one interviews with 24 health care providers. Interview data were analysed using a reflexive thematic analysis approach. RESULTS: We identified three overarching themes each for health care provider burnout and moral distress. Interviews revealed that providers experienced burnout through (i) increased expectations and (ii) unfavourable work environments, which led most of them to recognise (iii) a need to step back. Regarding moral distress, key themes were: (i) a sense of compromised care, (ii) feelings of bumping heads with authorities and patient families, and (iii) seeing patients make difficult decisions. CONCLUSION: Our study found that medical doctors, registered nurses and respiratory therapists working during the COVID-19 pandemic experienced and continue to experience significant burnout and moral distress. This was often driven by both institution- and system-level factors. There is a need for sustained investment to build and support a motivated health care workforce to prepare for future pandemics and health emergencies.

Sociodemographic Characteristics, Anxiety, Depression Levels, and Emotional and Behavioral Problems in Hospitalized COVID-19-Positive Children and Adolescents.

ABSTRACT: This study aimed to investigate anxiety, depression levels, and emotional/behavioral problems of children and adolescents while being treated in the COVID-19 unit. The present study included 50 children who were COVID-19 positive, aged 7-18 years, and 50 age- and gender-matched healthy controls. The sociodemographic data form and Revised Child Anxiety and Depression Scale-Child Version (RCADS-C) were applied to all children, and all families were asked sociodemographic data form, Revised Child Anxiety and Depression Scale-Parent Version (RCADS-P), and Strengths and Difficulties Questionnaire (SDQ). There was no significant difference between the patient and control groups in terms of anxiety, depression levels, and emotional/behavioral problems. The conduct problems subscale score of SDQ in the patient group was found to be significantly lower than the control group (p = 0.037). Separation anxiety subscale scores of RCADS (p = 0.034) and the rate of accompanying companions (p = 0.01) in the patient group were found to be significantly higher in preadolescents than in adolescents. In conclusion, this study demonstrated that children and adolescents who were COVID-19 positive were not different from healthy children in terms of anxiety and depression levels, and emotional and behavioral problems in the acute period during inpatient treatment.

Prevalence, Risk Factors and Pain Subtypes of Post-COVID Pain in Nonhospitalized Older Adults: A Cross-Sectional Study.

BACKGROUND: Post-COVID pain (PCP) is a condition that ensues from an infection of coronavirus disease 2019 (COVID-19). Some researchers have explored the prevalence of PCP and its characteristics in the individuals who experience it. However, most individuals involved in the previous studies were middle-aged, and those studies focused mainly on hospital patients and musculoskeletal PCP. Existing data on PCP and its subtypes among older adults and outpatients are scanty. OBJECTIVE: Our study aims to identify PCP's prevalence and associated risk factors and to compare the quality of life (QoL), sleep quality, and anxiety and depression levels in nonhospitalized elderly COVID-19 survivors with different PCP subtypes. STUDY DESIGN: A cross-sectional study. SETTING: The study was conducted from April 2023 to June 2023 after the first outbreak of the Omicron variant of SARS-CoV-2 in the Taikang Yanyuan Continuing Care Retirement Community (CCRC) in China. METHODS: Eligible participants were surveyed using the Numeric Rating Scale (NRS), Douleur Neuropathique-4 questionnaire (DN4), EuroQol 5D-5L questionnaire (EQ-5D-5L), Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder 7 (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9) scale. COVID-19 symptoms and laboratory parameters were obtained through an electronic healthcare system. Descriptive analysis was performed based on the presence of PCP and PCP subtypes. Multivariable logistic regression analysis and multiple linear regression were used for risk-factor analysis and adjustment of confounding factors. RESULTS: A total of 668 individuals (female: 59.3%, median age: 84 years) who had been infected with COVID-19 for a median duration of 145 (126-168) days were enrolled in our study. PCP was observed in 9.4% (63/668) of elderly COVID-19 survivors. Number of COVID-19 symptoms (aOR 1.31, 95%CI 1.05-1.64, P = 0.018) and previous chronic pain (aOR 4.24, 95%CI 1.59-11.27, P = 0.004) were risk factors associated with PCP. Individuals with neuropathic PCP exhibited higher NRS scores (5 [5-6] vs. 3 [3-4], P < 0.001) and more use of analgesic drugs (70.0%, 7/10 vs. 20.8%, 11/53, P = 0.005) for pain management. Neuropathic PCP was associated with lower scores on the EQ-5D index (B = -0.210, 95% CI -0.369 to -0.051, P = 0.011) and EQ-VAS (B = -10.808, 95% CI -21.149 to -0.468, P = 0.041) and higher PHQ-9 scores (B = 3.154, 95% CI 0.674-5.634, P = 0.014). LIMITATIONS: It is difficult to establish a strong causality between PCP and SARS-CoV-2 infection due to the study's cross-sectional nature. Selection bias could not be eliminated, since our study relied on volunteer participation. Due to neuropathic PCP's lower prevalence than nonneuropathic PCP, larger sample sizes and multicenter studies are crucial for a comprehensive understanding of the neuropathic PCP condition. CONCLUSION: Our study found a PCP prevalence of 9.4% in nonhospitalized older adults who had survived COVID-19. Number of COVID-19 symptoms and history of previous chronic pain seemed to be potential risk factors for PCP. Neuropathic PCP was associated with lower QoL and a more severe depression level.