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2.
BMJ Open Respir Res ; 7(1)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32873607

RESUMO

BACKGROUND: Studies suggest that certain black and Asian minority ethnic groups experience poorer outcomes from COVID-19, but these studies have not provided insight into potential reasons for this. We hypothesised that outcomes would be poorer for those of South Asian ethnicity hospitalised from a confirmed SARS-CoV-2 infection, once confounding factors, health-seeking behaviours and community demographics were considered, and that this might reflect a more aggressive disease course in these patients. METHODS: Patients with confirmed SARS-CoV-2 infection requiring admission to University Hospitals Birmingham NHS Foundation Trust (UHB) in Birmingham, UK between 10 March 2020 and 17 April 2020 were included. Standardised admission ratio (SAR) and standardised mortality ratio (SMR) were calculated using observed COVID-19 admissions/deaths and 2011 census data. Adjusted HR for mortality was estimated using Cox proportional hazard model adjusting and propensity score matching. RESULTS: All patients admitted to UHB with COVID-19 during the study period were included (2217 in total). 58% were male, 69.5% were white and the majority (80.2%) had comorbidities. 18.5% were of South Asian ethnicity, and these patients were more likely to be younger and have no comorbidities, but twice the prevalence of diabetes than white patients. SAR and SMR suggested more admissions and deaths in South Asian patients than would be predicted and they were more likely to present with severe disease despite no delay in presentation since symptom onset. South Asian ethnicity was associated with an increased risk of death, both by Cox regression (HR 1.4, 95% CI 1.2 to 1.8), after adjusting for age, sex, deprivation and comorbidities, and by propensity score matching, matching for the same factors but categorising ethnicity into South Asian or not (HR 1.3, 95% CI 1.0 to 1.6). CONCLUSIONS: Those of South Asian ethnicity appear at risk of worse COVID-19 outcomes. Further studies need to establish the underlying mechanistic pathways.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Hospitalização/estatística & dados numéricos , Mortalidade/etnologia , Pandemias , Pneumonia Viral , Estudos de Coortes , Comorbidade , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Pneumonia Viral/etnologia , Pneumonia Viral/terapia , Modelos de Riscos Proporcionais , Fatores de Risco , Índice de Gravidade de Doença , Reino Unido/epidemiologia
3.
ACS Chem Neurosci ; 11(19): 2944-2961, 2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-32870641

RESUMO

A significant proportion of people who test positive for COVID-19 have chemosensory deficits. However, the reported prevalence of these deficits in smell and taste varies widely, and the reason for the differences between studies is unclear. We determined the pooled prevalence of such chemosensory deficits in a systematic review and meta-analysis. We searched the COVID-19 portfolio of the National Institutes of Health for studies that reported the prevalence of smell or taste deficits or both in patients diagnosed with COVID-19. One-hundred-four studies reporting on 38 198 patients qualified and were subjected to a systematic review and meta-analysis. Estimated random prevalence of olfactory dysfunction was 43.0%, that of taste dysfunction was 44.6%, and that of overall chemosensory dysfunction was 47.4%. We examined the effects of age, gender, disease severity, and ethnicity on chemosensory dysfunction. Prevalence of smell or taste dysfunction or both decreased with older age, male gender, and disease severity. Ethnicity was highly significant: Caucasians had a three times higher prevalence of chemosensory dysfunctions (54.8%) than Asians (17.7%). The finding of geographic differences points to two causes that are not mutually exclusive. A virus mutation (D614G) may cause differing infectivity, while at the host level genetic, ethnicity-specific variants of the virus-binding entry proteins may facilitate virus entry in the olfactory epithelium and taste buds. Both explanations have major implications for infectivity, diagnosis, and management of the COVID-19 pandemic.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Infecções por Coronavirus/fisiopatologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Transtornos do Olfato/etnologia , Pneumonia Viral/fisiopatologia , Fatores Etários , Betacoronavirus/genética , Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Grupos Étnicos , Variação Genética , Humanos , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/fisiopatologia , Pandemias , Peptidil Dipeptidase A/genética , Pneumonia Viral/epidemiologia , Prevalência , Serina Endopeptidases/genética , Índice de Gravidade de Doença , Fatores Sexuais
4.
Am J Prev Med ; 59(4): 481-492, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32829968

RESUMO

INTRODUCTION: This study examines COVID-19-associated discrimination regardless of infection status. It evaluates the contribution of various risk factors (e.g., race/ethnicity and wearing a face mask) and the relationship with mental distress among U.S. adults in March and April 2020, when the pandemic escalated across the country. METHODS: Participants consisted of a probability-based, nationally representative sample of U.S. residents aged ≥18 years who completed COVID-19-related surveys online in March and April (n=3,665). Multivariable logistic regression was used to predict the probability of a person perceiving COVID-19-associated discrimination. Linear regression was used to analyze the association between discrimination and mental distress. Analyses were conducted in May 2020. RESULTS: Perception of COVID-19-associated discrimination increased from March (4%) to April (10%). Non-Hispanic Black (absolute risk from 0.09 to 0.15 across months) and Asians (absolute risk from 0.11 to 0.17) were more likely to perceive discrimination than other racial/ethnic groups (absolute risk from 0.03 to 0.11). Individuals who wore face masks (absolute risk from 0.11 to 0.14) also perceived more discrimination than those who did not (absolute risk from 0.04 to 0.11). Perceiving discrimination was subsequently associated with increased mental distress (from 0.77 to 1.01 points on the 4-item Patient Health Questionnaire score). CONCLUSIONS: Perception of COVID-19-associated discrimination was relatively low but increased with time. Perceived discrimination was associated with race/ethnicity and wearing face masks and may contribute to greater mental distress during early stages of the pandemic. The long-term implications of this novel form of discrimination should be monitored.


Assuntos
Afro-Americanos , Grupo com Ancestrais do Continente Asiático , Infecções por Coronavirus , Máscaras , Pandemias , Pneumonia Viral , Discriminação Social , Percepção Social , Adulto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Asiático/psicologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/psicologia , Feminino , Humanos , Masculino , Saúde Mental/tendências , Pneumonia Viral/etnologia , Pneumonia Viral/psicologia , Angústia Psicológica , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Discriminação Social/prevenção & controle , Discriminação Social/psicologia , Discriminação Social/estatística & dados numéricos , Inquéritos e Questionários
5.
Palliat Med ; 34(9): 1241-1248, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32736485

RESUMO

BACKGROUND: Palliative care services face challenges in adapting and responding to the COVID-19 pandemic. Understanding how palliative care needs and outcomes have changed during the pandemic compared to before the pandemic is crucial to inform service planning and research initiatives. AIM: To evaluate the impact of COVID-19 on symptoms, clinical characteristics, and outcomes for patients referred to a hospital-based palliative care service in a district general hospital in London, UK. DESIGN: A retrospective service evaluation. Data were extracted from the electronic patient records. SETTING/PARTICIPANTS: The first 60 inpatients with confirmed COVID-19 infection, referred to the hospital palliative care service between 1 March 2020 and 23 April 2020, and another 60 inpatients, referred to the hospital palliative care service between 11 March 2019 and 23 April 2019, were included from a district general hospital in East London, UK. RESULTS: Patients with COVID-19 have lower comorbidity scores, poorer performance status, and a shorter time from referral to death compared to patients without COVID-19. Breathlessness, drowsiness, agitation, and fever are the most prevalent symptoms during COVID-19 compared to pain and drowsiness pre-COVID-19. Time from admission to referral to palliative care is longer for Black, Asian and minority ethnic patients, especially during COVID-19. CONCLUSION: Early referral to palliative care is essential in COVID-19, especially for Black, Asian and minority ethnic groups. There is urgent need to research why Black, Asian and minority ethnic patients are referred late; how palliative care services have changed; and possible solutions to setting up responsive, flexible, and integrated services.


Assuntos
Infecções por Coronavirus/enfermagem , Cuidados Paliativos/estatística & dados numéricos , Pneumonia Viral/enfermagem , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Betacoronavirus , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Londres , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Tempo
6.
Artigo em Inglês | MEDLINE | ID: mdl-32748825

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has created challenges that have caused profound changes in health behaviors. This study aimed to explore how COVID-19 is affecting the health-related quality of life (QoL) among Chinese adults. METHODS: The data of health-related behaviors and QoL were collected via online surveys from 2289 adults (mean age = 27.8 ± 12 years) who had been isolated at home for an average of 77 days. RESULTS: More than 50% of the respondents reported that their time engaged in daily physical activity (PA) decreased, while sedentary behavior (SB) time increased compared with that before the lockdown. Only 20% of the respondents reported engaging in moderate-to-vigorous PA, 23% of adults reported changed their diets to be healthier, and 30% reported consuming more vegetables, fruits, and milk products than before home-isolation. During home-isolation, 75.2% of the adults rated their sleep quality as very good, and 65% reported that they were satisfied with their QoL. Sleep quality mediated the relationship between PA and QoL. CONCLUSION: The two-to-three-month home-isolation has had mixed effects on adult health behaviors in China. The participants were found to have focused more on their eating quality and patterns, which had a positive influence on their QoL. However, people should be encouraged to exercise at home with limited space to maintain a generally healthy lifestyle during a prolonged quarantine.


Assuntos
Infecções por Coronavirus/psicologia , Dieta/estatística & dados numéricos , Exercício Físico , Pneumonia Viral/psicologia , Quarentena/psicologia , Sono , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/psicologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Betacoronavirus , Coronavirus , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pandemias , Qualidade de Vida , Quarentena/estatística & dados numéricos , Comportamento Sedentário , Inquéritos e Questionários , Adulto Jovem
7.
PLoS One ; 15(7): e0236173, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687535

RESUMO

Hyperuricemia (HU) is a marker for heart failure. There are relatively few data in the Asian population regarding the effects of hyperuricemia and gouty disorders on cardiac remodeling and diastolic dysfunction (DD), an intermediate stage in the development of heart failure. We consecutively recruited asymptomatic Asian individuals to undergo cardiovascular surveys. We categorized them into Non-HU, HU, and Gout groups. We measured cardiac structure and indices for diastolic function, including tissue Doppler (TDI)-derived LV e' and E/e'. Among 5525 participants, 1568 had HU and 347 had gout. The presence of gout and higher uric acid levels (SUA) (<4, 4-6, 6-8, 8-10, > = 10 mg/dL) were associated with greater LV wall thickness, greater LV mass/volumes, larger LA volume, lower LV e' and higher E/e'. Higher SUA was associated with greater LV mass index (adjusted coefficient: 0.37), greater mass/volume ratio (adjusted coefficient: 0.01) and larger LA volume index (adjusted coefficient: 0.39, all p<0.05). Both HU and Gout groups were associated with lower LV e' (coefficient: -0.086, -0.05), higher E/e' (coefficient: 0.075, 0.35, all p <0.05), larger LA volume, and higher DD risk (adjusted ORs: 1.21 and 1.91 using Non-HU as reference, respectively, both p <0.05). SUA set at 7.0 mg/dL provided the optimal cut-off for identifying DD, with markedly lower e' (HU: 8.94 vs 8.07, Gout: 7.94 vs 7.26 cm/sec) and higher LV E/e' in HU/Gout women than in men (HU: 7.84 vs 9.79 cm/sec for men and women, respectively, all p <0.05). Hyperuricemia, even at a relatively low clinical cut-off, was associated with unfavorable remodeling and was tightly linked to diastolic dysfunction. The presence of gout likely aggravated these conditions. Women with hyperuricemia or gout had worse diastolic indices than men despite similar degrees of LV remodeling.


Assuntos
Doenças Assintomáticas/epidemiologia , Gota/epidemiologia , Hiperuricemia/epidemiologia , Disfunção Ventricular Esquerda/epidemiologia , Remodelação Ventricular , Adulto , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Ecocardiografia Doppler , Feminino , Gota/sangue , Gota/diagnóstico , Átrios do Coração/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Hiperuricemia/sangue , Hiperuricemia/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores Sexuais , Taiwan/epidemiologia , Ácido Úrico/sangue , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/fisiopatologia
8.
Health Qual Life Outcomes ; 18(1): 211, 2020 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-32620107

RESUMO

PURPOSE: Risk behaviors are significantly impacting physical and psychological health among adolescents, resulting in a tremendous public health issue. The aim of this study is to examine the association of clustered risk behaviors with mental health and physical activity, and identify to what extent the clustering of various risk behaviors is associated with psychological health and physical activity in Chinese adolescents. METHODS: Students aged 16-18 years, male 16.2 ± 1.03, female 16.3 ± 1.56, were recruited from 30 high schools to complete an online questionnaire in fall semester 2017. A structured questionnaire, 2017 state and local youth risk behavior survey was revised, modified, and translated into Chinese. Five questions were designed to assess physical activity times of the last 7 days. Symptom checklist 90 (SCL-90) was used to investigate the mental health status of the participants. Statistical analyses were done employing chi-square tests, two step cluster analysis, logistic regression. RESULT: Results illustrate that girls report a significantly higher mean of being bullied in school, electronically bullied, feeling sad or hopeless, and trying cigarette smoking. Two-step cluster analysis and regression analysis find that alcohol use, smoking and sedentary behavior have significant effect on adolescent health. Logic regression demonstrated that risk behaviors have significantly associated with mental health and physical activity in specific cluster. CONCLUSION: This study finds that a specific behavior cluster has significant impact on mental health and physical activity among adolescents. Integrating risk behaviors cluster with factors can be employed to target high-risk adolescents who have poor physical and psychosocial health. The research suggest that more effective and feasible school intervention programs can be designed to promote adolescent health-related behavior in terms of those pathways.


Assuntos
Comportamento do Adolescente/psicologia , Grupo com Ancestrais do Continente Asiático/psicologia , Exercício Físico/psicologia , Comportamentos de Risco à Saúde , Saúde Mental/estatística & dados numéricos , Assunção de Riscos , Estudantes/psicologia , Adolescente , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , China , Feminino , Humanos , Modelos Logísticos , Masculino , Instituições Acadêmicas/estatística & dados numéricos , Inquéritos e Questionários
9.
Health Qual Life Outcomes ; 18(1): 217, 2020 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-32635917

RESUMO

BACKGROUND: Acute myocardial infarction (AMI) is a significant cause of mortality and morbidity worldwide. Today, with increasing life quality and social economy, people pay much attention to the cost-effectiveness of a treatment strategy. This study investigated the preferences of individuals who would be potential caregivers or patients for AMI treatment in order to provide liable and instructive information for cardiologists and other related physicians. METHODS: A discrete choice experiment was conducted among people to assess preferences for hypothetical AMI treatment scenarios characterized by the attributes of treatment method, mortality within 5 years, complication rate within 1 year, treatment duration and expense. A conditional logit regression model and latent class analysis were used to interpret the collected data systematically. The relative importance of each attribute and willingness to pay of people on the trade-offs between different treatment strategies were estimated. RESULTS: Participants valued mortality within 5 years most highly (average importance: 40.9, 95%CI 0.447-0.530). Three classes of participants were identified: Class 1 placed the most importance on treatment duration, class 2 corresponded with the overall result while expense was regarded as the most important attribute in class 3. Individuals favored an intermediate treatment duration of about 10 days instead of the shortest (95% CI 1.044-1.248, P < 0.001). People's characteristics (sex, age, marriage, education and income) affected their preferences (P < 0.01). CONCLUSION: People considered a mortality rate within 5 years as the most crucial attribute in the MI treatment and preferred an intermediate treatment duration of about 10 days. Furthermore, the findings estimated the trade-offs acceptable to patients and heterogeneity in preferences for AMI treatment.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Comportamento de Escolha , Infarto do Miocárdio/terapia , Preferência do Paciente/psicologia , Preferência do Paciente/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos
10.
Health Qual Life Outcomes ; 18(1): 218, 2020 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641044

RESUMO

BACKGROUND: The demand for assessing health-related quality of life (HRQoL) in chronic otitis media (COM) is increasing globally. The currently available Chinese-language patient-reported outcome measurement (PROM) specific for COM includes merely a limited range of related symptoms and dimensions. Hence, in this study, we aim to translate, culturally adapt, and validate the Zurich Chronic Middle Ear Inventory (ZCMEI-21) in Chinese, to enable a comprehensive evaluation of the patients' subjective health outcome in COM. METHODS: We sampled and surveyed 223 COM patients at three tertiary referral centers in China, using the Chinese translation of ZCMEI-21 (ZCMEI-21-Chn) and the EQ-5D questionnaire, a generic measure of HRQoL. Confirmatory factor analysis (CFA) was performed to investigate the structural model fit to the dataset. Cronbach's α and test-retest reliability coefficient were calculated to establish reliability, and correlation was tested between ZCMEI-Chn scores and EQ-5D scores for convergent validity. RESULTS: A total of 208 adult patients with COM were included, with a mean age of 46 years (SD 14 years) and a male proportion of 41% (85/208). A modified bifactor model with ωH of 0.65 and ECV of 0.47 was found to fit the scale scores, indicating fair general factor saturation and multidimensionality of the instrument. ZCMEI-21-Chn demonstrated good reliability (Cronbach's α = 0.88, test-retest reliability = 0.88). The total scores of ZCMEI-21-Chn had a moderate correlation with a question directly addressing HRQoL (r = 0.40, p < 0.001), EQ-5D descriptive system score (r = 0.57, p < 0.001), and EQ-5D visual analogous scale (r = 0.30, p < 0.001). CONCLUSIONS: The ZCMEI-21-Chn is valid, reliable and culturally adapted to Chinese adult patients with COM. This study offers clinicians an efficient and comprehensive instrument to quantify COM patients' self-reported health outcomes, which could facilitate the standardization of HRQoL data aggregation in COM on a global scale.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Doença Crônica/psicologia , Autoavaliação Diagnóstica , Otite Média/psicologia , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções
11.
Diabetes Metab Syndr ; 14(5): 1037-1041, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32640415

RESUMO

BACKGROUND AND AIMS: COVID-19 disease has been associated with disproportionate mortality amongst world population. We try to elucidate various reasons for lower mortality rate in the Indian subcontinent due to COVID-19 pandemic. METHOD: We carried out a comprehensive review of the literature using suitable keywords such as 'COVID-19', 'Pandemics', 'disease outbreaks' and 'India' on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the month of May 2020 during the current COVID-19 pandemic and assessed mortality data. RESULTS: The mortality observed in Indian and south Asian subcontinent is lower than in the west. Multifactorial reasons indicated for this differential mortality due to COVID-19 have been described in the current literature. CONCLUSIONS: The effects of COVID-19 on the health of racial and ethnic minority groups are still emerging with disproportionate burden of illness and death amongst some black and ethnic minority groups. Overall the current COVID-19 related mortality appears to be lower in the health and resource challenged populous Indian subcontinent. Further scientific studies would be helpful to understand this disparity in mortality due to COVID-19 in the world population.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/mortalidade , Grupos Étnicos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Pneumonia Viral/mortalidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Países Desenvolvidos , Humanos , Incidência , Índia/epidemiologia , Metanálise como Assunto , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Taxa de Sobrevida
12.
J Public Health (Oxf) ; 42(3): 486-492, 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32618332

RESUMO

BACKGROUND: Coronavirus infection Disease 19 impacted every part of the world and routine life. Recent report from the Office of national statistics in UK reported disproportionate death among Black Asian and minority ethnic (BAME) population. NHS is heavily relied on the BAME work force both in front line and in the community. We attempted to explore the beliefs and perception about reported worrying issue among BAME health work force in a Diverse city of Leicester. METHODS: This is a cross-sectional survey using 20 questions in an electronic format. The target population was identified through Leicester Asian Doctors Society and Leicester Asian Nurses Society. The questionnaire was then distributed electronically to the members. Survey questionnaire was accessed by 372, incomplete response (172) were excluded and 200 completed responses were analysed. RESULTS: Majority of BAME workforce are routinely involved in front line duties. More than 70% were anxious about their role during this pandemic. The Personal Protective Equipment (PPE) supply was adequate, and the support received from the local healthcare providers was more than satisfactory. The work force perceived co-morbidity, lack of PPE and testing were one of the few reasons for increased death in BAME. BAME group felt adequate provision of PPE, increased testing and improving mental health well-being is required to alleviate concerns and improve BAME working life in NHS. CONCLUSION: BAME workforce are routinely involved in front line work and current anxiety level is very high. Adequate provision of mental health support with clear risk stratification for return to work is required urgently.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Grupo com Ancestrais do Continente Asiático/psicologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Grupos Minoritários/psicologia , Pneumonia Viral/mortalidade , Pneumonia Viral/psicologia , Saúde Pública/estatística & dados numéricos , Adulto , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Idoso , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Reino Unido/epidemiologia
13.
PLoS One ; 15(7): e0235974, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32658926

RESUMO

OBJECTIVE: To investigate the relationship between food patterns and mild cognitive impairment (MCI) among Chinese elderly to provide evidence for risk prevention and control of MCI among elderly population. METHODS: Between February 2017 to October 2018, a stratified multistage cluster sampling method was used to select participants from 760 communities of six districts in Xi'an, China, for 49-item food frequency questionnaire survey. A total of 2311 participants aged 60 to 88 years were included in the study with 444 (19.2%) participants of MCI among Chinese community-dwelling elderly adults. Food patterns associated with risk of dementia were assessed by using a reduced rank regression (RRR) analysis, and the multivariate linear regression was used to test trends of risk factors across scores for the food pattern. RESULTS: Four dietary patterns were extracted which explained 88.65% of the total variation in food intakes. Furthermore, the food pattern 1 (FP1) accounted for 60.25% of the total variation of all responsible variables and as a target dietary pattern in the study, which was related with high intake of legumes, vegetables, fruits, milk and dairy products, nuts and a low intake of noodles and cereals (p<0.05). Multivariate linear regression analysis showed that participants with a high score for FP1 had higher direction, memory and language function and FP1 can improve the ability of cognitive function (p<0.05). CONCLUSION: The FP1 of Chinese dietary patterns was significantly correlated with higher cognitive function which can reduce the risk of MCI among Chinese elderly.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Disfunção Cognitiva/etiologia , Dieta/efeitos adversos , Comportamento Alimentar/psicologia , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/patologia , Disfunção Cognitiva/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários
14.
J Med Internet Res ; 22(7): e20001, 2020 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-32614778

RESUMO

BACKGROUND: Existing health disparities based on race and ethnicity in the United States are contributing to disparities in morbidity and mortality during the coronavirus disease (COVID-19) pandemic. We conducted an online survey of American adults to assess similarities and differences by race and ethnicity with respect to COVID-19 symptoms, estimates of the extent of the pandemic, knowledge of control measures, and stigma. OBJECTIVE: The aim of this study was to describe similarities and differences in COVID-19 symptoms, knowledge, and beliefs by race and ethnicity among adults in the United States. METHODS: We conducted a cross-sectional survey from March 27, 2020 through April 1, 2020. Participants were recruited on social media platforms and completed the survey on a secure web-based survey platform. We used chi-square tests to compare characteristics related to COVID-19 by race and ethnicity. Statistical tests were corrected using the Holm Bonferroni correction to account for multiple comparisons. RESULTS: A total of 1435 participants completed the survey; 52 (3.6%) were Asian, 158 (11.0%) were non-Hispanic Black, 548 (38.2%) were Hispanic, 587 (40.9%) were non-Hispanic White, and 90 (6.3%) identified as other or multiple races. Only one symptom (sore throat) was found to be different based on race and ethnicity (P=.003); this symptom was less frequently reported by Asian (3/52, 5.8%), non-Hispanic Black (9/158, 5.7%), and other/multiple race (8/90, 8.9%) participants compared to those who were Hispanic (99/548, 18.1%) or non-Hispanic White (95/587, 16.2%). Non-Hispanic White and Asian participants were more likely to estimate that the number of current cases was at least 100,000 (P=.004) and were more likely to answer all 14 COVID-19 knowledge scale questions correctly (Asian participants, 13/52, 25.0%; non-Hispanic White participants, 180/587, 30.7%) compared to Hispanic (108/548, 19.7%) and non-Hispanic Black (25/158, 15.8%) participants. CONCLUSIONS: We observed differences with respect to knowledge of appropriate methods to prevent infection by the novel coronavirus that causes COVID-19. Deficits in knowledge of proper control methods may further exacerbate existing race/ethnicity disparities. Additional research is needed to identify trusted sources of information in Hispanic and non-Hispanic Black communities and create effective messaging to disseminate correct COVID-19 prevention and treatment information.


Assuntos
Grupos de Populações Continentais/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Grupos Étnicos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Pneumonia Viral/epidemiologia , Inquéritos e Questionários , Adulto , Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Betacoronavirus , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Mídias Sociais , Estados Unidos/epidemiologia , Adulto Jovem
15.
Niger Postgrad Med J ; 27(3): 224-229, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687123

RESUMO

Background: Tension-type headache (TTH) is one of the most common reasons patients seek medical treatment. Psychiatric co-morbidities such as anxiety and depression have been commonly observed in patients with TTH. Objective: The objective was to study the prevalence and severity of co-morbid generalized anxiety disorder (GAD) and major depressive disorder (MDD) in patients with TTH. Materials and Methods: The present cross-sectional study was conducted in the Tertiary Health Care Centre in Central Rural India, with a sample size of 85. Data were recorded in the predesigned, semi-structured questionnaire. Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HDRS) were used to categorise the co-morbid anxiety and depression. Results: About 48.2% of the study participants were in the age group of 31-40 years with a mean age of 36.8 ± 7.1 years. Higher proportions of female study participants (64.7%) were observed. Majority of the study participants were literate (76.5%), employed (57.7%), married (78.8%) and had rural residence (54.1%). The prevalence of co-morbid GAD was 70.6%, whereas the prevalence of co-morbid MDD was 54.1%. According to HAM-A, 31.8% had mild, 21.2% had moderate, while 17.6% had severe anxiety levels. According to HDRS, 34.1% had mild, 16.5% had moderate and 3.5% had severe co-morbid depression. Conclusion: TTH is frequently associated with co-morbid GAD and MDD.


Assuntos
Transtornos de Ansiedade/epidemiologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Transtorno Depressivo Maior/epidemiologia , Cefaleia do Tipo Tensional/epidemiologia , Adolescente , Adulto , Transtornos de Ansiedade/diagnóstico , Grupo com Ancestrais do Continente Asiático/psicologia , Comorbidade , Estudos Transversais , Transtorno Depressivo Maior/diagnóstico , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Prevalência , Escalas de Graduação Psiquiátrica , População Rural , Índice de Gravidade de Doença , Fatores Socioeconômicos , Inquéritos e Questionários , Cefaleia do Tipo Tensional/diagnóstico , Centros de Atenção Terciária
17.
Nature ; 584(7821): 430-436, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32640463

RESUMO

Coronavirus disease 2019 (COVID-19) has rapidly affected mortality worldwide1. There is unprecedented urgency to understand who is most at risk of severe outcomes, and this requires new approaches for the timely analysis of large datasets. Working on behalf of NHS England, we created OpenSAFELY-a secure health analytics platform that covers 40% of all patients in England and holds patient data within the existing data centre of a major vendor of primary care electronic health records. Here we used OpenSAFELY to examine factors associated with COVID-19-related death. Primary care records of 17,278,392 adults were pseudonymously linked to 10,926 COVID-19-related deaths. COVID-19-related death was associated with: being male (hazard ratio (HR) 1.59 (95% confidence interval 1.53-1.65)); greater age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions. Compared with people of white ethnicity, Black and South Asian people were at higher risk, even after adjustment for other factors (HR 1.48 (1.29-1.69) and 1.45 (1.32-1.58), respectively). We have quantified a range of clinical factors associated with COVID-19-related death in one of the largest cohort studies on this topic so far. More patient records are rapidly being added to OpenSAFELY, we will update and extend our results regularly.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Asma/epidemiologia , Estudos de Coortes , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Modelos de Riscos Proporcionais , Medição de Risco , Caracteres Sexuais , Fumar/epidemiologia , Medicina Estatal , Adulto Jovem
18.
PLoS One ; 15(7): e0235761, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628738

RESUMO

The Women's Experience with Battering (WEB) scale is a self-report instrument that uses a 10-item Likert-type scale to measure IPV victims' cognitive and affective experience of battering. This study aimed to validate the Chinese version of the WEB scale using gender-neutral questions, Experience of Battering Scale (Chinese) (EBS-C), to assess the psychological vulnerability of victims of intimate partner violence (IPV). The study adopted a range of methods, including translation and back translation, expert reviews, cognitive debriefing, and test-retest reliability assessment. The EBS-C was validated in a purposive convenience sample of 718 Chinese-speaking participants (male = 362; female = 356) aged 18-24 (mean age = 21.4) in Hong Kong. The results of CFA showed a good model fit: CFI = .97, TLI = .96, RMSEA = .05, SRMR = .03. The EBS-C was also found to be significantly associated with the Revised Conflict Tactics Scales (CTS2; r = .13-.17, p < .01), depression (BDI-II: r = .15, p < .01), anxiety (GAD-7: r = .17, p < .01), interpersonal support (ISEL-12: r = -.27, p < .01), relationship satisfaction (RAS: r = -.36, p < .01), and self-esteem (RSES: r = -.22, p < .01). The study demonstrated the EBS-C to be a reliable and valid measure for assessing the psychological vulnerability of IPV victims. It is thus useful for identifying the risks such individuals face by assessing their experience of fear, danger, and disempowerment in the intimate relationship relative to abusive incident-based measures alone. The EBS-C will also be useful for developing effective treatments to address the psychological vulnerability resulting from IPV and will facilitate cross-cultural comparative research aimed at enriching our knowledge of IPV victimization.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Mulheres Maltratadas/psicologia , Vítimas de Crime/psicologia , Violência por Parceiro Íntimo/psicologia , Autorrelato , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/psicologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Mulheres Maltratadas/estatística & dados numéricos , Feminino , Nível de Saúde , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Maus-Tratos Conjugais/estatística & dados numéricos , Adulto Jovem
19.
Brain Behav Immun ; 88: 44-49, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32497776

RESUMO

BACKGROUND: Differentials in COVID-19 hospitalisations and mortality according to ethnicity have been reported but their origin is uncertain. We examined the role of socioeconomic, mental health, and pro-inflammatory factors in a community-based sample. METHODS: We used data on 340,966 men and women (mean age 56.2 years) from the UK Biobank study, a prospective cohort study with linkage to hospitalisation for COVID-19. Logistic regression models were used to estimate associations between ethnicity and hospitalisation for COVID-19. RESULTS: There were 640 COVID-19 cases (571/324,306 White, 31/4,485 Black, 21/5,732 Asian, 17/5,803 Other). Compared to the White study members and after adjusting for age and sex, Black individuals had over a 4-fold increased risk of COVID-19 infection (odds ratio; 95% confidence interval: 4.32; 3.00-6.23), and there was a doubling of risk in the Asian group (2.12; 1.37, 3.28) and the 'other' non-white group (1.84; 1.13, 2.99). After controlling for potential explanatory factors which included neighbourhood deprivation, household crowding, smoking, body size, inflammation, glycated haemoglobin, and mental illness, these effect estimates were attenuated by 33% for Blacks, 52% for Asians and 43% for Other, but remained raised for Blacks (2.66; 1.82, 3.91), Asian (1.43; 0.91, 2.26) and other non-white groups (1.41; 0.87, 2.31). CONCLUSIONS: There were clear ethnic differences in risk of COVID-19 hospitalisation and these do not appear to be fully explained by measured factors. If replicated, our results have implications for health policy, including the targeting of prevention advice and vaccination coverage.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Infecções por Coronavirus/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Hospitalização/estatística & dados numéricos , Pneumonia Viral/etnologia , Idoso , Betacoronavirus , Índice de Massa Corporal , Proteína C-Reativa/imunologia , Estudos de Coortes , Comorbidade , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/terapia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etnologia , Inglaterra/epidemiologia , Feminino , Volume Expiratório Forçado , Hemoglobina A Glicada/metabolismo , Nível de Saúde , Humanos , Inflamação , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pandemias , Questionário de Saúde do Paciente , Pneumonia Viral/imunologia , Pneumonia Viral/terapia , Fatores Socioeconômicos
20.
PLoS One ; 15(6): e0235056, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32579575

RESUMO

Globally, cancer patients obtain much of their disease information online. Online health communities allow patients to share questions and information about diseases. However, there have been few studies on the factors affecting online health community participation behavior in cancer patients. Online social networking is associated with mental health problems, and patients with thyroid cancer experience high levels of distress, anxiety and depression. The purpose of this study was to investigate factors associated with use of online health communities by patients with thyroid cancer to understand the characteristics of patients participating in such online communities. A questionnaire survey was completed by 114 thyroid cancer patients admitted for surgery at a general hospital in Seoul, Korea. General characteristics, clinical characteristics, attitude toward cancer, distress, and anxiety and depression scores of patients who joined an online health community (user group) and patients who did not (non-user group) were compared. The factors affecting online health community participation were education (p = 0.049), tumor size (p = 0.010), attitude toward cancer (p = 0.022), and anxiety and depression (p = 0.021). The average score of satisfaction with the online health community was 4.25 of 5. The user group had larger tumors, a high awareness of the risk of thyroid cancer, and high levels of anxiety and depression. Patients who actively used the online health community have relatively larger cancer size and had higher levels of mental stress. As such patients are often very anxious and depend heavily on the gathered information, the quality of this information is important. Healthcare professionals need to develop appropriate interventions for patients participating in the online health community.


Assuntos
Carcinoma Papilar/psicologia , Participação da Comunidade/estatística & dados numéricos , Inquéritos Epidemiológicos/estatística & dados numéricos , Neoplasias da Glândula Tireoide/psicologia , Adolescente , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/etnologia , Ansiedade/psicologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/etnologia , Depressão/diagnóstico , Depressão/etnologia , Depressão/patologia , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , República da Coreia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/etnologia , Adulto Jovem
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