scholarly journals The Impact of COVID-19 on Routine Medical Care and Cancer Screening

Author(s):  
Neil S. Wenger ◽  
Annette L. Stanton ◽  
Ryan Baxter-King ◽  
Karen Sepucha ◽  
Lynn Vavreck ◽  
...  

Abstract Background COVID-19 restrictions and fear dramatically changed the use of medical care. Understanding the magnitude of cancelled and postponed appointments and associated factors can help identify approaches to mitigate unmet need. Objective To determine the proportion of medical visits cancelled or postponed and for whom. We hypothesized that adults with serious medical conditions and those with higher anxiety, depressive symptoms, and avoidance-oriented coping would have more cancellations/postponements. Design Four nationally representative cross-sectional surveys conducted online in May, July, October, and December 2020. Participants 59,747 US adults who completed 15-min online surveys. 69% cooperation rate. Measures Physical and mental health visits and cancer screening cancelled or postponed over prior 2 months. Plan to cancel or postpone visits over the next 2 months. Relationship with demographics, medical conditions, local COVID-19 death rate, anxiety, depressive symptoms, coping, intolerance of uncertainty, and perceived COVID-19 risk. Key Results Of the 58% (N = 34,868) with a medical appointment during the 2 months before the survey, 64% had an appointment cancelled or postponed in May, decreasing to 37% in December. Of the 41% of respondents with scheduled cancer screening, 20% cancelled/postponed, which was stable May to December. People with more medical conditions were more likely to cancel or postpone medical visits (OR 1.19 per condition, 95% CI 1.16, 1.22) and cancer screening (OR 1.20, 95% CI 1.15, 1.24). Race, ethnicity, and income had weak associations with cancelled/postponed visits, local death rate was unrelated, but anxiety and depressive symptoms were strongly related to cancellations, and this grew between May and December. Conclusions Cancelled medical care and cancer screening were more common among persons with medical conditions, anxiety and depression, even after accounting for COVID-19 deaths. Outreach and support to ensure that patients are not avoiding needed care due to anxiety, depression and inaccurate perceptions of risk will be important.

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 20
Author(s):  
Blain Murphy ◽  
Tony Benson ◽  
Amanda McCloat ◽  
Elaine Mooney ◽  
Chris Elliott ◽  
...  

COVID-19 has led to dramatic societal changes. Differing movement restrictions across countries have affected changes in consumers’ food practices, with a potentially detrimental impact on their health and food systems. To investigate this, this research explored changes in consumers’ food practices during the initial COVID-19 phase and assessed the impact of location on these changes. A sample of 2360 adults from three continents (Island of Ireland (IOI), Great Britain (GB), United States (USA), and New Zealand (NZ)) were recruited for a cross-sectional online survey (May–June 2020). Participants completed questions in relation to their cooking and food practices, diet quality, and COVID-19 food-related practices. Significant changes in consumers’ food practices during the pandemic were seen within and between regions, with fewer cooking practices changes found in the USA. Food practices, which may put added pressure on the food system, such as bulk buying, were seen across all regions. To prevent this, organisational food practices, including planning ahead, should be emphasized. Additionally, while positive cooking-related practices and increases in fruit and vegetable intake were found, an increase in saturated fat intake was also seen. With the additional pressure on individuals’ physical and mental health, the essentiality of maintaining a balanced diet should be promoted.


2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Yongjie Zhou ◽  
Ruoxi Wang ◽  
Lei Liu ◽  
Ting Ding ◽  
Lijuan Huo ◽  
...  

Abstract Background Although more and more attention has been paid to the psychological consequences of the lockdown policy amongst pregnant women, the underlying mechanism linking the lockdown policy to maternal depression has not been studied in the context of China. This study aimed to explore the association between the lockdown policy and maternal depressive symptoms, and whether such association was mediated by internet use and/or family support. Methods This cross-sectional study used multi-stage sampling techniques in central and western China. Data were collected from 1266 pregnant women using a structtured questionnaire that measured internet use, family support, and depressive symptoms. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depressive symptoms. Internet use was measured by length of usage and varierity of purpose for internet use. Family support was measureed by spousal support and parental support. The structural equation modelling was employed to conduct mediation analysis to test the specificity of the hypothetical paths. Results Overall, 527 respondents (41.63%) presented depressive symptoms. The lockdown policy was negatively associated with depressive symptoms in pregnant women (β = − 0.925, 95% CI = −1.510, − 0.360). The impact of the lockdown policy on depressive symptoms was partially mediated by internet use (β = 1.589, 95% CI = 0.730, 2.807) and family support (β = − 0.162, 95% CI = − 0.341, − 0.017), accounting for 42.67% of the total effect. Conclusions The lockdown policy was generally associated with fewer depressive symptoms in pregnant women. The lockdown policy increased maternal depressive symptoms through increased internet use, but decreased maternal depressive symptoms through enhanced family support. The findings suggest that the psychological consequence of the lockdown policy may vary across different populations, and warrant the need to take into consideration the features of subgroups.


Author(s):  
Takafumi Abe ◽  
Kenta Okuyama ◽  
Tsuyoshi Hamano ◽  
Miwako Takeda ◽  
Masayuki Yamasaki ◽  
...  

Although some neighborhood environmental factors have been found to affect depressive symptoms, few studies have focused on the impact of living in a hilly environment, i.e., land slope, on depressive symptoms among rural older adults. This cross-sectional study aimed to investigate whether a land slope is associated with depressive symptoms among older adults living in rural areas. Data were collected from 935 participants, aged 65 years and older, who lived in Shimane prefecture, Japan. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) and defined on the basis of an SDS score ≥ 40. Land slopes within a 400 m network buffer were assessed using geographic information systems. Odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were estimated using logistic regression. A total of 215 (23.0%) participants reported depressive symptoms. The land slope was positively associated with depressive symptoms (OR = 1.04; 95% CI = 1.01–1.08) after adjusting for all confounders. In a rural setting, living in a hillier environment was associated with depressive symptoms among community-dwelling older adults in Japan.


2021 ◽  
Author(s):  
Min Yi Sum ◽  
Sherry Kit Wa Chan ◽  
Gloria Hoi Yan Wong

BACKGROUND Adolescence and young adulthood is a period of heightened risk of mental disorders onset. The Covid-19 pandemic may have impacted the daily lives and learning of students, exposing them to risks of emotional distress. Understanding factors associated with individual differences in distress can inform remedial strategies for schools. OBJECTIVE To investigate the impact of Covid-19 on undergraduate students’ lifestyle and learning, and explore relationship between depressive symptoms, resilience, and optimism/pessimism bias in undergraduate students in Hong Kong. METHODS Cross-sectional online survey of undergraduate students in a university (n=1020) before and during the third wave of Covid-19 outbreak in Hong Kong between May and August 2020. Changes in habits and family conflicts, depressive symptoms (measured using Patient Health Questionnaire-9), resilience (measured using Connor-Davidson Resilience Scale), optimism/pessimism towards Covid-19 risks, and knowledge about Covid-19 were recorded. Multivariable linear regression and mediation analyses were used to explore relationships with depressive symptoms. RESULTS 61.7% of respondents have mild to severe depressive symptoms. The regression model found that 18.5% of the variance in depressive symptoms was explained by resilience, pessimism bias, changes in sleep, decrease in study at home, and increase in family conflict. Mediation analysis showed that resilience is indirectly related to depressive symptoms through its relationship with pessimism (ab = -0.042, CI = -0.057 to -0.013). Higher resilience was associated with lower depressive symptoms even after accounting for resilience’s indirect effect through pessimism (c’ = 0.311, P < .001). CONCLUSIONS The findings highlight the mental health vulnerability of undergraduate students. Measures to reduce family conflict, maintain healthy daily habits, adjust optimism/pessimism bias, and enhance resilience may be useful for improving the mental wellbeing of undergraduate students during the pandemic.


2021 ◽  
Vol 9 ◽  
Author(s):  
Paula Mayara Matos Fialho ◽  
Franca Spatafora ◽  
Lisa Kühne ◽  
Heide Busse ◽  
Stefanie M. Helmer ◽  
...  

Background: Results of previous studies examining the impact of the SARS-CoV-1 epidemic in 2003 on university students' mental well-being indicated severe mental health consequences. It is unclear how the current COVID-19 pandemic and the changes in study conditions due to federal regulations affected mental well-being in the German student population. We examined university students' perceptions of study conditions during the COVID-19 pandemic and investigated associations between study conditions and depressive symptoms.Methods: A cross-sectional online survey was conducted in Germany in May 2020 at four universities (N = 5,021, 69% female, mean age: 24 years, SD: 5.1). Perceived study conditions, as well as sociodemographic information, were assessed with self-generated items and the CES-D 8 scale was used to determine depressive symptoms. Associations between perceived study conditions (academic stress and academic satisfaction), in general, and confidence to complete the semester, in particular, and depressive symptoms were analyzed using generalized linear regressions.Results: Fifty-four percent of survey participants felt that the university workload had significantly increased since the COVID-19 pandemic; 48% were worried that they would not be able to successfully complete the academic year; 47% agreed that the change in teaching methods caused significant stress. Regarding depressive symptoms, the mean score of the CES-D 8 scale was 9.25. Further, a positive association between perceived study conditions and depressive symptoms was found (p &lt; 0.001), indicating that better study conditions were associated with fewer depressive symptoms. Results of the generalized linear regression suggest that better student mental well-being was related to higher confidence in completing the semester.Conclusions: This study provides first insights into perceived study conditions and associations with depressive symptoms among students during the COVID-19 pandemic in Germany. Findings underline the need for universities to provide intervention strategies targeting students' mental well-being during the course of the pandemic.


2013 ◽  
Vol 25 (3) ◽  
pp. 77 ◽  
Author(s):  
OBA Owoeye ◽  
SRA Akinbo ◽  
OA Olawale ◽  
BA Tella ◽  
NM Ibeabuchi

Background. Exposure to competitive football is increasing among male youth football players in Nigeria. However, medical support to abate the impact of injuries appears inadequate and there is limited literature to show whether youth football players are knowledgeable about, and practise effective measures for injury prevention in football (IPF).Objective. To assess the knowledge and behaviour of male youth football players regarding IPF and the availability of medical care for players.Methods. We conducted a cross-sectional study among all registered first-division players of a male youth football league in Lagos, Nigeria. Using a self-administered questionnaire, we assessed players’ knowledge regarding IPF, awareness of the Fédération Internationale de Football Association (FIFA) 11+ injury-prevention programme, injury-prevention behaviour and availability of medical attendants during training and competitive matches.Results. The mean age of the players was 18.5 years (standard deviation (SD) ±1.7; range 12 - 19). Their overall mean knowledge score regarding IPF was 4.40 (SD ±1.92) from a total score of 9, with the majority falling into the poor (39.1%) and fair (43.9%) knowledge categories. Most (79.3%) players were not aware of the FIFA 11+ programme. Less than half (40.5%) wore shin guards during training sessions, while 52.5% reported wearing shin guards during matches. Less than two-thirds always warmed up or cooled down at training or matches. About three-quarters (73.1%) and over half (52.1%) reported not having medical attendants working with their teams during matches and training, respectively.Conclusion. There is a clear deficiency in the knowledge and behaviour of injury-prevention measures among Nigerian male youth football players, and adequate medical care is lacking. There is a need for injury-prevention advocacy and implementation of effective interventions to bridge the identified deficiencies in youth football in Nigeria.


2018 ◽  
Vol 46 (4) ◽  
pp. 286-291 ◽  
Author(s):  
Luigi Cirillo ◽  
Roberta Cutruzzulà ◽  
Chiara Somma ◽  
Marco Gregori ◽  
Giuseppe Cestone ◽  
...  

Background: Depression is the most common psychiatric disorder in long-term dialysis patients and a risk factor for morbidity and mortality. Although there is a relevance of the issue in the dialysis setting, we still know little about possible relationships between depression and uraemia-related biochemical abnormalities. Our aims were to evaluate (1) the prevalence of depression in our haemodialysis (HD) and peritoneal dialysis (PD) population using a validated and easy-to-implement screening tool and (2) the association between depression and the main uraemia-related clinical and biochemical parameter changes. Methods: In this monocentric cross-sectional study, all patients of our centre with at least 3 months of dialysis were screened by Patient Health Questionnaire-9 (PHQ-9), a self-administered depression-screening questionnaire validated in dialysis setting. The impact of depressive symptoms on daily life was also assessed. We then analysed relationships between the PHQ-9-derived depressive score, functional impairment score, demographic, clinical and laboratory variables. Results: In our cohort of 145 patients, depressive symptoms were found in 69 patients (46%). Stratifying for severity, mild, moderate and severe grade accounted for 31, 13 and 2% respectively. Depressive symptoms affected 36% of patients on PD versus 52% of patients on HD. Moreover, the PD patients had significantly less functional impairment derived from depressive symptoms than the HD patients. Simple and multiple regression analysis identified serum phosphorus as the only uraemia-related laboratory parameter that was high statistically associated with depressive score. Conclusions: Using a reliable, simple and fast tool, we found that depressive symptoms affect almost half of dialysis patients, particularly so the HD cohort. Severity of depressive symptoms seems related to serum levels of phosphorus possibly because depression affects compliance to therapy.


2022 ◽  
Vol 13 (1) ◽  
pp. 19-24
Author(s):  
Neha Thakur (Rai) ◽  
Arvind Kumar Singh ◽  
Narendra Rai ◽  
Devesh Kumar Shukla

Background: With the ongoing growth and expansion of digital media and COVID-19 pandemic, children are inclining more and more toward spending time on digital media as compared to outdoor sports, leading to poor physical and mental growth. Developed nations have already set up a screen time guideline which is yet to be established in developing nations. This study was conducted with the objectives of identifying the needs of screen time guidelines and to study the impact of screen time on mental and physical health in children. Aims and Objectives: This study aims to check the screen time in children aged 2–18 and find the health consequences both physical and psychological in those children. Materials and Methods: A cross-sectional study on children aged 2–18 years was conducted between 2019 and 2020. Parents were asked to fill a pre-structured questionnaire. Impact on health physical and mental were assessed by pediatrician and psychologist. Results: A total of 155 children were enrolled in the study. Mean child hours in children aged 2–5 years, 5–10 years, and 10–18 years were 4 h, 5.83 h, and 6.29 h on week days and 5.64 h, 5.76 h, and 7.69 h on weekends, respectively. More than one-third of children had age of onset of screen time below 2 years of age. About 70% of children had malnutrition. Only 18% of parents were aware of concept of screen free days. Screen time had negative impact on health (P=0.0001) and on behavior of child (P=0.001). Average increase in screen time during COVID-19 was nearly 3 times the pre-COVID era. Conclusion: This study has paved the way for the need of larger study and development of guidelines on impact of screen time on children in developing nations where screen time guidelines is yet to be set more so in era of COVID 19 pandemic.


Author(s):  
Xiaohua Ye ◽  
Jingya Huang ◽  
Liang Xia ◽  
Xiaojun Xu ◽  
Xiao Gong ◽  
...  

Few studies have focused on the potential relationship between secondhand smoke (SHS) exposure and depressive symptoms. This study aimed to explore the potential association between SHS exposure and depressive symptoms and differentiate this association in setting-specific exposure and symptom-specific outcomes. A cross-sectional study was conducted in Guangdong province of China from September to December 2010 using a multistage sampling method to randomly sample adults aged 18 years and older. SHS exposure was defined as inhalation by non-smokers of the smoke exhaled from smokers for at least 1 day a week in the past 30 days. Depressive symptoms were measured using the nine-item Patient Health Questionnaire. The zero-inflate negative binomial regression models were used to explore the associations between SHS exposure and depressive symptoms. A total of 2771 non-smokers were included in this study, with mean age of 49.6 ± 14.0 years and 70.3% of females. The prevalence of depressive symptoms was significantly higher in participants with SHS exposure than in those without exposure (incidence rate ratio (IRR) = 1.32, 95% confidence interval (CI) 1.16–1.51), and there were similar positive associations for SHS exposure in medical facilities (IRR = 1.37, 95% CI 1.17–1.61) and in schools (IRR = 1.46, 95% CI 1.20–1.77). Notably, there was a monotonically increasing dose-response relationship between frequency of SHS exposure and depressive symptoms. When differentiating this relationship by the dimensions of depressive symptoms, there were similar dose-response relationships for cognitive-affective and somatic symptoms. When differentiating this relationship by sex, only females showed a significant dose-response relationship. Our findings suggest dose-response relationships between SHS exposure and depressive symptoms in sex-specific and symptom-specific manners. Future longitudinal studies are needed to establish the biological mechanisms of the impact of SHS exposure.


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