Predominancyof Coping Styles in Patients with Type II Diabetes in Low Socio Economic Status Groups

Background: Coping style is a person’s characteristic strategies used in response to life problems or traumas. Coping serves a protective function .This study aims to examine the impact of coping styles predominance in the training programme given to patients with type II diabetes of low socioeconomic status group.30 patients with type II diabetes of low socioeconomic status group were selected using purposive sampling from the diabetic clinic for the assessment of coping style. Coping style was assessed using “Coping styles of adults with Type 1 and Type 2 diabetes” by Karlsen and Bru (1998). Paired t-test was used to assess the effectiveness of coping styles enhancement training programme for patients with type II diabetes. The study revealed that there is significant increase in the level of coping styles of patients with type II diabetes due to coping styles enhancement training programme.

COVID-19 infections in day care centres in Germany: social and organisational determinants of infections in children and staff in the second and third wave of the pandemic

Background During the SARS-CoV-2 pandemic, German early childhood education and care (ECEC) centres organised children’s attendance in different ways, they reduced opening hours, provided emergency support for a few children, or closed completely. Further, protection and hygiene measures like fixed children-staff groups, ventilation and surface disinfection were introduced in ECEC centres. To inform or modify public health measures in ECEC, we investigate the occurrence of SARS-CoV-2 infections among children and staff in ECEC centres in light of social determinants (i.e. the socioeconomic status of the children) and recommended structural and hygiene measures. We focus on the question if the relevant factors differ between the 2nd (when no variant of concern (VOC) circulated) and the 3rd wave (when VOC B.1.1.7 (Alpha) predominated). Methods Based on panel data from a weekly online survey of ECEC centre managers (calendar week 36/2020 to 22/2021, ongoing) including approx. 8500 centres, we estimate the number of SARS-CoV-2 infections in children and staff using random-effect-within-between (REWB) panel models for count data in the 2nd and 3rd wave. Results ECEC centres with a high proportion of children with low socioeconomic status (SES) have a higher risk of infections in staff and children. Strict contact restrictions between groups like fixed group assignments for children and fixed staff assignments to groups prevent infections. Both effects tend to be stronger in the 3rd wave. Conclusion ECEC centres with a large proportion of children with a low SES background and lack of using fixed child/staff cohorts experience higher COVID-19 rates. Over the long run, centres should be supported in maintaining recommended measures. Preventive measures such as the vaccination of staff should be prioritised in centres with large proportions of low SES children.

Post-COVID-19 Condition and Health Status

Background: Observational studies of the long-term effects of COVID-19 infection generally focus on individual symptoms rather than health status. Objective: Longitudinal assessment of general health status following COVID-19 infection. Design: Observational study, with data collected from two telephone surveys at 32 ± 10 and 89 ± 25 days after discharge from the hospital or emergency department (ED) for a COVID-19 infection. Medicaid or no insurance was our marker of low socioeconomic status (SES). Acute disease severity was determined by summing 10 severity markers (yes-no) from the health encounter. Baseline comorbidity was a modified Charlson Index. Participants: 40 patients. Mean age was 54 ± 15 years, 50% were female, and 40% had low socioeconomic status. Main Measures: (1) the 20-item Medical Outcomes Study Short-Form General Health Survey (SF-20); (2) Dyspnea (modified Medical Research Council); (3) Psychological symptoms (Patient Health Questionnaire for Anxiety and Depression); (4) Cognitive function (Cognitive Change Questionnaire); (5) Fatigue (Short Fatigue Questionnaire); (6) A 10-item review of systems (ROS) questionnaire. Key Results: Percentages with abnormal symptoms at the first and second surveys were (respectively): Dyspnea (40, 33), Fatigue (53, 50), Anxiety (33, 18), Depression (20, 10), PHQ-4 Composite (25, 13), and Cognitive (18, 10). Mean scores on the SF-20 subscales, Physical Functioning, Role Functioning, Social Functioning, Health Perception, Mental Health, and Pain were numerically lower than means from a published study of elderly outpatients. With the exception of Pain, all SF-20 subscale scores improved significantly by the second survey. In multivariable analyses, dyspnea was predictive of impairment in all SF-20 subscales at the second survey. Conclusions: COVID-19 infection causes persistent abnormality across multiple patient-reported outcome areas, including health status. The persistence of impairment in each health status component is influenced by baseline dyspnea.

Trends in Nutritional Biomarkers by Demographic Characteristics Across 14 Years Among US Adults

Background: Understanding trend in nutritional status is crucial to inform national health priorities to improve diets and reduce related diseases. The present study aimed to analyze trends in the concentrations of all measured nutritional biomarkers and their status among US adults across 14 years.Methods: Trends on the concentrations of nutritional biomarkers and nutritional status evaluated by the prevalence of deficiency, inadequacy, excess, and dyslipidemia were analyzed among US adults in 7 cross-sectional National Health and Nutrition Examination Surveys (NHANES 2003–2016) and by age, sex, race/ethnicity, and socioeconomic status.Results: A total of 38,505 participants (weighted mean age of 47.2 years, 51.4% women) were included in the present study. Across 14 years, increased trends were found in red blood cell (RBC) folate, serum vitamin B12, vitamin D and albumin, the prevalence of iodine deficiency, vitamin B6 inadequacy, and hypophosphatemia, whereas decreased trends were observed in serum vitamin E, phosphorus, total calcium, total protein, apolipoprotein B (Apo B), low-density-lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC), blood lead, cadmium, mercury, and the prevalence of vitamin C deficiency, vitamin D inadequacy, iodine excess, and dyslipidemia with elevated LDL-C, TC, TG, and lowered HDL/LDL. Non-Hispanic blacks (NHB) and participants with low socioeconomic status were accounted for the poor nutritional status of most biomarkers compared to their comparts.Conclusion: Most nutritional biomarkers and their status were improved among US adults from 2003 to 2016, but some specific populations should be paid much attention to improve their nutritional status, especially for NHB and participants with low socioeconomic status.

Developing and implementing a new methodology to test the affordability of currently popular weight loss diet meal plans and healthy eating principles

Background Weight loss diets continue to rise in popularity; however, the associated costs are seldom reported. Certain weight loss diets may be unaffordable and differ from their traditional nutrition composition to include non-conventional premium products. In contrast, healthy eating principles such as the Australian Guide to Healthy Eating (AGHE) and the Mediterranean Diet (MedDiet) place an emphasis on fresh produce and staple foods but are sometimes thought to be unaffordable. A new methodology was piloted to assess the cost of weight loss diets using seven meal plans. Methods Seven meal plans were analysed to quantify the absolute grams required of all ingredients across seven days and multiplied by the cost of the ingredient per gram to determine the total cost of each ingredient based on unit size and price. The weekly grocery shopping cost was determined through summation of all ingredients and their entire unit size to compare weekly costs. Results Weekly meal plans (absolute grams) cost between $93-193AUD. The AGHE meal plan was the least expensive and 8 Weeks to Wow was the most expensive. Weekly grocery shopping of entire units cost between $345-$625AUD, over $100AUD greater than the spending of an average Australian ($237AUD/week). Conclusions The financial feasibility for long-term sustainment of weight loss diets may be questionable for groups including low-income earners and low socioeconomic status. Further, when dietary patterns are adapted for weight loss, or followed by consumers, deviations from foundational principles tend to occur which may influence overall cost.

Telemedicine

Using telemedicine systems, physicians around the world have been able to provide health access to their own communities and others abroad. Telemedicine is still a developing field in the health sciences, but much progress has been made with the advent of new communication technologies. Today, telemedicine offers an alternative to traditional physician consultations, especially for those patients with different needs. Patients with mobility issues, low socioeconomic standing, and far away from big cities have seen benefits from this form of patient care. Not only has telemedicine been able to just bridge these gaps, but it has also provided a new way for the international community of health practitioners to cooperate and aid areas in need of specialized care in the developing world. New cooperation programs between developed and developing countries have been developed to bring specialist knowledge to areas that otherwise would not have access to it. Telemedicine is a way to take care of patients in this technological area and perhaps will become the new standard of care.

Negotiating Virtual Learning During a Pandemic

The goal of this chapter is to highlight strategies used by educators to reduce disproportionality in school discipline during turbulent times, such as a pandemic and periods of social unrest. Public schools located in low socioeconomic areas are witness to the overrepresentation of students of color, both male and female, being disproportionately punished. Additionally, these students also suffer academically due to a lack of technological resources, both in school and at their homes. The authors of this chapter are public school educators, who have worked to find solutions to resolve student's loss of knowledge during the COVID-19 pandemic, while recognizing that additional measures are also needed to address school discipline in both face-to-face and virtual settings.