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"Frontline Healthcare workers suffering from psychosomatic disorders during COVID-19 (a pandemic): A Systematic review","Purpose: The emergence of SARS CoV-2, has imposed high pressure on the healthcare system worldwide. As a consequence, frontline healthcare workers were impacted widely. The aim of this systematic review is to examine the impact of COVID-19 on mental status of FHW during pandemic. Methods: Databases such as PubMed, Scopus, google scholar were searched extensively from the date of inception till April 2021. All cross-sectional studies published in English assessing the mental condition and well-being of frontline caregivers during COVID-19 were included in the study. The quality assessment was done by Newcastle Ottawa scale. Results: Ten thousand eight hundred sixty-nine articles were found. After conscientious literature search, total 78 articles were included satisfying the objective of the review. The highest and lowest values for the rates of depression, anxiety and insomnia was found to be 99.51% & 6.07%, 85.7% & 73.6%, and 5.3% & 11.4%, respectively. Conclusion: It has been found that FHW were psychologically impacted by the pandemic. This could be due to lack of resources such as PPE, organizational support, inefficient relevant knowledge regarding the novel virus, its extremely indelible transmission rates, fear of contamination, stigmatization, and/or due to prevalence of ignorance by government and health policy makers. Prospero registration no- CRD42021244612 Key words; Mental disorders, Frontline healthcare workers, Psychosomatic disorders, psychological morbidities, COVID-19.","Rhythm Joshi; Nidhi B. Agarwal; Dinesh Bhurani; Mohd. Ashif Khan","https://medrxiv.org/cgi/content/short/2021.11.09.21266105","20211111","","medRxiv","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21792,""
"Drawing lessons on better governing for emergencies for improved resilience against health emergencies","The COVID-19 pandemic has taught us that preparednessfor and resilience against health emergencies is critical. To improve preparedness for health emergencies, the emergency preparedness and response governance architecture at all levels should be strengthened. It should be based on cross-cutting, whole-of-government, and whole-of-society approaches, moving away from siloed perspectives. Moreover, resilience against health emergencies should be based on universal health coverage and anchored in the International Health Regulations (IHR) 2005 core capacities implementation. Capacities and capabilities that are required to improve health services for national and global health security should also be strengthened.","European Observatory on Health Systems and Policies, Nitzan, Dorit, Perehinets, Ihor, Meyer, J. Sam, Smallwood, Catherine A. H.","https://apps.who.int/iris/handle/10665/344934","","Database: WHOIRIS; Publication details: Eurohealth; 27(1):16-19, 2021.; Publication details: Eurohealth; 27(1):16-19, 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21793,""
"Uncertainty management in organizational crisis communication: the impact of crisis responsibility uncertainty and attribution-based emotions on publics' further crisis information seeking","PurposeAlthough uncertainty has been identified as a key crisis characteristic and a multi-faceted construct essential to effective crisis management research and practice, only a few studies examined publics' perceived uncertainty with a focus on crisis severity uncertainty, leaving crisis responsibility uncertainty uninvestigated in organizational crisis settings.Design/methodology/approachTo close this research gap empirically, this study employed data from an online survey of a total of 817 US adults to examine how participants' crisis responsibility uncertainty and their attribution-based crisis emotions might impact their crisis responses such as further crisis information seeking.FindingsFirst, findings show that participants' crisis responsibility uncertainty was negatively associated with their attribution-independent (AI) crisis emotions (i.e. anxiety, fear, apprehension and sympathy) and external-attribution-dependent (EAD) crisis emotions (i.e. disgust, contempt, anger and sadness), but positively associated with internal-attribution-dependent (IAD) crisis emotions (i.e. guilt, embarrassment and shame). Second, crisis responsibility uncertainty and AI crisis emotions were positive predictors for participants' further crisis information seeking. Third, AI crisis emotions and IAD crisis emotions were parallel mediators for the relationship between participants' crisis responsibility uncertainty and their further crisis information seeking.Practical implicationsOrganizations need to pay attention to the perceived uncertainty about crisis responsibility and attribution-based crisis emotions since they can impact the decision of seeking crisis information during an ongoing organizational crisis.Originality/valueThis study improves uncertainty management in organizational crisis communication research and practice, connecting crisis responsibility uncertainty, attribution-based crisis emotions and publics' crisis information seeking.","Yen-I, Lee, Lu, Xuerong, Jin, Yan","https://doi.org/10.1108/JCOM-02-2021-0018","","Database: ProQuest Central; Publication details: Journal of Communication Management; 25(4):437-453, 2021.; Publication details: Journal of Communication Management; 25(4):437-453, 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21794,""
"Health-Related Quality of Life in patients with Checkpoint Inhibitor Enterocolitis","IntroductionImmune checkpoint inhibitors (CPI) have transformed the treatment of many advanced cancers but cause immune related adverse events including enterocolitis (CPI-E). The conventional inflammatory bowel diseases ulcerative colitis (UC) and Crohn’s disease (CD) are associated with unfavourable health-related quality of life (HRQoL) outcomes, but there are currently no data on HRQoL in the setting of CPI-E. This study aimed to investigate HRQoL in CPI-E.MethodsA prospective study was conducted across two London hospital trusts between February-April 2021. UC, CD and CPI-E patient cohorts were recruited from outpatient clinics and the biologic infusion unit. Disease activity was assessed using non-invasive scoring systems: modified-Partial Mayo Score (m-PMS), modified-Harvey Bradshaw Index (m-HBI), Simple Crohn’s and Colitis Activity Index (SCCAI) and Common Terminology Criteria for Adverse Events (CTCAE). HRQoL outcomes were assessed using validated questionnaires: Patient Health Questionnaire-8 (PHQ-8), Generalised Anxiety Disorder-7 (GAD-7), IBD-Questionnaire (IBD-Q) and Multidimensional Assessment of Fatigue (MAF).ResultsSeventy-five patients (33 CD, 21 UC, 21 CPI-E) were recruited. 33 CD patients (100%) and 20 UC patients (95.2%) were receiving biologic therapy. Thirteen CPI-E patients (61.9%) received Anti-PD1/PDL1 monotherapy and (38.1%) received combination anti-PD1 and anti-CTLA-4 therapy. Twenty-four CD patients (72.7%), 11 UC patients (52.4%) and 16 CPI-E patients (76.2%) were shielding due to the COVID-19 pandemic. Using m-PMS, m-HBI, SCCAI and CTCAE, >80% in each of the three cohorts were either classed as being in remission or having mild disease activity. Three CPI-E patients (14.3%) had moderate depression (PHQ-8 =10) and a further 9 (42.9%) had mild depression (PHQ-8 score 5-9). Nine CPI-E patients (42.9%) had significant fatigue (MAF score =30) and 6 (28.6%) had mild or moderate anxiety (GAD-7 =5). There were no significant differences in PHQ-8, GAD-7, IBD-Q and MAF between CPI-E, CD and UC patients, suggesting comparable levels of psychological morbidity in the three groups. Significant correlations were found between CPI-E disease activity and IBD-Q and GAD-7 scores.ConclusionOur study suggests that psychological morbidity in CPI-E is common and comparable to rates in CD and UC, even in the setting of clinical remission. Clinicians should be aware of this complication and take a holistic approach to this patient group.","Torkizadeh, Melissa, Hajir, Ibraheim, Radhakrishnan, Shiva, Larkin, James, Howson, William, Williams, Horace, Hicks, Lucy, Moulton, Calum D.; Alexander, James L.; Powell, Nick","https://doi.org/10.1136/gutjnl-2021-BSG.185","","Database: ProQuest Central; Publication details: Gut; 70(Suppl 4):A100, 2021.; Publication details: Gut; 70(Suppl 4):A100, 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21795,""
"Investigating the effect of psychological capital on evidence-based clinical practice of nurses in dealing with patients with coronavirus disease: The mediating role of psychological security","Background: The coronavirus pandemic has caused fear and anxiety worldwide, especially amongst nurses. Examining the psychological effects of this disease on the mental health of nurses involved in the care of patients with this infection is critically important. This study aimed to investigate the relationship between the nurses’ psychology capital and their views on mental security, job satisfaction and clinical performance. Methods: One hundred consenting nurses from a university general hospital in Arak, Iran, completed three well-established questionnaires that asked about their psychology knowledge, views on mental security and clinical performance. The data were analyzed statistically, using confirmatory factor analysis and partial least squares method. Also, the path analysis test, t-test and regression beta coefficient were used to test the study’s four hypotheses on psychological capital and security. Results: The findings indicated that there were significant relationships, based on the theoretical model, amongst the nurses’ views on their psychology knowledge (or capital) and that it had a positive and significant effect on nurses' psychological security for working with COVID-19 patients. Also, the knowledge positively impacted their clinical performance and professional efficacy, while improving their sense of optimism, patience and hope for future. Conclusions: There were positive interactions between the nurses’ psychological capital and the clinical performance, mental security, optimism and hope. Nurses with psychology capital had less worries on these subjects than those who lacked it. Such nurses believed they were more resourceful and able to provide better care to patients with coronavirus infection than those who lacked the knowledge. © 2021, Iran University of Medical Sciences. All rights reserved.","Tabatabaei, M.; Sharifi, S.; Noferesti, A.; Fahimdanesh, F.; Jamilian, H.; Tavakol, K.","https://doi.org/10.32598/IJPCP.28.2.3824.1","","Database: Scopus; Publication details: Iranian Journal of Psychiatry and Clinical Psychology; 28(2), 2021.; Publication details: Iranian Journal of Psychiatry and Clinical Psychology; 28(2), 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21796,""
"Psychometric properties of obsession with COVID-19 scale in the general population of Kermanshah, Iran","Aims Obsession with COVID-19 scale examines the persistent and disturbing thinking about COVID-19. The current study aimed to determine the psychometric properties Instrument & Methods This research is a descriptive-cross sectional study to determine the psychometric properties of OCS. The study population included all people of Kermanshah in 2020. Four hundred individuals were included in the study using convenience sampling. The measurements utilized include the online forms of the demographic information questionnaire, Obsession with COVID-19 Scale, The Depression, Anxiety and Stress Scale, and The Yale-Brown Obsessive-Compulsive Scale. Data analysis was done using SPSS 21 and Amos 20. The descriptive statistics indicators, confirmatory factor analysis, Spearman’s rank correlation coefficient, and Cronbach’s alpha were applied. Findings The study population consisted of 94 male and 306 female individuals (23.50% and 76.50%, respectively). The mean±SD of the participants’ age was 29.48±9.32. Cronbach’s alpha of the scale was measured to be 0.79. There was a significant convergent validity between Obsession with COVID-19 Scale with The Depression, Anxiety and Stress Scale, and Yale-Brown Obsessive-Compulsive Scale (p<0.001). Also, the single-factor model of the scale had strong fitness indexes. Conclusion The obsession with the COVID-19 scale has high and acceptable validity and reliability in the general population of Kermanshah. Copyright © 2021, the Authors.","Reisi, S.; Sadeghi, Kh, Parvizifard, A.; Behrozi, S.; Ahmadi, S. M.; Ahmadi, S. M.","https://doi.org/10.29252/acadpub.ijwph.13.2.91","","Database: Scopus; Publication details: Iranian Journal of War and Public Health; 13(2):91-96, 2021.; Publication details: Iranian Journal of War and Public Health; 13(2):91-96, 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21797,""
"Psychological distress among students of higher education due to e-learning crackup: moderating role of university support","Purpose: The emergence of electronic learning during the COVID-19 outbreak has been the way by which higher education has attempted to save the situation. However, e-learning still causes psychological distress because of its crackups and fear. Hence, the authors aim to study the impact of e-learning crackup on fear of academic year loss and psychological distress by incorporating university support as a moderator. Design/methodology/approach: Partial least squares structural equation modeling (PLS-SEM) has been used to analyze data. Findings: The results depict that e-learning crackup fosters students' fear of academic year loss, but e-learning crackup has an insignificant impact on psychological distress. However, psychological distress is driven by fear of an academic year loss. Lastly, university support moderates the relationship between e-learning crackup and psychological distress, but no moderating role exists between fear of academic year loss and psychological distress. Originality/value: The recent pandemic has severely affected the mental health of students. Therefore, it is crucial to study the reasons that foster distress among them. But, unfortunately, there is a prominent absence of research for inspecting students' psychological distress because of the e-learning crisis, especially in the wake of COVID-19. © 2021, Emerald Publishing Limited.","Qazi, Z.; Qazi, W.; Raza, S. A.; Khan, K. A.","https://doi.org/10.1108/JARHE-02-2021-0069","","Database: Scopus; Publication details: Journal of Applied Research in Higher Education;2021.; Publication details: Journal of Applied Research in Higher Education;2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21798,""
"Never waste a crisis!? - The impact of the covid-19 crisis on the mental health of EDM Djs","The COVID-19 crisis places an unprecedented strain on an industry already characterized by poor mental health due to challenging working conditions, including the difficulty of sustaining a living, anti-social working hours, exhaustion, and the inability to plan time and future. This article discusses the current mental health conditions of musicians in dealing with the exceptional situation through a retrospective perspective on those affected. Based on a qualitative interview study conducted with EDM DJs during the first lockdown in Germany, I use three exemplary cases to give insights into their individual experienced living environments and working conditions. I show how the COVID-19 crisis is related to their previous life situation, mental state, and personal self-perceptions as DJs. I further argue that the current crisis may not only have a negative impact on the (already poor) mental health of creative professionals but may also bring health-promoting potential. © 2022 Universidad Nacional. All rights reserved.","Ptatscheck, M.","https://doi.org/10.5429/2079-3871(2021)v11i1.5en","","Database: Scopus; Publication details: IASPM Journal; 11(1):38-55, 2021.; Publication details: IASPM Journal; 11(1):38-55, 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21799,""
"Deliberate foreign body ingestion during COVID-19","PTU-25 Table 1 2018 2019 2020 Total FBI Referral 10 20 31 Total DFBI 2 (20%) 4 (20%) 17 (55%) Number of patients 2 2 9 Objects Batteries Toothbrush, coins Bra wire, batteries, pen, glasses, paperclip, screws, toothbrush, blades Discussion2020 demonstrated a marked increase in OGD for FBI, of which 55% were DFBI compared with 20% in preceding years. All patients were =40 years of age. Commonest objects were long e.g. pens or high risk e.g. batteries/razors. However, a wider variety of objects were swallowed during the pandemic.Our outcomes reflect those in published data1, with most procedures successful when objects were known to be in the stomach.DFBI is often spontaneous and stress related, rather than a suicide attempt, on a background of complex personality disorder. It is thought DFBI gives a psychological ‘gain’ in forcing care, with multiple healthcare contacts resulting from the act2.Care plans are common in other forms of DSH but lacking in DFBI. These may benefit repeat attenders, ensuring endoscopy only performed when strictly necessary and minimising the psychological gain from the act.Mental health issues have increased during the pandemic, this has impacted on already stretched endoscopy services with increase in DFBI, possibly due to decreased access to psychiatric services. This act is resource intensive and difficult to manage, a care plan should be considered after admission with DFBI.4. Birk M et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: ESGE Clinical Guideline. Endoscopy. 2016:48;1-81. Poynter B et al. Hard to Swallow: A systematic review of deliberate foreign body ingestion. Gen Hosp Psych. 2011:33(5);518-524Palese C, Al-kawas F. Repeat intentional foreign body ingestion: the importance of a multidisciplinary approach. Gast & Hep. 2012: 8(7);485-489","Phillips, Andrew, Axe, Kate","https://doi.org/10.1136/gutjnl-2021-BSG.98","","Database: ProQuest Central; Publication details: Gut; 70(Suppl 4):A54-A55, 2021.; Publication details: Gut; 70(Suppl 4):A54-A55, 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21800,""
"Sadness, Negativity, and Uncertainty in Education During COVID-19 on Social Media","The global COVID-19 pandemic increased social media usage to obtain information and to share concerns, feelings, and emotions, turning it into a prolific field of research through which it is possible to understand how audiences are coping with the multitude of recent challenges. This paper presents results from a social media analysis of 61532 education-related news headlines posted by the major daily news provider in Portugal, Sic NotÃcias, on Facebook, from January to December 2020. We focus on how the news impacted on audiences’ emotional response and discourse, and we analyze the key issues of the most commented news content. The results show a prevailing sadness among audiences and a very negative discourse all throughout 2020, with a high degree uncertainty being expressed. The main concerns revolved around parents supporting children in their first remote learning endeavors, financial sustainability, the lack of devices, the disinfection of schools, and the students’ mobility, particularly in the non-higher education context.","Oliveira, Luciana, Silva, Paulino, Mesquita, Anabela, Arminda Sa, Sequeira, Oliveira, Adriana","https://doi.org/10.4018/IJOPCD.2022010103","","Database: ProQuest Central; Publication details: International Journal of Online Pedagogy and Course Design; 12(1):1-21, 2022.; Publication details: International Journal of Online Pedagogy and Course Design; 12(1):1-21, 2022.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21801,""
"The symptom burden of irritable bowel syndrome in tertiary care during the Covid-19 pandemic","IntroductionRecent data on the natural history of Irritable Bowel Syndrome (IBS) highlight the prognostic importance of extra-intestinal and psychological symptom profiles. Those with a high psychological burden have been shown to have the worst prognosis, and are consequently most likely to be referred to tertiary care. The Covid-19 pandemic caused significant disruption to tertiary services and affected the mental health of the nation, however there is minimal data on the effects on patients with IBS in tertiary care. We therefore compared the symptom profiles of tertiary referrals with refractory IBS, 12-months before, and 12-months after the onset of Covid-19 restrictions in the UK.MethodsAs part of their routine care, all patients with refractory IBS referred to the tertiary service before and after the Covid-19 pandemic prospectively completed a series of questionnaires during their baseline consultation including;IBS symptom severity score (IBS-SSS), non-colonic symptom score, Hospital Anxiety and Depression (HAD), and Quality of Life (QoL). Demographic data and symptom profiles were compared between patients seen in the 12 months before the pandemic (22/03/2019 - 22/03/2020) with those seen in the 12-months after (23/03/2020 - 23/03/2021), using non-parametric tests.ResultsOverall, 190 patients (median age 43 years, n=157 (82.6%) female, 41.0% IBS-C, 24.7% IBS-D, IBS-M 33.7% and 0.5% IBS-U) with refractory IBS were included. Compared to those seen in the 12-months before the pandemic (n=107), the cohort seen during the Covid-19 pandemic (n=83) had a significantly higher median IBS-SSS (318 vs. 352, p=0.03), and more extra-intestinal symptoms (non-colonic score: 225 vs. 269, p=0.03). During the pandemic, median abdominal pain (50 vs. 63, p=0.05) and abdominal distension scores (60 vs. 75, p=0.008) were significantly higher, and patients that were unmarried had a higher median IBS symptom severity (IBS-SSS: 320 vs. 359, p=0.03). Interestingly, those seen during the pandemic had more difficulty with sleep (53 vs. 68, p=0.03), and more feelings of helplessness and loss of control (50 vs. 70, p=0.02), compared to those seen before the pandemic. There was no difference in the levels of anxiety and depression between the pre and post lockdown groups (HAD-Anxiety: 11 vs. 11.5, p=0.96;HAD-Depression: 8 vs. 8, p=0.84).ConclusionsThis study has shown for the first time that patients seen in tertiary care with refractory IBS during the covid-19 pandemic had a significantly higher symptom burden emphasising the importance of gut-brain axis in IBS. Furthermore, lack of support and perceived loss of control appear to be contributory factors.","Noble, Hithin, Hasan, Syed S.; Whorwell, Peter J.; Dipesh, Vasant","https://doi.org/10.1136/gutjnl-2021-BSG.31","","Database: ProQuest Central; Publication details: Gut; 70(Suppl 4):A17-A18, 2021.; Publication details: Gut; 70(Suppl 4):A17-A18, 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21802,""
"A patient centred pathway to support self management for patients with non-alcoholic fatty liver disease","IntroductionThe aim of this project was to implement the new pathway ‘Transforming the care of patients with non-alcoholic fatty liver disease’ in the secondary care Gastroenterology Clinic with a view to reducing the number of patients requiring medical review, meet waiting time targets and promote supported self-managementNon-alcoholic fatty liver disease (NAFLD) is a spectrum of liver pathology, strongly associated with obesity and diabetes. Lifestyle change aimed at weight loss through diet and physical activity is the mainstay of clinical management guidelines for NAFLD (NICE 2016). Only 34% of people link being overweight to liver disease (versus over 80% understanding the link between ex cess weight and heart disease, high blood pressure and diabetes).Evidence highlights just providing NAFLD patients with information and advice to change behaviour is an insufficient intervention. Readiness to change weight-related behaviours (both physical activity and eating habits) is often low and not associated with severity of liver disease. Being diagnosed with NAFLD is insufficient to propel people into the ‘preparation/action’ stage of change. This is not surprising given that NAFLD is often asymptomatic. Patients do not ‘see’ their condition. (Stewart et al 2014).A multi-disciplinary approach promoting supported self-management is recommended. A review by Taylor et al (2014) stated that all healthcare organisations should be providing self-management as an integral component of care.MethodsLocal health intelligence data was reviewed to justify rationale for establishing a new pathway for patients with NAFLD. According to health intelligence figures, 862 patients were admitted to hospital with NAFLD and NASH as either their main reason for admission or a secondary reason during a 12 month period (1st October 2018 - 30 September 2019).Prior to the new pathway the majority of patients with abnormal Liver Function Test (LFT) were referred to hospital and saw medical staff at their first appointment. Due to the volume of patients this led to a long waiting list to be seen. GPs were unsure when to refer patients and which bloods/investigations should be performed beforehand. There was no dedicated input from Health Psychology or Diabetes Specialists.The Lead Clinician and Lead Hepatology Nurse Specialist led on development of a new pathway. They agreed input and way forward for a multidisciplinary approach with General Practitioners, dietetic and psychology departments. It was agreed GPs would perform chronic liver disease screen, ultrasound and FIB4. If ultrasound suggested NAFLD patients would be referred to the new multi-disciplinary clinic. Each patient was seen by a Liver Nurse for a fibroscan and if required they also saw a Consultant in the same clinic. All appropriate patients were referred for psychology assessment in the same clinic slot. Dietetic support was available asynchronously.Following the initial clinic appointment all review appointments were offered by psychology (4-8 review virtual review appointments).Repeat bloods were done at blood hubs set up locally. Patients were only brought back into clinic if they required more tests, a repeat fibroscan and for 6 month review.Over a 15 month period 101 patients received a brief low intensity psychology intervention. Participants were encouraged to change their health behaviour. Each participant was seen for an assessment (and up to 8 weekly follow-up consultations via email, telephone or video call). Each patient was reviewed by the Health Psychologist at three and six months. At each contact participants were asked to complete A Hospital Anxiety and Depression Scale (HADs) fourteen item scale (Zigmond and Snaith, 1983) commonly used to determine the levels of anxiety and depression that a person is experiencing.Each participant was provided with a Fitbit Inspire fitness tracker at their baseline appointment and were asked to record and report back their seven day average step count to the Health Psychologist. A goal setting booklet and four week walking plan was provided to assist with this.Results101 patients, (53% Males and 47% Females) agreed to participate. The BMI of patients assessed was 40.1 (113.5kg). Almost all patients were not meeting guidelines of 150mins of physical activity per week. Baseline step count was 1635. The majority presented with two or more long term conditions alongside NAFLD. Most common being Type 2 Diabetes (44%) and anxiety/depression (27%). Average Fib 4 score was 1.4, KPa 14.4. HbA1c 58.8, Cholesterol 5.0, ALT 81.4, AST 58.4.91% of patients were followed up (9% drop out). Average weight loss 5.5kg (range 0.5kg- 23kg). 82% increased daily step count (1635 to 5958). Anxiety scores (HADs) decreased from (7.4 to 6) and Depression scores reduced 6.3 to 3.3.Due to Covid 19 restrictions we don’t have repeat measures on medical markers for all patients. However some case studies are encouraging.At the end of their 6 month follow-up appointment, participants were asked to provide free text qualitative feedback on their thoughts about the new pathway and multi-disciplinary approach.Questions asked included ‘What happened?’, ‘How did you feel?’, ‘What was good?’ and ‘What could be improved?’Comments received included‘Great service’ ‘Kept in touch- keeps your mind on it’‘Found the health psychology input helpful. Having someone to talk to who was interested in me cheered me up’’ Really useful to have someone to report back to in terms of achieving weight loss goals ‘‘Extremely helpful in terms of explaining why weight loss was so important’Think it is really helped having someone who is supportive and willing to listen is a big help. You don’t feel you’re achieving anything if you’ve got nobody to bounce it off’.‘I feel more confident that I can make changes’‘First Class Service –, I feel a lot more positive’‘The support I received at the NAFLD clinic was useful, it was good to talk about weight and why it was important to change things. Made me realise I needed to start making changes for myself and my family. We have all lost weight’‘Felt supported from the team. Telephone support really worked for me. Made me feel good and realise the progress I had made’ConclusionsThe results have identified that patients who attended the multi-disciplinary clinic made substantial improvements to their lifestyle. Average daily step count increased over the 6 month period, from 1635 to 5958. 82% patients reported an increase in activity levels;27% patients had been shielding but reported doing home based exercise programmes. Average self-reported weight loss at 6 months was 5.5kg (range 0.5kg- 23kg). There were also a reduction in the average anxiety and depression scores using HADS, from 7.4 to 6 for anxiety and 6.3 to 3.3 for depression.The majority of patients, who engaged reported an increase in self-efficacy in terms of achieving weight loss. An important outcome (measured via patient’s qualitative feedback) was around self-confidence and recognition that small changes were a great step in the right direction.A learning point when we are able to fully resume normal service delivery is to try and increase the number of patients benefitting from this service. We see scope to potentially access patients earlier in primary care before they are referred to the Gastroenterology Team thus reducing waiting times and freeing up secondary care medical staff for more complex cases.Although the Liver Nurse Specialist team were fully on board with identifying suitable patients, not all eligible patients took the service up. We are not sure the reason for this, although we are aware that the cohort of patients with NAFLD are often considered the ‘hard to reach’ patients, faced with multiple challenges, which may mean ‘health’ can slip down their priority list. It is worth noting that the majority of patients seen had complex long standing issues contributing to their poor health. Aspects of family functioning including conflict and divorce;emotional eating, insomnia, depression, anxiety we e highlighted and in most cases were worked with throughout the support sessions from the psychologist.Overall, it is considered that this new pathway and multidisciplinary clinic has been very worthwhile. There have been noticeable improvements identified through the use of appropriate assessment tools and from positive qualitative patient and clinician feedback. In terms of future plans funding has been secured to work with innovation colleagues to provide a virtual version of supported self-management for less complex patients. This will allow a greater through put of patients and help further implement the new NAFLD pathway and multi-disciplinary approach.","McCallum, Mary, Mukhopadhya, Ashis, Dundas, Pauline","https://doi.org/10.1136/gutjnl-2021-BSG.374","","Database: ProQuest Central; Publication details: Gut; 70(Suppl 4):A202-A203, 2021.; Publication details: Gut; 70(Suppl 4):A202-A203, 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21803,""
"Characteristics and factors associated with vaccine hesitancy in a predominantly black systemic lupus erythematosus cohort","1204 Table 1Factors Associated with COVID-19 Vaccine Perception in SLE Patients from the Georgians Organized Against Lupus CohortCategory Sub-Category Overall (n=598) COVID-19 Vaccination Perception Receptive (n=342) Hesitant (n=252) P-Value Socio- demographics Age at Survey Completion (year) 18-34 85 (14.2) 30 (8.8) 55 (21.8) <0.0001 34-54 264 (44.1) 132 (38.6) 131 (52.0) 55+ 249 (41.6) 180 (52.6) 66 (26.2) Gender male 40 (6.7) 24 (7.0) 15 (6.0) 0.6 female 558 (93.3) 318 (93.0) 237 (94.0) Race Non-Black 129 (21.6) 105 (30.7) 23 (9.1) <0.0001 Black 469 (78.4) 237 (69.3) 229 (90.9) Marital Status Never married 203 (34.0) 95 (27.8) 107 (42.6) 0.0001 Married 201 (33.7) 140 (40.9) 59 (23.5) Separated 24 (4.0) 14 (4.1) 9 (3.6) Divorced 104 (17.4) 57 (16.7) 47 (18.7) Widowed 22 (3.7) 15 (4.4) 7 (2.8) Living with Partner 43 (7.2) 21 (6.1) 22 (8.8) Living in Poverty Yes 147 (25.5) 52 (15.8) 94 (38.5) <0.0001 Current Work Status Employed 248 (42.8) 150 (45.6) 97 (39.4) <0.0001 Off work force 125 (21.6) 92 (28.0) 31 (12.6) Unemployed 206 (35.6) 87 (26.4) 118 (48.0) Educational Attainment = High School 159 (27.0) 73 (21.7) 85 (34.3) <0.0001 Some College 186 (31.6) 97 (28.8) 87 (35.1) = College 243 (41.3) 167 (49.6) 76 (30.6) Insurance type Medicare and/or Medicaid 307 (51.6) 160 (46.9) 144 (57.6) <0.0001 Private 233 (39.2) 166 (48.7) 66 (26.4) Under or uninsured 55 (9.2) 15 (4.4) 40 (16.0) Health Care Provider Primary Care Physician visit in past 12 months Yes 505 (84.4) 298 (87.1) 203 (80.6) 0.03 Rheumatologist visit in past 12 months Yes 516 (86.3) 294 (86.0) 220 (87.3) 0.6 Lupus Characteristics Disease Duration (year) Mean ± SD 18.7 ± 10.4 20.4 ± 10.4 16.2 ± 9.7 <0.0001 Age at Lupus Diagnosis (year) Mean ± SD 32.7 ± 11.9 34.4 ± 12.3 30.3 ± 11.1 <0.0001 Disease Activity: Systemic Lupus A tivity Questionnaire (SLAQ) score Mean ± SD 12.6 ± 8.2 12.2 ± 7.7 13.3 ± 8.8 0.1 Organ Damage: Self-Administered Brief Index Damage (BILD) score Mean ± SD 3.3 ± 3.0 3.4 ± 3.2 3.2 ± 2.6 0.4 Organ Damage Group No Damage (BILD=0) 73 (12.2) 41 (12.0) 32 (12.7) 0.9 Mild damage (BILD=1 or 2) 199 (33.3) 116 (33.9) 82 (32.5) Severe damage (BILD=3) 326 (54.5) 185 (54.1) 138 (54.8) Medications - current glucocorticoids 247 (42.3) 127 (38.1) 120 (48.4) 0.01 methotrexate 35 (6.2) 16 (4.9) 19 (7.9) 0.1 cyclosporine 1 (0.2) 1 (0.3) 0.4 dapsone 8 (1.4) 4 (1.2) 4 (1.7) 0.7 belimumab 29 (5.1) 17 (5.2) 11 (4.5) 0.7 anti-TNF agents 9 (1.6) 5 (1.5) 4 (1.6) 0.9 hydroxychloroquine 415 (70.6) 236 (70.4) 177 (70.8) 0.9 cyclophosphamide 11 (1.9) 7 (2.2) 4 (1.7) 0.8 mycophenolate mofetil 116 (20.2) 59 (18.1) 57 (23.4) 0.1 azathioprine 73 (12.7) 35 (10.7) 38 (15.7) 0.1 rituximab 13 (2.3) 4 (1.2) 9 (3.7) 0.1 Highest Steroid Dose in the past 12 months (mg/day) Mean ± SD 18.7 ± 21.8 17.2 ± 22.5 20.3 ± 21.2 0.3 Sources of trusted COVID-19 information Government 298 (49.8) 202 (59.1) 94 (37.3) <0.0001 News 289 (48.3) 182 (53.2) 103 (40.9) 0.003 Social Media 44 (7.4) 24 (7.0) 20 (7.9) 0.7 Doctors 445 (74.4) 276 (80.7) 165 (65.5) <0.0001 Lupus Advocacy or Support Groups 333 (55.7) 203 (59.4) 128 (50.8) 0.04 COVID-19 Well-Being Concern for COVID-19 in general Not at all concerned 9 (1.5) 2 (0.6) 7 (2.8) 0.049 A little concerned 34 (5.7) 14 (4.1) 20 (8.0) Moderately concerned 77 (13.0) 42 (12.4) 34 (13.6) Very concerned 200 (33.7) 119 (35.0) 79 (31.6) Extremely concerned 274 (46.1) 163 (47.9) 110 (44.0) Concern lupus will worsen 0 (not concerned) 63 (10.8) 39 (11.6) 22 (9.1) 0.5 1 21 (3.6) 15 (4.5) 6 (2.5) 2 18 (3.1) 11 (3.3) 7 (2.9) 3 22 (3.8) 12 (3.6) 10 (4.1) 4 10 (1.7) 6 (1.8) 3 (1.2) 5 57 (9.8) 24 (7.1) 32 (13.2) 6 35 (6.0) 19 (5.6) 16 (6.6) 7 40 (6.8) 24 (7.1) 16 (6.6) 8 63 (10.8) 41 (12.2) 22 (9.1) 9 46 (7.9) 27 (8.0) 19 (7.8) 10 (extremely concerned) 209 (35.8) 119 (35.3) 90 (37.0) Concern for getting infected with COVID-19 0 (not concerned) 43 (7.4) 22 (6.5) 20 (8.3) 0.4 1 15 (2.6) 6 (1.8) 9 (3.8) 2 24 (4.1) 15 (4.5) 9 (3.8) 3 18 (3.1) 10 (3.0) 7 (2.9) 4 17 (2.9) 9 (2.7) 8 (3.3) 5 69 (11.9) 32 (9.5) 37 (15.4) 6 30 (5.2) 20 (5.9) 9 (3.8) 7 39 (6.7) 25 (7.4) 14 (5.8) 8 62 (10.7) 41 (12.2) 21 (8.8) 9 54 (9.3) 31 (9.2) 23 (9.6) 10 (extremely concerned) 209 (36.0) 126 (37.4) 83 (34.6) Concern for someone in family getting infected 0 (not concerned) 37 (6.4) 20 (6.0) 16 (6.6) 0.2 1 14 (2.4) 6 (1.8) 8 (3.3) 2 13 (2.2) 5 (1.5) 8 (3.3) 3 10 (1.7) 5 (1.5) 5 (2.1) 4 12 (2.1) 8 (2.4) 4 (1.7) 5 61 (10.5) 28 (8.4) 33 (13.6) 6 24 (4.1) 14 (4.2) 10 (4.1) 7 30 (5.2) 17 (5.1) 12 (5.0) 8 63 (10.9) 44 (13.2) 19 (7.9) 9 61 (10.5) 41 (12.3) 20 (8.3) 10 (extremely concerned) 254 (43.9) 146 (43.7) 107 (44.2) Vaccination Attitudes Examination (VAX) scale Mistrust (do not feel safe, cannot rely to stop serious infection, do not feel protected) Mean ± SD 3.2 ± 1.6 2.4 ± 1.2 4.2 ± 1.5 <0.0001 Unseen Effect (problems yet to be discovered, unforeseen problems in children, worry about unknown future effects) Mean ± SD 4.1 ± 1.3 3.9 ± 1.2 4.4 ± 1.4 <0.0001 Profiteering (Pharma profits, authorities profit, vaccination programs are a big con) Mean ± SD 2.8 ± 1.5 2.4 ± 1.3 3.4 ± 1.4 <0.0001 Natural Immunity (natural immunity lasts longer, natural exposure gives safest protection, natural exposure is safer) Mean ± SD 2.6 ± 1.3 2.3 ± 1.2 3.0 ± 1.3 <0.0001 VAX score Mean ± SD 3.2 ± 1.0 2.8 ± 0.9 3.8 ± 0.9 <0.0001 Vaccine Beliefs People with lupus have more vaccine side effects Strongly disagree 37 (6.3) 30 (8.8) 6 (2.4) <0.0001 Disagree 81 (13.7) 67 (19.7) 12 (4.8) Neither agree nor disagree 367 (62.0) 209 (61.5) 157 (63.3) Agree 73 (12.3) 26 (7.6) 47 (19.0) Strongly agree 34 (5.7) 8 (2.4) 26 (10.5) Vaccine will flare lupus Strongly disagree 48 (8.1) 41 (12.1) 6 (2.4) <0.0001 Disagree 83 (14.0) 71 (20.9) 10 (4.0) Neither agree nor disagree 382 (64.5) 209 (61.5) 172 (69.4) Agree 54 (9.1) 12 (3.5) 42 (16.9) Strongly agree 25 (4.2) 7 (2.1) 18 (7.3) Vacci e is not as effective in lupus Strongly disagree 71 (12.0) 56 (16.6) 13 (5.2) <0.0001 Disagree 117 (19.8) 90 (26.6) 26 (10.5) Neither agree nor disagree 347 (58.8) 169 (50.0) 177 (71.4) Agree 39 (6.6) 18 (5.3) 21 (8.5) Strongly agree 16 (2.7) 5 (1.5) 11 (4.4) Vaccination Behavior Number of flu shots in the past 3 seasons 0 118 (19.9) 33 (9.7) 85 (33.9) <0.0001 1 86 (14.5) 41 (12.0) 45 (17.9) 2 71 (12.0) 39 (11.4) 32 (12.7) 3 319 (53.7) 228 (66.9) 89 (35.5) Psychosocial Perceived Stress Mean ± SD 15.8 ± 7.0 15.6 ± 7.1 16.1 ± 6.9 0.4 Healthcare Discrimination: Better care if different race/ethnic group Yes 86 (20.1) 53 (20.2) 33 (20.0) 0.9 PROMIS Self-efficacy: manage medication and treatment (T-score) Mean ± SD 49.2 ± 9.4 49.7 ± 9.2 48.5 ± 9.6 0.1 Brief Resilience Scale Mean ± SD 3.6 ± 0.8 3.7 ± 0.8 3.5 ± 0.8 0.02 PROMIS Depression (T-Score) Mean ± SD 49.3 ± 9.3 48.3 ± 8.7 50.5 ± 10.0 0.004 Everyday Discrimination Mean ± SD 1.4 ± 0.6 1.4 ± 0.6 1.5 ± 0.6 0.2 PROMIS=Patient-Reported Outcomes Measurement Information SystemAbstract 1204 Table 2Factors associated with COVID-19 vaccine perception in sle patients from the georgians organized against lupus cohort, multivariate analyses Model 1 Model 2 Model 3 Model 4 Model 5 Model 6 Factor OR (95%CI) P-Value OR (95%CI) P-Value OR (95%CI) P-Value OR (95%CI) P-Value OR (95%CI) P-Value OR (95%CI) P-Value Age at survey (per 5 years<U+2193>) 1.3 (1.2-1.4) <0.0001 1.3 (1.2-1.4) <0.0001 1.3 (1.2-1.4) <0.0001 1.3 (1.2-1.4) <0.0001 1.3 (1.2-1.4) <0.0001 1.3 (1.2-1.4) <0.0001 Disease duration (per 5 years<U+2193>) 1.0 (0.9-1.2) 0.5 1.0 (0.9-1.2) 0.7 1.0 (0.9-1.2) 0.7 1.0 (0.9-1.2) 0.7 1.0 (0.9-1.2) 0.7 1.0 (0.9-1.1) 0.8 Education (per 3 years<U+2193>) 1.5 (1.2-1.8) 0.0003 1.5 (1.2-1.8) 0.0003 1.5 (1.2-1.8) 0.0002 1.5 (1.2-1.8) 0.0004 1.5 (1.2-1.9) 0.0001 1.5 (1.2-1.8) 0.0002 Black race 4.7 (2.7-8.3) <0.0001 4.8 (2.7-8.4) <0.0001 4.7 (2.7-8.4) <0.0001 4.8 (2.7-8.5) <0.0001 5.0 (2.8-8.9) <0.0001 4.7 (2.7-8.4) <0.0001 Female gender 1.4 (0.7-3.0) 0.4 1.4 (0.7-3.0) 0.4 1.4 (0.7-3.1) 0.4 1.4 (0.7-3.0) 0.4 1.5 (0.7-3.3) 0.3 1.4 (0.7-3.0) 0.4 Unemployed vs Employed 1.5 (1.0-2.3) 0.1 1.6 (1.0-2.6) 0.1 1.6 (1.0-2.5) 0.1 1.5 (1.0-2.5) 0.1 1.5 (0.9-2.5) 0.1 1.6 (1.0-2.5) 0.1 Not Married or With Partner 1.2 (0.8-1.8) 0.4 1.2 (0.8-1.8) 0.4 1.2 (0.8-1.8) 0.4 1.2 (0.8-1.8) 0.4 1.2 (0.8-1.8) 0.3 1.2 (0.8-1.8) 0.4 No primary care visit in past year 1.2 (0.7-2.1) 0.4 1.3 (0.7-2.1) 0.4 1.3 (0.8-2.2) 0.4 1.3 (0.8-2.2) 0.4 1.2 (0.7-2.1) 0.4 Disease activity (Systemic Lupus Activity Questionnaire, per 3 units <U+2191>) 1.0 (0.9-1.1) 0.9 1.0 (0.9-1.1) 0.9 1.0 (0.9-1.1) 0.9 1.0 (0.9-1.04) 0.3 1.0 (0.9-1.1) 0.98 Organ damage (Self-Administered Brief Index Damage, per 1 unit<U+2191>) 1.0 (0.9-1.04) 0.3 1.0 (0.9-1.04) 0.4 1.0 (0.9-1.04) 0.4 1.0 (0.9-1.04) 0.4 1.0 (0.9-1.04) 0.3 PROMIS Self-efficacy: manage medication and treatment (per 5 units <U+2193>) 1.0 (0.9-1.2) 0.5 Brief Resilience Scale (per 1 unit <U+2193>) 1.2 (0.9-1.5) 0.3 PROMIS Depression (per 5 units <U+2191>) 1.2 (1.0-1.3) 0.01 Everyday Discrimination (per 1 unit <U+2191>) 1.1 (0.8-1.6) 0.5 OR=odds ratio;CI=confidence interval;PROMIS=Patient-Reported Outcomes Measurement Information System;VAX=Vaccination Attitudes Examination.ConclusionsVery high levels (42.1%) of VH persist in a predominantly Black SLE population. Despite lower vaccine uptake, 66.1% with COVID-19 VH had a recent flu vaccine, indicating potential vaccine receptivity. With less trust in the government, news, doctors, and lupus groups, community leaders and peers should lead outreach. Focus should include those who are younger, Black, and from lower socioeconomic groups, particularly with depression.","Lim, S. Sam, Dunlop-Thomas, Charmayne, Bao, Gaobin, Drenkard, Cristina","https://doi.org/10.1136/lupus-2021-lupus21century.71","","Database: ProQuest Central; Publication details: Lupus Science & Medicine; 8(Suppl 2):A49-A53, 2021.; Publication details: Lupus Science & Medicine; 8(Suppl 2):A49-A53, 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21804,""
"Clinical case of gastroesophageal reflux disease exacerbation in a middle-aged patient with covid-19","Objective. To describe COVID-19 influence on gastroesophageal reflux disease (GERD) exacerbation using clinical case. Main points. COVID-19 infection remains an urgent problem for modern medicine due to its high contagiousness and rapid dis-tribution among the working population. We presented a clinical case of a 49-year-old female patient with respiratory complaints and extraesophageal manifestations of GERD. Conclusion. This clinical case showed that clinicians should consider various mechanisms of respiratory symptoms, which becomes exceptionally relevant during the COVID-19 pandemic. The development of atypical symptoms in a patient of working age without concomitant pathology causes difficulties in early diagnosis and timely treatment, in contrast to comorbid elderly and senile patients. Several mechanisms led to an exacerbation of GERD with the development of wheezing. Therefore, a clinician should meticulously take a medical history, form a trusting relationship with a patient, detect and correct early signs of anxiety and depression with a multidisciplinary team. © 2021, Media Sphera Publishing Group. All rights reserved.","Larina, V. N.; Ryzhikh, A. A.; Karpenko, D. G.; Taraskova, K. I.; Oynotkinova, O. Sh","https://doi.org/10.17116/dokgastro20211003170","","Database: Scopus; Publication details: Russian Journal of Evidence-Based Gastroenterology; 10(3):70-76, 2021.; Publication details: Russian Journal of Evidence-Based Gastroenterology; 10(3):70-76, 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21805,""
"Intentional Foreign Body Ingestion during the COVID-19 crisis: A cry for help?","PTH-29 Table 1IFBI endoscopies against COVID timelineEndoscopies for IFBI Total year 2019 Jan-Dec 2020 Total year 2020 01/01/20-23/03/20 (pre-lockdown) 23/03/20-10/05/20 (1st lockdown) 10/05/20-31/10/20 (variable easing of restrictions) 31/10/20-31/12/20 (2nd national lockdown + tiered restrictions) Total number 5 5 1 28 7 41 Procedures per week 0.10 0.43 0.15 1.13 0.80 0.79 ConclusionsThere has been a large increase in IFBI requiring emergency endoscopy in 2020. Mental health stresses during the pandemic seem to have had a role in susceptible individuals reaching crises point in this behaviour. Sustained effects of increased anxiety, in combination with patchy access to mental health services, may have led to this manifestation of self-harm. This represents yet another unforeseen consequence of the COVID pandemic that has affected the utilisation of endoscopy services locally.","Hanna, Luke, Nina-Joyce, Shehata, Jarvis, Tracie, Thursby-Pelham, Fergus, Subramaniam, Sharmila","https://doi.org/10.1136/gutjnl-2021-BSG.344","","Database: ProQuest Central; Publication details: Gut; 70(Suppl 4):A185, 2021.; Publication details: Gut; 70(Suppl 4):A185, 2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21806,""
"The impact of COVID-19 on mental, neurological and substance use services in the Eastern Mediterranean Region: results of a rapid assessment","Mental health is an integral part of the response to COVID-19. How is the pandemic affecting services for mental neurological and substance use disorders? This report based on a rapid assessment carried out globally by the World Health Organization (WHO) between June and August 2020 presents detailed results for WHO’s Eastern Mediterranean Region including both regional and country-level analysis. It identifies significant disruption to services but also innovative approaches which are helping to facilitate access.","World Health Organization, Regional Office for the Eastern Mediterranean","https://apps.who.int/iris/handle/10665/348126","","Database: WHOIRIS; GREY-COVIDWHO; Publication type: non-conventional","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21807,""
"Fourth meeting of the Technical Advisory Group on the Mental Health Impacts of COVID-19 in the WHO European Region","","World Health Organization, Regional Office for Europe","https://apps.who.int/iris/handle/10665/347077","","Database: WHOIRIS; GREY-COVIDWHO; Publication type: non-conventional","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21808,""
"Health inequity and COVID-19 in North Macedonia: fact sheet","Health inequities are the unfair and avoidable differences in health status within a population. In North Macedonia and across countries of the WHO European Region, some people live healthier lives and have better health outcomes than others, even with the same access to health services, due to insecurity in livelihoods (e.g. income, living conditions, employment, quality and security of local neighbourhoods). For example, even thoughimprovements have been made in average levels of health and life expectancy, these gains have not been shared equally across different sections of society. Health inequities are not new. Prior to the arrival of the novel coronavirus disease (COVID-19) in North Macedonia, women with the most years of education could expect to live three years longer than women with the fewest years of education, while men with the most years of education could expect to live almost six years longer than men with the fewest years of education.People’s quality of life is linked to the conditions in which they are born, grow, learn, work and age, as well as to health systems. Living with long-standing limiting illness (e.g. noncommunicable diseases, respiratory disease, and depression/anxiety disorders) reduces a person’s quality of life and is a risk factor for poverty and social exclusion, as well as for severe illness and premature death from COVID-19, if infected. In North Macedonia,there is a greater gap in living with long-standing limiting illness between men and women with fewest years of education, and women with fewest years of education are most affected. Equity-proofed investments in health systems can help to reduce unmet need for health care and the number of people living with long-standing limiting illness, and they also increase the health, social and economic resilience of individuals, families and communities.","World Health Organization, Regional Office for Europe","https://apps.who.int/iris/handle/10665/345237","","Database: WHOIRIS; GREY-COVIDWHO; Publication type: non-conventional","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21809,""
"WHO European framework for action on mental health 2021-2025: draft for the Seventy-first Regional Committee for Europe","The WHO European Framework for Action on Mental Health (EFAMH), covering the period 2021–2025, sets outa response to current mental health challenges arising from the negative impact that the COVID-19 pandemic hashad on population mental health and well-being. The EFAMH provides a coherent basis for intensified efforts tomainstream, promote and safeguard mental well-being as an integral element of COVID-19 response and recovery;to counter the stigma and discrimination associated with mental health conditions;and to advocate for and promote investment in accessible quality mental health services. Implementation and monitoring of this Framework for Action will be powered by the Pan-European Mental Health Coalition, a flagship initiative of the European Programme of Work 2020–2025. This publication was tabled as a background document for the discussion on mental health during the 71st session of the Regional Committee for Europe, Virtual session, 13–15 September 2021.","Regional Committee for Europe, 71st session","https://apps.who.int/iris/handle/10665/344609","","Database: WHOIRIS; GREY-COVIDWHO; Publication type: non-conventional","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21810,""
"Action required to address the impacts of the COVID-19 pandemic on mental health and service delivery systems in the WHO European Region: recommendations from the European Technical Advisory Group on the mental health impacts of COVID-19, 30 June 2021","These recommendations from the Technical Advisory Group (TAG) on the Mental Health Impacts of COVID-19 in the WHO European Region represent the work of the TAG between February and June 2021. At its second meeting on 23 March 2021, the TAG agreed to frame the recommendations across three key areas of impact: general population and communities;vulnerable groups;and public mental health services. Draft recommendations for each thematic area underwent two rounds of discussion at the third and fourth TAG meetings, held respectively on 23 April and 28 May 2021. The recommendations are endorsed by the TAG as representing the best available evidence and expert advice on the mental health impacts of COVID-19 and associated opportunities for action.","World Health Organization, Regional Office for Europe","https://apps.who.int/iris/handle/10665/342932","","Database: WHOIRIS; GREY-COVIDWHO; Publication type: non-conventional","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21811,""
"Third meeting of the Technical Advisory Group on the mental health impacts of COVID-19 in the WHO European Region: virtual meeting 23 April 2021, 10:00–12:00 CET","The consequences of the COVID-19 pandemic have exacted an enormous toll on the mental health and well-being of thepopulation. The Technical Advisory Group (TAG) on the Mental Health Impacts of COVID-19 in the WHO European Region firstmet (virually) on 23 February 2021 to convene the new group of experts, discuss the situation and share perspectives on the group’s priority concerns. Following a second meeting on 23 March 2021 the TAG met again on 23 April 2021 to discuss, constructively challenge and integrate the initial proposals on priority concerns and recommendations around the three previously agreed key areas of impact: public mental health services;general population and communities;and vulnerable groups.","World Health Organization, Regional Office for Europe","https://apps.who.int/iris/handle/10665/341434","","Database: WHOIRIS; GREY-COVIDWHO; Publication type: non-conventional","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21812,""
"Second meeting of the Technical Advisory Group on the mental health impacts of COVID-19 in the WHO European Region Virtual meeting 23 March 2021, 12:00–14:00 CET","The consequences of the COVID-19 pandemic have exacted an enormous toll on the mental health and well-being of the population. The first meeting of the Technical Advisory Group (TAG) on the Mental Health Impacts of COVID-19 in the WHO European Region took place virtually on 23 February 2021 to convene the new group of experts, discuss the situation and share perspectives on the group’s priority concerns. The second meeting of the TAG was held virtually on 23 March 2021 to further explore the priority areas and hear from invited speakers on framing the mental health response in COVID-19 from a global perspective and delivering the response at country level. The meeting agreed that each TAG subgroup will draft a short thematic briefing paper describing key priorities and proposing a set of core recommendations for further consideration by the TAG at the next meeting on 23 April 2021.","World Health Organization, Regional Office for Europe","https://apps.who.int/iris/handle/10665/340963","","Database: WHOIRIS; GREY-COVIDWHO; Publication type: non-conventional","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21813,""
"First meeting of the Technical Advisory Group on the mental health impacts of COVID-19 in the WHO European Region: virtual meeting, 23 February 2021, 10:00 – 12:00 CET","The consequences of the COVID-19 pandemic have exacted an enormous toll on the mental health and well-being of the population. The first meeting of the Technical Advisory Group (TAG) on the mental health impacts of COVID-19 in the WHO European Region took place virtually on 23rd February 2021 to convene the new group of experts, discuss the situation and to share perspectives on the group’s priority concerns. The WHO Regional Director for Europe addressed participants, sharing his vision for health in the region and the importance of prioritizing mental health. Co-chairs of the TAG were nominated and invited speakers to share findings from a background technical paper commissioned by WHO Europe as a reference document for the technical advisory group, as well as perspectives from services and across the life-course were shared by TAG members. Advice and guidance were sought on the key mental health impacts of COVID-19 and the critical gaps in the response faced by countries. Members of the TAG were asked to submit their top three priority issues and concerns for the group to focus on in the coming months which will help to inform Member States recovery plans and the WHO European Region Framework for Action on Mental Health.","World Health Organization, Regional Office for Europe","https://apps.who.int/iris/handle/10665/340714","","Database: WHOIRIS; GREY-COVIDWHO; Publication type: non-conventional","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21814,""
"In the wake of the pandemic: preparing for long COVID","This brief’s key messages are:COVID-19 can cause persistent ill-health. Around a quarter of people who have had the virus experience symptoms that continue for at least a month but one in 10 are still unwell after 12 weeks. This has been described by patient groups as “Long COVIDâ€. Our understanding of how to diagnose and manage Long COVID is still evolving but the condition can be very debilitating. It is associated with a range of overlapping symptoms including generalized chest and muscle pain, fatigue, shortness of breath, and cognitive dysfunction, and the mechanisms involved affect multiple system and include persisting inflammation, thrombosis, and autoimmunity. It can affect anyone, but women and health care workers seem to be at greater risk. Long COVID has a serious impact on people’s ability to go back to work or have a social life. It affects their mental health and may have significant economic consequences for them, their families and for society. Policy responses need to take account of the complexity of Long COVID and how what is known about it is evolving rapidly. Areas to address include: The need for multidisciplinary, multispecialty approaches to assessment and management;Development, in association with patients and their families, of new care pathways and contextually appropriate guidelines for health professionals, especially in primary care to enable case management to be tailored to the manifestations of disease and involvement of different organ systems;The creation of appropriate services, including rehabilitation and online support tools;Action to tackle the wider consequences of Long COVID, including attention to employment rights, sick pay policies, and access to benefit and disability benefit packages;Involving patients both to foster self-care and self-help and in shaping awareness of Long COVID and the service (and research) needs it generates;and implementing well-functioning patient registers and other surveillance systems;creating cohorts of patients;and following up those affected as a means to support the research which is so critical to understanding and treating Long COVID.","European Observatory on Health Systems and Policies, Rajan, Selina, Khunti, Kamlesh, Alwan, Nisreen, Steves, Claire, Greenhalgh, Trish, MacDermott, Nathalie, Sagan, Anna, McKee, Martin","https://apps.who.int/iris/handle/10665/339629","","Database: WHOIRIS; GREY-COVIDWHO; Publication details: Health Systems and Policy Analysis|Policy brief 39;2021.; Publication details: Health Systems and Policy Analysis|Policy brief 39;2021.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21815,""
"Regional Youth Symposium on Mental Health Promotion in the COVID-19 Era, Virtual meeting, 15 November 2020 : meeting report","","World Health Organization, Regional Office for the Western Pacific","http://iris.wpro.who.int/handle/10665.1/14712","","Database: WHOIRIS; GREY-COVIDWHO; Publication type: non-conventional","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21816,""
"Factors associated with carer psychological and physical health during end-of-life caregiving: an observational analysis of a population-based post-bereavement survey of carers of people with cancer","OBJECTIVE: Family caregivers play an essential role in end-of-life care but suffer considerable impact on their own health. A better understanding of main factors related to carers' health is important to inform interventions. The purpose of the study was to test for the first time the potential impact of a comprehensive set of observable variables on carer health during end-of-life caregiving within a population-based carer sample. DESIGN: National retrospective, cross-sectional, 4-month post-bereavement postal census survey of family carers of people who died from cancer. SETTING AND PARTICIPANTS: Relatives who registered a death from cancer during a 2-week period in England were identified from death certificates by the Office of National Statistics; response rate was 1504/5271 (28.5%). OUTCOME MEASURES: Carers' mental health was measured through General Health Questionnaire (GHQ)-12; general health was measured through EuroQoL EQ-Visual Analogue Scale (EQ-5D VAS). METHODS: Survey questions to measure potential variables associated with carer health were based on past research and covered patients' symptoms and functioning; caregiving activities and hours; informal and formal help received; work hours, other caregiving, volunteering; changes to work, income and expenditure; sleep and relaxation; and demographic variables. Bivariate analyses and ordinary least square regression were performed to investigate these variables' relationship with outcomes. RESULTS: Patients' psychological symptoms and functioning, caregiving hours, female gender and self-sought formal help related to worse mental health. General practitioner and social care input and relaxation related to better mental health. Patients' psychological symptoms, caregiving hours and female gender were associated with worse general health, and older age, employment and relaxation were associated with better general health. CONCLUSIONS: Improvements in carers' health overall may be made by focusing on potential impacts of patients' psychological symptoms on carers, facilitating respite and relaxation, and paying particular attention to factors affecting female carers.","Grande, Gunn; Rowland, Christine; Cotterill, Sarah; Batistatou, Evridiki; Hanratty, Barbara","https://dx.doi.org/10.1136/bmjopen-2020-047275","","Country: GB; REINO UNIDO; UNITED KINGDOM; REINO UNIDO; UK; GREAT BRITAIN; INGLATERRA; ENGLAND; ESCOCIA; SCOTLAND; Database: MEDLINE; Publication details: BMJ Open;11(10): e047275, 2021 10 29.; Publication details: BMJ Open;11(10): e047275, 2021 10 29.; Publication type: article","WHO","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21817,""
"Acute Hepatitis due to Hepatic Glycogenosis after Insulin Overdose and Oral Glucose Administration in an Adolescent","","","https://doi.org/10.1210/jendso/bvab142","20211101","","Scopus","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21818,""
"Depression in late life: Linking the immunometabolic dysregulation with clinical features","","","https://doi.org/10.1016/j.rpsm.2021.06.004","20211001","","Scopus","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21819,""
"How to maintain mental health in turbulent times: Can mobile applications be a part of the solution?","","","https://doi.org/10.23919/SpliTech52315.2021.9566350","20210908","","Scopus","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21820,""
"Innovating resilience: How avoiding reducing innovation through cost-cutting can boost performance in a crisis","","","https://doi.org/10.1108/SD-10-2021-0109","20210101","","Scopus","Undecided","","","","","","","","","","","","","False","False","","","","","False","False","False","","False","False","False","False","False","False","False","False","False","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","2021-11-12","",21821,""