Significant Lifestyle Changes Research Articles

Impact of Coronavirus Disease Lockdown on Children With Type 1 Diabetes Mellitus in Al-Khobar, Saudi Arabia.

BackgroundAfter the emergence of the novel coronavirus disease pandemic, Saudi Arabia implemented lockdown restrictions to counter this infection and prevent its spread. There have been a lot of challenges to the majority of people, especially diabetic patients, which might result in an increased risk of developing complications and significant lifestyle changes, including physical inactivity, unhealthy diet, and psychological distress.ObjectiveThis study aims to assess the impact of coronavirus disease lockdown on children with type 1 diabetes (T1D) mellitus in Al-Khobar, Saudi Arabia.MethodsThis is a questionnaire-based cross-sectional study which was conducted in pediatric patients, aged ≤18 years old, with type I diabetes, who were attending the endocrine clinic at the King Fahd Hospital of the University (KFHU) in Al-Khobar, Saudi Arabia. A total of 250 patients were identified from the hospital databases, a total of 164 patients were included in the study, and one of the parents/guardians was interviewed through mobile phone after taking their consent.ResultsThe medication compliance during the lockdown has significantly increased as the percentage of children who did not miss any dose of medications increased to 92.7% in comparison to 70.7% before the lockdown (P=0.000). Also, diabetic ketoacidosis (DKA)-related intensive care unit admission had significantly decreased during the lockdown (P=0.001). Regarding the number of consumed meals, it increased from 53.7% up to 68.3% before and during the lockdown period, respectively (P=0.005). In addition, there was no significant change in children's psychological health during the lockdown period (p= 0.123).ConclusionThe study indicates that there was an increase in compliance to medications, a significant decrease in intensive care unit and emergency department admission due to hypo/hyperglycemia during the lockdown period. Medical practitioners are encouraged to educate diabetic patients regarding the importance of self-blood glucose monitoring, healthy lifestyle, psychological wellbeing, and regular follow-up through virtual clinics.

The health impact of an innovative summer camp for older adults: a pilot study using an interdisciplinary collaborative approach

BackgroundHealthy aging with dignity and aging in place are important for Taiwanese individuals. Although Taiwan did not experience COVID-19 outbreaks prior to May 2021, many older adults have been encouraged to stay at home since the beginning of the global pandemic in January 2020. Such shelter-in-place recommendations have resulted in significant lifestyle changes, limiting activities associated with aging with dignity such as exercise and community engagement. Few studies have explored how to promote or maintain holistic health practices and physical fitness in older adults residing in rural communities during the COVID-19 pandemic. This pilot study aimed to establish an interdisciplinary collaboration with community care workers (CCWs) and evaluate the impact of an innovative summer camp (ISC) program for older adults residing in rural areas.MethodsA quasi-experimental pre-post-test design with an interdisciplinary collaborative approach was implemented. The ISC program was based on a standardized protocol of modified Baduanjin exercise combined with three recreational breathing games. Participants were recruited from three community centers around the western coastal region of Yunlin County between June and August 2020. The ISC program was designed and executed by a nurse-led health promotion research team that collaborated with trained CCWs for 90 min per day, five days per week, for 12 weeks. Participants and CCWs wore facemasks during all activities. Paired t-test was used to measure changes in physical biomarkers, pulmonary lung function, and health-related fitness changes.ResultsSixty-eight participants completed the ISC program. The ISC program significantly improved the participants’ physiological biomarkers and health-related fitness, including reduced body weight, waistline, and systolic blood pressure, and increased forced vital capacity, biceps arm flexion, and ability to sit and stand from a chair, step with a knee up in situ, and stand on one foot with eyes open. Most participants reported that they felt happy, satisfied, and hoped that this program would be continued in their community center.ConclusionsThis interdisciplinary, collaborative ISC program improved physical biomarkers and health-related fitness in older adults. Despite limitations, results strongly suggested that primary healthcare providers and CCWs can employ the described ISC program to promote wellness in older adults.

Fizička aktivnost i fizičke vežbe u pandemiji - promene i posledice

COVID-19 (coronavirus) was discovered at the end of 2019 and became a global pandemic in 2020. To fight the COVID-19 pandemic, numerous countries around the world have imposed different social restrictions in the hopes of slowing the virus's spread. For more than two years, humanity has been exposed to stress, which has resulted in a significant change in human lives and a negative impact on people's health due to the need for a completely different adjustment to everyday life. Every new, unfamiliar scenario triggers tension, which is a natural response to a threat. All of this resulted in people being confined to their houses, prevented them from seeing loved ones or taking care of daily tasks, decreased their mobility, forced them to work from home, and completely altered their daily routines. The SARS-CoV-2 coronavirus pandemic has created a global social threat, both economic and medical, with significant lifestyle changes. Part of the strategy to limit the spread of the virus was social isolation, which is incompatible with the human need for physical activity. The COVID-19 pandemic has stopped sport and its development in a significantly different way than any known pandemic so far. People whose main occupation is sports were especially affected. The fight against the spread of COVID19 has resulted in the closure of sports clubs, facilities, gyms, stadiums, swimming pools, dance and fitness studios, physical therapy centers, parks and playgrounds. A significant number of studies were conducted during the pandemic in order to determine the impact of the pandemic on various aspects of social life, precisely because of the situation that was imposed on the entire society and because of the change in the format of everyday life that deviated from the usual. Physical activity is one of them. This work aims to review those works by systematizing the goals, contents and results of those researches, in order to determine how much they were represented and what conclusions were reached based on them.

Physician-patient communication in vascular surgery: Analysis of encounters in academic practice.

Objective:To assess physician–patient communication in vascular consults with the aim of identifying areas for improvement.Introduction:Shared decision-making in clinical consults can enhance patient outcomes. Its potential benefits are significant in vascular surgery, where decisions are dependent on the patient’s definition of quality of life and outcomes are influenced by significant lifestyle changes.Methods:In this qualitative cross-sectional study, encounters between five vascular surgeons and their patients with two asymptomatic vascular diseases were audio recorded, transcribed, and analyzed for validated sociolinguistic statistics. The nine-item shared decision-making questionnaire was used to gauge subjective patient perspective.Results:Physicians spent an average of 19 min and 28 s (±8:55) per consult and an average of 12 min and 7 s talking to the patient (±6:33). Physicians used formalized language about 10.3 times an encounter (±8.39), checked for understanding 6.4 times (±4.84), and asked more close-ended than open-ended questions (10.5 ± 6.15 versus 4.6 ± 2.37). Physicians accounted for 46.34% of utterances (±6%) and averaged 5.8 interruptions per encounter (±4). Patients and company accounted for 53.66% of total utterances (±6%) and averaged 10.1 clarification questions (±9.78). The average nine-item shared decision-making questionnaire Likert-type score per patient was 2.82 on a range of −3 to +3 (±0.33), with positive numbers indicating agreement. On average, patients strongly (+2) or completely (+3) agreed that physicians covered the nine criteria.Conclusion:The 9-item shared decision-making questionnaire data showed that patients mostly felt their physician was adequate in exhibiting shared decision-making behaviors. However, physicians asked closed-ended questions that elicited “yes/no” or brief responses, continuously interrupted patient narratives, and rarely checked for understanding from their patients. These subliminal behaviors restrict patient participation in shared decision-making and may be corrected via longitudinal intervention.

Short-Term Use of Continuous Glucose Monitoring Devices in the Multidisciplinary Active Diabetes Clinic

The MemorialCare Medical Foundation ACTIVE Diabetes program aims to engage poorly controlled diabetic patients in the management of their chronic disease in order to reduce their risk of macrovascular and microvascular complications. This is done through a combination of medication management and lifestyle coaching. Newer technologies such as continuous glucose monitoring (CGM) devices have become commonly used in order to support patient engagement in diabetes management. In our practice, short term use of CGM devices have been shown to increase patients’ awareness of blood sugar trends which leads to improvements in lifestyle changes and medication adherence. Our team first observed this benefit in a case study where significant lifestyle changes were made while a patient was on a CGM for a short period of time. Short term use of CGM devices, if used appropriately, can lead to an improvement in A1C without an increase in medications.

Grief Experience After Deaths: Comparison of Covid-19 and non-Covid-19 Causes.

The grief caused by loved ones’ death causes grief is a global phenomenon. The Covid-19 pandemic caused significant changes in human lifestyles and the experience of grief. The purpose of the present study was to compare grief experiences in the deceased's relatives caused by Covid-19 and non-Covid-19. Seventy-five first- and second-degree relatives of the deceased infected with Covid-19 (n = 33) and non-Covid-19 (n = 42) in a Gorgan hospital in northern Iran were included cross-sectional study using convenience sampling. Data were collected using the GEQ-34 grief experience questionnaire and demographic variables and questions related to funeral and burial. The results revealed that the deceased's burial quality caused by the Covid-19 group was significantly lower (p = 0.035). However, the feeling of the Covid-19 label is significantly higher (p <0.001). There was no significant variation in grief's broad experience between the two groups (P > 0.05). Nevertheless, the experience of grief was significantly different in the group of relatives of the deceased infected by Covid-19 in terms of notoriety (P = 0.040) and physical reactions (p = 0.002). Educational interventions to reduce stigma and discrimination due to death caused by Covid-19 and clinical and psychological support of relatives of the deceased due to Covid-19 are recommended by compiling appropriate messages from different channels.

650 Quality of life of patients with end stage heart failure treated with left ventricular assist devices

Abstract Aims Nowadays continuous flow left ventricular assist devices (LVAD) have become a reality for patients with end-stage heart failure (HF) who are failing maximal medical treatment, both eligible or not for heart transplantation. LVADs have demonstrated to improve functional capacity and clinical outcomes, including breathing and activity tolerance, but the impact on patients quality of life (QoL) is still a vexed and open question. Moreover, the device implantation actually requires significant life style changes, high motivation and adherence to treatment, both for patients and their caregivers. Patients must learn to live with the device and to interface with the controller and batteries system, adjusting everyday life’s activities to the device presence. The purpose of our study is to evaluate how the implantation of HeartMate 3™ impact on patients-related QoL and clinical outcomes, compared with general population and other chronic diseases. Methods and results Eight patients (pts) with a diagnosis of end-stage HF were implanted with the HeartMate 3™ LVAD from May 2017 to October 2019 in the Cardiac Surgery Unit of Brotzu Hospital. During a follow-up visit (28.7 ± 11.9 months after surgery), the 7 pts presenting were assessed with two questionnaires, the SF-12 and EuroQoL-5D, in order to evaluate improvement of quality of life compared with clinical presentation. Afterwards we compared the average SF-12 total result with 28 controls from general population and with other important chronic diseases. The analysis of SF-12 questionnaires showed an average of 28.00 ± 8.98 (VN: 12–47) as total score, 11.7 ± 3.4 (VN: 6–20) as physical health component score and 16.2 ± 6.5 (VN: 6–27) as mental health component score. These findings, though within the range of ‘normality’, are closer to the lower scores and show the negative impact of LVAD in everyday patients-related quality of life. Comparing the NYHA functional class with these results, we found a statistically significant negative linear correlation for both total (−0.80, P = 0.03) and mental health component scores (−0.75, P = 0.049). Average total score of our pts significatively differs compared with 28 controls of general population (28.00 ± 8.98 vs. 38.64 ± 6.80, P = 0.014), as well as compared with other chronic diseases like Wilson’s disease (P &amp;lt; 0.001), celiac disease (P &amp;lt; 0.001), obsessive-compulsive disorder (P &amp;lt; 0.001), panic disorder (P &amp;lt; 0.001), major depressive disorder (P = 0.009), multiple sclerosis (P &amp;lt; 0.011), food disorders (P = 0.023), and carotid atherosclerosis (P = 0.049). The EuroQoL-5D questionnaire investigates five particular ‘dimensions’ of the subjectively perceived health-related quality of life (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and shows similar. We found a poor average score at Visual Analogue Scale (58.5 ± 18.86) and a statistically significant negative linear correlation with NYHA functional class (−0.76, P = 0.046). The 42.86% referred no pain or discomfort and in the other four dimensions most of them reported ‘moderate limitations’, both physical or mental, especially for self-care domain (85.71%), as inevitable result of the device’s size. Conclusions LVAD can improve clinical outcomes and functional capacity of carefully select pts with end-stage HF, but the complications encountered during mechanical support and the lifestyle changes required can affect negatively patients well-being. Many studies have shown that most patients experience significant improvement even in QoL’s perception but for others the device have a negative impact on many aspects of normal daily living as well as emotional, mental and social functioning. Our study confirms this conflicting results: physical related-quality of life improves after LVAD implantation but emotional and psychological distress may persist, especially during long-term support, as a result of complications, co-morbidities and personal’s attitudes, values and way of life.

Financial Hardship Amongst Patients with Hematologic Malignancies: Using the EMR to Streamline and Prioritize Patient-Centered Care

Background: Self-reported financial hardship (FH) amongst cancer patients is increasingly becoming a challenge for patients, caregivers, and healthcare providers. FH not only leads to financial struggles, significant lifestyle changes, and emotional distress, but also contributes to treatment noncompliance, affecting clinical outcomes. As treatment costs rise, it is crucial to develop efficient methods to proactively identify and alleviate FH in hematology practice. One potential approach is utilizing automated processes to identify those at highest risk of FH. At Mayo Clinic, screening for FH involves using a single financial strain question ‘How hard is it for you to pay for the very basics like food, housing, medical care, and heating?‘ which all cancer patients answer annually as part of the institution's Social Determinants of Health (SDOH) assessment. Answers are on a five-point scale including not hard at all, not very hard, somewhat hard, hard, and very hard. In this study, we assess the prevalence and predictors for FH (denoted by a response of “Very hard” “Hard” or “Somewhat hard”) amongst the Mayo Clinic hematologic malignancy patient population. Our study objective was to determine if this automated process could identify those at risk for FH.Methods: Patients who received care for hematologic malignancies (lymphoma, leukemia, plasma disorders, myelodysplastic/myeloproliferative disorders, and other heme malignancies) at any of the Mayo Clinic cancer centers (Minnesota, Arizona, and Florida) and who had completed the SDOH screen at least once were included in this study. The electronic medical record (EMR) and Mayo Clinic Cancer Registry were utilized to extract demographic and disease variables. Patient's home zip code was used to determine rural/urban residence, distance from cancer center, and the Area Deprivation Index (ADI), a measure of socioeconomic disadvantage based on home zip code (ranging from 1-100, with 100 representing the most disadvantaged). Multivariable logistic regression modeling was used to examine predictor variables for FH in this patient population.Results: The final cohort included 10,024 patients from 2018 to 2020. Median age was 64.6 years (IQR 58.1,73.7), 58% were male, and 79% married. Race/ethnicity composition was 94% White (n=9,268), 2.5% Black (n=246), 0.4% American Indian/Alaskan Native (44), and 4% Hispanic (n=360). Fifty-six percent of patients had Medicare and 41% had commercial insurance. Fifty percent were retired, 40% were working/students, and 72% were urban residents. Mean ADI was 41.2. Fifty-six percent of patients had lymphomas, 23.5% had plasma cell disorders, 8.5% had leukemias, 6.8% had other hematological malignancies, and 5.5% had myelodysplastic/myeloproliferative neoplasms. FH was reported by 12.8% (n=1286) of the patients. Table 1 shows the results of the multivariable model. A significantly higher likelihood of endorsing FH was noted in Hispanic vs non-Hispanics, Black and American Indian/Alaskan Native groups vs whites, Disabled/Unemployed vs working, Medicaid, Medicare, and Self-Pay groups vs commercial insurance, higher ADI (5 th quintile vs 1 st), and myelodysplastic/myeloproliferative disorder and other hematologic malignancy vs lymphoma patients. Older age, being retired, and living farther from the cancer center were associated with significantly less likelihood of endorsing FH.Conclusion: Our study used automated data extraction from the EMR to efficiently identify predictors of FH in hematologic cancer patients. Employing a dichotomized and automated “flag” for FH, particularly if incorporated in the EMR, could ease the identification of SDOH issues, facilitate timely connection to appropriate resources, and help provide better patient-centered care. [Display omitted] DisclosuresAilawadhi: Sanofi: Consultancy; Cellectar: Research Funding; Karyopharm: Consultancy; Ascentage: Research Funding; Genentech: Consultancy; Janssen: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Beigene: Consultancy; GSK: Consultancy, Research Funding; AbbVie: Consultancy; Medimmune: Research Funding; Pharmacyclics: Consultancy, Research Funding; Takeda: Consultancy; Amgen: Consultancy, Research Funding; Xencor: Research Funding. Fonseca: OncoTracker: Consultancy, Membership on an entity's Board of Directors or advisory committees; Takeda: Consultancy; BMS: Consultancy; Mayo Clinic in Arizona: Current Employment; Aduro: Consultancy; AbbVie: Consultancy; GSK: Consultancy; Merck: Consultancy; Juno: Consultancy; Scientific Advisory Board: Adaptive Biotechnologies: Membership on an entity's Board of Directors or advisory committees; Patent: Prognosticaton of myeloma via FISH: Patents & Royalties; Novartis: Consultancy; Bayer: Consultancy; Celgene: Consultancy; Caris Life Sciences: Membership on an entity's Board of Directors or advisory committees; Kite: Consultancy; Janssen: Consultancy; Amgen: Consultancy; Pharmacyclics: Consultancy; Sanofi: Consultancy. Griffin: Exact Sciences: Research Funding.

Impact of COVID-19 on eating habits, sleeping behaviour and physical activity status of final-year medical students in Ankara, Turkey.

The massive increase in COVID-19 cases led to the implementation of nationwide lockdown in Turkey. While enforced lockdown is an effective strategy to abate the transmission of the virus, it causes significant lifestyle changes in every part of the community. This study aims to assess the changes in eating habits, sleeping behaviour and physical activity status of final-year medical students (interns) whose education was suspended during the pandemic. In this cross-sectional epidemiological study, an online questionnaire was created. Interns were asked questions regarding socio-demographic status, eating habits, sleeping behaviour and physical activity status before and during COVID-19 pandemic. Changes in dietary habits and sleep quality were evaluated under the guidance of Turkey Dietary Guidelines, Determination of Nutritional Status Report, Turkey National Nutrition and Health Survey and Pittsburgh Sleep Quality Index. Hacettepe University Faculty of Medicine - Ankara, Turkey. Among 536 students, a total of 340 students (63·4 %) answered the questionnaire. After the beginning of lockdown, an increase in BMI was observed in both female (P = 0·002) and male students (P = 0·013). Students having healthy dietary habits increased by 18·8 % and unhealthy dietary habits decreased by 3·2 % during lockdown (P < 0·001). Overall, 63·2 % of students reported a decrease in physical activity, and 33·6 % reported a reduction in sleep quality, whereas 38·6 % reported an improvement in sleep quality. There was no significant difference in sleep quality between genders (P = 0·075). This study indicated that medical school suspension and enforced lockdown led to significant changes in interns' eating behaviour, physical activity and sleeping habits.

MP19-04 QUALITY OF LIFE AFTER A UROLOGIC CANCER DIAGNOSIS

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making II (MP19)1 Sep 2021MP19-04 QUALITY OF LIFE AFTER A UROLOGIC CANCER DIAGNOSIS Ridwan Alam, Sunil Patel, Max Kates, Nirmish Singla, Mohamad Allaf, Trinity Bivalacqua, and Phillip Pierorazio Ridwan AlamRidwan Alam More articles by this author , Sunil PatelSunil Patel More articles by this author , Max KatesMax Kates More articles by this author , Nirmish SinglaNirmish Singla More articles by this author , Mohamad AllafMohamad Allaf More articles by this author , Trinity BivalacquaTrinity Bivalacqua More articles by this author , and Phillip PierorazioPhillip Pierorazio More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002004.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Quality of life (QOL) plays an important role in the care of patients with urologic malignancies, each of which is associated with a unique risk-benefit profile. We sought to compare the differential effects of a cancer diagnosis on quality of life across a number of urologic malignancies. METHODS: The Surveillance, Epidemiology, and End Results database was linked to the Medicare Health Outcomes Survey (SEER-MHOS) in this population-based cohort study. Patients were identified based on the diagnosis of a urologic malignancy and a complete QOL questionnaire, which is comprised of mental component summary (MCS) and physical component summary (PCS) scores. Six types of urologic cancers were examined: 1) bladder, 2) ureteral, 3) kidney, 4) prostate, 5) testicular, and 6) penile. Patients were classified based on whether the survey was taken before or after cancer diagnosis. Multivariable regressions were performed to examine the effect of a cancer diagnosis on QOL scores, after controlling for potential confounders. RESULTS: A total of 40,020 patients were included: cancer of the bladder in 7775, ureter in 580, kidney in 3197, prostate in 28,118, testicle in 148, and penis in 202. The diagnosis of cancer was significantly associated with a drop in MCS scores in all cancers except testicular (Figure). Those with ureteral cancer suffered the greatest drop in MCS scores (-3.76 points, p<0.001), even after adjustment (-3.75 points, p=0.007). The strength in association between MCS and diagnosis was the greatest for bladder cancer patients (-1.18 points, p<0.001). PCS scores also dropped significantly in all cancers except testicular (Figure), with the greatest drop seen in penile cancer patients (-6.64 points, p<0.001). After adjustment, however, this relationship was no longer significant (-3.95 points, p=0.08). Instead, bladder cancer patients demonstrated the greatest drop in physical health scores (-2.27 points, p<0.001). CONCLUSIONS: QOL is affected to varying degrees after the diagnosis of a urologic cancer based on the type of malignancy. Bladder cancer patients are at particularly high risk of mental and physical health decline after diagnosis when compared to other urologic cancer patients, possibly due to the significant lifestyle changes associated with this disease process. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e328-e328 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ridwan Alam More articles by this author Sunil Patel More articles by this author Max Kates More articles by this author Nirmish Singla More articles by this author Mohamad Allaf More articles by this author Trinity Bivalacqua More articles by this author Phillip Pierorazio More articles by this author Expand All Advertisement Loading ...

One year into the clash of pandemics of diabetes and COVID-19: Lessons learnt and future perspectives.

There is a bidirectional relationship between coronavirus disease 2019 (COVID-19) and diabetes. Furthermore, the COVID-19 pandemic has catalyzed the use of technology in diabetes care. Future research is required to assess the impact of COVID-19 on new-onset diabetes and the influence of diabetes on responses to COVID-19 vaccines.

Criterion Validity and Reliability of SF-12 Health Survey Version 2 (SF-12v2) in a Student Population during COVID-19 Pandemic: A Cross-Sectional Study

Objective The novel coronavirus SARS-CoV-2, responsible for the COVID-19 pandemic, led to strict domestic quarantine, social isolation policies, and consequently significant psycho-emotional and lifestyle changes. The individual and societal fear and anxiety cause significant stress affecting health-related quality of life (HRQOL). There is evidence of the psychological and mental health effects of the current pandemic on students, who are known to be a vulnerable population. A decrease in physical activity was reported among students, and it is known to contribute to stress levels, which is strongly associated with HRQOL. This study is aimed at evaluating the validity and reliability of SF-12 Health Survey version 2 (SF-12v2) in the assessment of self-perceived quality of life of Italian students following lifestyle changes due to the outbreak of COVID-19. Methods A cross-sectional study was conducted with university students attending the faculty of Medicine and Surgery or Health Professions. The Physical Component Summary (PCS12) and the Mental Component Summary (MCS12) of SF-12v2 were compared to the Perceived Stress Scale (PSS). Internal consistency was examined using Cronbach's Alpha Coefficient. Concurrent validity was evaluated comparing SF-12v2 values to PSS scores, and the Pearson Correlation Coefficient (PCC) was calculated. Cross-cultural validity was investigated through several analyses for correlations between SF-12v2 scores and the gender of participants, University of Italy, body mass index (BMI), and time spent sitting and exercising. Results The SF-12v2 questionnaire was administered to 583 medical and health professionals' students in July 2020. Cronbach's Alpha showed acceptable reliability for PCS12 and MCS12. In line with expectations, PCS12 scores differed by BMI groups, while the MCS12 was associated with PSS score and showed differences between genders, BMI groups, time spent sitting, and time spent exercising. Conclusion The Italian version of SF-12v2 is a valid and reliable instrument to assess health-related quality of life among medical and health professionals' students.

Research on the impact of distance learning during the COVID-19 pandemic on the lifestyle and quality of education of medical students. Experience of the obstetrics and gynecology department

Introduction. To prevent the spread of the COVID-19 pandemic, medical educational institutions have moved o quarantine with distance learning. It was implemented suddenly and imperatively, which can have long-term consequences not only in the form of a decrease in the quality of education, but also in the form of certain psychological problems for both students and faculty.Aims: to assess the impact of the forced transition to distance learning during the pandemic of a new coronavirus infection on the lifestyle and the degree of satisfaction with education of medical students.Materials and methods. A one-stage descriptive study was carried out in which 165 students of the 4th-5th year of the Faculty of Medicine and Prevention, who studied remotely at the Department of Obstetrics and Gynecology, took part in it. Among them, an anonymous survey was conducted, which included questions of lifestyle, degree of satisfaction and their opinion on the quality of education.Results. According to the results of the questioning, distance education influenced the lifestyle of the majority of the students surveyed — 32% began to get better sleep, 26% noted the appearance of sleep disorders. With regard to the nutrition of students, a similar picture is observed — 55% began to eat more regularly and balanced, 21% - ate excessively. Only 7.3% students are most actively involved in the distance learning process, most are periodically distracted (88.5%) or are engaged in other activities (4.2%). The theoretical component of distance learning was assessed by students quite high — 7.7 ± 2.4 points. However, the practical skills caused a lot of dissatisfaction were rated low 4.1 ± 2.4 points. Among the advantages of distance education — 92.7% singled out time and financial savings. Of the shortcomings — 86.1% indicated the lack of work with patients.Conclusions. The transfer of medical students to distance education entails not only a possible decrease in the quality of education and student motivation to study, but also a significant change in lifestyle.

P23 Dietary Changes Among Japanese Adults Since the Spread of COVID-19

<h3>Background</h3> Preventive measures adopted for COVID-19 have brought about significant changes in lifestyle and have affected dietary habits worldwide. <h3>Objective</h3> To examine the factors relating to dietary changes among Japanese adults since the spread of COVID-19. <h3>Study Design, Settings, Participants</h3> A cross-sectional questionnaire survey was conducted via the internet in November 2020. All 6,000 participants, comprising 3,044 male and 2,956 female adults, aged 20–64 years, who registered with a research company received the questionnaire on email. <h3>Measurable Outcome/Analysis</h3> The questionnaire included items on demographic characteristics; socioeconomic factors; past medical history; COVID-19 infection situation of their family and neighbors; fear of COVID-19; and lifestyle habits and healthy changes in dietary habits since the spread of COVID-19. The participants were given multiple choices in answers: changed to healthier; changed to unhealthier; and no-change. Multinomial logistic regression analysis was conducted to examine factors associated with dietary changes. <h3>Results</h3> Of the participants, 1,215 (20.3%) answered that their dietary habits became healthier, 491 (8.2%) answered as unhealthy, while a majority of them (4,294; 71.6%), said their dietary habits remained unchanged. The results of the multinomial logistic regression analysis with unchanged as the reference indicated that healthier and unhealthier dietary change were negatively associated with age (OR [95% CI]: 0.89[0.84-0.95], 0.89 [0.81-0.97]) and positively associated with the past medical history of dyslipidemia (1.44 [1.11-1.86], 1.74 [1.23-2.46]) and fear of COVID-19 (1.05 [1.04-1.07], 1.02 [1.01-1.04]). Unhealthy change was positively associated with living alone, COVID-19 infection of colleagues, stress, and BMI; while annual household income, COVID-19 infection of oneself and friends, health literacy, frequency of exercise, and smoking were positively associated with healthier dietary changes. <h3>Conclusion</h3> This study suggested that the factors determining healthy and unhealthy dietary change since the spread of COVID-19 were age, COVID-19 infection, and fear of COVID-19. <h3>Funding</h3> Health, Labour and Welfare Policy Research Grants, Special Research (Grant Number JP 20CA2040).

Body Mass Index, Practice of Physical Activity and Lifestyle of Students During COVID-19 Lockdown.

PurposeSeveral factors influence the student’s physical activity and lifestyle. The coronavirus disease (COVID‐19) lockdown has restricted student’s activity and altered their routine lifestyle. This prospective cohort study aimed to determine the significant changes in body mass index (BMI), physical activity, and lifestyle of the students including diet, sleep, and mental health before and during COVID-19 lockdown.MethodsThe study participants were 628 students studying bachelor’s degree programs, between 18 and 30 years of age, both genders from the university of Al-Ahsa, Saudi Arabia. The lockdown began on 23 March and ended on 21 June 2020 in Saudi Arabia. The students were interviewed before (March 2020) and during (June 2020) lockdown. The structured tool included baseline information of the students, anthropometric data, global physical activity questionnaire (GPAQ), dietary recall, Pittsburgh sleep quality index (PSQI), and perceived stress scale (PSP). Chi-square tests were used to associate the baseline information with BMI changes during the lockdown.ResultsBMI of the students showed that 32% increased their weight, 22% lost their weight and 46% maintained the same weight during COVID-19 lockdown. The physical activity significantly decreased and sedentary time increased (p = 0.0001). Regarding the lifestyle components, fast and fried food consumption decreased, and calorie intake increased significantly (p = 0.001). Stress level (p = 0.001) significantly decreased, and sleep level (p = 0.001) increased during lockdown. The variables associated with weight changes were the level of students (p < 0.05) and time spent on social media per day (p < 0.0001).ConclusionThough half of the students maintained the same BMI during the lockdown, students who increased BMI were associated with physical activity and lifestyle. Hence, health awareness on weight maintenance, active physical activities, and a healthy lifestyle must be created among the students, which help in creating and implementing policies in the future.

Sleep disorders reveal distress among children and adolescents during the Covid-19 first wave: results of a large web-based Italian survey

BackgroundMeasures to contain the Covid-19 pandemic led to significant lifestyle changes for children and adolescents mainly related to the closure of schools and recreational activities, reduced social interaction, and increased family concerns.MethodsA cross-sectional online survey of 78 questions investigating social determinants of health, mood changes, symptoms of anxiety, increase in sleep disorders and unusual repetitive movements was offered to parents living in Italy with children ≤18 years; including families of children with disabilities, autism spectrum disorders, chronic diseases, and specific learning disabilities. The survey was conducted on the Qualtrics platform 6 months after the beginning of the pandemic and distributed in hospitals and paediatricians’ waiting rooms as well as through social networks. The primary outcomes were the increase in sleep disorders among children and adolescents. Possible risk factors were investigated through multivariable regression.ResultsSix thousand two hundred ten volunteer parents responded to the questions concerning mood changes, sleep disorders and unusual repetitive movements, and were included in the present study. The majority were female (91.8%) and Italian (97.0%). 72.7% answered that their children had become more nervous, worried, or sad (80.2% in children with learning disabilities); 77.6% reported feelings of loneliness and 69.3% more difficulties in children falling asleep, 30.2% in staying asleep, and 18.7% an increase in nightmares and/or sleep terrors. Statistical analysis identified socioeconomic status, parent’s job loss, food insecurity, family attitude toward the pandemic, and children’s mood swing, feelings of loneliness, or missing outdoor activities, as major risk factors for sleep disorders.ConclusionThe first Covid-19 lockdown impacted children’s and adolescents’ health through an increase in sleep disorders. In the following phases of the pandemic, this evidence may be useful to investigate and treat these disorders as well as make decisions about containment health policies concerning this age group.

687 Changes in adolescent sleep habits during the COVID-19 pandemic

IntroductionDuring the COVID-19 pandemic, adolescents have experienced significant lifestyle changes. With an increase in technological dependency and changes in school formats, sleep behaviors may be altered. As individuals with overweight or obesity (OWOB) already report higher rates of sleep issues, they may be particularly at risk during this time. However, to date, there are no data on changes in sleep behavior in adolescents with OWOB during the COVID-19 pandemic.MethodsParticipants included 10 adolescents with BMI ≥85th percentile (Mage=16.30 years, SDage=1.06; 60% male; 70% African American). Prior to the COVID-19 pandemic, participants completed sleep diaries twice per day for one week, noting caffeine intake, bedtime, naps, perceived sleep quality, and media use in bed. Participants then completed sleep diaries again during the COVID-19 pandemic. Five separate paired-samples t-tests assessed differences in sleep behaviors and quality.ResultsA paired-samples t-test demonstrated significantly earlier average bedtime before (M=11:20 PM, SD=55.16 minutes) than during (M=12:29 AM, SD=71.27 minutes) COVID-19 (t(9)=-3.0, p=0.015). A second paired-samples t-test demonstrated lower average media use in bed before (M=11.67, SD=10.97 minutes) than during (M=32.13, SD=27.28 minutes) the COVID-19 pandemic (t(9)=-2.3, p=0.050). No other significant differences were found.ConclusionAdolescents engaged in later bedtimes and increased media use in bed during the COVID-19 pandemic. This suggests adolescents’ sleep schedules have shifted later during the COVID-19 school year, due to either later wake times associated with virtual schooling or disruption in typical daily schedule as a result of the pandemic. However, no differences were found regarding caffeine intake, number of naps, and sleep quality. The significant findings regarding later adolescent bedtimes may reflect delayed sleep phase or possibly improved circadian alignment due to delayed school start times and at-home classes. The null findings regarding naps and caffeine intake may be reflective of the stability of daytime sleepiness. While we would expect daytime sleepiness to improve with increased circadian alignment, the effects may be diminished by increased media use in bed and decreased energy expenditure during the day. Given the observed relationships, current sleep hygiene interventions may require a focus on stimulus control and reducing time with media in bed.Support (if any):

Psychological Impact: Unseen Effects of COVID-19

Impact of COVID-19 on mental health has affected various dimensions of human life. Various emergency government decisions and policies were developed during this period. Forced implementation of lockdown and quarantine during the pandemic made a significant impact on the general public and frontline health-care workers. The uncertainty due to COVID-19 caused major psychological problems such as anxiety, depression, stress, uncontrolled fear, and significant lifestyle changes. It has affected the world economy and also changed education and learning process.

A Study of the Effects of the COVID-19 Pandemic on the Experience of Back Pain Reported on Twitter® in the United States: A Natural Language Processing Approach.

The COVID-19 pandemic has changed our lifestyles, habits, and daily routine. Some of the impacts of COVID-19 have been widely reported already. However, many effects of the COVID-19 pandemic are still to be discovered. The main objective of this study was to assess the changes in the frequency of reported physical back pain complaints reported during the COVID-19 pandemic. In contrast to other published studies, we target the general population using Twitter as a data source. Specifically, we aim to investigate differences in the number of back pain complaints between the pre-pandemic and during the pandemic. A total of 53,234 and 78,559 tweets were analyzed for November 2019 and November 2020, respectively. Because Twitter users do not always complain explicitly when they tweet about the experience of back pain, we have designed an intelligent filter based on natural language processing (NLP) to automatically classify the examined tweets into the back pain complaining class and other tweets. Analysis of filtered tweets indicated an 84% increase in the back pain complaints reported in November 2020 compared to November 2019. These results might indicate significant changes in lifestyle during the COVID-19 pandemic, including restrictions in daily body movements and reduced exposure to routine physical exercise.

Mulberry leaf extract improves glycaemic response and insulaemic response to sucrose in healthy subjects: results of a randomized, double blind, placebo-controlled study

BackgroundThere are many benefits of maintaining healthy blood glucose levels, and studies have shown that lifestyle changes such as changes to diet can successfully restore normoglycaemia in participants with dysglycaemia. Significant health-related lifestyle changes are often difficult to implement and functional ingredients that can reduce glycaemic and insulaemic responses may help at risk populations. The aim of this study was to investigate whether a mulberry leaf extract could lower the glycaemic and insulinaemic responses to 75 g sucrose in healthy individuals.MethodsA double-blind, randomised, placebo-controlled, crossover design trial was conducted by the Oxford Brookes Centre for Nutrition and Health. Thirty-eight participants were recruited into the trial and, after an overnight fast, were given 75 g sucrose + white mulberry leaf extract, or 75 g sucrose alone. Capillary blood samples were collected at 15-min intervals in the first hour and at 30-min intervals over the second hour to determine glucose and plasma insulin levels. Data analysis was conducted using a paired samples T test or a Wilcoxon signed rank test.ResultsThe addition of mulberry leaf extract to sucrose resulted in a significantly lower glycaemic response and insulinaemic response compared to a matched placebo (sucrose alone). The change in blood glucose measurements were significantly lower at 15 min (p < 0.001), 30 min (p < 0.001), 45 min (p = 0.008), and 120 min (p < 0.001) and plasma insulin measurements were significantly lower at 15 min (p < 0.001), 30 min (p < 0.001), 45 min (p < 0.001), 60 min (p = 0.001) and 120 min (p < 0.001). The glucose iAUC (− 42%, p = 0.001), insulin iAUC (− 40%, p < 0.001), peak glucose (− 40.0%, p < 0.001) and peak insulin (− 41%, p < 0.001) from baseline were significantly lower for white mulberry leaf extract compared with the placebo. White mulberry leaf extract was well tolerated and there were no reported adverse events.ConclusionsMulberry leaf extract can be used as part of lifestyle changes that may lead to healthy blood glucose levels.Trial registration: ISRCTN99601810 (23 October 2020, retrospectively registered)