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Aged Patients With Mental Disorders in the COVID-19 Era: The Experience of Northern Italy

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... The stigma associated with mental health in older adults influences treatment-seeking behavior (Conner et al., 2010), and reinforces the negative aspects of the aging process during the pandemic. Together, these factors impose an important barrier to care, particularly when it coexists with social isolation (Serafini, Bondi, Locatelli, & Amore, 2020). Furthermore, they may increase stigma, which itself is a relevant predictor of negative outcomes, such as segregation abuse and higher institutionalization rates (Banerjee, 2020a). ...
... Many factors are reinforced by the negative internalized aspects of aging, such as frailty, decreased productivity and independence (Sargent-Cox, 2017). Living alone, the feeling of loneliness, despair, hopelessness and disconnectedness are well-known independent risk factors for suicide in late life (Draper, 2014;Serafini et al., 2020) that are amplified during a pandemic. This may be combined with a feeling of devaluation or burdensomeness to society in general (wand, Zhong, Chiu, Draper, & De Leo, 2020), especially with the rationing of ventilators in favor of younger individuals (Rosenbaum, 2020). ...
... This may be combined with a feeling of devaluation or burdensomeness to society in general (wand, Zhong, Chiu, Draper, & De Leo, 2020), especially with the rationing of ventilators in favor of younger individuals (Rosenbaum, 2020). Situations of social crisis such as the COviD-19 pandemic reinforces prejudice towards older adults with mental disorders (Serafini et al., 2020). in addition, it is known that the existence of mental disorders increases the risk of suicide (Conejero, Olié, Courtet, & Calati, 2018). ...
Article
Objective: To identify factors associated with mental health of older adults during the pandemic and to provide strategies to mitigate their psychosocial impact in the elderly. Method: An integrative text mining analysis in Medline was performed to identify studies on the mental health of older adults during the pandemic. Subsequently, statistical topic modeling was performed to identify the most prevalent terms and topics discussed in included studies. Results: A total of 29 studies were retrieved until July 1st 2020, including a majority of letters (12 studies) and commentaries (8 studies). The most frequent terms overall were: loneliness (n = 137), support (n = 132), home (n = 102), suicide (n = 96) and help (n = 94). The most prevalent terms were then divided in five topics: home (33%), suicide (32%), apps (15%), loneliness (12%) and physical activity (9%). Additionally, a section focused on low- and middle-income countries was included. A summary of strategies to mitigate the effects of pandemic in mental health of older adults was also provided. Conclusion: These factors demonstrate the importance of developing strategies for psychosocial support that take into consideration the particularities of the elderly. Different levels of care are immediately necessary to diminish the devastating impact of the pandemic in the mental health of older adults.
... The subthemes accommodated three concepts: acute COVID-19 services, the need for supplementary oxygen and ICU services. According to the data from studies contributing to this theme, there is a higher occurrence of acute respiratory distress syndrome [12] and a high risk of presenting complications from COVID-19 [11] and the particular need for ICU service [54]. are among the main aspects. ...
... Based on the studies' data, these services are presented as nine subthemes of access to homecare, tele health services, routine/outpatient healthcare services, oral, mental and palliative services, medications, and chronic and other primary healthcare services. Studies have identified a higher prevalence of known risk factors for suicide [30,33], increased risks of mental and physical health problems [32], susceptibility to the effects of stress and major depression [12,29], probability of mental disorders [12] as well as preexisting or experience of loneliness [19,30,33,35]. In addition, among the older people during the COVID-19 pandemic, the need to improving positive coping strategies [33] and more substantial psychosocial support [11] are considered as mental health strategies. ...
... Based on the studies' data, these services are presented as nine subthemes of access to homecare, tele health services, routine/outpatient healthcare services, oral, mental and palliative services, medications, and chronic and other primary healthcare services. Studies have identified a higher prevalence of known risk factors for suicide [30,33], increased risks of mental and physical health problems [32], susceptibility to the effects of stress and major depression [12,29], probability of mental disorders [12] as well as preexisting or experience of loneliness [19,30,33,35]. In addition, among the older people during the COVID-19 pandemic, the need to improving positive coping strategies [33] and more substantial psychosocial support [11] are considered as mental health strategies. ...
Article
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Background Access to healthcare and service utilization are both considered essential factors for improving the general health and wellbeing of older people, especially at the time of COVID-19 pandemic. The aim of the study is to explore factors affecting healthcare access and health service utilization for older people during the pandemic. Methods PubMed, Web of Science, Scopus and Embase were systematically searched for relevant articles. Access, utilization, health, elderly and COVID-19 were used as keywords in the search strategy. A total of 4308 articles were identified through the initial database search; 50 articles were included in the review as passing the eligibility criteria. The searches were conducted up to August 2021. Data extraction was performed, and evidence was descriptively illustrated. Thematic analysis was used to explore factors influencing the elderly’s access and utilization of healthcare services, using Max QDA 10 , a qualitative analysis software. Results Among articles included in the review ( n = 50), a majority of the studies were from the United States (36%), followed by India (8%). According to the main healthcare services, a large number of articles (18%) were related to mental health services, followed by digital health services (16%). Factors were identified at an individual, provider and systems level. Seven main themes emerged from the thematic analysis, as determinants of elderly’s access and utilization of healthcare services during COVID-19 pandemic. These included: access to non-COVID related services, access to COVID-related services, literacy and education, accommodation challenges, perceived attitudes of aging, and policies and structures, and social determinants. Conclusion Mental health and digital health services were identified as major issues influencing or contributing to or influencing older people’s health during the COVID-19 pandemic. We also argue on the importance of a rounded view, as attention to a range of factors is vital for policy decisions towards sustainable care and equitable interventions for improving the health of older people.
... 9 demência, por exemplo (Wang 2020b). Estudos apontam que idosos portadores de COVID-19 e com alguma condição psicológica preexistente, isolados em hospital na Itália, apresentaram surgimento de delírio grave em cerca de 40% dos casos (Serafini et al., 2020). ...
... Também é necessário avaliar como os distúrbios podem refletir no isolamento, Wang (2020a) observou que pacientes com psicose tendem a ficar mais desconfiados nesse tipo de situação, na hipocondria há aumento de preocupações físicas, pessoas com declínio cognitivo ou demência podem apresentar mais desafios comportamentais. Para a categoria de idosos que já possuíam condições psicológicas fragilizadas preexistentes, autoridades regionais na Itália, estabeleceram que, devem ser atendidos com apoio contínuo em hospitais psiquiátricos, em leitos específicos (Serafini et al., 2020). ...
Article
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Introduction: COVID-19 is an infectious disease caused by the new coronavirus. The disease appeared in China in December 2019, and was classified as a Pandemic. The elderly are at the main risk group for COVID-19 infection. The main preventive measure is social isolation, so it is necessary to assess the challenges of this practice in the mental health of the elderly. The objective of this study is to investigate in the literature the challenges faced in social isolation for the mental health of the elderly during the COVID-19 pandemic. Methodology: Integrative Literature Review, carried out in the databases; United States National Library of Medicine (NLM) - PubMed - and SciVerse Scopus (Elsevier), with studies from January to May 2020. Health descriptors '' Coronavirus '', '' Mental health '' and '' older adults ''. Results: 15 studies were included. Only research that addressed the challenges of social isolation in the mental health of the elderly, as well as strategies adopted by some countries to alleviate the problem that was formed in the pandemic of COVID-19. Conclusion: The importance of isolation in the prophylaxis of COVID-19 is recognized, however, it is clear that it can trigger and / or aggravate psychological disorders in the elderly. Some countries have adopted strategies to work with the elderly population in a situation of social isolation.
... The rapid transmission of COVID-19 infection as well as the higher case-fatality rate might exacerbate existing psychiatric disorders, and enhance the risk of new episodes: namely, severe delirium, psychomotor agitation, anxiety and depressive symptoms [44][45][46]. Elderly patients usually suffer from lower social support and may be less familiar with services and technology that can make social distancing easier, thus enhancing loneliness, despair and hopelessness [43][44][45][46]. ...
... The rapid transmission of COVID-19 infection as well as the higher case-fatality rate might exacerbate existing psychiatric disorders, and enhance the risk of new episodes: namely, severe delirium, psychomotor agitation, anxiety and depressive symptoms [44][45][46]. Elderly patients usually suffer from lower social support and may be less familiar with services and technology that can make social distancing easier, thus enhancing loneliness, despair and hopelessness [43][44][45][46]. ...
Article
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The COVID-19 outbreak is having a significant impact on both cardiac rehabilitation (CR) inpatient and outpatient healthcare organization. The variety of clinical and care scenarios we are observing in Italy depends on the region, the organization of local services and the hospital involved. Some hospital wards have been closed to make room to dedicated beds or to quarantine the exposed health personnel. In other cases, CR units have been converted or transformed into COVID-19 units. The present document aims at defining the state of the art of CR during COVID-19 pandemic, through the description of the clinical and management scenarios frequently observed during this period and the exploration of the future frontiers in the management of cardiac rehabilitation programs after the COVID-19 outbreak.
... There are several reports regarding high prevalence of mental health problems linked to COVID-19 crisis in China and some of these were attributed to impacts on daily life [162,163] . It has also been reported that the mental health of children and older people have been affected by the crisis [164,165] . A significant rise in stress levels could negatively modulate the immune system and increase the risk of susceptibility to infections [166] . ...
Preprint
Ramadan is a sacred month in Islam which involves 29-30 days of dawn-till-dusk dry-fasting. Millions of Muslims are observing Ramadan fasting (RF) this year in the midst of the COVID-19 pandemic. Certain ethnic groups in the UK, including Muslims, have been disproportionately affected by COVID-19, raising fears that fasting could bring additional risks. This review presents evidence that RF is safe and beneficial for healthy people. However, fasting during COVID-19 may hamper these benefits due to social isolation, physical inactivity, stress etc. It is concluded that RF during the COVID-19 pandemic is not a cause for concern for healthy people who adopt a balanced diet, drink plenty of fluids, engage in regular physical activity etc. Ill people are exempt from fasting and should seek medical advice if they wish to fast. RF during the COVID-19 pandemic will be unique and future research will reveal its impact on human health. The COVID-19 virus is expected to remain for some time and may become seasonal. Therefore, the evidence and guidance presented in this review is valid beyond Ramadan as intermittent fasting is practiced more widely, irrespective of religion, throughout the year as a therapeutic means for several conditions.
... While six months is a relatively short window and the worldwide spread of the pandemic has been dramatic, experiences from a geriatric psychiatry inpatient unit in China (20) and Italy (21) provide early evidence that older adults in hospital based settings may experience worsening of psychiatric symptoms under lockdown measures. Over the coming months, these initial experiences may help providers elsewhere anticipate and plan care more effectively. ...
... [26] A study from Northern Italy stated individual factors (sensory and cognitive deficits, comorbidities, and polypharmacy), infective factors (neurotrophic effects of the virus, immunocompromised state, and frailty), and environmental factors (social isolation, institutionalization, and intensive care admissions) as the important risks for psychosocial condition of the elderly and reported 30%-50% neuropsychiatric associates of COVID-19 to be delirium, agitation, and depression, though the exact prevalence of each was not reported. [27] A multinational (Brazil, Portugal, and Norway) report on the mental health of the elderly during COVID-19 cautioned against increased hospitalization, fear of death, stigma, age-related prejudice, and distancing from family as the factors for increasing psychiatric comorbidity in this age group. [28] Risk minimization, physical safety, and social integrity were the suggested steps by these authors based on the case vignettes that they have discussed. ...
... There are several reports regarding high prevalence of mental health problems linked to COVID-19 crisis in China and some of these were attributed to have impacts on daily life [162,163]. It has also been reported that the mental health of children and older people have been affected by the crisis [164,165]. A significant rise in stress levels could negatively modulate the immune system and increase the risk of susceptibility to infections [166]. ...
Article
Full-text available
Background: Ramadan is a sacred month in Islam, which involves 29–30 days of dawn-till-dusk dry-fasting. Millions of Muslims observed Ramadan fasting (RF) this year in the midst of the COVID-19 pandemic. Certain ethnic groups worldwide, including Muslims, have been disproportionately affected by COVID-19, raising fears that fasting could bring additional health risks. This directly impacted on the current challenges faced by health professionals. The COVID-19 virus is expected to become seasonal. Therefore, the evidence presented in this review is valid beyond Ramadan as intermittent fasting is practiced more widely, irrespective of religion, throughout the year as a therapeutic and prophylactic means for several conditions. Methods: A wide range of literature databases were searched for the effects of RF and intermittent fasting on human health and then linked to COVID-19 impact to generate the evidence. Results: This review presents a body of evidence proving RF is safe and beneficial for healthy people who adopt a balanced diet, drink plenty of fluids, and engage in regular physical activity. Fasting reduces levels of pro-inflammatory cytokines (IL-1β and IL-6), which are associated with severe COVID-19. Furthermore, increased handwashing and hygiene during Ramadan may reduce infection risks. For some, social isolation, physical inactivity, reduced access to food and stress – linked to the pandemic – may minimize the benefits that may have been achieved during a “normal” Ramadan. Conclusions: RF during the COVID-19 pandemic is not a cause of concern for healthy people. Ill people are exempt from fasting and should seek medical advice if they wish to fast. RF during the COVID-19 pandemic is a unique experience and future research will reveal its impact on human health.
... Last, but not least, the elderly and people with chronic long-term health conditions are at higher risk of negative mental health consequences of confinement and social distancing. The rapid COVID-19 transmission, as well as, the higher case-fatality in vulnerable groups may enhance the risk of psychopathological decompensation and exacerbate existing psychiatric disorders (8). ...
... They already have special physical, psychosocial, and environmental vulnerabilities associated with age (24). Case fatality in individuals 65 years or above is higher than that in other populations (25). Their frailty brings the risk of various infections and decreases the immune response; they have more comorbidities and more hospitalizations, increasing the chance of being infected with COVID-19 (26). ...
Article
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The number of people with dementia worldwide is expected to increase to approximately 1.3 billion in 2050. Almost 90% of patients diagnosed with dementia suffer from behavioral and psychological symptoms of dementia (BPSD). BPSD causes and risk factors are multiple and complex and can be responsible for hospitalizations in long-term institutions, psychiatric hospitalizations and search for health services. Recently, the world imposition of social distance and self-isolation as the best preventive measures for the COVID-19 pandemic has created challenges in the health care and management of this population, which may trigger or aggravate BPSD, and most caregivers are not prepared to address it. In face of this actual social distancing, telemedicine comes to be a tool for improving the management of these acute symptoms and mental care. In this article, we discuss and disseminate recommendations on this important alternative of assistance, especially considering the cases of BPSD. In this context of a pandemic, even patients with BPSD and caregivers require more frequent and updated guidance, considering the difficult context to social distance. Telemedicine can reduce the risk for the development of negative outcomes in mental health precipitated by the reduction of social contact and less access to health services, improving dementia symptom management, mainly BPSD.
... Age, dementia, and MDD are risk factors for suicide [4]. Comprehensive monitoring of this population is needed because the virus, and the stressors associated with social isolation can exacerbate the symptoms of age-associated disorders [10]. ...
Article
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Since December 2019, the world has been experiencing the challenge of facing coronavirus disease-19 (COVID-19), a severe infectious disease caused by the new coronavirus, SARS-CoV-2. The individuals with the most severe symptoms and the highest risk of death are the elderly and those with chronic illness. Among chronic conditions, those with a certain degree of chronic inflammation may predispose to a more severe evolution of COVID-19. Elderly with psychiatric disorders can present a persistent inflammatory state, a characteristic of the age’s immunological senescence, but the disorder can accentuate that. Social isolation is still the safest way to avoid contamination. However, isolated older people may have or worsen mental health conditions due to isolation and health concerns. In this scenario, a SARS-CoV-2 infection may progress to more severe disease. Conversely, COVID-19 can predispose or aggravate psychiatric disorders, as it induces a cytokine storm, causing systemic hyper inflammation. It may damage the blood-brain barrier, resulting in inflammation in the central nervous system. Besides, SARS-CoV-2 is likely to reach and trigger an inflammatory process directly in the nervous system. This review makes an update about research on the mental health of the elderly during the pandemic. Also, it discusses the vulnerability of these individuals in the face of stress and in the case of contracting COVID-19, considering mainly the stress’s hormonal and inflammatory mechanisms. Finally, the review points out possible care and attention strategies and entertainment and activities that can reduce the damage to mental and physical health and improve the elderly’s quality of life.
... Personal care workers can provide specialized support (Moore and Kolencik, 2020;Sheares, 2020) by remotely monitoring individuals at risk of mental illness and vulnerable populations. Serafini et al. (2020) note that inequities and intolerance as regards to marginalized people (e.g., aged individuals having mental disorders) may be typically increased in situations of social distress, panic, irritation, and apprehension. Lima et al. (2020) put it that primary care providers working in critical and intensive care units and hospitals should receive specialized training for supplying mental healthcare. ...
Article
Full-text available
This study reviews the existing literature on psychiatric interventions for individuals affected by the COVID-19 epidemic. My article cumulates previous research on how extreme stressors associated with COVID-19 may aggravate or cause psychiatric problems. The unpredictability of the COVID-19 epidemic progression may result in significant psychological pressure on vulnerable populations. Persons with psychiatric illnesses may experience worsening symptoms or may develop an altered mental state related to an increased suicide risk. The inspected findings prove that psychological intervention measures for patients affected by the epidemic should be designed and personalized adequately. Preventive measures seek to decrease infection rates and cut down the risk of the public healthcare system to eventually be overburdened. Throughout the COVID-19 crisis, people with psychiatric illnesses may confront a decrease in mental health services. As limitations in the current review, by focusing only on articles published in journals indexed in Web of Science, Scopus, and ProQuest, I inevitably disregarded other valuable sources. Subsequent research directions should clarify the effectiveness of online mental health services in providing remote psychiatric interventions to individuals affected by the COVID-19 epidemic.
... Recent studies reported that anxiety, depression, and sleep problems increased significantly after the COVID-19 outbreak [2,3]. Some reports suggested that older adults are one of the most vulnerable groups experiencing negative psychological and mental health consequences of the COVID-19 pandemic [2,[4][5][6][7]. The World Health Organization (WHO) warned that the spread of coronavirus would have a negative impact on mental and psychological stability especially among vulnerable groups such as older adults [6]. ...
Article
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Objectives: Mental health is the cornerstone of public health, particularly for older adults. There is a clear need to examine the impact of COVID-19 on mental health among older adults in South Korea, where the incidence of COVID-19 was relatively low and widespread transmission was controlled without a national lockdown. Methods: This analysis included a total of 1917 participants from the Experience Survey on Healthcare Use of Older Adults, which was conducted for adults aged 65 years or older by face-to-face interview. Results: The results showed that older adults with a good understanding of COVID-19 public health measures were less likely to experience mental health problems. In contrast, those with a greater risk perception of contracting COVID-19 had higher odds of experiencing tension and anxiety in addition to sadness and depression. Older adults who had a greater fear of COVID-19 and perceived higher-risk of contracting COVID-19 experienced more sleep problems. Conclusion: The findings provide new evidence on the factors that influence the mental health of older adults in South Korea during the pandemic and suggest the development of policy interventions.
... Psychological distress, namely depression and anxiety, is often present in socially distant older adults, and massively increased during the quarantine. There is also increasing evidence for the risk of suicide among this population, which is often underestimated among clinicians 3,4 . Partial or complete lockdowns have imposed reduced healthcare access, leading to a systematic problem in gathering daily medications and attending to medical consultations. ...
Article
Older adults faced unique challenges in the pandemic due to their increased vulnerability to coronavirus disease 2019 (COVID-19) and its complications. Pandemic-related restrictions such as physical distancing, stay-at-home orders, lock-down, and mandatory face cover affected older adults in unique ways. Additionally, older adults experienced psychosocial concerns related to discrimination based on ageism and emotional distress from exposure to conflicting messages in the media. They experienced several forms of loss and associated grief and survivor guilt. Pandemic added to their loneliness and social isolation. Furthermore, older adults experienced the fear and anxiety related to COVID and the fear of contracting the disease and dying from it. Pandemic experience included events potential to generate the desire and capability for suicide. Several studies report varying symptoms such as loneliness, anxiety, and depression among older adults during the pandemic. However, during the initial months of the pandemic, there were reports on coping and resilience among this population. The impact of COVID-19 on older adults' mental health may have long-term implications. This narrative review examines the impact of COVID-19 on older adults' mental health and psychosocial wellbeing. Additionally, the review highlights various factors that affected their psychosocial wellbeing during the COVID-19 pandemic.
Article
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COVID-19 has forced lockdowns and social distancing across the world. This has increased feelings of loneliness and reduced opportunities for physical exercise and environmental stimulation for the elderly. It was feared that all this would cause poor mental health in the elderly. However, well-designed studies reported that medically fit elderly and those without psychiatric comorbidities coped well with the pandemic. Cognitive flexibility, ability to regulate emotions and healthy lifestyle helped the elderly cope with this challenging situation. This article discusses the resilience measures used by the elderly to cope with the pandemic and make recommendations for use by the general population during the unprecedented situation caused by the COVID-19 pandemic.
Article
Abstract Background: Coronavirus disease 2019 (Covid-19) has led to more than 111,973,202 confirmed cases, and more than 2,478,409 deaths worldwide. Mortality rates are significantly higher in the elderly than in others during the epidemic of COVID-19; age is significant vulnerabilities to COVID-19. Analysis of clinical features according to the latest published data allows better understanding and better clinical judgment. Methods: In this review study, using the keywords, COVID-19, severe acute respiratory syndrome coronavirus (SARS-CoV-2), coronavirus, viral and elderly pneumonia, pandemic, epidemic, quarantine, mental health, and social isolation in articles indexed in Embase, Proquest, Pub med, Google Scholar, Science direct, Scopus, Medline, Cochrane databases from December 2019 to February 2020, were searched. Findings: The elderly of more than 65-year-old are classified in high-risk groups, are more vulnerable than other age groups, and require more attention. Social isolation, social distance, and lockdown has raised concerns about their mental health to prevent the spread of COVID-19. Conclusion: Due to the increasing population of the elderly, such biological disasters, if do not take care of and pay enough attention to the various dimensions and problems caused by its consequences, would affect acute and long-term consequences on community health and general health of the elderly. Keywords: COVID-19; Elderly; Mental health; Social isolation; Quarantine; Pandemics
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Psychological Effects Of Covid-19 In Individuals Wıth Diabetes The epidemic of novel coronavirus disease 2019 (Covid-19) has become a stressful situation in which sick and healthy individuals have to adapt to some changes. Individuals with chronic illness who are also susceptible to Covid-19 experience more stress because they are at higher risk for poor health outcomes. Individuals diagnosed with diabetes mellitus (DM) with chronic health problems are at high risk for adverse mental health consequences of home quarantines and social distancing. Interaction of Covid-19, diabetes and mental health issues; has created a complex situation for individuals with diabetes, which leads to difficulties in adapting to the psychological situation. In this direction; The psychological effects of Covid-19 on individuals with diabetes are mentioned in this review.
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Bu çalışma, Tübitak Sobag tarafından desteklenen 120k613 proje kodlu saha araştırmasının bulgularını içermektedir. Araştırmanın amacı yaşlıların (65 yaş ve üstü) Covid-19 salgını döneminde salgın öncesi ve sırasında enformasyon arama edimlerini saptamak ve bu enformasyonu nasıl değerlendirdiklerini ortaya koymaktır. Araştırmada, salgın öncesinde ve sürecinde yaşlıların nasıl bir medya repertuvarları olduğu, enformasyona hangi kaynaklardan ulaştıkları, elde edilen enformasyona ne düzeyde güven duydukları, dijital sermaye durumları tespit edilmiştir. Bunun için, 10 Temmuz ile 27 Ağustos 2020 tarihleri arasında, 12 istatistiki bölgeyi temsil eden Antalya, Ankara, Bursa, Çanakkale, Diyarbakır, Erzurum, İstanbul, İzmir, Kayseri, Samsun, Trabzon ve Van illerinde ikamet eden Türkiye’nin 65 yaş ve üstü nüfusu temsil eden (n=1075) örneklem grubundan, telefon ve yüz yüze görüşme tekniği kullanılarak veri toplanmıştır. Anket aracılığıyla, katılımcıların sosyo-demografik özellikleri, iletişim araçları sahipliği, medya repertuvarları, salgına ilişkin bilgi düzeyleri, Covid-19 öncesi ve sürecinde haber/enformasyon alma tercih ve pratikleri, enformasyon eksiklikleri, Covid-19 öncesi ve sürecinde çeşitli enformasyon kaynaklarına ve araçlarına güven düzeylerine ilişkin veri toplanmıştır. İlişkisel sosyolojik bakış açısıyla araştırmanın katılımcıların toplumsal cinsiyeti, yaşı, toplumsal sınıfı kesişiminde salgın öncesi ve sonrası medya repertuvarları, salgına ilişkin elde edilen enformasyonel içeriğe güven ile dijital sermaye durumu (sahiplik ve yetkinlik) hakkında durumları tespit edilmiştir. Anahtar Sözcükler 65 yaş ve üstü yaşlılar, Covid-19 pandemisi, medya repertuvarı, dijital sermaye, enformasyon arama, enformasyona güven, teyit, enformasyondan şüphe duyma, bağlantıda kalma, parasosyal etkileşim
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Deployment of Smart Home Technologies (SHTs) in the coming decade for geriatric rehabilitation services will cause a paradigm shift. This chapter critically reviews the practical utility of SHTs from a clinician’s perspective, giving an overview of use of SHTs in geriatric rehabilitation. Achieving technical success is not the same as demonstrating a clinical difference in healthcare outcomes. Technology acceptance from the beneficiary’s perspective is essential. Evidence based, thorough, and systematic evaluation is required. Like other disruptive technologies, the potential of SHT to cause a great impact should not be underestimated. SHT connotes excitement often accompanied with hype and unbelievable expectations. Limitations, disadvantages, and the necessity to ensure that SHT is a tool and not an end by itself will be highlighted. This communication will peep into the future and discuss the use of artificial intelligence–enabled chatbots and robots.
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Background: Growing research indicates complex relationships among dimensions of depression and anxiety. Vulnerability to depression and anxiety in emerging adults, due to individual difference factors, may be intensified by disruptions associated with the COVID-19 pandemic. Methods: Undergraduates ( n=653, mean age=19.8, range 18–23) completed questionnaires that assessed distinct dimensions of depression (motivational anhedonia: MA, low positive affect: LPA), anxiety (anxious apprehension, anxious arousal), and rumination as well as factors associated with risk in this population (age, trauma exposure, approach-avoidance temperament). One portion of the sample completed questionnaires before and the other after the onset of COVID restrictions. Results: Post-onset participants reported higher MA and, for older students, higher repetitive negative thinking. Other relationships emerged between specific dimensions and individual differences. Conclusions: Distinguishing specific dimensions of internalizing symptoms in the context of new pandemic restrictions provided insight into risk and protective factors that may contribute to internalizing symptom vulnerability.
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Background: Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods: We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results: The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions: During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.).
Article
Objective To investigate the characteristics and prognostic factors in the elderly patients with COVID-19. Methods Consecutive cases over 60 years old with COVID-19 in Renmin Hospital of Wuhan University from Jan 1 to Feb 6, 2020 were included. The primary outcomes were death and survival till March 5. Data of demographics, clinical features, comorbidities, laboratory tests and complications were collected and compared for different outcomes. Cox regression was performed for prognostic factors. Results 339 patients with COVID-19 (aged 71±8 years,173 females (51%)) were enrolled, including 80 (23.6%) critical, 159 severe (46.9%) and 100 moderate (29.5%) cases. Common comorbidities were hypertension (40.8%), diabetes (16.0%) and cardiovascular disease (15.7%). Common symptoms included fever (92.0%), cough (53.0%), dyspnea (40.8%) and fatigue (39.9%). Lymphocytopenia was a common laboratory finding (63.2%). Common complications included bacterial infection (42.8%), liver enzyme abnormalities (28.7%) and acute respiratory distress syndrome (21.0%). Till Mar 5, 2020, 91 cases were discharged (26.8%), 183 cases stayed in hospital (54.0%) and 65 cases (19.2%) were dead. Shorter length of stay was found for the dead compared with the survivors (5 (3-8) vs. 28 (26-29), P < 0.001). Symptoms of dyspnea (HR 2.35, P = 0.001), comorbidities including cardiovascular disease (HR 1.86, P = 0.031) and chronic obstructive pulmonary disease (HR 2.24, P = 0.023), and acute respiratory distress syndrome (HR 29.33, P < 0.001) were strong predictors of death. And a high level of lymphocytes was predictive of better outcome (OR = 0.10, P < 0.001). Conclusions High proportion of severe to critical cases and high fatality rate were observed in the elderly COVID-19 patients. Rapid disease progress was noted in the dead with a median survival time of 5 days after admission. Dyspnea, lymphocytopenia, comorbidities including cardiovascular disease and chronic obstructive pulmonary disease, and acute respiratory distress syndrome were predictive of poor outcome. Close monitoring and timely treatment should be performed for the elderly patients at high risk.