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Purpose To identify possible technological solutions that can contribute to stroke patients' participation at home. Methods In this qualitative case study, data on factors that negatively influenced participation at home were collected via semi-structured interviews with stroke patients (n = 6). Additionally, data on possible technologies to improve this participation were collected via a group interview with experts (n = 4). The domains "cognition, mobility, self-care, and getting along" (International Classification of Functioning, Disability and Health) guided the data collection and interpretation; open, axial and selective coding was part of the analysis. Results Patients reported 21 factors negatively influencing participation at home, including psychological, cognitive, and physical factors. Experts suggested technological solutions regarding these factors to increase participation of stroke patients; digital assistants, apps, and virtual reality were frequently mentioned. To facilitate the use of these technologies, experts indicated the importance of involving patients in their design. They also suggested that rehabilitation specialists and family members could support the uptake and use of technologies. Conclusions Various technologies were identified by experts as having the potential to improve the participation of stroke patients in their homes. Future research may study the influence of these technologies on the actual participation of stroke patients at home.Implications for rehabilitationThe identified technological solutions can support rehabilitation specialists in guiding stroke patients towards technologies that can support a patient's participation at home.Rehabilitation specialists can be champions in introducing, recommending and promoting technologies to stroke patients and their families, as well as in training them to use technologies.Virtual reality as a technology can be part of rehabilitation, not only to train stroke patients in daily life activities but also to increase empathy and understanding in caregivers and carers on stroke impairments.Rehabilitation specialists can recommend technologies integrated in daily life and presented as general consumer goods; stroke patients are more likely to adopt these kind of technologies.

The majority of pediatric burns in Mongolia occur within the home, particularly in the spaces dedicated to cooking. This makes home environment modification a priority for injury prevention. Many of these injuries are caused by electric appliances used in traditional tent-like dwellings (called a ger). In the present study, we designed and provided a context appropriate kitchen rack to 50 households with children aged 0-3 years living in gers and investigated parental views on the acceptability of the rack and willingness-to-pay (WTP) through face-to-face structured individual and group interviews and the contingent valuation method. We used the DCchoice package of R to estimate the median WTP and its 95% confidence interval by the household income, previous experience of childhood burn injury, and the number of children in the household. There was a total of 89 children aged

Patients with lung cancer are especially vulnerable to coronavirus disease 2019 (COVID-19) with a greater than sevenfold higher rate of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19, a greater than threefold higher hospitalization rate with high complication rates, and an estimated case fatality rate of more than 30%. The reasons for the increased vulnerability are not known. In addition, beyond the direct impact of the pandemic on morbidity and mortality among patients with lung cancer, COVID-19, with its disruption of patient care, has also resulted in substantial impact on lung cancer screening and treatment/management.COVID-19 vaccines are safe and effective in people with lung cancer. On the basis of the available data, patients with lung cancer should continue their course of cancer treatment and get vaccinated against the SARS-CoV-2 virus. For unknown reasons, some patients with lung cancer mount poor antibody responses to vaccination. Thus, boosting vaccination seems urgently indicated in this subgroup of vulnerable patients with lung cancer. Nevertheless, many unanswered questions regarding vaccination in this population remain, including the magnitude, quality, and duration of antibody response and the role of innate and acquired cellular immunities for clinical protection. Additional important knowledge gaps also remain, including the following: how can we best protect patients with lung cancer from developing COVID-19, including managing care in patient with lung cancer and the home environment of patients with lung cancer; are there clinical/treatment demographics and tumor molecular demographics that affect severity of COVID-19 disease in patients with lung cancer; does anticancer treatment affect antibody production and protection; does SARS-CoV-2 infection affect the development/progression of lung cancer; and are special measures and vaccine strategies needed for patients with lung cancer as viral variants of concern emerge.

Although the association between sleep problems and suicidal behaviors were found in many studies, their associations are not built until now. One of the reasons may be the identified differences among different suicide behaviors, which also implied that sleep quality may play different roles on these suicidal behaviors. However, absent study explores the possible distinguishing associations between sleep quality and different suicidal behaviors.This is a population-based study conducted in Hebei province, China. Totally, 21,376 valid questionnaires were analyzed in this study. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Suicidal behaviors, living alone, and social-demographic variables were assessed for all the participants.The prevalence of suicidal ideation, plan, and attempt were 1.4%, 0.3%, and 0.2%, respectively. The PSQI scores were separately associated with suicidal ideation (OR=1.25, p0.001), plan (OR=1.19, p0.001), and attempt (OR=1.18, p0.001). The similar results were also supported when we compared conditional suicidal behaviors with general population without any suicidal behaviors. However, when we compared suicide attempters with suicidal ideators (with or without suicide plan), the associations between PSQI scores and suicide attempt were not supported (OR=1.93, P0.05 or OR=1.02, p0.05).The cross-sectional design made us cannot get any causal relationships. The self-reported sleep quality may also produce some influence on the results.The results imply us that improving sleep quality may be not effective to control further suicidal behaviors, when people have considered or planned to suicide. The findings also can be translated into the clinical and preventive practice for suicide control.

Background Research has demonstrated dietary quality benefits of family meals and meals prepared at home. Less is known about associations between the proportion of family evening meals made at home and key personal, behavioral, and environmental characteristics. Moreover, most studies often measure these data retrospectively. Objective The objective of this study is to describe the proportion of evening meals made at home measured in real time and to assess associations between personal, behavioral, and environmental characteristics that are associated with a higher proportion of evening meals prepared and consumed at home. Design This study is a cross-sectional secondary analysis of baseline data collected during 2017 and 2018 from the New Ulm at Home study, a randomized controlled trial conducted in rural Minnesota to evaluate the effectiveness of a childhood obesity prevention program for school-aged children. Participants/setting The present study analyzes a subset of the New Ulm at Home trial data from families (N = 108) who completed at least four evening meal screeners collected in real time with ecological momentary assessment technology over a 2-week period. Main outcome measure The main outcome measure was the proportion of family evening meals made at home, calculated using two cutpoints (≤50% of evening meals prepared at home vs >50%; ≤70% vs >70%). Statistical analysis Descriptive statistics were used to describe the proportion of evening meals prepared at home. Logistic regression analyses adjusted for parent education were used to assess associations between family characteristics and the two different proportions of meals made at home. Results Most family evening meals were prepared and eaten at home (62%). Logistic regression models indicated meal planning skills (odds ratio=1.19, 95% CI 1.01 to 1.39) and mealtime routines (odds ratio=1.20, 95% CI 1.03 to 1.40) were significantly associated with odds of preparing more than 50% of evening meals at home. Only meal planning skills (odds ratio=1.27, 95% CI 1.06 to 1.51) was significantly associated with odds of preparing more than 70% of evening meals at home. Conclusions Study findings indicated mealtime routines and meal planning skills were associated with preparing more than 50% of evening meals at home, but only meal planning skills were associated with preparing more than 70% of evening meals at home, which may suggest the importance of adapting interventions for families. Future research should build on these findings in randomized controlled trials.

Home environmental conditions can affect the prevalence of childhood asthma and allergies.To assess the relationship between the prevalence of childhood asthma, bronchitis, and allergies and the condition of the home environment.In 2018 and 2019, a cross-sectional study on 2932 children from elementary schools in the Silesian Voivodship (Southern Poland) was conducted. The questionnaire was based on the International Study of Asthma and Allergies in Childhood (ISAAC). In order to determine the association between the home environment (presence of moulds, furry pets) and respiratory symptoms and diseases, a logistic regression analysis was performed by calculating the odds ratio (OR), determiningAsthma risk factors were male sex, heating with solid fuel and presence of moulds. The prevalence of respiratory symptoms, bronchitis, and allergic diseases is statistically more common with the presence of moulds in dwellings. A protective effect of the presence of pets on the prevalence of asthma (OR = 0.77; 95% CI: 0.59-0.99), allergy to pet allergens (OR = 0.59; 95% CI: 0.45-0.76), allergy to house dust mite (OR = 0.70; 95% CI: 0.56-0.87) and wheeze in the last 12 months (OR = 0.70; 95% CI: 0.54-0.91) and ever (OR = 0.85; 95% CI: 0.70-1.02) was observed.The study confirmed the known adverse influence of the presence of moulds and heating with solid fuel on the prevalence of asthma, bronchitis, respiratory symptoms and allergic diseases. The protective influence of pets on the occurrence of the health disorders under study was demonstrated.

Background: The initial aim was to study the effects of face masks worn by recently infected individuals on the airborne spread of SARS-CoV-2, but findings motivated us to proceed with comparing the presence of SARS-CoV-2 in air samples near infected individuals at home with those near infected intensive care unit (ICU) patients. Aim: To assess the presence of SARS-CoV-2 in the air of homes of infected individuals and in ICU rooms of critically ill patients with COVID-19 who were undergoing different forms of potential aerosol-generating medical procedures. Methods: A high-volume air sampler method was developed that used a household vacuum cleaner with surgical face masks serving as sample filters. SARS-CoV-2 RNA was harvested from these filters and analysed by polymerase chain reaction. Fog experiments were performed to visualize the airflow around the air sampler. Air samples were acquired in close proximity of infected individuals, with or without wearing face masks, in their homes. Environmental air samples remote from these infected individuals were also obtained, plus samples near patients in the ICU undergoing potential aerosol-generating medical procedures. Findings: Wearing a face mask resulted in a delayed and reduced flow of the fog into the air sampler. Face masks worn by infected individuals were found to contain SARS-CoV-2 RNA in 71% of cases. SARS-CoV-2 was detected in air samples regardless of mask experiments. The proportion of positive air samples was higher in the homes (29/41; 70.7%) than in the ICU (4/17; 23.5%) (P < 0.01). Conclusion: SARS-CoV-2 RNA could be detected in air samples by using a vacuum cleaner based air sampler method. Air samples in the home environment of recently infected individuals contained SARS-CoV-2 RNA nearly three times more frequently by comparison with those obtained in ICU rooms during potential aerosol-generating medical procedures.

Background Although it has been suggested that loneliness is a risk factor for adverse health outcomes, living arrangement may confound the association. This study aimed to investigate whether the associations of loneliness with adverse health outcomes differ in community-dwelling older adults according to different living arrangements. Methods In the 2008/2009 wave of Chinese Longitudinal Healthy Longevity Survey, 13,738 community-dwelling older adults (≥65 years) were included for analyses. Living arrangements and loneliness were assessed. Health outcomes including cognitive and physical functions were assessed using MMSE, ADL/IADL scales and Frailty Index in the 2008/2009 and 2011/2012 waves; mortality was assessed in the 3-year follow-up from 2008/2009 to 2011/2012. The effect modificaitons of loneliness on adverse health outcomes by living arrangements were estimated using logistic regression or Cox proportional hazards regression models. Results Living alone older adults were significantly more likely to be lonely at baseline (52% vs 29.5%, OR = 1.90, 95% CI = 1.67–2.16, P P P P = 0.002, respectively). In contrast, among the living alone older adults, loneliness was only significantly associated with higher prevalence of frailty (OR = 1.42, 95% CI = 1.07–1.90, P = 0.017). Living arrangement significantly modified the associations of loneliness with prevalent cognitive impairment and 3-year mortality (P values for interaction = 0.005 and 0.026, respectively). Conclusions Living arrangement modifies the associations of loneliness with adverse health outcomes in community-dwelling older adults, and those who lived with others but felt lonely had worse cognitive and physical functions as well as higher mortality. Special attention should be paid to this population and more social services should be developed to reduce adverse health outcomes, in order to improve their quality of life and promote successful aging.

Summary Context The administration of immune checkpoints inhibitors (ICIs) within hospitalization at home (HaH) organizations is an interesting alternative to conventional care. Three surveys were carried out to describe the different organizational models of French HaHs and criteria used by physicians in patient selection. Methods Three surveys were conducted between April 1 and August 31, 2020. The first one was addressed to all French HaHs, and the two others to public HaHs and oncologists treating patients with solid cancer in the Auvergne-Rhone-Alpes region. Results Overall, 54 French HaHs and 23 oncologists participated to the study. The health professionals involved in the patients’ care were very heterogeneous, although in 92% of cases, the treatment prescription was made by the oncologist. HaH physicians were more involved in clinical assessment the day before treatment (19% vs. 0%), treatment validation (56% vs. 15%), and treatment prescription (19% vs. 0%), while nurses were better equipped (emergency kit available in 81% versus 50% of cases) when HaHs did carry out ICIs compared to when they did not. Most oncologists agreed that age, neuropsychiatric disorders, home environment, as well as treatment duration and good tolerance should be considered in patient selection. ECOG PS status and treatment response were less consensually considered. Conclusion These results highlight the variability in French HaH organizations and patient selection criteria for employing ICIs at home. This study resulted in recommendations for administrating ICIs in HaH settings, which will likely be instrumental in further promoting this activity across France.

The bedside encounter between a patient and physician remains the cornerstone of the practice of medicine. However, physicians and trainees spend less time in direct contact with patients and families in the modern health care system. The current pandemic has further threatened time spent with patients. This lack of time has led to a decline in clinical skills and a decrease in the number of faculty members who are confident in teaching at the bedside. We offer several strategies to get physicians and trainees back to the bedside to engage in clinical skills teaching and assessment. We recommend that providers pause before bedside encounters to be present with patients and learners and to develop clear goals for a bedside teaching session. We suggest that clinical teachers practice an evidence-based approach, which includes an hypothesis-driven physical examination. We encourage the use of point-of-care technology to assist in diagnosis and to allow learners to calibrate traditional physical examination skills with real-time visualization of disease. Tools like point-of-care ultrasound scans can be powerful levers to get learners excited about bedside teaching and to engage patients in their clinical care. We value telemedicine visits as unique opportunities to engage with patients in their home environment and to participate in patient-directed physical examination maneuvers. Finally, we recommend that educators provide feedback to learners on specific clinical examination skills, whether in the clinic, the wards, or during dedicated clinical skills assessments.

Objectives The growth of solo living has important implications for the rising “loneliness epidemic” among older adults. This study considered whether 2 forms of social connectedness—extra-household core discussion networks and social participation—buffer the loneliness associated with living alone. Method Our study used data from 2 surveys (National Social Life, Health, and Aging Project; Survey of Health, Ageing and Retirement in Europe) encompassing 20 developed Western countries in 2009/2010 and 2015/2016 (n = 110,817). Harmonizing measures across data sets, we estimated survey-specific and pooled longitudinal regression models with interaction terms. Results High levels of social connectedness only moderately buffered the loneliness associated with living alone in later life. Findings were largely consistent across regions of Europe and the United States, though the buffering patterns were most robustly identified for widowed solo dwellers. Discussion Extra-household connections are partial compensators, but do not seem to fully replace the ready companionship afforded by residential copresence in later life. Future research is needed to understand whether the efficacy of compensatory connections differs by gender, race/ethnicity, and across more diverse global regions.

Purpose This study aims at determining the risk of physical inactivity and sedentary behaviors on overweight and obesity among primary school children aged 10–13 years in Tanzania. Design/methodology/approach A case-control study was conducted from January to March 2020 involving 69 overweight/obese children as cases and 138 normal weight children as controls. Cases were identified as having body mass index-for-age ≥ +1 standard deviation (SD) and controls as those having BMI-for-age range between −2 SD to t-test was used to compare means of activity score between cases and controls. Binary logistic regression was used to predict risk factors for overweight/obesity. Findings Risk factors for overweight/obesity were listening to music and/or radio for >2 h/week (OR 2.7, 95% CI 1.2–6.1) and walking for exercise 2 h/week (OR 0.14, 95% CI 0.03–0.7) was a protective factor against overweight/obesity. Controls had a significantly higher mean score of being active during lunch breaks compared to cases (p = 0.012). Cases had higher weight, height and percentage body fat than controls (p < 0.001). The home environment provided more avenues for physical activity than the school environment. Originality/value To the best of the authors’ knowledge, this is original research work and the first case-control study to predict physical activity and sedentary behaviors as risk factors for overweight and obesity in Tanzanian school children.

BACKGROUND Phantom boarder symptom (PBS) is classified as a delusional misidentification syndrome, and is often encountered in elderly individuals who have mild or major neurocognitive disorders. With the ageing of society, patients presenting with PBS are increasing in Japan. This retrospective study was conducted to examine the aetiology and identify significant predictors of PBS. METHODS The records of 511 consecutive patients who visited our hospital with suspicion of dementia between September 2013 and September 2019 were retrospectively examined. From those, 16 patients who presented with PBS (1 male, 15 females; mean age 79.9 ± 4 years) were selected and case features were investigated in detail. Clinical symptoms, background factors, and final diagnoses were noted. PBS was most common in patients affected by dementia with Lewy bodies (DLB). Predictive factors were evaluated using multiple logistic regression analysis. RESULTS The final diagnosis of the 16 subjects was DLB in 7, Alzheimer's disease in 3, delusional disorder in 3, unspecified dementia in 2, and vascular dementia in 1. Analysis limited to DLB cases showed that a low Mini-Mental State Examination (MMSE) score and living alone were related to higher risk for PBS. CONCLUSION Various types of dementia, especially DLB, as well as cognitive impairment and living alone were found to be strong predictors of PBS.

The joint treatment of mentally ill children and their parents represents a special treatment concept in child and adolescent psychiatry. A study conducted by the Working Group (BAG) "Early Childhood" shows the current situation of care and possible models of child and adolescent psychiatric parent-child treatment in Germany. Using the parent-child ward of the Child and Adolescent Psychiatry Department in Magdeburg as an example, the combined treatment of mentally ill children and their parents is presented. The treatment approach consists of a three-week diagnostic phase, after which families are discharged again to their home environment followed by a five-week therapy block, for which the families have to be readmitted to the ward. With a focus on the parent-child relationship, the treatment concept - in contrast to regular child psychiatric treatments - is dynamically adapted to the quality of the parent-child interaction and not primarily related to the disorder of the children. First studies indicate the effectiveness of the special treatment setting and illustrate the efficiency of a joint treatment of parents and child, which, however, is associated with increased economic costs. Based on these results, the chances and limitations of parent-child wards are discussed and conclusions for parent-child treatment are drawn.

INTRODUCTION Biopsychosocial approaches to health care are critical to addressing childhood obesity. This study aimed to examine how multiple indicators of the home environment related to child weight-related outcomes. We hypothesized that families with home environments of higher chaos and stress, and lower quality parent-child interactions, would have children with a higher body mass index (BMI), less healthy dietary intake, and less healthy eating behaviors. METHODS Data were drawn from the cross-sectional Phase I of the Family Matters study. Participants were 150 racially/ethnically diverse families with a child between 5 to 7 (mean, 6.4) years old. We used a latent profile analysis approach. A 4-class solution fit the data well, and we used predicted class posterior probabilities to assign families to classes. We then regressed the results onto the distal outcomes of child BMI, healthy dietary intake, and healthy eating behaviors. RESULTS Families were classified as Collaborative-Chill (n = 38), Busy Bees (n = 37), Engaged (n = 61), and Inconsistent-Distant (n = 14). Collaborative-Chill was used as the reference class. Inconsistent-Distant families had children with higher BMI (P < .001) that were more food responsive (P < .001). Busy Bees families had children who were more food responsive (P = .04) and more satiety responsive (P = .02). Engaged families had children who were marginally more food responsive (P = .06). CONCLUSION Household chaos, parent stress, and parent-child interactions are important components of the home environment implicated in children's weight-related outcomes. Health care providers should consider these indicators with child patients who struggle with obesity.

Increasing evidences supported that subjective cognitive decline (SCD) might be a potential first symptomatic manifestation of Alzheimer’s disease (AD). The rapidly growing number of SCD individuals who seek medical help and advice also makes it urgent to develop more precise strategy for SCD. Therefore, this study aimed to explore the risk factors for SCD. Logistics and linear regression models were performed to investigate 41 factors for SCD in 1165 participants without objective cognitive impairment. Cochran-Armitage trend test was used to confirm the constant trend toward higher prevalence of SCD with an increasing number of risk factors. A high overall prevalence of SCD was found in total participants (42%). Eight factors were eventually identified as risk factors for SCD, including four stable factors associated with both SCD statues and severity (older age, thyroid diseases, minimal anxiety symptoms, and day time dysfunction; odds ratio (OR) ranging from 1.74 to 2.29) as well as four suggestive factors associated with either SCD statues or severity (female sex, anemia, lack of physical exercises, and living alone; OR ranging from 1.30 to 2.29). The prevalence of SCD gradually increased with the number of risk factors clustering increased in individuals (p for trend

Objectives: Previous studies have shown that participation in social activities (SA) can prevent cognitive decline (CD) and that living arrangements (LA) can affect cognitive function. This study aimed to evaluate the effects of SA and LA on CD, as well as their interactions, using longitudinal data.Methods: Data were used from the 2006-2018 Korean Longitudinal Study for Aging, which followed 10 254 adults older than 45 years over a 12-year period. CD was defined as a ≥4-point score decrease in the Mini-Mental Status Exam over 2 years. We developed an extended Cox proportional hazards model for time-dependent covariates to estimate the hazard ratio (HR) of CD in 4 groups: (1) socially active and living with others, (2) socially active and living alone, (3) socially inactive and living with others (SILO), and (4) socially inactive and living alone (SILA). The model was stratified by gender and adjusted for important confounders.Results: The HR of CD was significantly higher in the SILO group in men (HR,1.36; 95% confidence interval [CI], 1.08 to 1.78) and in the SILA group in women (HR, 1.72; 95% CI, 1.08 to 2.75). However, the interaction term for gender was not significant.Conclusions: Among socially inactive elderly adults, the HR of CD was elevated in men who lived with others and in women who lived alone, although the interaction term for gender was not significant. Socially inactive men who live with others and socially inactive women who live alone are particularly encouraged to participate in SA to prevent CD.

Introduction: The total number of pulmonary TB cases in Indonesia in 2019 was 562,049 cases. West Java became the top 3 provinces with the incidence of pulmonary TB in Indonesia. in Depok City there are 4,695 cases of pulmonary TB cases. Irenk Medical Center Clinic serves Pulmonary TB Referral services, with a total of 90 cases in 2019-2020. This study aims to determine whether there is a relationship between the physical condition of the house, air circulation, and history of contact with pulmonary TB patients. The benefits of this research are that it can be used as a reference and consideration in making a program that can solve problems in environmental-based pulmonary TB cases, especially in the city of Depok and information facilities add public insight in making environmental health efforts, especially the home environment. Methods: The research design used was case control, the population of this study was people with pulmonary TB, and the control population was people who did not have pulmonary TB. The sample of this study amounted to 74 respondents, consisting of 37 cases and 37 controls, the instrument used was a questionnaire and the data were analyzed by univariate, bivariate, and multivariate with logistic regression test. The variables studied included the physical condition of the house, air circulation, and history of contact with pulmonary TB patients. Multivariate analysis was performed by logistic regression test Results: There are three variables related to the incidence of pulmonary TB, namely the physical condition of the house, air circulation, and history of contact with patients with pulmonary TB. The physical condition of the house is a risk factor for the incidence of pulmonary TB with an aOR of 11.95 (2.86-50.89; p=0.039). Air circulation has an aOR value of 5.86 (1.09-31.46; p=0.000), history of contact with patients with pulmonary TB has an aOR value of 27.39 (5.42-138.48); p=0.001). Discussion: Health promotion strategies need to be carried out in the form of counseling to control the incidence of pulmonary TB. Especially in the service area of the Irenk Medical Center Clinic, Depok. The counseling is centered on improving physical conditions and air circulation in the house as well as maintaining contact with sufferers

This study aims to investigate the relationship between chronotype preferences/sleep problems and trauma symptoms during the COVID-19 outbreak of adolescents diagnosed with Anxiety Disorder (AD) in the pre-COVID-19 period. The sample of this study consisted of 71 adolescents with AD. Trauma symptoms were evaluated using the Children's Event Impact Scale (CRIES-13); sleep habits were assessed using the Pittsburgh Sleep Quality Index (PSQI); and chronotype was evaluated using the Children's Chronotype Questionnaire (CCQ). The CRIES-13 arousal scores and PSQI sleep latency scores were significantly higher in the eveningness type group compared with the non-eveningness type group. The CRIES-13 arousal scores of adolescents with AD were related to the CCQ and PSQI scores. In linear regression analysis, sleep problems were found to be an associated factor on the CRIES-13 scores. The findings of the present study suggest that during the COVID-19 pandemic, the chronotype may play an important role in the adversities experienced by adolescents with AD. In addition, it was thought that the association between sleep problems and trauma in adolescents with AD who spent a lot of time in the home environment during the pandemic period needs further evaluation.

BACKGROUND: Social distancing measures to prevent the spread of coronavirus disease 2019 may cause changes in psychosocial factors. This study aimed to clarify changes in psychosocial factors among older adults before and after Japan's declaration of a state of emergency over coronavirus disease 2019. METHODS: This was a longitudinal cohort questionnaire study. A baseline survey was conducted in March 2020, and a follow-up survey was conducted in August 2020. The subjects were 1103 community-dwelling older adults not certified as having long-term care needs who responded to both the baseline and follow-up surveys. Changes in psychosocial factors before and after the state of emergency declaration were analysed by gender using the McNemar-Bowker test. RESULTS: Data for 397 men (mean age ± standard deviation: 80.6 ± 4.7 years) and 486 women (80.3 ± 4.3 years) were analysed in this study. The frequency of meeting friends increased over the study period for men (P = 0.04). An increasing number of women lived alone (P = 0.01). However, many people's financial status improved (P < 0.01), and the number of friends met in the previous month increased (P < 0.01). CONCLUSIONS: None of the examined psychosocial factors worsened, except for the increase in the number of women living alone. However, many of the study subjects refrained from engaging in certain activities. If the coronavirus disease 2019 pandemic persists, changes in psychosocial factors may occur. Therefore, a long-term investigation of the secondary psychosocial effects of coronavirus disease 2019 is necessary.

This study aims to analyse the effectiveness of a psychosocial intervention programme in preventing loneliness and increasing self-efficacy and social participation among older women living alone in Spain. A sequential, nested experimental design was used, with a primary quantitative quasi-experimental pre-post study with a control group (CG) and a secondary qualitative study. A total of 48 women participated, and 34 of them (the experimental group, EG) received a 25-hour psychosocial support intervention delivered by volunteers who focused on three aspects: conversation, attribution retraining and behavioural activation. The other women remained on the waiting list (CG = 14). The women (EG and CG) were all interviewed before and after the intervention and a follow-up of the EG was performed at 6 months (N = 25). Semi-structured interviews were used to collect sociodemographic and health-related data, as well as data on satisfaction with the programme and its benefits. Validated instruments were used to collect data on the dependent variables (self-efficacy in ageing, subjective social participation and loneliness). Quantitative and qualitative methods were used for data analysis. Compared to the pre-test results, women in the EG improved their self-efficacy in ageing (t-test: -2.246; p: 0.031; d: 0.30), and, more specifically, their self-efficacy in managing socio-emotional problems such as loneliness (t-test: -1.995; p: 0.054; d: 0.25) and in managing their health (t-test: -2.450; p: 0.020; d: 0.47). No significant differences were observed between the follow-up and the post-test results, meaning that the changes identified after the intervention remained stable. Four additional categories of benefits were identified in the participants' discourses. In conclusion, the intervention appears to be beneficial and effective in improving self-efficacy, which is a well-established predictor of loneliness in old age, in a group of vulnerable individuals. Further studies on this type of community intervention are necessary to prevent loneliness among older people.

Purpose To quantify the association of visual field (VF) damage on physical activity away-from-home, per away-from-home excursion, and at-home. Design Prospective cohort study. Methods Among 229 participants with glaucoma or suspected glaucoma, the severity of VF damage was defined as average sensitivity within the integrated VF (IVF). Participants wore accelerometers and global positioning system trackers for 7 days to measure physical activity and characterize activity location. Multivariable negative binomial regressions were used to test whether away-from-home activity per day, physical activity per away-from-home excursion, and at-home activity per day varied by the severity of VF damage. Results Each 5-dB decrement in IVF sensitivity was associated with a lower number of away-from-home activities per day (18% less moderate and vigorous physical activity [MVPA] minutes/d, 95% confidence interval, 0.69-0.97) and physical activities per away-from-home excursion (20% less MVPA minutes/excursion, 95% confidence interval, 0.65-0.98). Similar findings were noted for other away-from-home activity measures (including active minutes/steps per day, or active minutes/steps per excursion). However, worse IVF sensitivity was not associated with measures of at-home activities (MVPA minutes/d, active minutes/d, and steps/d), time spent at or away from home, or excursions/wk (P > .1 for all). Conclusions Restriction of physical activity in more patients with severe glaucoma results mostly from activity restriction outside the home environment. These findings highlight the importance of maintaining a safe home environment (where activity is less restricted) and increasing confidence to perform activity, particular high-intensity activity, when leaving the home amongst patients with glaucoma.

Objectives: Socioeconomic disadvantages interact with numerous factors which affect geriatric mental health. One of the main factors is the social relations of the elderly. The elderly have different experiences and meanings in their social lives depending on their socio-cultural environment. In this study, we compared the effects of social relations on depression among the elderly according to their living arrangement (living alone or living with others) and residential area.Methods: We defined social relations as “meetings with neighbors” (MN). We then analyzed the impact of MN on depression using data from the Korean Longitudinal Study of Aging Panel with the generalized estimating equation model. We also examined the moderating effect of living alone and performed subgroup analysis by dividing the sample according to which area they lived in.Results: MN was associated with a reduced risk of depressive symptoms among elderlies. The size of the effect was larger in rural areas than in large cities. However, elderly those who lived alone in rural areas had a smaller protective impact of MN on depression, comparing to those who lived with others. The moderating effect of living alone was significant only in rural areas.Conclusions: The social relations among elderlies had a positive effect on their mental health: The more frequent MN were held, the less risk of depressive symptoms occurred. However, the effect may vary depending on their living arrangement and environment. Thus, policies or programs targeting to enhance geriatric mental health should consider different socio-cultural backgrounds among elderlies.

Objectives: to analyze the influence of the quality in the environment on children’s motor development between six to 15 months old attending early childhood education centers. Methods: a cross-sectional and analytical study addressing children’s motor development between six to 15 months old, both sexes, enrolled in nursery (0-12 months) and preschoolers (12-24 months). The Affordances in the Home Environment for Motor Development-Infant Scale and Alberta Infant Motor Scale were used in the Brazilian versions Results: the sample was comprised of 104 children and 30 early childhood education centers: presenting a mean age of 9.15 months, 88% attended full-time and 12% part-time schooling (mornings or afternoons). One center was classified with a low Affordances, 26 were considered Sufficient, and three were Adequate. Of the participating children, 40% presented typical motor development. The higher levels of Affordances suggest better motor development, and lower levels of suspected delayed motor development. Conclusion: the environments of early childhood education centers influence children’s motor performance, especially daily activities and the use of toys. The lower the Affordances level, more likely children are suspected of delayed motor development. Resumo Objetivos: analisar a influência da qualidade do ambiente no desenvolvimento motor de crianças na faixa etária entre seis e 15 meses que frequentam centros de educação infantil. Métodos estudo de delineamento transversal e analítico sobre o desenvolvimento motor de crianças entre seis e 15 meses de idade, de ambos os sexos, matriculadas em turmas de berçário (0-12 meses) e maternal I (12-24 meses), com utilização das escalas validadas Affordances in the Home Environment for Motor Development-Infant Scale e Alberta Infant Motor Scale. Resultados: a amostra de 104 crianças e 30 centros de educação infantil apresentou idade média de 9,15 meses, 88% permanecia em período integral e 12% meio período (manhã ou tarde), um centro foi classificado como Affordance Fraca, 26 Suficiente e três Adequada. Das crianças participantes, 40% apresentaram desenvolvimento motor normal. Os maiores níveis de Affordance indicam melhor desenvolvimento motor e níveis menores de Affordance sinalizam suspeita de atraso motor. Conclusão: o ambiente de centros de educação infantil em que a criança está inserida exerce influência no desempenho motor, principalmente ligado às atividades diárias e uso de brinquedos. Quanto menor o nível de Affordance mais possibilidades de suspeita de atraso motor infantil.

Objective To evaluate the secondary attack rate (SAR) in children and adolescents, contacts of essential activities workers who were infected by SARS‐CoV‐2; and to describe associated clinical and epidemiological data. Methods A cross‐sectional study conducted in children and adolescents aged 5 to 19 years of age, that were household contacts of parents and other relatives who were infected by SARS‐CoV‐2 in the city of Goiânia, Central Brazil, from March to October 2020. Sociodemographic and clinical data were collected from all participants. Nasopharyngeal and oropharyngeal swabs were collected and tested for SARS‐CoV‐2 RNA using real‐time reverse transcription polymerase chain reaction (RT‐PCR). Factors associated with SARS‐CoV‐2 infection and SAR were analyzed using Poisson regression. Results A total of 267 children and adolescents were investigated. The prevalence of SARS‐CoV‐2 RNA by the real‐time RT‐PCR test and/or the presence of COVID‐19 associated symptoms (anosmia/ageusia and flu syndrome) was 25.1% (95.0% Confidence Interval [95.0% CI] = 20.3‐30.6). More than half (55.1%) of the participants had sygns and symptoms. The most prevalent signs and symptoms in positive individuals were nasal congestion (62.7%), headache (55.2%), cough (50.8%), myalgia (47.8%), runny nose (47.8%), and anosmia (47.8%). The Poisson model showed that the following signs or symptoms were associated with SARS‐CoV‐2 infection: fever, nasal congestion, decreased appetite, nausea, anosmia, and ageusia. Families that had more than one infected adult, in addition to the index case, presented greater transmissibility to children and adolescents. Conclusions Our results contribute to the hypothesis that children and adolescents are not important sources of transmission of SARS‐CoV‐2 in the home environment during a period of social distancing and school closure; even though they are susceptible to infection in the household (around ¼ of our study population).

Purpose To measure the effects of the NIC intervention fall prevention on the magnitude of the NANDA-I Risk for falls' risk factors and of NOC indicators related to falls in older adults with arterial hypertension. Background Nurses can use nursing taxonomies to provide effective care in preventing falls in specific populations. Methods Clinical, randomized, open, parallel, and multicenter trial following the CONSORT recommendations for nonpharmacological trials. The clinical trial was registered. The research was conducted with 118 older adults allocated to intervention and control groups and matched by sex and age. The intervention was conducted in the participants' homes in three different moments and consisted of nursing activities belonging to the NIC Fall prevention and implemented with the aid of a protocol with operational definitions. Findings Three months after the intervention, there was a significant intergroup difference in the frequency of Risk for falls and of the following factors/conditions: cluttered environment, unfamiliar setting, exposure to unsafe weather-related condition, insufficient anti-slip material in the bathroom, history of falls, acute illness, orthostatic hypotension, hearing impairment, and impaired vision. There was also a positive change in the magnitude of the following NOC indicators: risk control, cognitive orientation, knowledge: fall prevention, safe home environment, comfort level, vision compensation behavior, and leisure participation. Conclusions The NIC intervention Fall prevention was effective in modifying risk factors belonging to Risk for falls and NOC indicators related to falls in older adults. Implications for nursing practice The tested intervention is important and should be instituted, mainly by nurses from primary care services who make home visits to older adults.

Objective: There are few studies on fractional exhaled nitric oxide (FeNO) among children in subtropical areas. We studied associations between FeNO and respiratory symptoms, reported diagnosed allergies and indoor and outdoor environmental factors in first grade junior high school students (N = 270) in upper northern Thailand. Methods: Data on demographics, health and home environment were collected by a questionnaire distributed in dry season (February-March 2018). FeNO was measured when the research team visited the school. Daily outdoor pollution data (PM10 and ozone) were collected from the nearest monitoring station 3 days (lag 3) and 7 days (lag 7) before the FeNO measurements. Two-level (student, school) linear mixed models were used to analyze associations, adjusting for gender and family education level. Results: In total, 29.6% had elevated FeNO level (>20 ppb) and 7.8% reported any allergy diagnosed by a doctor. Male gender (p = 0.02), diagnosed allergy (p = 0.001), especially to cat (p = 0.001) and house dust mite (HDM) allergies (p = 0.001) were associated with FeNO. Eye symptoms (p = 0.01), rhinitis symptoms (p = 0.03) and dyspnea (p = 0.05) in the last 3 days were associated with FeNO. Household indoor mold (p = 0.03), gas cooking (p = 0.03) and PM10 (lag 3 and lag 7) were negatively (protective) associated with FeNO. Conclusions: Diagnosed allergy, especially to cat and HDM, can be associated with increased FeNO. Indoor mold and gas cooking can be associated with lower FeNO. Ocular, nasal and dyspnea symptoms reported by students in dry season in northern Thailand can be associated with FeNO, a biomarker of Th2 driven airway inflammation.

The aim of the present study was to characterize sedentary time (ST) and sedentary bouts among young children, across a typical week and by day type (childcare days, non-childcare days and weekends), over a 12-month period. ST % (ST/accelerometer wear time*100) and number of sedentary bouts/hours were assessed using accelerometers at two time-points 12-months apart in 153 toddlers and 74 pre-schoolers. Differences between baseline and follow-up according to the whole week and the different day types were calculated using linear mixed models with adjustment for age, sex, socio-economic status and zBMI. During the weekend, toddlers had more 20–30 min/h sedentary bouts at follow-up than at baseline (MD: 0.03). In pre-schoolers, ST % (MD:-8.4), the number of 1–4 min/h (MD:-1.45), 5–9 min/h (MD: −0.46) and 10–19 min/h sedentary bouts (MD:-0.11) were lower at baseline, compared to follow-up, on non-childcare days; as were the number of 5–9 min/h sedentary bouts on weekends (MD:0.40). P

Objective The aim of this study was to investigate the association between a change in household support during the Covid-19 pandemic and surgeon stress. Background The hours and unpredictability of surgical practice often necessitate the employment of household extenders (eg, child caregivers) to maintain a safe home environment for surgeons and their families. The Covid-19 pandemic destabilized these relationships and provided an opportunity to reflect on the role that household extenders play in a surgical household. Methods A multi-institutional telephone survey of surgeons practicing at five geographically diverse academic institutions was conducted (May 15, 2020-June 5, 2020). Surgeons were classified by change in household extenders (HE) during the pandemic (decrease, increase, no change, or none). The primary outcome was self-reported surgeon stress level. Multivariable linear regression was used to examine the relationship between change in HE and surgeon stress, adjusting for training and relationship status, the presence of pets and children in the household, and study site. Results The majority (182, 54.3%) of surgeons employed HE before the pandemic; 121 (36.1%) reported a decrease in HE during the pandemic, 9 (2.7%) reported an increase, and 52 (15.5%) reported no change. Stress scores varied significantly by change in HE group (P = 0.016). After controlling for potential confounders, having an increase in HE was associated with a higher stress score (+1.55 points) than having no decrease in HE (P = 0.033), and having a decrease in HE was associated with a higher stress score (+0.96 points) than having no decrease (P = 0.004). Conclusions Household extenders play a vital and complex role in enabling the healthcare workforce to care of the population. Surgeons who experienced a change in household extenders reported the highest stress levels. We suggest that health systems should proactively support surgeons by supporting the household extender workforce.

Dental trauma is a highly prevalent problem worldwide. The aim of this study was to describe characteristics of trauma to anterior primary teeth and its sequelae for primary and successor teeth over a 10-year period of assistance at the paediatric dental traumatology clinic in the State University of Rio de Janeiro, Brazil. The data were obtained from the dental records of children assisted from 2006 to 2016. Inclusion criteria were trauma to anterior primary teeth; aged

Leptospirosis is a zoonotic disease in sub-tropical and tropical climates, could develop into epidemics in both rural and urban areas. Leptospirosis usually occurs after the patient comes into after contact with flood. In the last 5 years the case of disease has increased in DKI Jakarta, as well as in the Kebagusan sub-district of South Jakarta which consists of 8 RWs, from 2017-2019 there were found 5 cases and potential for an epidemic at surrounding of neighborhood. Therefore, community engagement has a vital role to improve a disease prevention needs, thus those community are able to do an independently prevention activity or groups in their habitant. The activity begins with conducting an environment observational, advocacy and coordination, education and training for cadres, public facilities and infrastructure handling workers (PPSU) and residents representative of 3 RWs. From education results activities carried out on 36 targets, the pre-posttest on educated intervention was significant (p=0.000, T-paired test). It’s mean that the target increase their knowledge and understands the potential and risk of leptospirosis disease carried by rats for individual health and community after interventions. Empowerment can be started from the family level to maintain the cleanliness of the home environment as a form of personal responsibility and an important key to break the chain of leptospirosis transmission caused by rats

Objective The COVID-19 pandemic has resulted in significant changes to daily life and many health-related behaviors. The objective of this study was to examine the how stay-at-home/safer-at-home mandates issued in Colorado (March 2020 ? May 2020) impacted lifestyle behaviors and mental health among individuals with overweight or obesity participating in two separate behavioral weight loss trials (n = 82). Methods Questionnaires were used to collect qualitative and quantitative data on challenges to weight loss presented by the COVID-19 pandemic, including changes in dietary intake, physical activity, sedentary behavior, mental health during the stay-at-home/safer-at-home mandates. Results Using a convergent mixed method approach integrating qualitative and quantitative data, the greatest challenge experienced by participants was increased stress and anxiety, which led to more unhealthy behaviors. The majority perceived it to be harder to adhere to the prescribed diet (81%) and recommended physical activity (68%);however, self-reported exercise on weekdays increased significantly and 92% of participants lost weight or maintained weight within ±1% 5-6 weeks following the stay-at-home mandate. Conclusion Study results suggest that obesity treatment programs should consider and attempt to address the burden of stress and anxiety stemming from the COVID-19 pandemic and potential negative effects they may have on weight management behaviors. This article is protected by copyright. All rights reserved.

Introduction The majority of burn injuries in the paediatric age group occur in the home environment and are preventable. Water pipe smoking, commonly known as shisha, is an old practice of tobacco smoking dating from the 16th century with the use of hot coals and water in social gatherings at homes or cafes. The increasing use of shisha worldwide in youth raises public health concerns regarding its detrimental health effects and potential for serious thermal injury. Our aim is to identify and classify epidemiological trends of shisha related burns in the paediatric age group across New South Wales and the Australian Capital Territory. Methods A retrospective review from January 2009 – December 2019 at The Children’s Hospital at Westmead Burns Unit. All burn injuries of age less than 16 years that attended or were referred to the unit were included in this study. Results There were 10 patients who presented with a shisha related burn injury. There was an equal distribution of males to females with all burns occurring in the home or a park. The most common types of injury were a full thickness or mid-dermal burns respectively, three of which required split thickness skin grafting. Conclusions Shisha smoking is part of many cultures that has many potential burn hazards to children and family. Educational awareness targeted to shisha users can bring a better understanding about its potential for burn injury in children.

Purpose The COVID-19 pandemic has affected healthcare systems worldwide. Data on the impact on otolaryngological clinics and private practices is sparse. This study aimed to present data on healthcare worker (HCW) screening, status of HCW, pre-interventional testing, the use of personal protective equipment (PPE) and the economic impact of the pandemic. Methods Otolaryngological private practices and hospital-based departments were surveyed nationwide using an online questionnaire. Participating facilities were recruited via the German Society for Oto-Rhino-Laryngology and the German Association for Otolaryngologists in Bavaria. Results 365 private practices (2776 employees) and 65 hospitals (2333 employees) were included. Significantly more hospitals (68.7%) than practices (40.5%) performed pre-interventional testing in their outpatients (p

Befriending is a service in which volunteers provide companionship and support usually to people who are lonely or isolated. Such services are promoted in Scotland’s national strategy to improve the lives of people with dementia, around a third of whom live alone. However, little is known about the perspectives of recipients. Taking a holistic qualitative case study approach, the aim of this research was to explore how people living alone with dementia experienced befriending and the contexts in which their befriending relationships were meaningful. Three people were visited on five separate occasions. Largely unstructured conversations allowed individuals to prioritise areas of importance to them within the broad topics of befriending, everyday life, social networks and biography. Participants also had the option of ‘showing’ how they spent their time with their befriender. Data were analysed using the voice-centred relational method. Three key messages emerged: befriending satisfied unmet needs and wishes for particular kinds of relationship; befriending was a facilitated friendship; and befriending was a human response to contingent and existential limitations.

Aims Caregivers of persons living with ventricular assist devices (VADs) are integrally involved in both medical and non-medical care. We sought to understand tasks caregivers perform after surgical recovery, ways the home is adapted for those tasks, and presence of home safety hazards. Methods and results We conducted semi-structured interviews with persons living with a VAD and their caregivers. Pictures were taken of areas in the home where: (i) caregiving activities occurred, (ii) VAD or medical supplies were kept, and (iii) home adaptations were made for VAD care. Pictures were described in written detail and analysed. A qualitative descriptive approach was used for analysis. The sample consisted of 10 dyads, with mostly spousal relationships (60%) between male patients (60%) and female caregivers (80%). Three themes were identified: (i) Evolution of Caregiving and Support: Patients gain independence, but caregivers are still needed, (ii) Adapting the Home Environment: Changes are focused on functional needs, and (iii) Hidden Dangers: Illumination of safety concerns by photographs. Assistance with bathing, driveline care, and medication management were common caregiving tasks. Most home adaptations occurred in the bathroom and bedroom including sleeping recliners, shower chairs, removable shower heads, and hanging hooks to hold VAD equipment. Safety hazards included minimal space for safe ambulation, infection risk, and home-made adaptations to the environment. Conclusions These findings describe key home caregiving tasks, home adaptations, and safety concerns that require further education and support. Utilizing pictures may be a feasible method for assessing VAD teaching, caregiving needs, and identifying potential risks.

Objetivo: Descrever a experiência com as orientações educativas de alta hospitalar sob a perspectiva de uma enfermeira inserida no modelo Primary Nursing. Método: Relato desenvolvido a partir da vivência profissional em uma clí­nica médica de unidade hospitalar em São Luí­s, Maranhão, de janeiro a dezembro de 2020. As orientações educativas de enfermagem ocorriam através de treinamentos com os cuidadores e familiares dos pacientes, previamente í alta. Resultados: As informações eram repassadas de forma dialogada, priorizando o familiar e/ou cuidador que seria mais presente no domicí­lio, enfatizando orientações educativas de enfermagem relacionadas aos cuidados gerais com a pele, cuidados com a traqueostomia, gastrostomia ou jejunostomia, administração de dieta enteral e de medicamentos. Conclusão: O planejamento das orientações educativas na alta hospitalar são atribuições importantes do enfermeiro primário, promovendo a continuidade do cuidado e segurança por parte dos cuidadores em realizar assistência aos pacientes neurosequelados no ambiente domiciliar.