The objective was to examine pandemic-related changes in depression and anxiety symptoms in adolescents and young adults in Germany considering pre-existing depression and anxiety problems. In this ...cross-sectional study, 11,523 adolescents and young adults aged 14-21 years who perceived an impact of the Coronavirus disease (COVID-19) pandemic on their mental health reported the frequencies of depression and anxiety symptoms retrospectively for different pre-pandemic and pandemic phases. Data were collected using web-based questionnaires between January 5th and February 20th, 2022. Depression and anxiety were assessed with a modified version of the Patient Health Questionnaire (PHQ-4). Scale-fit cut-offs were used to identify pre-existing elevated depression and anxiety scores. Multilevel mixed linear models were conducted to assess changes in depression and anxiety symptoms from 2019 to 2021 and compare for age, gender and pre-pandemic mental health problems. Among young people who were experiencing mental health changes as a result of the pandemic, the frequency of depression and anxiety symptoms increased during the COVID-19 pandemic. This association was moderated by age, gender, and pre-existing elevated depression/anxiety scores. For young people without elevated pre-pandemic depression/anxiety, the scores increased strongly over time, with 61% reporting elevated depression symptoms and 44% reporting elevated anxiety symptoms in 2021. In contrast, self-perceived change was minimal for adolescents and young adults with elevated pre-pandemic depression and anxiety. Among young people whose mental health has been affected by the COVID-19 pandemic, the group without pre-pandemic mental health conditions reported greater deterioration than those with elevated pre-pandemic depression and anxiety scores. Thus, adolescents and young adults without pre-existing depression and anxiety problems who perceived a change in general mental health due to the pandemic reported an alarming increase in symptoms of depression and anxiety during the COVID-19 pandemic period.
Zusammenfassung
Hintergrund und Ziel
Die COVID-19-Pandemie hat den beruflichen Alltag von Lehrpersonal erheblich verändert. Das Ziel dieser Arbeit ist es, die Auswirkungen der Pandemie auf die ...emotionale Erschöpfung und die Berufszufriedenheit von Lehrpersonal zu untersuchen.
Methoden
Eine Gelegenheitsstichprobe von 2531 Schulleitungen und Lehrkräften aus Nordrhein-Westfalen wurde im Oktober 2020 rekrutiert. Veränderungen der emotionalen Erschöpfung während der Pandemie wurden mit 9 Items des Maslach-Burnout-Inventars gemessen, Veränderungen der Berufszufriedenheit wurden mit 6 Items direkt gemessen. Adjustierte Regressionsmodelle wurden gerechnet, um Risiko- und Schutzfaktoren zu bestimmen, die mit der Veränderung der emotionalen Erschöpfung und der Berufszufriedenheit assoziiert sind.
Ergebnisse
Risikofaktoren, die sowohl mit häufiger wahrgenommenen Erschöpfungssymptomen als auch mit einer verringerten Berufszufriedenheit in Zusammenhang standen, waren: die zusätzliche Arbeitsbelastung während der Pandemie, die Belastung durch Unsicherheit, die wahrgenommene Belastungsänderung, Sorgen um die Schüler:innen sowie die Tätigkeit an einer Grundschule. Ein unterstützendes Schulumfeld war sowohl mit seltener wahrgenommenen Erschöpfungssymptomen als auch mit einer stabilen Berufszufriedenheit assoziiert.
Diskussion
Aus Sicht des Lehrpersonals ging die Coronavirus-Krankheit-2019 (COVID-19)-Pandemie mit subjektiven Veränderungen der emotionalen Erschöpfung und der Berufszufriedenheit einher. Bei über der Hälfte des Lehrpersonals war sie mit einer höheren emotionalen Erschöpfung sowie bei jeder fünften Lehrkraft mit einer verringerten Berufszufriedenheit assoziiert. Aufgrund der Studienanlage sind kausale Schlussfolgerungen nicht möglich.
Purpose
Accurate surgical reconstruction of arterial vascular supply is a crucial part of living kidney transplantation (LDKT). The presence of multiple renal arteries (MRA) in grafts can be ...challenging. In the present study, we investigated the impact of ligation versus anastomosis of small accessory graft arteries on the perioperative outcome.
Methods
Clinical and radiological outcomes of 51 patients with MRA out of a total of 308 patients who underwent LDKT with MRA between 2011 and 2020 were stratified in two groups and analyzed. In group 1 (20 patients), ligation of accessory arteries (ARAs) and group 2 (31 patients) anastomosis of ARAs was performed.
Results
Significant differences were observed in the anastomosis-, surgery-, and warm ischemia time (WIT) in favor of group 1. Students
t
-test showed comparable serum creatinine levels of 2.33 (± 1.75) to 1.68 (± 0.83) mg/dL in group 1 and 2.63 (± 2.47) to 1.50 (± 0.41) mg/dL in group 2, were seen from 1 week to 1 year after transplant. No increased rates of Delayed graft function (DGF), primary transplant dysfunction and transplant rejection were seen, but graft loss and revision rates were slightly higher when the ARAs were ligated. Analysis of Doppler sonography revealed that segmental perfusion deficits tend to regenerate during the clinical course.
Conclusion
Ligation of smaller accessory renal arteries may not affect the outcome of living kidney transplantation, except for a minor increase in the reoperation rate. Segmental perfusion deficits of the graft seem to regenerate in most cases as seen in Doppler sonography.
The risk of death is increased for persons with epilepsy. The literature on causes of death in epilepsy is based mainly on cohorts with epilepsy of mixed aetiologies. For clinical purposes and ...improved understanding of mortality in different epilepsies, more information is needed on mortality in epilepsies of specific causes. In poststroke epilepsy (PSE), seizures occur in a setting of vascular disease and high mortality rates. The extent to which epilepsy contributes to mortality in this patient group is poorly understood. We therefore aimed to describe causes of death (COD) in PSE on a national scale. A previously identified cohort of 7740 patients with epilepsy or seizures after a stroke in 2005-2010 was investigated. A total of 4167 deaths occurred before the end of 2014. The standardized mortality ratio for the study cohort was 3.56 (95% CI: 3.45-3.67). The main underlying causes of death were disorders of the circulatory system (60%) followed by neoplasms (12%). Diseases of the nervous system were the sixth leading underlying COD (3%), and epilepsy or status epilepticus was considered the underlying COD in approximately a similar proportion of cases as neurodegenerative disorders (0.9% and 1.1%, respectively). Epilepsy was considered a contributing COD in 14% of cases. Our findings highlight the importance of optimal management of vascular morbidity in patients with PSE. The large proportion of patients with epilepsy as a contributing COD indicate the need of high ambitions also regarding the management of seizures in patients with PSE.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Previous research has suggested that some COVID-19 infections and deaths have gone unrecorded, especially in the early days of the pandemic. Therefore, it is likely that people in Massachusetts were ...exposed to, infected with, and died from COVID-19 before the first death was recorded and that other deaths in early 2020 may have been due to COVID-19, but were not coded that way. This study sought to determine the number of deaths in the first 4 months of 2020 that may have been due to COVID-19, by comparing deaths with selected ICD-10 codes to the same time frame in 2019 and 2018.
Death certificate information was obtained for the first 21 weeks of 2018, 2019, and 2020. We calculated and compared the number of deaths for specific ICD-10 codes that may be related to COVID-19 during this time period for each year.
There was a notable increase in deaths potentially related to COVID-19 between the 11th and 17th weeks of 2020 in comparison with the same time period in 2018 and 2019.
Even after Massachusetts began recording deaths as being due to COVID-19, the number of deaths that may have been due to the disease was higher than would have been expected based on data from the two preceding years. These findings may indicate that some COVID-19 deaths were not being recorded or that the pandemic was exacerbating other health issues.
Purpose
Recently, the robotic surgical system, Hugo™ was approved for clinical use. The transfer of skills is important for understanding the implementation of surgical innovation. We explored the ...transfer of skills from the DaVinci® to the Hugo™ by studying the learning curve and short-term patient outcomes during radical prostatectomy (RARP).
Methods
We examined the transfer of skills from one surgeon performing RARP from the first case with the Hugo™ system in April 2022. The surgeon had previously performed > 1000 RARPs using DaVinci®. Perioperative and clinical outcomes were collected for procedures on both Hugo™ and DaVinci®. Patient follow-up time was 3 months.
Results
Nineteen Hugo™ cases and 11 DaVinci® cases were recorded. No clinically relevant difference in procedure time was found when transferring to Hugo™. Patients operated using Hugo™ had more contacts postoperatively compared to the DaVinci®, all Clavien–Dindo (CD) grade 1 (53% vs 18%). Three patients from the Hugo™ group were re-admitted within 30 days with catheter malfunction (CD grade 1), infection without a focus (CD grade 2), and ileus due to a hernia in the port hole (CD grade 3b). The 3-month follow-up showed similar results in prostate-specific antigen levels (PSA) and erectile dysfunction between the two robotic systems, but a higher incidence of incontinence was found for the Hugo™.
Conclusion
We observed that the skills of an experienced robotic surgeon are transferable from DaVinci® to Hugo™ when performing RARP. No obvious benefits were found for using Hugo™ compared to DaVinci® for RARP although this needs confirmatory studies.
Energy drinks (EDs) have become popular worldwide. Despite growing concerns about negative health effects of ED, they are increasingly popular among adolescents, yet little is known about the context ...and patterns of ED use in adolescents.
This study examined the prevalence and correlates of ED use as well as initiation rates and predictors among German adolescents over a one-year period.
A school-based longitudinal study of 6902 adolescents ages 9–19 years was conducted in 44 schools in six Federal states of Germany in 2016–2018. Demographics, ED use, drug use behavior, advertising exposure, intrapersonal, interpersonal, and community factors were assessed.
Lifetime ED use was reported by 61.7% of the participants, while 21.4% reported past 30-day use. In two multilevel models, lifetime and past 30-day ED use were positively associated with male sex, older age, drug use, poor dietary habits, higher BMI, sensation seeking, worse school performance, and more frequent ad exposure (p < .01). One quarter of the non-users initiated ED use in 12 months. ED initiation was positively associated with male sex (AOR, 1.50 95% CI, 1.11–2.03), greater sensation seeking traits (AOR, 1.25 95% CI, 1.08–1.43), more frequent ED ad exposure (AOR, 1.31 95% CI, 1.12–1.53), and curiosity about trying EDs (AOR, 2.31 95% CI, 1.74–3.07), while inversely associated with better school performance (AOR, 0.84, 95% CI, 0.73–0.97) and attending a gymnasium-type school (AOR, 0.69 95% CI, 0.50–0.96).
ED consumption is common among German adolescents. The association between EDs and negative health and lifestyle outcomes and risky behaviors is concerning. Parents, school officials, and healthcare providers should be aware of signs and consequences of excessive ED consumption and limit their use by adolescents. Adopting policies that limit the direct marketing to minors under the age of 18 years can be also beneficial in curbing this epidemic.
To examine the relationship between regional socioeconomic deprivation and adherence to the 24-h movement guidelines among children and adolescents, a cross-sectional study was conducted. A total of ...17,433 students aged 9–17 participated in a survey in winter 2021/2022. Daily screen time (ST), moderate-to-vigorous physical activity (MVPA), and sleep behavior were outcome variables. The German Index of Socioeconomic Deprivation (GISD), a regional socioeconomic objective measure, was the exposure variable. Associations between GISD and health behaviors were examined using regression models. Models were adjusted for age, gender, school type, and individual self-reported socioeconomic status (SES). The proportions of meeting the MVPA, ST, and sleep duration guidelines were 14%, 22%, and 34%, respectively. A total of 2.3% met all guidelines. Students from the most deprived communities were half as likely to meet all three guidelines compared to students from the most affluent regions (OR = 0.49 0.28; −0.03, p = 0.010). There was a consistent relationship between GISD and lower levels of adherence to screen time guidelines (most deprived compared to most affluent: OR = 0.49 0.38; 0.64, p < 0.001). There was no association between GISD and adherence to sleep time guidelines. We found mixed results for the association between GISD and MVPA. Regional SES appears to be an important factor associated with screen time. Screen time should be limited through intervention programs, especially in disadvantaged areas. Parents should be made aware of their children’s increased media consumption. Recommendations for screen time should be clearly communicated, as should the health disadvantages of increased media consumption in childhood and adolescence.
Pulmonary Tuberculosis (TB) is diagnosed through sputum samples. As sputum sampling is challenging in children and cachexic patients, the development of diagnostic tests using saliva appears ...promising but has been discouraged due to low bacterial load and poor sensitivity. Here, we present a novel and rapid method to enrich Mycobacterium tuberculosis (Mtb) from saliva, which may serve as a basis for a diagnostic saliva test. Lipobiotin-functionalized magnetic beads (LMBs) were incubated with Mtb-spiked PBS and saliva from healthy donors as well as with saliva from TB patients. Flow cytometry was used to evaluate the capacity of the beads to bind Mtb, while real-time quantitative polymerase chain reaction (qPCR) was utilized to detect Mtb and determine the amount of mycobacterial DNA in different sample types. We found that LMBs bind Mtb efficiently when compared to non-functionalized beads. The development of an qPCR assay based on the use of LMBs (LMB assay) allowed us to enrich mycobacterial DNA in spiked sample types, including PBS and saliva from healthy donors (enrichment of up to ~8.7 fold). In Mtb-spiked saliva samples, we found that the LMB assay improved the detection rate of 10.sup.2 bacteria in a volume of 5 ml from 0 out of 15 (0%) to 6 out of 15 (40%). Consistent with that, the LMB assay increased the rate of correctly identified saliva samples from TB patients in two independent cohorts. Implementation of the principle of the LMB-based assay may improve the sensitivity of existing diagnostic techniques, e.g. by functionalizing materials that facilitate Mtb sampling from the oral cavity.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
No studies have reported on the impact at team level of the Medtronic Hugo
™
RAS system. We described the work patterns and learning curves of an experienced robotic nurse team adapting to the new ...robotic system. We prospectively recorded the robotic nurse team’s preoperative, perioperative, and postoperative tasks on the first 30 robotic procedures performed. The data were descriptively analyzed, and Gantt Charts were created for a timeline overview of the work patterns. We compared the operative times between the Medtronic Hugo
™
RAS and the Davinci
®
system. The preoperative phase seemed to improve with a median time of 94 min (IQR 81–107). After 20 surgeries, the work pattern became more consistent where the scrub and circulating nurses worked simultaneously. There was no noticeable improvement for the perioperative and postoperative phases with a stable median time of 170 min (IQR 135–189) and 26 min (IQR 22–31). We found that the work pattern seemed to stabilize after 20 surgeries but with a continued decrease in preoperative time without a learning curve plateau. The robotic nurse team suffered from few breaks and long working hours because only a few nurses at our facility were trained in the Hugo
™
system.
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