Poverty in old age in times of COVID-19 - Empirical results from Austria

Early in the pandemic, researchers were cautioning that COVID-19 and the associated health policy countermeasures would have an increased negative impact on groups that were already vulnerable before the pandemic. One of these groups are older people affected by poverty, who according to official figures make up 13.9% of older population in Austria. Even before the pandemic, their living situation was considered precarious. Not without reason, this group has been identified as a high-risk group of the pandemic, due to their increased likelihood of severe COVID-19 related illness and their limited monetary resources and thus lower chances of coping with the pandemic. Nevertheless, research on this group has remained sparse to date. Therefore, the aim of the study is to focus on older people (60+ years) below the poverty line and to compare them with non-poor individuals. Data from the SHARE (Survey of Health Aging and Retirement in Europe) project is used, combining data from the two SHARE Corona Surveys (summer 2020 and summer 2021) and the SHARE Corona Special Austria Survey (December 2020) to gain the most complete picture of life situation during the pandemic. Results demonstrate that older people in poverty were more likely to report poor subjective health before as well as during the pandemic yet were significantly more likely to refuse vaccination against COVID-19, despite adhering to other measures against the pandemic to the same extent as non-poor people. Restrictions in the health care system affected both groups equally and no significant differences in the frequency of social contacts could be found. However, older people below the poverty line were significantly more likely to rely on social support to obtain necessities during the pandemic and were less likely to use the internet. Together, these results point out that disadvantage exist for the older poor in some but not all areas of life during the pandemic. This paper is aimed at providing first insights into the lives of poor older persons during a taxing time and may perhaps inspire more in-depth study of this particularly understudied population

The effect of COVID-19 on loneliness in the elderly. An empirical comparison of pre-and peri-pandemic loneliness in community-dwelling elderly

Old-age loneliness is a global problem with many members of the scientific community suspecting increased loneliness in the elderly population during COVID-19 and the associated safety measures. Although hypothesized, a direct comparison of loneliness before and during the pandemic is hard to achieve without a survey of loneliness prior to the pandemic. This study provides a direct comparison of reported loneliness before and during the pandemic using 1:1 propensity score matching (PSM) on a pre- and a peri-pandemic sample of elderly (60C years) individuals from Lower Austria, a county of Austria (Europe). Differences on a loneliness index computed from the short De Jong Gierveld scale were found to be significant, evidencing that loneliness in the elderly population had in fact risen slightly during the COVID-19 pandemic and its associated safety measures. Although the reported loneliness remained rather low, this result illustrated the effect of the “new normal” under COVID-19. As loneliness is a risk factor for physical and mental illness, this result is important in planning the future handling of the pandemic, as safety measures seem to have a negative impact on loneliness. This work confirms the anticipated increase in loneliness in the elderly population during COVID-19

Caught between two fronts: successful aging in the time of COVID-19

Purpose–The COVID-19 pandemic poses a great challenge for older people both in terms of the severity of the disease and the negative consequences of social distancing. Assumptions about negative effects on the lives of the elderly, affecting dimensions of successful aging (such as the preservation of social relationships), have thus far been hypothetical and have lacked empirical evidence. The aim of this paper is to shed empirical light on the effects of COVID-19 on the everyday life of older people against the background of the concept of successful aging. Design/methodology/approach– Data of a standardized, representative telephone survey with residents of Lower Austria, a county of Austria, were used for this secondary analysis. The sample included 521 persons of 60 years of age and older. For this paper, contingency analyses (x2coefficients,z-tests using Bonferroni correction) and unidimensional correlational analyses were calculated. Findings–The empirical data show that successful aging along the three dimensions of successful aging is a challenge in the time of the COVID-19 pandemic–leaving the elderly caught between twofronts. Originality/value– The present work focusses on a unique moment in time, describing the changes tot he lives of Austrian elderly because of the social distancing measures imposed to protect against the spread of COVID-19. These changes are discussed in the theoretical framework of successful aging

Dual-energy CT collagen density mapping of wrist ligaments reveals tissue remodeling in CPPD patients: first results from a clinical cohort

Objectives: To evaluate differences in collagen density as detected by dual-energy computed tomography (DECT) of wrist ligaments between patients with calcium pyrophosphate-dihydrate deposition disease (CPPD) and a control group in order to gain insight into changes of the extracellular matrix in response to crystal deposition. Materials and methods: This retrospective study included 28 patients (18 with CPPD, 10 controls) who underwent DECT of the wrist. Collagen density maps were reconstructed from the DECT datasets and used to measure densities in regions of interest (ROIs) placed in the scapholunate (SL) ligament (dorsal, palmar, proximal), lunotriquetral (LT) ligament, and extensor carpi radialis (ECR) tendon, (n = 260 measurements). The presence of calcifications on standard CT images in these regions was assessed by a blinded reader. Densities were compared with nonparametric tests, and linear regression analysis was performed to investigate the impact of age, sex, and CT- detected calcium deposition on collagen density. Results: Collagen density in the SL ligament was significantly higher in CPPD patients than in controls (overall mean: 265.4 ± 32.1 HU vs. 196.3 ± 33.8 HU; p < 0.001). In the ECR tendon, collagen densities did not differ significantly (p = 0.672): 161.3 ± 20.1 HU in CPPD vs. 163.6 ± 12.0 HU in controls. Regression analysis showed that diagnosis, but not age or calcification, had a significant impact on collagen density. Conclusion: Collagen density of the SL ligament is significantly higher in CPPD patients than in control patients. Further research is needed to understand these changes in the extracellular matrix of ligaments in CPPD

Dietary Patterns in Adolescent Obesity as Predictors of Long-Term Success Following an Intensive Inpatient Lifestyle Programme

(1) Background: Lifestyle interventions for adolescents with obesity show minor long-term effects on anthropometric parameters. The persistence of dietary changes after obesity inpatient rehabilitation has not been sufficiently investigated. (2) Objectives: To analyse dietary patterns in German adolescents with obesity as predictors of long-term success following an intensive inpatient lifestyle programme regarding food choices as well as body weight and comorbidities. (3) Methods: Food consumption data of 137 German adolescents with obesity aged 10-17 years were collected by a nutrition interview. Cluster analysis was used to group the participants according to their food consumption. Dietary patterns, changes in body weight and insulin resistance were compared over a 2-year-period. (4) Results: Three dietary patterns were identified. Big Eaters (n = 32) consume high amounts of total sugar and meat, Moderate Eaters (n = 66) have a diet comparable to the national average, and Snackers (n = 39) have a particularly high consumption of total sugar. Big Eaters and Snackers significantly reduced the consumption of total sugar. Among Moderate Eaters, no persistent changes were observed. (5) Conclusion: Weight reduction interventions can induce long-lasting changes in the diet of adolescents with obesity. Therefore, the success of a weight reduction intervention should not be determined by weight reduction only

Exposure incidents among medical students in a high-prevalence HIV setting

INTRODUCTION : Occupational injuries in medical students are concerning, especially in countries with a high prevalence of bloodborne infections. With more HIV-infected patients on antiretroviral treatment, appropriate post-exposure prophylaxis (PEP) depends on knowledge of source patients’ infection status and treatment response. This study determined the number and type of exposure incidents, reporting practices, and PEP use among medical students at the University of Pretoria, South Africa. METHODOLOGY : Data were collected from an anonymous voluntary questionnaire completed by medical students from years 1 to 6 of study as well as from incident records archived at the Department of Family Medicine. Data were described and tests of association performed in Stata 11. RESULTS : Thirteen percent of students overall and 21% of senior students reported an incident in the preceding year. The majority of incidents occurred during phlebotomy, with fatigue and work pressure found to be major contributing factors. Underreporting was common and many students displayed a lack of risk awareness and a preference for managing the incident privately. Although 59% knew the HIV-status of the source patient, less than a third knew the viral load and only 16.9% the regimen. Side-effects on antiretroviral treatment used for PEP were common and only about three-quarters of the students completed the course. CONCLUSIONS : We recommend targeted training, especially in the senior years, together with improving the work environment through attention to working hours, sharps disposal and ready availability of safety devices, improved reporting systems, individualised PEP, and possibly the implementation of an occupational injury support line.http://www.jidc.org/index.php/journal 2036-6590am2017Family MedicineImmunologyMedical Virolog

Caenorhabditis elegans predation on Bacillus anthracis: Decontamination of spore contaminated soil with germinants and nematodes

Remediation of Bacillus anthracis-contaminated soil is challenging and approaches to reduce overall spore levels in environmentally contaminated soil or after intentional release of the infectious disease agent in a safe, low-cost manner are needed. B. anthracis spores are highly resistant to biocides, but once germinated they become susceptible to traditional biocides or potentially even natural predators such as nematodes in the soil environment. Here, we describe a two-step approach to reducing B. anthracis spore load in soil during laboratory trials, whereby germinants and Caenorhabditis elegans nematodes are applied concurrently. While the application of germinants reduced B. anthracis spore load by up to four logs depending on soil type, the addition of nematodes achieved a further log reduction in spore count. These laboratory based results suggest that the combined use of nematodes and germinants could represent a promising approach for the remediation of B. anthracis spore contaminated soil

The 2010 South African guidelines for the management of HIV and AIDS: A review

The South African (SA) National Department of Health (DoH) released new guidelines for the management of HIV/AIDS in April 2010. We discuss here controversial issues and operational challenges in the guidelines; the stimulation of debate and contributing to future guidelines; the timing of initiation of antiretroviral treatment, scope and timing of laboratory monitoring and testing of concomitant conditions, operational challenges such as paediatric HIV treatment and nurse-driven care, and procedures relating to the guidelines such as the need for transparency of the guideline committee and the standard of evidence used to develop the guidelines. We welcome comment and sharing of further insights that will contribute to future guidelines

Blood-borne infections in healthcare workers in South Africa

The risks associated with infection of healthcare workers and students with blood-borne pathogens, specifically HIV, hepatitis B virus and hepatitis C virus, are often neglected. South Africa (SA) currently has no official policies or guidelines in place for the prevention and management of these infections. This article reviews the available data and international guidelines with regard to infected healthcare practitioners and makes minimum recommendations for the SA setting.http://www.samj.org.zahb201