Changes in perceived stress and lifestyle behaviors in response to the COVID-19 pandemic in The Netherlands:An online longitudinal survey study

The COVID-19 pandemic has substantial implications for physical and mental wellbeing. This study investigated changes, over time, in lifestyle behaviors and perceived stress during the initial phase of the pandemic and associations with COVID-19 symptoms, in the Dutch general population. An online longitudinal survey study was performed with pre-lockdown measurements in February, and subsequently in April and June 2020 (n = 259, mean age 59 ± 14 years, 59% women). Self-report questionnaires were used to assess weight, diet quality, physical activity, alcohol intake, and smoking. Perceived stress was measured using the validated perceived stress scale (PSS-10). The presence of COVID-19 symptoms (yes/no) was defined as fever, or >3 of the following symptoms: weakness/tiredness, muscle ache, dry cough, loss of smell/taste, and breathing difficulties. Data were analyzed using linear mixed models, adjusted for age, sex, educational level, marital status and (change in) employment status. Minimal increases over time were observed in alcohol intake (0.6 ± 0.7 to 0.7 ± 1.1 glasses/day, p = 0.001) and smoking (9.5 ± 8.7 to 10.9 ± 9.4 cigarettes/day among 10% smokers, p = 0.03), but other lifestyle behaviors remained stable. In April 2020, 15% reported COVID-19-related symptoms, and in June 2020, this was 10%. The presence of COVID-19 symptoms was associated with increased perceived stress (p interaction = 0.003) and increased alcohol consumption (p interaction = 0.03) over time. In conclusion, in this prospective study, COVID-19 symptoms were associated with increases in perceived stress and alcohol consumption. Future research on biopsychosocial determinants and underlying mechanisms of lifestyle changes, as a response to the COVID-19 pandemic, is needed

Sex and gender-stratified risks of psychological factors for adverse clinical outcomes in patients with ischemic heart disease: A systematic review and meta-analysis

Background:  Psychological factors are associated with adverse prognosis in patients with ischemic heart disease (IHD). However, it is unknown whether these risk factors differ between women and men. Methods:  PubMed, EMBASE, and PsycINFO were searched to identify studies assessing the risk of psychological factors for major adverse cardiovascular events (MACE) in samples with IHD. Psychological factors included anger/hostility, anxiety, depression, psychological distress, social support, Type A behavior pattern, Type D personality, and Posttraumatic Stress Disorder (PTSD). Results:  A total of 44 articles (64 separate reports) including 227,647 women and 321,894 men reporting confounder-adjusted hazard ratios (HRs) or relative risks (RRs) were included in the primary analysis. Results based on random-effects models showed that the association between psychological factors (all combined) and MACE was stronger in men (n = 321,236; 57 reports; HR = 1.37, 95%CI 1.27-1.48) than in women (n = 226,886; 56 reports; HR = 1.21, 95%CI 1.12-1.30; p = .017). A subset of the studies focusing on women showed significant associations between anger/hostility, depression, and distress with MACE. For men, statistically significant associations were found for anxiety, depression, and distress with MACE. Conclusions:  Psychological factors are associated with MACE in samples with IHD in both women and men, with a small, but significant higher risk for men. Because of the limited number of studies on other psychological factors than depression and anxiety and the current major focus on MACE reflecting lesions in the major coronary arteries which is more typical in men than women, more research is needed to better identify sex and gender differences in IHD

Systematic review of prognostic factors for work participation in patients with sciatica

Sciatica impacts on the ability to work and may lead to a reduced return to work. This study reviewed and summarised prognostic factors of work participation in patients who received conservative or surgical treatment for clinically diagnosed sciatica. We searched MEDLINE, CINAHL, EMBASE and PsycINFO until January 2018. Cohort studies, using a measure of work participation as outcome, were included. Two independent reviewers performed study inclusion and used the Quality In Prognosis Studies tool for risk of bias assessment and GRADE to rate the quality of the evidence. Based on seven studies describing six cohorts (n=1408 patients) that assessed 21 potential prognostic factors, favourable factors for return to work (follow-up ranging from 3 months to 10 years) included younger age, better general health, less low back pain or sciatica bothersomeness, better physical function, negative straight leg raise-test, physician expecting surgery to be beneficial, better pain coping, less depression and mental stress, less fear of movement and low physical work load. Study results could not be pooled. Using GRADE, the quality of the evidence ranged from moderate to very low, with downgrading mainly for a high risk of bias and imprecision. Several prognostic factors like pain, disability and psychological factors were identified and reviewed, and these could be targeted using additional interventions to optimise return to work

Quality indicators for community care for older people: A systematic review

<div><p>Background</p><p>Health care systems that succeed in preventing long term care and hospital admissions of frail older people may substantially save on their public spending. The key might be found in high-quality care in the community. Quality Indicators (QIs) of a sufficient methodological level are a prerequisite to monitor, compare, and improve care quality. This systematic review identified existing QIs for community care for older people and assessed their methodological quality.</p><p>Methods</p><p>Relevant studies were identified by searches in electronic reference databases and selected by two reviewers independently. Eligible publications described the development or application of QIs to assess the quality of community care for older people. Information about the QIs, the study sample, and specific setting was extracted. The methodological quality of the QI sets was assessed with the Appraisal of Indicators through Research and Evaluation (AIRE) instrument. A score of 50% or higher on a domain was considered to indicate high methodological quality.</p><p>Results</p><p>Searches resulted in 25 included articles, describing 17 QI sets with 567 QIs. Most indicators referred to care processes (80%) and measured clinical issues (63%), mainly about follow-up, monitoring, examinations and treatment. About two-third of the QIs focussed on specific disease groups. The methodological quality of the indicator sets varied considerably. The highest overall level was achieved on the domain ‘Additional evidence, formulation and usage’ (51%), followed by ‘Scientific evidence’ (39%) and ‘Stakeholder involvement’ (28%).</p><p>Conclusion</p><p>A substantial number of QIs is available to assess the quality of community care for older people. However, generic QIs, measuring care outcomes and non-clinical aspects are relatively scarce and most QI sets do not meet standards of high methodological quality. This study can support policy makers and clinicians to navigate through a large number of QIs and select QIs for their purposes.</p><p>PROSPERO Registration: 2014:CRD42014007199</p></div

Methodological characteristics of the quality indicator sets assessed with the AIRE instrument ^a.

<p>Methodological characteristics of the quality indicator sets assessed with the AIRE instrument <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0190298#t003fn002" target="_blank">^a</a>.</p

PRISMA flow diagram of the selection process.

<p>PRISMA flow diagram of the selection process.</p