Using Mindfulness to Reduce Anxiety and Depression of Patients With Fever Undergoing Screening in an Isolation Ward During the COVID-19 Outbreak

A cross-section study of the relationship between lifestyles and severity of COVID-19 symptoms in people living with HIV

SARS-CoV-2 and its subvariants continue to spread globally. People living with HIV (PLWH), who have weakened immune systems, have heightened concerns about the virus. Thus, the relationship between COVID-19 and HIV remains unclear, and the risks of COVID-19 for PLWH have yet to be fully understood. The study conducted a retrospective cross-sectional survey on the Wenjuanxing platform to identify lifestyle risk factors and epidemic phenotypes associated with the severity of COVID-19 in PLWH. All respondents were over 18 years old and were receiving antiretroviral therapy. The survey included questions about their health status during the COVID-19 illness, and questions about basic sociodemographic information, lifestyle factors, and HIV treatment history. This study included 984 HIV patients with a mean age of 54.44 ± 14.4 years. Among the participants, 635 (64.53%) were male. A total of 33 (3.35%) respondents were unvaccinated, while 951 (96.65%) had received at least one vaccine dose, with 868 (88.21%) participants having received three or more vaccine doses. The association between the severity of COVID-19 symptoms and CD4 count (p = 0.652) and HIV viral load (p = 0.916) was found to be statistically insignificant. In reduced multivariate logistic model, passive smoking increased the risk of severe COVID-19 symptoms compared with non-smokers (odds ratios [OR] 1.66; 95% confidence interval [CI] 1.11-2.48). Mild (OR 2.23; 95% CI 1.55-3.24) and moderate/severe anxiety (OR 5.22; 95% CI 2.36-13.28) were also positively associated with severe COVID-19 symptoms compared to individuals with no anxiety. Comorbidity (OR 1.5; 95% CI 1.04-2.17) demonstrated a significant association with severe COVID-19 symptoms. Moderate/severe anxiety was significantly associated with a higher hospital admission rate (OR 2.62; 95% CI 1.27-5.37) compared to those without anxiety. Patients who consumed whole grains more than three times per week had a lower risk of hospital admission (OR 0.61; 95% CI 0.41-0.89). However, both anxiety and wholegrain intake were nonsignificant for hospitalization rates in individuals who tested positive for COVID-19 through real-time PCR or antigen test. In full multivariate logistic model for SARS-CoV-2 infection of hospitality, CD4 count (> 500 cells/mm3) (OR 0.64; 95% CI 0.41-0.99) and the CD4 count (200-500 cells/mm3) (OR 0.68; 95% CI 0.45-1.04) were significantly associated with hospital admission rates compared to CD4 count (< 200 cells/mm3), but the results were inconsistent in the reduced logistic models and analysis of Group B. This study indicates that anxiety is positively associated with worsened COVID-19 symptoms and higher hospitalization rates, suggesting a significant link between anxiety and the severity of COVID-19. However, the study did not find evidence of a correlation between CD4 count, HIV viral load, and the severity of COVID-19 or hospitalization rates.

The effect of mindfulness meditation on depressive symptoms during the COVID-19 pandemic: a systematic review and meta-analysis

Currently, 280 million people worldwide experience depression, ranking it third in the global burden of disease. The incidence of depression has risen due to the COVID-19 pandemic, making it essential to examine evidence-based practices in reducing depressive symptoms during this unprecedented time. This systematic review and meta-analysis aim to analyze randomized controlled trials during the COVID-19 pandemic that evaluated the effect of mindfulness meditation on depressive symptoms in individuals with depression. Four databases (PubMed, Embase, Web of Science, and Scopus) were searched in November 2023 using search terms including meditation, mindfulness, depression, and depressive symptoms. The meta-analysis was conducted using Review Manager 5.4 software (Cochrane Collaboration). A random model and Standard Mean Difference analysis with 95% CIs were used for continuous variables. The systematic review included 26 RCT studies. The meta-analysis showed significant effects of mindfulness meditation interventions (SMD = - 1.14; 95% CI - 1.45 to - 0.83; P < 0.001) in reducing depressive symptoms compared to comparison groups. The findings suggest a positive effect of mindfulness meditation on depressive symptoms in individuals with depression during the COVID-19 pandemic.

Effects of online mindfulness-based interventions (MBIs) on anxiety symptoms in adults: a systematic review and meta-analysis

BACKGROUND

An increasing number of studies have documented the effectiveness on various types of face-to-face and online mindfulness-based interventions (MBIs) in reducing anxiety among general population, but there is a scarcity of systematic reviews evaluating evidence of online MBIs on anxiety in adults. Therefore, we examined the effects of online mindfulness-based interventions (MBIs) on anxiety symptoms in adults and explored the moderating effects of participant, methods, and intervention characteristics.

METHODS

We systematically searched nine databases through May 2022 without date restrictions. Inclusion criteria were primary studies evaluating online mindfulness-based interventions with adults with anxiety measured as an outcome, a comparison group, and written in English. We used random-effects model to compute effect sizes (ESs) using Hedges' g, a forest plot, and Q and I² statistics as measures of heterogeneity; we also examined moderator analyses.

RESULTS

Twenty-six primary studies included 3,246 participants (39.9 ± 12.9 years old). Overall, online mindfulness-based interventions showed significantly improved anxiety (g = 0.35, 95%CI 0.09, 0.62, I² = 92%) compared to controls. With regards to moderators, researchers reported higher attrition, they reported less beneficial effects on anxiety symptoms (β=-0.001, Q_model=4.59, p = .032). No other quality indicators moderated the effects of online mindfulness-based interventions on anxiety.

CONCLUSION

Online mindfulness-based interventions improved anxiety symptoms in adult population. Thus, it might be used as adjunctive or alternative complementary treatment for adults. However, our findings must be interpreted with caution due to the low and unclear power of the sample in primary studies; hence, high-quality studies are needed to confirm our findings.

Effectiveness of Daily Mindfulness Meditation App Usage to Reduce Anxiety and Improve Well-Being During the COVID-19 Pandemic: A Randomized Controlled Trial

Introduction This study examined the effect of 10-minute daily meditation app usage for 30 days on adult anxiety and mental well-being during the first year of the COVID-19 pandemic. Methods Participants were randomized into intervention (10 minutes of daily usage of the Insight Timer app) or control groups. Participants completed surveys to assess anxiety and well-being pre- and post-study. Data were analyzed using t-tests, analysis of variance (ANOVA), or nonparametric equivalents. Results Pre-study results were comparable between groups. The pre- vs. post-study General Anxiety Disorder-7 (GAD-7) scores for anxiety decreased in the intervention group (n=18, median 5.5 vs. 3.0 (pre vs. post), p=0.0233, d=0.50), but not in the control group (n=28). The intervention group had a lower median GAD-7 score than the control group post-study (3.0 vs. 8.0, p=0.0223, d=0.35). Pre- vs. post-study mean 5-item World Health Organization Well-Being Index (WHO-5) scores were improved in both the control (11.6 vs. 12.9 (pre vs. post), p=0.0408, d=0.36) and intervention groups (12.0 vs. 16.3 (pre vs. post), p=0.0001, d=0.77), although it was higher in the intervention group (16.3 vs. 12.9, p=0.0056, d=0.88). Conclusion Ten minutes of daily meditation app usage for 30 days may reduce anxiety and improve well-being in adults during the COVID-19 pandemic.

Transvaginal natural orifice endoscopic surgery for ovarian cystectomy: a more suitable surgical approach for the day-care procedure

Introduction

Although previous studies have shown that vaginal natural orifice transluminal endoscopic surgery (vNOTES) has the advantages of causing less pain, faster recovery, and better concealment of surgical incisions, which aligns with the concept of the day-care procedure, this approach poses a greater risk of damaging adjacent organs (i. e., rectum and bladder) due to its anatomical specificity. Moreover, the day-care procedure may lead to relatively less preoperative evaluation and postoperative care. Hence, it is necessary to explore the safety and effectiveness of vNOTES for ovarian cystectomy in the day-care procedure, to provide a theoretical basis for the wider development of vNOTES surgery.

Materials and methods

This retrospective study included 131 patients at our hospital who underwent ovarian cystectomy from September 2021 to October 2022. Based on the surgical approach, patients were classified into transumbilical laparoendoscopic single-site surgery (LESS) and vNOTES groups. The patients' demographic characteristics and follow-up data were collected during the perioperative period and 1-month postoperatively.

Results

Vaginal natural orifice transluminal endoscopic surgery has less postoperative exhaust time, a lower postoperative 6-hour pain score, and a lower incidence of analgesic drug use, with higher surgical conversion incidence. Multiple linear regression analysis showed that the surgical conversion, chocolate cyst, bilateral cyst, and pelvic adhesion increased the operation duration by ~43 (95% CI: 10.309, 68.152, p < 0.001), 15 (95% CI: 6.342, 45.961, p = 0.036), 10 (95% CI: 3.07, 40.166, p = 0.019), and 8 (95% CI: 4.555, 26.779, p = 0.035) min, respectively. Interestingly, vNOTES decreased the operation duration by ~8.5 min (95% CI: -18.313, -2.699, p = 0.033).

Conclusion

Vaginal natural orifice transluminal endoscopic surgery was equally safe and effective for ovarian cystectomy compared to LESS. vNOTES aligned with the concept of the day-care procedure due to its reduced postoperative pain, shorter exhaust time, and absence of scarring. However, surgeons should conduct a comprehensive preoperative evaluation and exclude patients suspected to have severe pelvic adhesions.

Optimal diagnostic fever thresholds using non-contact infrared thermometers under COVID-19

Fever screening is an effective method to detect infectors associated with different variants of coronavirus disease 2019 (COVID-19) based on the fact that most infectors with COVID-19 have fever symptoms. Non-contact infrared thermometers (NCITs) are widely used in fever screening. Nevertheless, authoritative data is lacking in defining "fever" at different body surface sites when using NCITs. The purpose of this study was to determine the optimal diagnostic threshold for fever screening using NICTs at different body surface sites, to improve the accuracy of fever screening and provide theoretical reference for healthcare policy. Participants (n = 1860) who were outpatients or emergency patients at Chengdu Women's and Children's Central Hospital were recruited for this prospective investigation from March 1 to June 30, 2021. NCITs and mercury axillary thermometers were used to measure neck, temple, forehead and wrist temperatures of all participants. Receiver operating characteristic curves were used to reflect the accuracy of NCITs. Linear correlation analysis was used to show the effect of age on body temperature. Multilinear regression analysis was used to explore the association between non-febrile participant's covariates and neck temperature. The mean age of participants was 3.45 ± 2.85 years for children and 28.56 ± 7.25 years for adults. In addition 1,304 (70.1%) participants were children (≤12), and 683 (36.7%) were male. The neck temperature exhibited the highest accuracy among the four sites. Further the optimal fever diagnostic thresholds of NCITs at the four body surface measurement sites were neck (36.75 °C, sensitivity: 0.993, specificity: 0.858); temple (36.55 °C, sensitivity: 0.974, specificity: 0.874); forehead (36.45 °C, sensitivity: 0.961, specificity: 0.813); and wrist (36.15 °C, sensitivity: 0.951, specificity: 0.434). Based on the findings of our study, we recommend 36.15, 36.45, 36.55, and 36.75 °C as the diagnostic thresholds of fever at the wrist, forehead, temple and neck, respectively. Among the four surface sites, neck temperature exhibited the highest accuracy.

MAPPING MENTAL HEALTH INTERVENTIONS DURING THE COVID-19 PANDEMIC. A COMPARISON REVIEW OF CHINA AND WESTERN EUROPE

OBJECTIVE

The aim: To map and compare mental health interventions during the Covid-19 pandemic in China and Western-Europe. The focus was specifically on the availability, duration, target group, content, setting, and outcomes of the interventions.

PATIENTS AND METHODS

Materials and methods: A scoping review was conducted by utilising several scientific databases. A total of 479 articles were found after removing the duplicate records. After screening, 36 articles were included in the study. Relevant intervention characteristics were systematically mapped, and compared within and among countries.

CONCLUSION

Conclusions: All interventions had shared aims to improve the psychological resilience and to reduce psychological distress. In particular, anxiety- and depression-related symptoms were commonly addressed. On average, interventions in China were larger scaled, had longer durations, and often used combinations of strategies such as therapies and exercises both in-person and remotely. Interventions in Western-Europe tend to be locally implemented on a smaller scale, and often used a single strategy. Most Chinese interventions targeted adolescents, while all interventions in Western-Europe were meant for adults. Most interventions were assessed using quantitative methods using various mental health scales, showing statistically significant effects in improving mental health.