Background The coronavirus disease (COVID-19) outbreak in China was first reported to the World Health Organization (WHO) on December 31, 2019, and the first cases were officially identified around December 8, 2019. Although the origin of COVID-19 has not been confirmed, approximately half of the early cases were linked to a seafood market in Wuhan. However, the first two documented patients did not visit the seafood market. News reports, social media, and informal sources may provide information about outbreaks prior to formal notification. Objective The aim of this study was to identify early signals of pneumonia or severe acute respiratory illness (SARI) in China prior to official recognition of the COVID-19 outbreak in December 2019 using open-source data. Methods To capture early reports, we searched an open source epidemic observatory, EpiWatch, for SARI or pneumonia-related illnesses in China from October 1, 2019. The searches were conducted using Google and the Chinese search engine Baidu. Results There was an increase in reports following the official notification of COVID-19 to the WHO on December 31, 2019, and a report that appeared on December 26, 2019 was retracted. A report of severe pneumonia on November 22, 2019, in Xiangyang was identified, and a potential index patient was retrospectively identified on November 17. Conclusions The lack of reports of SARI outbreaks prior to December 31, 2019, with a retracted report on December 26, suggests media censorship, given that formal reports indicate that cases began appearing on December 8. However, the findings also support a relatively recent origin of COVID-19 in November 2019. The case reported on November 22 was transferred to Wuhan approximately one incubation period before the first identified cases on December 8; this case should be further investigated, as only half of the early cases were exposed to the seafood market in Wuhan. Another case of COVID-19 has since been retrospectively identified in Hubei on November 17, 2019, suggesting that the infection was present prior to December.
Background The increased number of older adults living alone has created a substantial care need. However, the utilization rate of services and facilities to meet these needs are surprisingly low. Many of older adults experience difficulties accessing these services, although it remains unclear how these obstacles impede access to services. This study explored the obstacles and difficulties experienced by urban older adults in seeking community care. Methods A phenomenological study was carried out and participatory observation and in-depth interviews were employed to investigate the process of seeking care of older adults in urban communities. A total of 18 urban community-dwelling older adults aged 75 years and over were included. Data collected were analysed by content analysis. Results We identified the pathways by which senior-only households sought community care and encountered obstacles. (1) lack of community care information: older adults did not know where and how to get services, even though the care institutions scattered throughout the community; (2) limited mobility: older adults often suffered from various chronic diseases, which physically hindered their access to care resources; (3) complex process of achieving care: the functional fragmentation and geographical dispersion of care institutions made the care-seeking process challenging and confusing for older adults; (4) incomprehension of needs expression: limited interaction time and communication barriers between staff of institutions and the older adults were the final obstacle. Only by surmounting these obstacles one by one can older adults access the care resources effectively. Conclusions When older adults in the community initiated calls for help, they encountered several obstacles. Their physiological and social disadvantages limited their ability to seek care physically. Lack of integration and clear guidance in the process of providing community care exacerbated these difficulties. Reform of care services should focus on the visibility and accessibility of services for older adults.
Purpose To synthesize the evidence for the immediate and short-term effects of appearance care on psychosocial outcomes in breast cancer patients in order to inform the design of future research and clinical practice.Methods A search of four databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science). The JBI Critical Appraisal Checklists were used by two reviewers to assess methodology quality. Subgroup analysis was conducted for the different time points measured after intervention.Results Seven studies were eligible for the meta-analysis, including two RCTs and ve quasi-experimental studies, from 1994 to 2022. The type of intervention was mainly grouped-education, led by beauty specialists, and the dose and frequency varied. The quality of included studies was moderate to high. The results showed that appearance care had positive immediate effect on self-esteem (SMD = 0.63, 95% CI 0.37 to 0.89), anxiety (SMD = -0.46, 95% CI -0.60 to -0.31), and depression (SMD = -0.41, 95% CI -0.62 to -0.19), with short-term effects on anxiety (SMD = -0.42, 95% CI -0.54 to -0.34), depression (SMD = -0.41, 95% CI -0.55 to -0.26) and sexual function (SMD = 0.50, 95% CI 0.18 to 0.81).The effect of appearance care on body image and quality of life was uncertain.Conclusion Appearance care could be a promising intervention to improve self-esteem, anxiety, depression, and sexual function among patients with breast cancer. More high-quality RCTs are needed to validate these ndings. Online appearance care programs and exploration of long-term effects should also be considered.
Introduction While traditional “non-medical” prevention and control measures have achieved remarkable results during the COVID-19 pandemic, they have generated difficult situations for older adult patients with chronic disease. The purpose of this study was to understand and identify the COVID-19 risk perception process and trajectory among older adults with chronic disease living in the community. Material and methods This was a qualitative research study that used in-depth semi-structured interviews to explore the experiences of 21 older adult patients with chronic disease. Data were analyzed using conventional content analysis methods. Results Three themes emerged: restricted travel, psychological shock and panic, and unintended consequences. Conclusions The perceptions of epidemic risk among older adult patients with chronic disease living in the community had varying characteristics at different stages. Correct identification of risk perception processes and trajectories will assist in formulating more scientific emergency measures in the event of future public health emergencies.
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