Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.

Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China.

BIOMEDICAL RESEARCH POLICY COMMITTEE REPORT WAS PUBLISHED AS A SUPPLEMENT TO THE AUGUSTJOURNAL OF MEDICAL EDUCATION. A REPRINT IS ENCLOSED. REQUESTS FOR ADDITIONAL COPIES SHOULD BE ADDRESSED TO THISOFFICE. -COPIES ARE BEING SENT TO MEMBERS OF CONGRESS AND THE KEY MEMBERS OF THE ADMINISTRATION. CALLING UPON-YOUR SENATORSAND CONGRESSMEN TO TELL THE STORY OF THE ROLE. OF MEDICAL SCHOOLS IN BIOMEDICAL RESEARCH AND HEALTH CARE IS IMPORTANT.I STRONGLY URGE THAT YOU MAKE AN 411 APPOINTMENT TO SEE YOUR CONGRESSIONAL REPRESENTATIVES WHILE YOU ARE IN WASHINGTON FOR THE COUNCIL MEETINGON OCTOBER 29. UPON REQUEST WE CAN SUPPLY THE NAMES OF APPOINTMENT SECRETARIES AND PHONE NUMBERS OF YOUR SENATORS AND CONGRESSMEN. APPROPRIATIONS COMMITTEE ACTED WITH EXTRAORDINARY ALACRITY THIS YEAR. THE-NIH APPROPRIATION WAS INCREASED BY 242 MILLION DOLLARSOVER 1971, REPRESENTING A 142 MILLION DOLLAR INCREASE OVER. THE ADMINISTRATION BUDGET, THE BLUE SHEET ASCRIBES APPROPRIATIONS OUTCOME TO THE EFFECTIVENESS OF THE COALITION FOR HEALTH FUNDING UNDER THE LEADERSHIP OF JOHN A. D. COOPER.

The Association of American Medical Colleges

1Department of Psychological Medicine, National University Health System, Singapore 2Department of Psychological Medicine, National University of Singapore, Singapore 3Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore Address for Correspondence: Dr Cyrus Ho Su Hui, Department of Psychological Medicine, National University Health System, Level 9, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228. Email: su_hui_ho@nuhs.edu.sg Mental Health Strategies to Combat the Psychological Impact of COVID-19 Beyond Paranoia and Panic

Mental Health Strategies to Combat the Psychological Impact of COVID-19 Beyond Paranoia and Panic

The prevalence of depression may be affected by changes in psychiatric practices and the availability of online mental health information in the past two decades. This study aimed to evaluate the aggregate prevalence of depression in communities from different countries between 1994 and 2014 and to explore the variations in prevalence stratified by geographical, methodological and socio-economic factors. A total of 90 studies were identified and met the inclusion criteria (n = 1,112,573 adults) with 68 studies on single point prevalence, 9 studies on one-year prevalence, and 13 studies on lifetime prevalence of depression. A random-effects model meta-analysis that was performed to calculate the aggregate point, one-year and lifetime prevalence of depression calculated prevalences of 12.9%, 7.2% and 10.8% respectively. Point prevalence of depression was significantly higher in women (14.4%), countries with a medium human development index (HDI) (29.2%), studies published from 2004 to 2014 (15.4%) and when using self-reporting instruments (17.3%) to assess depression. Heterogeneity was identified by meta-regression and subgroup analysis, and response rate, percentage of women and year of publication, respectively, were determined contribute to depression prevalence. This meta-analysis allows benchmarking of the prevalence of depression during the era when online health information emerged, facilitating future comparisons.

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Prevalence of Depression in the Community from 30 Countries between 1994 and 2014.

In this Review, Tsokos et al. describe recent advances in our understanding of systemic lupus erythematosus (SLE) that are driving repurposing of existing drugs as well as development of new treatments. Cytokines, tolerance pathways, local tissue mediators, and epigenetic mechanisms all show promise as novel targeted therapies that could lead to individualized care in SLE.

New insights into the immunopathogenesis of systemic lupus erythematosus

Background Recent advancement in Internet based technologies have resulted in the growth of a sub-specialized field, termed as "Infodemiology" and "Infoveillance". Infoveillence refers to the collation of infodemiology measures for the purpose of surveillance and trending. Previous research has only demonstrated the research potential of Web 2.0 medium in collation of data in crisis situation. Objectives The objectives for the current study are to demonstrate the methodology of implementation of a smartphone-based application for dissemination and collation of information during a crisis situation. Methods The Haze Smartphone application was developed using an online application builder and using HTML5 as the core programming language. A five-phase developmental method including a) formulation of user requirements, b) system design, c) system development, d) system evaluation and finally e) system application and implementation were adopted. The smartphone application was deployed during a one-week period via a self-sponsored Facebook post and via direct dissemination of the web-links by emails. Results A total of 298 respondents took part in the survey within the application. Most of them were between the ages of 20- to 29-years old and had a university education. More individuals preferred the option of accessing and providing feedback to a survey on physical and psychological wellbeing via direct access to a Web-based questionnaire. In addition, the participants reported a mean number of 4.03 physical symptoms (SD 2.6). The total Impact of Event Scale-Revised (IES-R) score was 18.47 (SD 11.69), which indicated that the study population did experience psychological stress but not posttraumatic stress disorder. The perceived dangerous Pollutant Standards Index (PSI) level and the number of physical symptoms were associated with higher IES-R Score (P Conclusions This study demonstrates how a smartphone application could potentially be used to acquire research data in a crisis situation. However, it is crucial for future research to further evaluate its effectiveness in a crisis situation.

Methodology of developing a smartphone application for crisis research and its clinical application.

Over the past decade, there have been massive advances in technology. These advances in technology have significantly transformed various aspects of healthcare. The advent of E-health and its influence on healthcare practice also implies that there is a paradigm shift in the way healthcare professionals work. Conventionally, healthcare professionals would have to refer to books and journals for updates in treatment algorithms, but with the advent of technology, they could access this information via the web or via various smartphone applications on the go. In the field of Psychiatry, one of the commonest mental health disorder to date, with significant morbidity and mortality is that of Major depressive disorder. Routinely, clinicians and healthcare professionals are advised to refer to standard guidelines in guiding them with regards to their treatment options. Given the high prevalence of conditions like Major Depressive Disorder, it is thus of importance that whatever guidelines that clinicians and healthcare professionals refer to are constantly kept up to date, so that patients could benefit from latest evidence based therapy and treatment. A review of the current literature highlights that whilst there are a multitude of smartphone applications designed for mental health care, previous systematic review has highlighted a paucity of evidence based applications. More importantly, current literature with regards to provision of treatment information to healthcare professionals and patients are limited to web-based interventions. It is the aim of this technical note to highlight a methodology to which the authors have conceptualized in the implementation of an evidence based mental health guideline applications, known as the `Wiki Guidelines' smartphone application. The authors hope to illustrate the algorithms behind the development of the application, and how it could be easily updated by the guidelines working group.

/pdf/the-wikiguidelines-smartphone-application-bridging-the-gaps-3nfittykeg.pdf

The `WikiGuidelines' smartphone application: Bridging the gaps in availability of evidence-based smartphone mental health applications.

Background The respective rates of obesity in Canada and the United states are estimated to be 24.1% and 34.1%. Due to the increased incidence of obesity, Bariatric surgery has been recognized as one of the treatment options. Patients who have undergone Bariatric surgery tend to need chronic long-term follow-up with a multi-disciplinary team. In the past decade, there has been massive advancement and development in Internet, Web-based and Smartphone technologies. However, there seemed to be a pacuity of applications in this area that enables post-bariatric patients to self-manage their own condition. In addition, past research have highlighted the limited evidence based with regards to currently available bariatric applications, mainly due to the lack of medical professionals involvement. Objective Our current research objective is to illustrate the development of a Bariatric After-care smartphone application and to highlight user preferences with regards to the features integrated within the application. Methodology The Bariatric Aftercare application was developed between the months of March 2014 to April 2014. Making use of low-cost online web-based application developmental technologies, the authors embarked on the development of the web-based application. Patients who attended their routine follow-up appointments are given the links to the web-based application. They were also recruited to participate in an online user evaluation survey to identify their preferences with regards to the features integrated. Results Since the inception of the web-based application to date, there has been a cumulative total of 385 unique assess to the online web-based application. There is a slight change in the confidence levels of the participants with regards to using the application to help them self-manage their own condition. The majority of the users have indicated that they preferred the information pertaining to what happens during each consult with members of the multidisciplinary team and also greatly valued the feature with regards to the ability to re-schedule their appointments. The vast majority also found the additional resources to be helpful. Conclusions This is one of the first studies to demonstrate the potential use of smartphone innovations in Bariatric After-care self-management. The current study has shown that users are generally receptive towards such an innovative implementation and has also highlighted some of their preferences with regards to such a self-management application for self-management of their health condition post bariatric surgery. In addition, the authors have also managed to demonstrate how clinicians could be involved in the formulation of a bariatric care application, which has an evidence base.

Pilot implementation and user preferences of a Bariatric After-care application.

Online and Smartphone based Cognitive Behavioral Therapy for Bariatric Surgery Patients: Initial Pilot Study

The WHO, in its report on the global status on alcohol and health, has clearly highlighted that alcohol use disorders are a major problem worldwide that has resulted in millions of deaths each year.1 Previous research2 conducted a content analysis of 500 alcohol smartphone applications made available in stores and highlighted the fact that the vast majority of …

https://innovations.bmj.com/content/bmjinnov/1/3/74.full.pdf

Melvyn Wb Zhang

Papers

Methodology of developing a smartphone application for crisis research and its clinical application.

The `WikiGuidelines' smartphone application: Bridging the gaps in availability of evidence-based smartphone mental health applications.

Pilot implementation and user preferences of a Bariatric After-care application.

Online and Smartphone based Cognitive Behavioral Therapy for Bariatric Surgery Patients: Initial Pilot Study

The alcohol self-management smartphone application: an evidence-based approach