Articles: pandemics.
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The COVID-19 pandemic highlighted the shortcomings of our health care delivery system for vulnerable populations and created a need to rethink health disparity education in medical training. We examined how the early COVID-19 pandemic impacted third-year medical students' attitudes, perceptions, and sense of responsibility regarding health care delivery for vulnerable populations. ⋯ Our findings describe an educational approach to care for vulnerable populations based on awareness, attitudes, and social action. Medical education must continue to teach students how to identify ways to mitigate disparities in order to achieve health equity.
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Older adults in acute hospitals are uniquely vulnerable to mental illness during the COVID-19 pandemic. We describe two eighteen-week periods of specialised liaison psychiatry for older inpatients in a large teaching hospital, pre- and mid-pandemic. Service delivery went from almost completely via face-to-face consultation in the Routine period, to majority remote work in the Pandemic period. ⋯ In the Pandemic period, 197 patients were assessed and received 3.1 consultations on average (range 1-19). Patient age trended toward older in the Pandemic period, mean 77 years (SD 6.9) vs 78 years (SD 1.32) in the Routine period. There were more referrals for behavioural disturbance and confusion during the Pandemic period, and more diagnoses of Behavioural and Psychological Symptoms of Dementia, Delirium and Adjustment Disorder during the Pandemic period vs the Routine period.
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For many, the lockdowns of the COVID-19 pandemic resulted in drastic behavior changes. While the immediate uncertainty and fear surrounding the initial lockdown has subsided, there are still significant changes to our daily lives and work that may have lasting impact on our health and well-being. One such change is the increase in physical inactivity and sedentarism, a result of decreased group activities, organized events, work and school from home mandates, and physical distancing. ⋯ Overall, health care providers are inconsistent and often ineffective at screening and counseling patients on the benefits of regular physical activity. Additionally, there is very little structured curricula for medical learners to address physical inactivity and other lifestyle factors that contribute to the health of our patients. As we adjust to new social practices and behaviors as a result of the COVID-19 pandemic, it is critical that we emphasize the need for education, screening, evidence-based interventions, advocacy, and effective role modeling on the importance of physical activity for our patients, communities, and our own well-being.