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Seeing your doctor during the pandemic

Also, see if your health care team offers telehealth appointments as an alternative. Virtual visits put you face-to-face with your doctor from the comfort and safety of your own home.

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If you’ve been putting off a visit to your doctor during COVID-19, you’re not alone.

Most adults (57%) agree the pandemic has changed how they feel about going to a health care provider’s office, according to a survey of 1,000 adults in October 2020 from an alliance of health care experts working to stop medical distancing, which was commissioned and sponsored by AbbVie.

The survey showed that in adults with chronic diseases, cancellations of their visits to the doctor amounted to 61%. Of those that had canceled appointments, 18% did not reschedule them. Some of the reasons included concerns about contracting COVID-19, not wanting to go into the hospital if not necessary and believing they can hold off on care until the end of the pandemic.

Keeping up with regular appointments is an important part of effective ongoing health care, especially for those managing chronic conditions. Continuous, clear and open communication with your health care providers is essential to getting the care you need.

See Your Doctor

Most important to know during this time are the measures your health care providers are taking, such as wearing personal protective equipment, practicing physical distancing and increasing cleaning and sanitization procedures. Find out what precautions health care providers are taking in your area.

Also, see if your health care team offers telehealth appointments as an alternative. Virtual visits put you face-to-face with your doctor from the comfort and safety of your own home.

“It’s generally wise to limit in-person interactions to safeguard against contracting COVID-19, but forgoing care for an ongoing health condition, especially a chronic illness, may put patients at unnecessary risk,” said Dr. Oren Cohen, chief medical officer, Labcorp Drug Development. “Our goal in health care is to keep patients safe and healthy. Health care providers have established robust protocols to minimize the risk of COVID-19 transmission. Calling ahead to understand the process for an office visit or test is a good idea. In some circumstances, telehealth visits may be a good option as well.”

Keep Up with Your Medicines

In addition to seeing your doctor, it’s also important to take your medications as prescribed. Stay in touch with your pharmacy and health care provider team to ensure prescriptions stay current. Also avoid waiting until the last minute to request a refill so you don’t encounter delays or potentially miss doses.

Seeing your doctor and taking your medications are very important to your ongoing care. It’s also a time to talk with your health care provider for more advice on how to get the care you need during the pandemic and beyond.

Take Control of Your Health Care During COVID-19

Health care providers are taking extra precautions and implementing additional protocols to conduct in-person visits in the safest way possible. Here’s what you can do to take care of your health:

  • Make and keep your appointments.
  • Reschedule any canceled appointments.
  • If you decide to see the doctor in-person, be sure to call your doctor and ask what health precautions are being taken.
  • Consider a telehealth visit as an alternative to going to an in-person visit.
  • Take your medications as prescribed.
  • Check the expirations of your medications and ask for refills with plenty of time to have them filled.
  • Ask your health care provider for additional ways to protect your health during this pandemic.

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NewsMakers

Patients who are overweight or obese at risk of more severe COVID-19

COVID-19 patients with obesity were more likely to require oxygen and had a 73 per cent greater chance of needing invasive mechanical ventilation. Similar but more modest results were seen in overweight patients. No link was found between being overweight or obese and dying in hospital from COVID-19.

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Patients who are overweight or obese have more severe COVID-19 and are highly likely to require invasive respiratory support, according to a new international study.

The research, led by the Murdoch Children’s Research Institute (MCRI) and The University of Queensland and published in Diabetes Care, found obese or overweight patients are at high risk for having worse COVID-19 outcomes. They are also more likely to require oxygen and invasive mechanical ventilation compared to those with a healthy weight.

MCRI researcher Dr Danielle Longmore said the findings, which highlighted the relationship between obesity and increased COVID-19 disease burden, showed the need to urgently introduce strategies to address the complex socio-economic drivers of obesity, and public policy measures such as restrictions on junk food advertising.

“Although taking steps to address obesity in the short-term is unlikely to have an immediate impact in the COVID-19 pandemic, it will likely reduce the disease burden in future viral pandemics and reduce risks of complications like heart disease and stroke,” she said.

The study looked at hospitalised SARS-CoV-2 patients from 18 hospitals in 11 countries including China, America, Italy, South Africa and The Netherlands.

Among the 7244 patients aged 18 years and over, 34.8 per cent were overweight and 30.8 per cent were obese.

COVID-19 patients with obesity were more likely to require oxygen and had a 73 per cent greater chance of needing invasive mechanical ventilation. Similar but more modest results were seen in overweight patients. No link was found between being overweight or obese and dying in hospital from COVID-19.

Cardiovascular and pre-existing respiratory diseases were associated with increased odds of in-hospital deaths but not a greater risk for needing oxygen and mechanical ventilation. For patients with pre-existing diabetes, there was increased odds of needing invasive respiratory support, but no additionally increase in risk in those with obesity and diabetes.

Men were at an increased risk of severe COVID-19 outcomes and needing invasive mechanical ventilation. In those aged over 65 years, there was an increased chance of requiring oxygen and higher rates of in-hospital deaths.

The University of Queensland’s Dr Kirsty Short, who co-led the research, said almost 40 per cent of the global population was overweight or obese.

“Obesity is associated with numerous poor health outcomes, including increased risk of cardiometabolic and respiratory disease and more severe viral disease including influenza, dengue and SARS-CoV-1,” she said.

Dr Short said while previous reports indicated that obesity was an important risk factor in the severity of COVID-19, almost all this data had been collected from single sites and many regions were not represented. Moreover, there was a limited amount of evidence available about the effects of being overweight or obese on COVID-19 severity.

“Given the large scale of this study we have conclusively shown that being overweight or obese are independent risk factors for worse outcomes in adults hospitalised with COVID-19,” she said.

MCRI Professor David Burgner, who co-led the research, said the data would help inform immunisation prioritisation for higher-risk groups.

“At the moment, the World Health Organization has not had enough high-quality data to include being overweight or obese as a risk factor for severe COVID-19 disease. Our study should help inform decisions about which higher-risk groups should be vaccinated as a priority,” he said.

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NewsMakers

Want a longer, healthier life? Resolve your arguments by day’s end, OSU study says

Researchers have long been aware of how chronic stress can affect health, from mental health problems such as depression and anxiety to physical problems including heart disease, a weakened immune system, reproductive difficulties and gastrointestinal issues.

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A recent Oregon State University study found that when people feel they have resolved an argument, the emotional response associated with that disagreement is significantly reduced and, in some situations, almost entirely erased.

That reduction in stress may have a major impact on overall health, researchers say.

“Everyone experiences stress in their daily lives. You aren’t going to stop stressful things from happening. But the extent to which you can tie them off, bring them to an end and resolve them is definitely going to pay dividends in terms of your well-being,” said Robert Stawski, senior author on the study and an associate professor in the College of Public Health and Human Sciences. “Resolving your arguments is quite important for maintaining well-being in daily life.”

Researchers have long been aware of how chronic stress can affect health, from mental health problems such as depression and anxiety to physical problems including heart disease, a weakened immune system, reproductive difficulties and gastrointestinal issues.

But it’s not just major chronic stressors like poverty or violence that can inflict damage.

“Daily stressors — specifically the minor, small inconveniences that we have throughout the day — even those have lasting impacts on mortality and things like inflammation and cognitive function,” said Dakota Witzel, lead author and a doctoral student in human development and family studies at OSU.

For the study, Stawski and Witzel used data from the National Study of Daily Experiences, an in-depth survey of more than 2,000 people who were interviewed about their feelings and experiences for eight days in a row.

The researchers looked at reports of both arguments and avoided arguments, defined as instances where the person could have argued about something but chose to let it slide so as not to have a disagreement. They then measured how the incident affected the person’s reported change in negative and positive emotions, both for the day of the encounter and the day after it occurred.

The measure of how an experience affects someone emotionally, an increase in negative emotions or a decrease in positive emotions, on the day it occurs is known as “reactivity,” while “residue” is the prolonged emotional toll the day after the experience occurs. Negative and positive affect refer to the degree of negative and positive emotions a person feels on a given day.

Results showed that on the day of an argument or avoided argument, people who felt their encounter was resolved reported roughly half the reactivity of those whose encounters were not resolved.

On the day following an argument or avoided argument, the results were even starker: People who felt the matter was resolved showed no prolonged elevation of their negative affect the next day.

The study also looked at age-related differences in response to arguments and avoided arguments and found that adults ages 68 and older were more than 40% more likely than people 45 and younger to report their conflicts as resolved. But the impact of resolution status on people’s negative and positive affect remained the same regardless of age.

The researchers had several explanations for older adults’ higher rate of resolution: Older adults may be more motivated to minimize negative and maximize positive emotions as they have fewer years remaining, which is consistent with existing theories of aging and emotion. They may also have more experience navigating arguments and thus be more effective at defusing or avoiding conflict.

“If older adults are really motivated to maximize their emotional well-being, they’re going do a better job, or at least a faster job, at resolving stressors in a more timely fashion,” Stawski said.

While people cannot always control what stressors come into their lives — and lack of control is itself a stressor in many cases — they can work on their own emotional response to those stressors, he said.

“Some people are more reactive than other people,” he said. “But the extent to which you can tie off the stress so it’s not having this gnawing impact at you over the course of the day or a few days will help minimize the potential long-term impact.”

In future research projects, Stawski and Witzel hope to further unpack the nature of people’s disagreements to measure which contexts and relationships provoke the most stressful arguments.

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NewsMakers

Living a stress-free life may have benefits, but also a downside

Stress is a universal human experience that almost everyone deals with from time to time. But a new study found that not only do some people report feeling no stress at all, but that there may be downsides to not experiencing stress.

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Stress is a universal human experience that almost everyone deals with from time to time. But a new study found that not only do some people report feeling no stress at all, but that there may be downsides to not experiencing stress.

The researchers found that people who reported experiencing no stressors were more likely to experience better daily well-being and fewer chronic health conditions. However, they were also more likely to have lower cognitive function, as well.

David M. Almeida, professor of human development and family studies at Penn State, said the study suggests that small, daily stressors could potentially benefit the brain, despite being an inconvenience.

“It’s possible that experiencing stressors creates opportunities for you to solve a problem, for example, maybe fixing your computer that has suddenly broken down before an important Zoom meeting,” Almeida said. “So experiencing these stressors may not be pleasant but they may force you to solve a problem, and this might actually be good for cognitive functioning, especially as we grow older.”

According to the researchers, a large number of previous studies have linked stress with a greater risk for many negative outcomes, like chronic illness or worse emotional wellbeing. But Almeida said that while it may make sense to believe that the less stress someone experiences the more healthy they will be, he said little research has explored that assumption.

“The assumption has always been that stress is bad,” Almeida said. “I took a step back and thought, what about the people who report never having stress? My previous work has focused on people who have higher versus lower levels of stress, but I’d never questioned what it looks like if people experience no stress. Are they the healthiest of all?”

The researchers used data from 2,711 participants for the study. Prior to the start of the study, the participants completed a short cognition test. Then, the participants were interviewed each night for eight consecutive nights, and answered questions about their mood, chronic conditions they may have, their physical symptoms — such as headaches, coughs or sore throats — and what they did during that day.

The participants also reported the number of stressors — like disagreements with friends and family or a problem at work — and the number of positive experiences, such as sharing a laugh with someone at home or work, they had experienced in the previous 24 hours.

After analyzing the data, the researchers found that there did appear to be benefits for those who reported no stressors throughout the study, about 10 percent of the participants. These participants were less likely to have chronic health conditions and experience better moods throughout the day.

However, those who reported no stressors also performed lower on the cognition test, with the difference equaling more than eight years of aging. Additionally, they were also less likely to report giving or receiving emotional support, as well as less likely to experience positive things happening throughout the day.

“I think there’s an assumption that negative events and positive events are these polar opposites, but in reality they’re correlated,” Almeida said. “But really, I think experiencing small daily stressors like having an argument with somebody or having your computer break down or maybe being stuck in traffic, I think they might be a marker for someone who has a busy and maybe full life. Having some stress is just an indicator that you are engaged in life.”

Almeida said the findings — recently published in the journal Emotion — suggest that it may not be as important to avoid stress as it is to change how you respond to stress.

“Stressors are events that create challenges in our lives,” Almeida said. “And I think experiencing stressors is part of life. There could be potential benefits to that. I think what’s important is how people respond to stressors. Respond to a stressor by being upset and worried is more unhealthy than the number of stressors you encounter.”

Susan T. Charles, University of California, Irvine; Jacqueline Mogle, Penn State; and Hye Won Chai, Penn State, also participated in this work.

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