No abstract

A COVID-19 lockdown and restrictive order has had a large impact on the lives of people. This cross-sectional study was conducted to identify factors affecting breastfeeding among mothers living in Thailand during the lockdown. Data were collected from 903 mothers with infants ages 0–12 months from 17 July 2020 to 17 October 2020 after the first nationwide COVID-19 lockdown period by an online platform and interview questionnaire survey. Multivariable logistic regression analysis was used to investigate the association between the effect of lockdown and breastfeeding practices with potential confounder adjustment including maternal age, ethnicity, newborn age <6 months, family income below $16,130 per annum, education below undergraduate level, and working status. Mothers changed breastfeeding practices in this period (n = 39, 4.32%) including having changed from exclusive breastfeeding to combined breastfeeding with formula milk (n = 22, 2.44%), and having reduced the frequency when compared to before the pandemic (n = 13, 1.44%). The associated factors of changing breastfeeding practices were “contact with healthcare services” (aOR = 0.46, 95% CI 0.22 to 0.96, p = 0.04), “infant feeding support from health personnel” (aOR = 0.39, 95% CI 0.16 to 1.94, p = 0.035), and “lack family support and help with feeding your baby after lockdown” (aOR = 7.04, 95% CI 1.92 to 25.84, p = 0.003). In conclusion, this study showed a slight decrease in breastfeeding in the sampled mothers during the COVID-19 lockdown in Thailand. A long-term national surveillance system for maintenance of breastfeeding should be established. Health care service interventions and additional information are needed to support mothers and families for breastfeeding during pandemics.

The deterioration of muscle strength in aging has been associated with fall risks. During the COVID-19 pandemic, older adults were restricted from doing outdoor activities. This study aimed to investigate the effect of Nine-Square Step Exercises (NSSE) on improving physical performance and balance in older adults at risk of falling. We conducted an open-labelled, assessor-blinded, randomized controlled trial in 46 (aged 65–84 years) community-dwelling older adults. They were randomly assigned to an NSSE group (n = 24) instructed to perform the program for at least 45 days over 8 weeks or a control group (n = 22). The outcomes were measured by the Timed Up and Go Test (TUG), the Berg Balance Scale (BBS), the Five-Times-Sit-to-Stand test (FTSS), and hand grip strength during the baseline, 4th and 8th weeks in both groups. A mixed-effect linear regression model analysis was performed to estimate the independent effect of NSSE by the intention-to-treat over the 8-week period. The NSSE group showed significant weekly changes in BBS (β 0.57, 95% CI: 0.30, 0.84), TUG (β −0.44, 95% CI: −0.74, −0.14), and FTSS (β −0.52, 95% CI: −0.78, −0.25), demonstrating beneficial improvements in lower extremity and balance, whereas the control group did not demonstrate significant changes over time in any parameter.

Objective This study aimed to explore significant pre-hospital factors affecting the survivability of Out-of-Hospital Cardiac Arrest (OHCA) patients in countries with developing EMS systems. Method A retrospective cohort study was conducted examining data from January 1, 2017 to December 31, 2020 from Utstein Registry databases in Thailand, collected through Pan-Asian Resuscitation Outcomes Study (PAROS). Data were collected from three centres, including regional, suburban-capital, and urban-capital hospitals. The primary endpoint of this study was 30-day survival or discharged alive after an OHCA event. The multivariable risk regression was done by modified Poisson regression with robust error variance to explore the association between 30-day survival and pre-hospital factors with potential confounders adjustments. Findings Of 1,240 OHCA cases transferred by Emergency Medical Services (EMS), 42 patients (3.4%) were discharged alive after 30 days, including 22 (8.6%), 8 (3.0%), and 12 (1.7%) from regional, suburban-capital, and urban-capital centres, respectively. The initial arrest rhythm was 89.7% unshockable, with no significant variations across the three centres. Overall, bystander Cardiopulmonary Resuscitation (CPR) was 40.4%. However, bystander CPR with Automated External Defibrillator (AED) application was 0.8%. Bystander CPR significantly increased 30-day survival probability (aRR 1.88, 95% CI 1.01 to 3.51; p 0.049). Additionally, reducing the EMS response time by one minute significantly increased OHCA survivability (aRR 1.12, 95% CI 1.04 to 1.20; p 0.001). Conclusions Response time and bystander CPR are the factors that improve the 30-day survival outcomes of OHCA patients. In contrast, scene time, transport time, and pre-hospital advanced airway management didn’t improve 30-day OHCA survival.

Numerous nations have implemented lockdown measures in response to the COVID-19 pandemic. As a consequence of the lockdown on daily living, social participation, and health service accessibility, vulnerable people, for example, new mothers, may experience an increase in mental health problems. This cross-sectional survey was conducted to investigate the impact of the COVID-19 pandemic lockdown on Thai new mothers and the variables affecting their mental health. The survey data were collected from 903 Thai mothers with infants aged 0–12 months using an online platform and a face-to-face interview questionnaire survey between 17 July and 17 October 2020, during the first nationwide COVID-19 lockdown period. For the final analysis, there were 862 participants who completed all of the questions. The full exploratory analysis was performed by multivariable linear regression to identify the variables influencing maternal mental health. Our study demonstrated that new mothers reported feeling a high extent to some extent of worry (44.9%), increased appetite (40.4%), becoming easily annoyed or irritable (39.1%), and feeling down (33.5%), whereas 82.7% felt able to cope with the first lockdown situation. Practiced relaxation techniques were associated with positive maternal mental health (adjusted β = 1.05, 95% CI 0.57 to 1.52, p < 0.001). The perceived impact of the COVID-19 lockdown was on the household’s ability to pay for rent, to make mortgage payments (adjusted β = −1.59, 95% CI −2.87 to −0.36, p = 0.011), the household’s ability to pay for other essentials, such as utilities and medication (adjusted β = −1.99, 95% CI −3.16 to −0.81, p = 0.001), household crowding after lockdown (adjusted β = −3.46, 95% CI −4.86 to −2.06, p < 0.001), and not going outside or doing outdoor activities (adjusted β = −2.22, 95% CI −3.35 to −1.08, p < 0.001). These impacts were significantly associated with negative mental health. In conclusion, our results emphasize the critical need for continuous monitoring of maternal mental health and developing an effective response strategy and activity for promoting maternal mental health under the stress of repetitive lockdowns and increased economic pressures.