Background Qualitative olfactory (smell) dysfunctions are a common side effect of post-viral illness and known to impact quality of life and health status. Evidence is emerging that taste and smell loss are common symptoms of Covid-19 that may emerge and persist long after initial infection. The aim of the present study was to document the impact of post Covid-19 alterations to taste and smell. Methods We conducted exploratory thematic analysis of user-generated text from 9000 users of the AbScent Covid-19 Smell and Taste Loss moderated Facebook support group from March 24 to 30th September 2020. Results Participants reported difficulty explaining and managing an altered sense of taste and smell; a lack of interpersonal and professional explanation or support; altered eating; appetite loss, weight change; loss of pleasure in food, eating and social engagement; altered intimacy and an altered relationship to self and others. Conclusions Our findings suggest altered taste and smell with Covid-19 may lead to severe disruption to daily living that impacts on psychological well-being, physical health, relationships and sense of self. More specifically, participants reported impacts that related to reduced desire and ability to eat and prepare food; weight gain, weight loss and nutritional insufficiency; emotional wellbeing; professional practice; intimacy and social bonding; and the disruption of people’s sense of reality and themselves. Our findings should inform further research and suggest areas for the training, assessment and treatment practices of health care professionals working with long Covid.

BackgroundExergaming has been proposed as an innovative method for physical activity promotion. However, large effectiveness studies are rare. In January 2011, dance mat systems were introduced in secondary schools in two districts in England with the aim of promoting an innovative opportunity for physical activity. The aim of this natural experiment was to examine the effect of introducing the dance mat exergaming systems on physical activity and health-related outcomes in 11–13 year old students using a non-randomised controlled design and mixed methods.MethodsParticipants were recruited from five schools in intervention districts (n = 280) and two schools in neighbouring control districts (n = 217). Data on physical activity (accelerometer), anthropometrics (weight, BMI and percentage of body fat), aerobic fitness (20-m multistage shuttle run test), health-related quality of life (Kidscreen questionnaire), self-efficacy (children’s physical activity self-efficacy survey), school attendance, focus groups with children and interviews with teachers were collected at baseline and approximately 12 months follow-up.ResultsThere was a negative intervention effect on total physical activity (-65.4 cpm CI: -12.6 to -4.7), and light and sedentary physical activity when represented as a percentage of wear time (Light: -2.3% CI: -4.5 to 0.2; Sedentary: 3.3% CI: 0.7 to 5.9). However, compliance with accelerometers at follow-up was poor. There was a significant positive intervention effect on weight (-1.7 kg, 95% CI: -2.9 to -0.4), BMI (-0.9 kg/m2, 95% CI: -1.3 to -0.4) and percentage of body fat (-2.2%, 95% CI: -4.2 to -0.2). There was also evidence of improvement in some health-related quality of life parameters: psychological well-being (2.5, 95% CI: 0.1 to 4.8) and autonomy and parent relation (4.2, 95% CI: 1.4 to 7.0).ConclusionsThe implementation of a dance mat exergaming scheme was associated with improvement in anthropometric measurements and parameters of health-related quality of life. However, the mechanisms of these benefits are unclear as there was insufficient data from physical activity to draw robust conclusions. Qualitative findings suggest that there was declining support for the initiative over time, meaning that potential benefits may not have been achieved.

BackgroundConsumption of fruit and vegetables is important for health, but is often lower than recommended and tends to be socio-economically patterned with lower consumption in more deprived groups. In 2008, the English Department of Health introduced the Change4Life convenience store programme. This aimed to increase retail access to fresh fruit and vegetables in deprived, urban areas by providing existing convenience stores with a range of support and branded point-of-sale materials and equipment.MethodsWe undertook a mixed-methods study of the Change4Life convenience store programme in the North East of England around two years after initial implementation. Store mapping (n = 87; 100% stores) and systematic in-store observations (n = 74; 85% stores) provided information on intervention fidelity; the variety, purchase price and quality of fresh fruit and vegetables on sale; and purchase price compared to a major supermarket. Ten qualitative interviews with a purposive sample of retailers and other professionals explored experiences of the intervention and provided further insight on quantitative results.ResultsIntervention stores were primarily located in socio-economically disadvantaged areas. Fidelity, in terms of presence of branded materials and equipment, was low and much was not being used as intended. Fresh fruit and vegetables on sale were of high quality and had a purchase price around 10% more than comparable products at a major supermarket.Interviewees were supportive of the health improvement aim of the intervention. Retailers were appreciative of part-funding for chill cabinets and free point-of-sale materials. The intervention suffered from: poor initial and on-going communication between the intervention delivery team and retailers; poor availability of replacement point-of-sale materials; and failure to cement intended links with health workers and community organisations.ConclusionsOverall, intervention fidelity was low and the intervention is unlikely to have had a substantial or long-term effect on customers’ consumption of fruit and vegetables.