Onset Of COVID-19 Pandemic Research Articles

Trajectories of internalizing symptoms among autistic and nonautistic youth during the COVID-19 pandemic.

The COVID-19 pandemic elicited increases in anxiety and depression in youth, and youth on the autism spectrum demonstrate elevations in such symptoms pre-pandemic. However, it is unclear whether autistic youth experienced similar increases in internalizing symptoms after the COVID-19 pandemic onset or whether decreases in these symptoms were present, as speculated in qualitative work. In the current study, longitudinal changes in anxiety and depression during the COVID-19 pandemic in autistic youth were assessed in comparison to nonautistic youth. A well-characterized sample of 51 autistic and 25 nonautistic youth (ageM = 12.8, range = 8.5-17.4 years, IQ > 70) and their parents completed the Revised Children's Anxiety and Depression Scale (RCADS), a measure of internalizing symptoms, repeatedly, representing up to 7 measurement occasions from June to December 2020 (N ~ 419 occasions). Multilevel models were used to evaluate changes in internalizing symptoms over time. Internalizing symptoms did not differ between autistic and nonautistic youth in the summer of 2020. As reported by youth themselves, internalizing symptoms decreased in autistic youth, both overall and compared to nonautstic peers. This effect was driven by decreases in generalized anxiety, social anxiety, and depression symptoms in autistic youth. Reductions in generalized anxiety, social anxiety, and depression in autistic youth may be due to COVID-19 pandemic-specific differences in response to social, environmental, and contextual changes that unfolded in 2020. This highlights the importance of understanding unique protective and resilience factors that may be evident in autistic individuals in response to broad societal shifts such as those seen in response to COVID-19.

Civil society priorities forglobal health: concepts andmeasurement.

The global health agenda-a high stakes process in which problems are defined and compete for the kind of serious attention that promises to help alleviate inequities in the burden of disease-is comprised of priorities set within and among a host of interacting stakeholder arenas. This study informs crucial and unanswered conceptual and measurement questions with respect to civil society priorities in global health. The exploratory two-stage inquiry probes insights from experts based in four world regions and pilots a new measurement approach, analysing nearly 20 000 Tweets straddling the COVID-19 pandemic onset from a set of civil society organizations (CSOs) engaged in global health. Expert informants discerned civil society priorities principally on the basis of observed trends in CSO and social movement action, including advocacy, programme, and monitoring and accountability activities-all of which are widely documented by CSOs active on Twitter. Systematic analysis of a subset of CSO Tweets shows how their attention to COVID-19 soared amidst mostly small shifts in attention to a wide range of other issues between 2019 and 2020, reflecting the impacts of a focusing event and other dynamics. The approach holds promise for advancing measurement of emergent, sustained and evolving civil society priorities in global health.

Zero Suicide Quality Improvement: Developmental and Pandemic-Related Patterns in Youth at Risk for Suicide Attempts

ABSTRACT The Zero Suicide (ZS) approach to health system quality improvement (QI) aspires to reduce/eliminate suicides through enhancing risk detection and suicide prevention services. This first report from our randomized trial evaluating a stepped care for suicide prevention intervention within a health system conducting ZS-QI describes (1) our screening and case identification process, (2) variation among adolescents versus young adults, and (3) pandemic-related patterns during the first COVID-19 pandemic year. Between April 2017 and January 2021, youths aged 12–24 years with elevated suicide risk were identified through an electronic health record (EHR) case-finding algorithm followed by direct assessment screening to confirm risk. Eligible/enrolled youth were evaluated for suicidality, self-harm, and risk/protective factors. Case finding, screening, and enrollment yielded 301 participants showing suicide risk indicators: 97% past-year suicidal ideation, 83% past suicidal behavior; and 90% past non-suicidal self-injury (NSSI). Compared to young adults, adolescents reported more past-year suicide attempts (47% vs. 21%, p < .001) and NSSI (past 6 months, 64% vs. 39%, p < .001); less depression, anxiety, posttraumatic stress, and substance use; and greater social connectedness. Pandemic onset was associated with lower participation of racial-ethnic minority youths (18% vs. 33%, p < .015) and lower past-month suicidal ideation and behavior. Results support the value of EHR case-finding algorithms for identifying youths with potentially elevated risk who could benefit from suicide prevention services, which merit adaptation for adolescents versus young adults. Lower racial-ethnic minority participation after the COVID-19 pandemic onset underscores challenges for services to enhance health equity during a period with restricted in-person health care, social distancing, school closures, and diverse stresses.

FAIMER Global Faculty Development: A Sustainable Partnership Model to Advance Health Professions Education.

The Foundation for Advancement of International Medical Education and Research (FAIMER), a member of Intealth, offers longitudinal faculty development programs (LFDPs) in health professions education (HPE) and leadership through its International FAIMER Institute (IFI) in the United States and FAIMER Regional Institutes (FRIs) globally. FAIMER fosters mutual collaboration and delineates shared responsibilities for FRI development in partnership with local institutions, using an adapted hub-and-spoke organizational design. This paper describes FAIMER's model, its sustainability, and its impacts at individual, institutional, and national levels. IFI was launched in 2001 in Philadelphia, Pennsylvania, as a 2-year part-time hybrid LFDP; with the COVID-19 pandemic onset, IFI transitioned to a fully online program. Since FAIMER's launch, 11 FRIs developed in Brazil, Chile, China, Egypt, India, Indonesia, and South Africa, each modeled on the IFI curriculum and adapted to local context. The more than 1,600 IFI and FRI graduates (fellows) from over 55 countries now form a global community of health professions educators who have shared exposure to HPE methods and assessment, leadership and management, educational scholarship and research, and project management and evaluation. Across all global locations and program formats, fellows self-reported a similar increase in knowledge and skills in HPE. All programs center on the fellows' institutional projects as experiential learning; these projects have focused primarily on educational methods and curriculum revisions. An increased quality of education was reported as the top impact resulting from fellows' projects. As a result of these programs, fellows have influenced education policy in their countries and established academic societies for HPE, thus contributing to recognition of the HPE academic specialty. FAIMER has successfully developed a sustainable model for advancing HPE globally, creating a vibrant network of health professions educators who have influenced country-specific educational policy and practice. FAIMER's model offers one approach to building global capacity in HPE.

Working-from-home persistently influences sleep and physical activity 2 years after the Covid-19 pandemic onset: a longitudinal sleep tracker and electronic diary-based study.

Working from home (WFH) has become common place since the Covid-19 pandemic. Early studies observed population-level shifts in sleep patterns (later and longer sleep) and physical activity (reduced PA), during home confinement. Other studies found these changes to depend on the proportion of days that individuals WFH (vs. work from office; WFO). Here, we examined the effects of WFH on sleep and activity patterns in the transition to normality during the later stages of the Covid-19 pandemic (Aug 2021-Jan 2022). Two-hundred and twenty-five working adults enrolled in a public health study were followed for 22 weeks. Sleep and activity data were collected with a consumer fitness tracker (Fitbit Versa 2). Over three 2-week periods (Phase 1/week 1-2: August 16-29, 2021; Phase 2/week 11-12: October 25-November 7, 2021; Phase 3/week 21-22: January 3-16, 2022), participants provided daily Fitbit sleep and activity records. Additionally, they completed daily phone-based ecological momentary assessment (EMA), providing ratings of sleep quality, wellbeing (mood, stress, motivation), and information on daily work arrangements (WFH, WFO, no work). Work arrangement data were used to examine the effects of WFH vs. WFO on sleep, activity, and wellbeing. The proportion of WFH vs. WFO days fluctuated over the three measurement periods, mirroring evolving Covid restrictions. Across all three measurement periods WFH days were robustly associated with later bedtimes (+14.7 min), later wake times (+42.3 min), and longer Total Sleep Time (+20.2 min), compared to WFO days. Sleep efficiency was not affected. WFH was further associated with lower daily step count than WFO (-2,471 steps/day). WFH was associated with higher wellbeing ratings compared to WFO for those participants who had no children. However, for participants with children, these differences were not present. Pandemic-initiated changes in sleep and physical activity were sustained during the later stage of the pandemic. These changes could have longer term effects, and conscious effort is encouraged to harness the benefits (i.e., longer sleep), and mitigate the pitfalls (i.e., less physical activity). These findings are relevant for public health as hybrid WHF is likely to persist in a post-pandemic world.

Differences in a Chain Supermarket's Sales to SNAP Shoppers Before and Since the COVID-19 Pandemic

ObjectiveThis study 1) compares grocery sales to Supplemental Nutrition Assistance Program (SNAP) shoppers in rural and urban grocery stores and 2) estimates changes in sales to SNAP shoppers in North Carolina (NC) since the pandemic. DesignWeekly transaction data among loyalty shoppers at a large grocery chain across NC from October 2019 to December 2020 (n = 32; 182 store weeks) to assess nutritional outcomes. SettingNorth Carolina large chain grocery stores. ParticipantsLarge chain grocery store/SNAP shoppers. InterventionRural/urban status of the stores and COVID-19 pandemic onset. Main Outcome MeasuresShare of total calories sold from fruits, vegetables, nuts, and legumes (FVNL) with and without additives, sugar-sweetened beverages (SSB), less healthful foods (LHF), and processed meats (PM). AnalysisMultivariate random effects models with robust standard errors to examine the association of rural/urban status before and since coronavirus disease 2019 with the share of calories sold to SNAP shoppers from each food category. We controlled for county-level factors (eg, sociodemographic composition, food environment) and store-level factors. ResultsWe did not find significant rural-urban differences in the composition of sales to SNAP shoppers in adjusted models. There was a significant decrease in the mean share of total calories from sugar-sweetened beverages (−0.43%) and less healthful food (−1.32%) and an increase in the share from processed meats (0.09%) compared with before the pandemic (P < 0.05). Conclusions and ImplicationsUrban-rural definitions are insufficient to understand nuances in food environments, and more support is needed to ensure healthy food access.

Use of the main psychoactive drugs during the COVID-19 pandemic among higher education student

Background: The higher education student population has a special risk of use and abuse of psychoactive drugs. Objective: To analyze the use of psychoactive drugs in higher education students and their relationship with the sociodemographic variables and the COVID-19 pandemic onset. Methodology: An analytical, observational, and cross-sectional study was conducted. Data were collected through a questionnaire applied after the first semester of the 2020/2021 school year to 8875 students of the Polytechnic Institute of Bragança from Portugal. A stratified sample of 825 participants for each of the five schools. Results: Alcohol and tobacco are the most used and abused substances due to the practice of binge drinking/smoking. Psychoactive and recreational drugs are less used. Use is affected by sociodemographic variables: gender, age, school, chronic diseases, and parents’ education/occupation. During the pandemic COVID-19, students perceive an increase in use except for alcohol. Conclusion: The use of psychoactive drugs in higher education students is affected by sociodemographic variables and the COVID-19 pandemic.

Faculty and students’ perspectives of online learning during COVID-19 crisis: Constraints and opportunities for Kenyan universities

At the onset of COVID-19 pandemic, all higher education institutions had to abruptly migrate from face-to-face mode of learning to virtual learning. Students and faculty members were thrown into the process of acquainting themselves with a fully virtual system. How prepared were institutions, faculty members, and students for the abrupt and massive transition to online learning? The study examined the faculty and students’ perspective of online learning during COVID-19 pandemic. Specifically, the study examined the perceptions of faculty and students on the preparedness of higher education institutions for online teaching and learning. The study also determined the perceptions of staff and students towards online education, constraints, and opportunities. A descriptive cross-sectional survey was conducted at a public university in Kenya. A semi-structured interview was conducted on a total sample of 36 respondents; 24 students and 12 faculty members to capture unique, idiosyncratic and whole individual viewpoints. A conventional Content Analysis was done to determine words or concepts within the transcripts. The findings showed that the study institution, faculty members, and students were unprepared for the immediate and massive shift to online teaching and learning and had challenges using virtual technologies for teaching and learning during the lockdown. These challenges ranged from insufficient or lack of internet bandwidth, training, increased teaching and learning workloads to limited time for interactions. Based on the findings, the study suggests significant implications for higher education institution leaders, policymakers, faculty, and students. The study contributes to the existing literature by analyzing the perceptions of faculty and students about the preparedness of institutions, faculty, and students on the abrupt shift to online learning during the COVID-19 pandemic.

Characteristics of the Patient's Internet Account (IKP) users in Poland between 2019 and 2021

Objective This retrospective database analysis aimed to characterize Patient's Internet Account (IKP) users in Poland, before and after the COVID-19 pandemic onset. Methods Data were received from the e-Health Centre – public administration office tasked with the digitization of healthcare in Poland. Data on the number of newly created Patient's Internet Accounts between January 2019 and December 2021 were collected. Moreover, data on the gender and age of the users were also analyzed. Results Between January 2019 and December 2021, the cumulative number of Patient’s Internet Account users increased from 32.6 thousand to 14.1 million. In 2021, December 2021, the cumulative number of Patient’s Internet Account users more than doubled (from 5.6 million in January to 14.1 million in December). In 2019, the monthly number of newly created Patient’s Internet Accounts varied from 17 thousand in February to 180 thousand in December. In the last quarter of 2020 (lifting major anti-epidemic restrictions), a significant increase in the monthly number of newly created Patient’s Internet Accounts was observed (500 thousand accounts per month). The highest number of newly created Patient’s Internet Accounts (over 1.25 million) was in April and July 2021. In December 2021, the highest number (3.3 million) of active Patient’s Internet Accounts was among children aged 0-17 (parental access) and Individuals aged 31-40 years (2.7 million). Conclusions This study revealed high interest in Patient’s Internet Accounts during the COVID-19 pandemic. An increase in the number of Patient’s Internet Account users was related to the new service functionalities such as COVID-19 test results and COVID-19 vaccination appointments.

Speleomycology of Air in Stopića Cave (Serbia).

Fungi can colonize organic matter present in subterranean sites and have a significant role as dwellers in different microniches of cave habitats. In order to analyze the content of airborne fungal propagules in different parts of "Stopića Cave," a touristic site in Serbia, air sampling was carried out in three seasons during 2020, prior to and during the onset of COVID-19 pandemic. Culturable mycobiota was identified using both microscopic techniques and ITS region/BenA gene barcoding, while multivariate analyses were employed to establish the link between fungal taxa and different environmental factors. The maximal measured fungal propagule concentrations were recorded during spring sampling which were based on fungal propagule concentration categories; the cave environment matches the category V. A total of 29 fungal isolates were identified, while Aspergillus, Cladosporium, Fusarium, Lecanicillium, Mucor, and Penicillium were the most diverse genera. According to the trophic mode, most of the isolated fungal species were pathotrophs (75.86%), but when regarding ecological guilds, the most dominant were undefined saprobes and animal pathogens (41.38% for each). Show caves are especially vulnerable to human impacts, and the fungal propagules' concentration within the caves could be good indices for the level of ecological disturbance.

High-performance association rule mining: Mortality prediction model for cardiovascular patients with COVID-19 patterns

On a global scale, 213 countries and territories have been affected by the coronavirus outbreak. According to researchers, underlying co-morbidity, which includes conditions like diabetes, hypertension, cancer, cardiovascular disease, and chronic respiratory disease, impacts mortality. The current situation requires for immediate delivery of solutions. The diagnosis should therefore be more accurate. Therefore, it's essential to determine each person's level of risk in order to prioritise testing for those who are subject to greater risk. The COVID-19 pandemic's onset and the cases of COVID-19 patients who have cardiovascular illness require specific handling. The paper focuses on defining the symptom rule for COVID-19 sickness in cardiovascular patients. The patient's chronic condition was taken into account while classifying the symptoms and determining the likelihood of fatality. The study found that a large proportion of people with fever, sore throats, and coughs have a history of stroke, high cholesterol, diabetes, and obesity. Patients with stroke were more likely to experience chest discomfort, hypertension, diabetes, and obesity. Additionally, the strategy scales well for large datasets and the computing time required for the entire rule extraction procedure is faster than the existing state-of-the-art method.

Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020

Autism spectrum disorder (ASD). 2020. The Autism and Developmental Disabilities Monitoring Network is an active surveillance program that estimates prevalence and characteristics of ASD and monitors timing of ASD identification among children aged 4 and 8 years. In 2020, a total of 11 sites (located in Arizona, Arkansas, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, Tennessee, Utah, and Wisconsin) conducted surveillance of ASD among children aged 4 and 8 years and suspected ASD among children aged 4 years. Surveillance included children who lived in the surveillance area at any time during 2020. Children were classified as having ASD if they ever received 1) an ASD diagnostic statement in an evaluation, 2) a special education classification of autism (eligibility), or 3) an ASD International Classification of Diseases (ICD) code (revisions 9 or 10). Children aged 4 years were classified as having suspected ASD if they did not meet the case definition for ASD but had a documented qualified professional's statement indicating a suspicion of ASD. This report focuses on children aged 4 years in 2020 compared with children aged 8 years in 2020. For 2020, ASD prevalence among children aged 4 years varied across sites, from 12.7 per 1,000 children in Utah to 46.4 in California. The overall prevalence was 21.5 and was higher among boys than girls at every site. Compared with non-Hispanic White children, ASD prevalence was 1.8 times as high among Hispanic, 1.6 times as high among non-Hispanic Black, 1.4 times as high among Asian or Pacific Islander, and 1.2 times as high among multiracial children. Among the 58.3% of children aged 4 years with ASD and information on intellectual ability, 48.5% had an IQ score of ≤70 on their most recent IQ test or an examiner's statement of intellectual disability. Among children with a documented developmental evaluation, 78.0% were evaluated by age 36 months. Children aged 4 years had a higher cumulative incidence of ASD diagnosis or eligibility by age 48 months compared with children aged 8 years at all sites; risk ratios ranged from 1.3 in New Jersey and Utah to 2.0 in Tennessee. In the 6 months before the March 2020 COVID-19 pandemic declaration by the World Health Organization, there were 1,593 more evaluations and 1.89 more ASD identifications per 1,000 children aged 4 years than children aged 8 years received 4 years earlier. After the COVID-19 pandemic declaration, this pattern reversed: in the 6 months after pandemic onset, there were 217 fewer evaluations and 0.26 fewer identifications per 1,000 children aged 4 years than children aged 8 years received 4 years earlier. Patterns of evaluation and identification varied among sites, but there was not recovery to pre-COVID-19 pandemic levels by the end of 2020 at most sites or overall. For 2020, prevalence of suspected ASD ranged from 0.5 (California) to 10.4 (Arkansas) per 1,000 children aged 4 years, with an increase from 2018 at five sites (Arizona, Arkansas, Maryland, New Jersey, and Utah). Demographic and cognitive characteristics of children aged 4 years with suspected ASD were similar to children aged 4 years with ASD. A wide range of prevalence of ASD by age 4 years was observed, suggesting differences in early ASD identification practices among communities. At all sites, cumulative incidence of ASD by age 48 months among children aged 4 years was higher compared with children aged 8 years in 2020, indicating improvements in early identification of ASD. Higher numbers of evaluations and rates of identification were evident among children aged 4 years until the COVID-19 pandemic onset in 2020. Sustained lower levels of ASD evaluations and identification seen at a majority of sites after the pandemic onset could indicate disruptions in typical practices in evaluations and identification for health service providers and schools through the end of 2020. Sites with more recovery could indicate successful strategies to mitigate service interruption, such as pivoting to telehealth approaches for evaluation. From 2016 through February of 2020, ASD evaluation and identification among the cohort of children aged 4 years was outpacing ASD evaluation and identification 4 years earlier (from 2012 until March 2016) among the cohort of children aged 8 years in 2020 . From 2016 to March 2020, ASD evaluation and identification among the cohort of children aged 4 years was outpacing that among children aged 8 years in 2020 from 2012 until March 2016. The disruptions in evaluation that coincided with the start of the COVID-19 pandemic and the increase in prevalence of suspected ASD in 2020 could have led to delays in ASD identification and interventions. Communities could evaluate the impact of these disruptions as children in affected cohorts age and consider strategies to mitigate service disruptions caused by future public health emergencies.

Supply side stakeholders’ viewpoints about medical tourism in India and the effects of COVID 19

Medical tourism is a field where healthcare and travel both coincide. Herein, people from different parts of the world travel to different countries in order to avail world-class treatment at an affordable price. With the onset of COVID-19 pandemic, this industry has been hit hard. However, this industry has still reflected back the waves of COVID-19 and has emerged better. This paper has made an effort to comprehend the viewpoints and opinions of the providers that accept medical tourism in India. The participants were selected using judgement and snowball sampling. The data was gathered through semi-structured interviews conducted using both face-to-face method as well as telephonic method. The data was then analysed using Atlas.ti software to highlight the various factors affecting medical tourism as well as its interaction with COVID19 pandemic.

Impact of the COVID-19 Pandemic on Providing Recommendations During Goals-of-Care Conversations: A Multisite Survey.

Background: Goals-of-care conversations (GoCCs) are essential for individualized end-of-life care. Shared decision-making (SDM) that elicits patients' goals and values to collaboratively make life sustaining treatment (LST) decisions is best practice. However, it is unknown how the COVID-19 pandemic onset and associated changes to care delivery, stress on providers, and clinical uncertainty affected SDM and recommendation-making during GoCCs. Aim: To assess providers' attitudes and behaviors related to GoCCs during the COVID-19 pandemic and identify factors associated with provision of LST recommendations. Design: Survey of United States Veterans Health Administration (VA) health care providers. Setting/Participants: Health care providers from 20 VA facilities with high COVID-19 caseloads early in the pandemic who had authority to place LST orders and practiced in select specialties (n = 3398). Results: We had 323 respondents (9.5% adjusted response rate). Most were age ≥50 years (51%), female (63%), non-Hispanic white (64%), and had ≥1 GoCC per week during peak-COVID-19 (78%). Compared with pre-COVID-19, providers believed it was less appropriate and felt less comfortable giving an LST recommendation during peak-COVID-19 (p < 0.001). One-third (32%) reported either "never" or "rarely" giving an LST recommendation during GoCCs at peak-COVID-19. In adjusted regression models, being a physician and discussing patients' goals and values were positively associated with giving an LST recommendation (B = 0.380, p = 0.031 and B = 0.400, p < 0.001, respectively) at peak-COVID-19. Conclusion: Providers who discuss patients' preferences and values are more likely to report giving a recommendation; both behaviors are markers of SDM during GoCCs. Our findings suggest potential areas for training in conducting patient-centered GoCCs.

Does pre-COVID impulsive behaviour predict adherence to hygiene and social distancing measures in youths following the COVID-19 pandemic onset? Evidence from a South African longitudinal study.

BackgroundEngagement in protective behaviours relating to the COVID-19 pandemic has been proposed to be key to infection control. This is particularly the case for youths as key drivers of infections. A range of factors influencing adherence have been identified, including impulsivity and risk taking. We assessed the association between pre-COVID impulsivity levels and engagement in preventative measures during the COVID-19 pandemic in a longitudinal South African sample, in order to inform future pandemic planning.MethodsData were collected from N = 214 youths (mean age at baseline: M = 17.81 (SD = .71), 55.6% female) living in a South African peri-urban settlement characterised by high poverty and deprivation. Baseline assessments were taken in 2018/19 and the COVID follow-up was conducted in June–October 2020 via remote data collection. Impulsivity was assessed using the Balloon Analogue Task (BART), while hygiene and social distancing behaviours were captured through self-report. Stepwise hierarchical regression analyses were performed to estimate effects of impulsivity on measure adherence.ResultsSelf-rated engagement in hygiene behaviours was high (67.1–86.1% “most of the time”, except for “coughing/sneezing into one’s elbow” at 33.3%), while engagement in social distancing behaviours varied (22.4–57.8% “most of the time”). Higher impulsivity predicted lower levels of hygiene (β = .14, p = .041) but not social distancing behaviours (β = −.02, p = .82). This association was retained when controlling for a range of demographic and COVID-related factors (β = .14, p = .047) and was slightly reduced when including the effects of a life-skills interventions on hygiene behaviour (β = −.13, p = .073).ConclusionsOur data indicate that impulsivity may predict adolescent engagement in hygiene behaviours post COVID-19 pandemic onset in a high risk, sub-Saharan African setting, albeit with a small effect size. For future pandemics, it is important to understand predictors of engagement, particularly in the context of adversity, where adherence may be challenging. Limitations include a small sample size and potential measure shortcomings.

Long-term functional ability trajectories and mental health among older people before and after the COVID-19 pandemic onset in Chile

Objectives Despite the advances in understanding the complex association between functional abilities and mental health in old age, studies have overlooked two important aspects. First, traditionally, research has employed cross-sectional designs, measuring limitations at a single time point. Second, most gerontological studies on this field have been conducted before the COVID-19 pandemic onset. This study aims to explore the association between diverse long-term functional ability trajectories across late adulthood and old age, and older people’s mental health in Chile, before and after the COVID-19 pandemic onset. Methods We use data from the population-representative and longitudinal ‘Chilean Social Protection Survey’, sequence analysis to reconstruct functional ability trajectory types from 2004 to 2018, and bivariate and multivariate analyses to measure their association with depressive symptoms in early 2020 (N = 891) and late 2020 (N = 672). We analyzed four age groups defined by their age at baseline (2004): people aged 46–50, 51–55, 56–60, and 61–65. Results Our findings indicate that erratic or equivocal patterns of functional limitations across time (with people transiting back and forth between low and high levels of limitations) show the worst mental health outcomes, both before and after the pandemic onset. Prevalence of people with depression increased after the COVID-19 onset in most groups, being particularly high among those with previous equivocal functional ability trajectories. Conclusions The relationship between functional ability trajectories and mental health calls for a new paradigm, moving away from age as the main policy guide, and highlighting the need to adopt strategies to improve population-level functional status as an efficient policy to address the challenges of population aging.

Medical student flourishing before and during the COVID-19 pandemic at one U.S. institution.

Introduction: Medical education research often focuses on measuring negative mental states like burnout, rather than focusing on positive states like well-being. Flourishing - a state that includes domains of happiness and mental health - is a way of thinking about well-being that may be relevant to education and research. The purpose of this prospective, observational study was to compare the relationship among flourishing, other well-being measures, and burnout in medical students via a survey administered at two time points. Methods: We surveyed medical students at one U.S. institution about their flourishing, satisfaction with work-life balance, quality of life, empathic concern, and burnout (emotional exhaustion and depersonalization) before and after the onset of the COVID-19 pandemic. Flourishing was measured using two scores, the Flourish Index (FI) and Secure Flourish Index (SFI), with higher scores indicating greater flourishing. Pre- and post-scores for both measures were compared. Results: 107/585 (18%) medical students responded to the survey and 78/107 (73%) participated in the post survey. At the first time point, respondents reported both a mean FI and SFI 6.7 (SD=1.3); higher levels of flourishing correlated with higher satisfaction with work-life balance (p<.001), higher quality of life (p<.001), and lower levels of burnout (emotional exhaustion p<.001; depersonalization p=.021). SFI scores were higher at the second time point (M=7.1, SD=1.2) than the first (M=6.7, SD=1.3, p=.026). FI, satisfaction with work-life balance, quality of life, empathic concern, and burnout were unchanged at the second time point. Discussion: Like past findings in medical residents, we found medical students' flourishing-as measured by FI and SFI scores-correlated with greater satisfaction with work-life balance, higher quality of life, and lower burnout. In this limited sample, we found flourishing remained largely unchanged after the COVID-19 pandemic onset.

Nowhere to go? A study of marginalization, social connection, and mental health outcomes among young adults experiencing the COVID-19 pandemic

The COVID-19 pandemic onset necessitated large-scale closures of third places, potentially exacerbating social barriers experienced by young adults in the United States. To better understand the role of urban form in facilitating socialization, we examine the effects of pandemic-based third place closures on mental health outcomes as mediated by changes in social connection. Because identifying as a racial, gender, or sexual minority can compound baseline disadvantages rooted in systemic inequities, we investigate outcome differences for non-white, woman/nonbinary, and LGBTQ+ young adults to disentangle identity-based nuances of the pandemic experience. In February 2021, we administered a web-based survey with retrospective name and place generators to 313 18-to-34-year-olds in California, Illinois, and Texas. A structural equation model is estimated showing the direct and indirect effects of physical and virtual mobility constraints on mental health. Both the closure of third places and dissatisfaction with alternative social spaces are associated with the deterioration of social connections and mental health. The strongest direct predictor of mental health decline is dissatisfaction with virtual socialization (more significant for women and nonbinary respondents). Surprisingly, two distinct categories of third places (i.e., 'civic' and 'commercial') reveal different relationships with social connections and mental health outcomes. Asian, other non-white, and non-heterosexual young adults experienced greater 'civic' visit reduction, while those with intersecting identities of low income and woman/nonbinary or Black experienced greater 'commercial' visit reduction. Physical and virtual mobility reductions contributed to the inequitable mental health outcomes experienced by young adults during the pandemic. This highlights the potential for a careful redesign of physical and virtual social spaces to support feelings of belonging/safety and spontaneous 'weak tie' interactions, encourages further investigation of social infrastructure's role in facilitating the maintenance of social connections and mental health, and reveals the value of examining differences in mobility-related experiences across social identities.

Reddit language indicates changes associated with diet, physical activity, substance use, and smoking during COVID-19.

COVID-19 has adversely impacted the health behaviors of billions of people across the globe, modifying their former trends in health and lifestyle. In this paper, we compare the psychosocial language markers associated with diet, physical activity, substance use, and smoking before and after the onset of COVID-19 pandemic. We leverage the popular social media platform Reddit to analyze 1 million posts between January 6, 2019, to January 5, 2021, from 22 different communities (i.e., subreddits) that belong to four broader groups-diet, physical activity, substance use, and smoking. We identified that before the COVID-19 pandemic, posts involved sharing information about vacation, international travel, work, family, consumption of illicit substances, vaping, and alcohol, whereas during the pandemic, posts contained emotional content associated with quarantine, withdrawal symptoms, anxiety, attempts to quit smoking, cravings, weight loss, and physical fitness. Prevalent topic analysis showed that the pandemic was associated with discussions about nutrition, physical fitness, and outdoor activities such as backpacking and biking, suggesting users' focus shifted toward their physical health during the pandemic. Starting from the week of March 23, 2020, when several stay-at-home policies were enacted, users wrote more about coping with stress and anxiety, alcohol misuse and abuse, and harm-reduction strategies like switching from hard liquor to beer/wine after people were socially isolated. In addition, posts related to use of substances such as benzodiazepines (valium, xanax, clonazepam), nootropics (kratom, phenibut), and opioids peaked around March 23, 2020, followed by a decline. Of note, unlike the general decline observed, the volume of posts related to alternatives to heroin (e.g., fentanyl) increased during the COVID-19 pandemic. Posts about quitting smoking gained momentum after late March 2020, and there was a sharp decline in posts about craving to smoke. This study highlights the significance of studying social media discussions on platforms like Reddit which are a rich ecological source of human experiences and provide insights to inform targeted messaging and mitigation strategies, and further complement ongoing traditional primary data collection methods.

Geo-visualization of Sarawak COVID-19 Publicly Available Data Employing Open-source Geospatial Software

The state government of Sarawak with the help of the Sarawak Disaster Management Committee (SDMC) has continuously made the updated information on the state COVID-19 situation and its ensuing control measures available to general public in the form of daily press statements. However, these statements are merely providing textual information on daily basis though the data are in fact rich in temporal and spatial properties. Since the onset of COVID-19 pandemic, spatiotemporal analysis becomes the key element to better understand the spread of COVID-19 in various spatial levels worldwide. Hence, there is an urgent need to convert this textual information into more valuable insights by applying geo-visualization techniques and geospatial statistics. The paper demonstrates the prospect of retrieving geospatial data from publicly available document to locate, map and analyze the spread of COVID-19 up to division level of Sarawak. Specifically, map visualization and geospatial statistical analysis are performed for the list of exposed locations, which are indeed locations visited by COVID-19 patients prior to being tested positive in Kuching division, using open-source geospatial software QGIS. It is found that these exposed locations concentrate on the build-up areas in the division and are in south-west to north-east direction of the center of Kuching in September and October 2021. Despite the number of exposed locations published is relatively small compared to the number of confirmed cases reported, both are nearly strongly correlated. The insights gained from such geospatial analysis may assist the local public health authorities to impose applicable disease control interventions at division level.