Participants In May Research Articles

A randomized trial of aerobic exercise in colorectal cancer: Rationale, design, recruitment, and exercise adherence results

BackgroundPhysical activity is associated with improved disease-free survival in colorectal cancer survivors. This report describes the purpose, design, recruitment, and exercise adherence results of the National Cancer Institute (NCI)-sponsored Exercise and Colorectal Cancer Treatment (EXACT) trial. MethodsThe primary objective of the EXACT trial is to determine if randomization to 150 min per week of moderate-intensity aerobic exercise reduces systemic inflammation among stage I-III colorectal cancer survivors compared with a waitlist control group over 12 weeks. Participants were provided with an in-home treadmill and heart rate monitor. Characteristics associated with randomization were identified using χ2 or Fisher's exact test for categorical variables and t-tests or analysis of covariance (ANCOVA). Exercise adherence was calculated as the total minutes exercised by total minutes prescribed. ResultsBetween August 2019 and February 2023, 3082 colorectal cancer survivors were invited to participate, 89 were screened, and 60 were randomized to the study protocol. Younger age (P = 0.02), female sex (P = 0.002), white race (P = 0.01), proximal time since tumor resection (P = 0.02), and regional tumor stage (P < 0.001) were associated with study participation. Average exercise adherence was 92.2 % (95 % CI: 85.5, 98.8) and all study participants achieved ≥80 % exercise adherence. Endpoint data collection was completed for all participants in May 2023. ConclusionThe results from the EXACT trial will characterize the changes that occur from exercise to advance our understanding of the biological mechanisms by which exercise may prevent tumor recurrence and death in colorectal cancer survivors.

Clinical research nurses perceive their role as being like the hub of a wheel without real power: Empirical qualitative research.

This study aimed to explore the experiences of being a clinical research nurse (CRN), in Sweden. A qualitative study analysing individual interview data. Interviews with 10 participants were conducted in April 2017 and repeated with five participants in May 2022. A semi-structured interview guide was used to cover topics such as experiences of working in a new role and professional challenges related to the role. The transcribed interviews were analysed inductively using qualitative content analysis. The main theme revealed that the CRNs experienced their work role as being like a hub in a wheel, using an ethical compass, but without real power. The six themes identified showed that CRNs worked independently and relied on clinical experiences as nurses but needed more education. They not only had a sense of duty but also too large responsibilities. Furthermore, they viewed their work as valuable and important. However, they needed an accentuated ethical compass and were also affected by power relations that negatively impacted work. Working as a CRN means being in a central position and working independently, which requires diverse skills and competencies. CRNs, however, face and manage complex ethical and practical challenges without real power. They experience huge responsibilities but need education and acknowledgement, indicating a need for improvement. This is an important message to stakeholders and managers about the necessity of taking adequate action to support CRNs who are crucial resources in clinical research. No patient or public contribution.

Dexmedetomidine Versus Midazolam for End-of-Life Sedation and Agitation: Protocol for a Randomized Controlled Trial (The DREAMS Trial).

Sedation at the end of life is used to relieve distressing symptoms including agitation and delirium. Standard care may include infused benzodiazepines or antipsychotics. These agents often result in deep sedation with loss of interaction with loved ones, which may be distressing. The DREAMS (Dexmedetomidine for the Reduction of End-of-life Agitation and for optiMised Sedation) trial aimed to compare the sedative and antidelirium effects of the alpha-2 agonist dexmedetomidine, a novel palliative care sedative, compared with midazolam, a benzodiazepine when administered by subcutaneous infusion at the end of life, with doses of both agents targeting lighter, or potentially interactive sedation. Participants were recruited from adult inpatients admitted for end-of-life care under a palliative care team in regional New South Wales, Australia. Inclusion criteria included patients older than 18 years, with a preference for lighter sedation at the end of life. Exclusion criteria included severe cardiac dysfunction (contraindication to dexmedetomidine). Participants consented and were placed on a treatment-pending list. Upon experiencing terminal deterioration, patients were randomized to either arm 1 (dexmedetomidine) or arm 2 (midazolam) as their treatment arm. These treatments were administered by continuous subcutaneous infusion. The level of consciousness and agitation of the patients were measured by the Richmond Agitation-Sedation Scale-Palliative version and the Memorial Delirium Assessment Score. Richmond Agitation-Sedation Scale-Palliative version assessments were performed by both nursing and medical staff, while Memorial Delirium Assessment Score assessments were carried out by medical staff only. Families and patients were asked to complete, as able, a patient comfort assessment form, to gauge perceptions of distress. Data were collected and matched with the breakthrough medication doses administered, along with qualitative comments in the medical record. In addition, the study tracked symptoms and patient functional status that were recorded as part of the Palliative Care Outcomes Collaborative, a national tracking project for monitoring symptom outcomes in palliative care. The DREAMS trial was funded in May 2020, approved by the ethics committee in November 2020, and started recruiting participants in May 2021. Data collection commenced in May 2021 and is anticipated to continue until December 2024. Publication of results is anticipated from 2024 to 2026. The evidence base for sedative dosing in palliative care for distress and agitation is not robust, with standard care based primarily on clinical experience and not robust scientific evidence. This study is important because it will compare a standard and a novel sedative used in end-of-life treatment. By assessing the potential efficacy and benefits of both, it seeks to optimize the quality of dying by providing targeted sedation that can improve the communication between dying patients and their loved ones. Australia New Zealand Clinical Trials Register ACTRN12621000052831; https://uat.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380889. DERR1-10.2196/55129.

The Influence of Identity on Multiracial Emerging Adults' Health and Experiences Seeking Healthcare in the United States: a Qualitative Study.

The Multiracial population, defined as having parents who are of two or more racial groups, increased from 2.9% of the United States population in 2010 to 10.2% in 2020. Existing research focused on monoracial populations shows that racial disparities and discrimination affect health. This study explores how emerging adults ages 18-29, who identify as Multiracial, describe the impact of identity on their health and experiences seeking health care in the United States. Semi-structured interviews were conducted with 21 participants in May 2021. Interview guide categories were the following: health and wellbeing, racial/ethnic identification, childhood upbringing, family influence, peer engagement, discrimination, forming resilience, language, and demographics. A thematic framework analysis was utilized. Overarching themes were as follows: mental health and Multiracial identity-related stress, childhood experiences, healthcare experiences, influences on seeking or not seeking care, and the impact of identity on physical health. Our findings suggest that Multiracial emerging adults perceive their identity to influence mental health more than physical health. Multiracial emerging adults face challenges with healthcare that are unique (e.g., discrimination based on identity defined or perceived by others) and others that are similar to their monoracial counterparts (e.g., structural racism, access to care). This study illustrates how structural factors trickle down to influence care sought and accessibility via socioeconomic status, insurance, childhood experiences, and racial and cultural beliefs about healthcare. Increased awareness and identification of Multiracial individuals and diversity in the workforce may help the US healthcare system better serve Multiracial emerging adults.

PEMERIKSAAN BERAT BADAN DAN TINGGI BADAN RUTIN SEBAGAI UPAYA OPTIMALISASI TUMBUH KEMBANG ANAK

In order to support the optimal growth and development of children, routine checks on a child's weight and weight are an important step in detecting potential problems or delays in a child's growth from an early age. This community service activity involved 20 participants consisting of students at TPA Al-Amiin aged 4-5 years. The objective of this activity is to conduct regular weight and height check-ups for the students at TPA Al-Amiin to monitor their growth and development.The community service method is carried out by providing routine weight and height check facilities every month at the Al-Amiin TPA. The participants were encouraged to take regular check-ups to monitor the growth of the children. In addition, an educative approach is also carried out through counseling to parents regarding the importance of examining growth and development and its benefits for children's development.The results of this community service show an increase in parental participation in routine checks on child growth and development at the Al-Amiin TPA. The number of participants in May was 20 children with the result that 18 children (90%) were in the normal growth and development category. With regular check-ups, potential problems or developmental delays in children can be detected earlier, so that appropriate interventions can be given to support optimal child development.In conclusion, routine checks on child growth and development at TPA Al-Amiin through community service can provide significant benefits in optimizing children's growth and development. With increased parental participation in examinations, children's development can be monitored regularly and interventions can be made early. These steps can serve as a model for similar institutions in increasing parental participation and optimizing the growth and development of children as a whole.

Hazardous drinking by older adults with chronic conditions during the COVID-19 pandemic: Evidence from a Chicago-based cohort.

It is unclear how older adults with chronic conditions, who have greater risk of alcohol-related adverse outcomes, used alcohol throughout the COVID-19 pandemic. We assess changes in hazardous drinking prevalence May 2020-December 2021 and factors associated with hazardous drinking. Data are from structured phone interviews of older adults (age 60+) with chronic conditions (e.g., hypertension, diabetes, pulmonary disease, heart disease) in a Chicago-based longitudinal cohort (Chicago COVID-19 Comorbidities survey, Waves 3-7, n = 247). We tested differences in the prevalence of hazardous drinking (defined as AUDIT-C score of 3+ for women and 4+ for men) across waves for the full sample, by demographic group (sex, race, and ethnicity), and by chronic condition burden (<3 conditions, 3+ conditions). Generalized estimating equations investigated associations of hazardous drinking with sociodemographic and pandemic coping-related factors (stress, loneliness, outside contacts, depression, anxiety). Participants were 66.8% female; 27.9% non-Hispanic Black, 14.2% Hispanic, 4.9% other race. Hazardous drinking was reported by 44.9% of participants in May 2020, but declined to 23.1% by July-August 2020 and continued to slowly decline to 19.4% by September-December 2021. Differences from May 2020 were significant at the 0.05 level. Subgroups followed similar trajectories. Hazardous drinking prevalence was initially higher but declined more among men than women, consistently higher among non-Hispanic White respondents than among Hispanic and non-Hispanic Black respondents, and declined more rapidly among adults with 3+ chronic conditions. In adjusted models, race and ethnicity were associated with lower prevalence of hazardous drinking (non-Hispanic Black: adjusted prevalence ratio [aPR] = 0.50, 95% confidence interval [CI] = 0.33, 0.74; other race: aPR = 0.26, 95% CI = 0.09, 0.81, compared with non-Hispanic White). No coping-related factors were significantly associated with hazardous drinking. Among a cohort of older adults with chronic conditions, almost half engaged in hazardous drinking in early summer of the COVID-19 pandemic. While prevalence fell, these rates reinforce the need for alcohol screening and intervention in clinical settings among this population.

Shift patterns, physical exercise, and Type 2 diabetes mellitus (T2DM): a prospective cohort study in China.

To examine the relationships between different shift patterns and Type 2 diabetes mellitus (T2DM) risk, and determine whether physical exercise reduced the incidence of T2DM in shift workers in the oil industry. Baseline data were collected from participants in May 2013 who were then followed for 4 years in a prospective cohort study. The cohort initially consisted of 3,002 workers and ultimately included 2,827 people. Baseline and follow-up questionnaires were sent to participants every 2 years (in May 2015 and May 2017) to update medical and lifestyle information during the follow-up period. The risk of T2DM among two shift workers [relative risk (RR) = 3.442, 95% CI: 1.904-6.799)], three shift workers (RR = 2.534, 95% CI: 1.484-4.571), and four shift workers (RR = 4.230, 95% CI: 2.680-7.518) was higher than that among day workers. An increasing trend was observed with respect to T2DM risk, with the lowest risk in three shift workers, moderate risk in two shift workers, and highest risk in four shift workers. In the interactive analysis between shift work and physical exercise, taking part in mild physical exercise increased the risk of T2DM for workers. Four shift workers who took part in mild physical exercise had an increased risk of T2DM. The relative excess risk due to interaction (RERI) was 33.769 (0.398-67.140). The attributable proportion due to interaction [API (%)] was 0.704 (0.529-0.880). The synergy index (SI) was 3.563 (1.900-6.683). Shift work is significantly correlated with increased incidence of T2DM. Risk of T2DM is lowest risk in three shift workers, moderate in two shift workers, and highest in four shift workers. Shift workers who participated in moderate and severe physical exercise had reduced risk of developing T2DM.

The relationships of shift work, hair cortisol concentration and dyslipidaemia: a cohort study in China

BackgroundCurrently, cardiovascular disease is the leading cause of death, and dyslipidaemia is an independent and modifiable major risk factor. Previous studies on shift work with dyslipidaemia and hair cortisol concentration (HCC) have yielded conflicting results. The aim of this study was to clarify the association between shift work, dyslipidaemia, and HCC. We further explored the mediating effect of HCC.MethodsIn this cohort study, baseline data were collected from participants in May 2013. The cohort included 2170 participants- 1348 shift workers and 822 non-shift workers- who were followed up for 6 years with four questionnaire surveys from July 2014, October 2015, and May to December 2019. Hair samples were collected from 340 participants during the baseline period for HCC testing with an automated radioimmunoassay. Dyslipidaemia was defined using the National Cholesterol Education Program Adult Treatment Panel III diagnostic criteria.ResultsShift workers had a higher risk of dyslipidaemia than workers on the fixed day shift (two-shift RR = 1.408, 95% CI: 1.102–1.798; three-shift RR = 1.478, 95% CI: 1.134–1.926; four-shift RR = 1.589, 95% CI: 1.253–2.015). Additionally, shift workers had higher HCC levels than fixed day shift workers, with geometric mean concentration (GMC) ± geometric standard difference (GSD) = 2.625 ± 2.012 ng/g, two-shift GMC ± GSD = 3.487 ± 1.930 ng/g, three-shift GMC ± GSD = 2.994 ± 1.813 ng/g, and four-shift GMC ± GSD = 3.143 ± 1.720 ng/g. High HCC was associated with a high incidence of dyslipidaemia. After controlling for confounding factors, this study showed that HCC played a role in mediating dyslipidaemia in shift workers and accounted for 16.24% of the effect.ConclusionsShift work was linked to increased risk of dyslipidaemia compared with fixed day shift work. Higher HCC was associated with a higher prevalence of dyslipidaemia. HCC had a significant mediating effect on dyslipidaemia in shift workers.

Association of Everyday Discrimination With Depressive Symptoms and Suicidal Ideation During the COVID-19 Pandemic in the All of Us Research Program

The COVID-19 pandemic has coincided with an increase in depressive symptoms as well as a growing awareness of health inequities and structural racism in the United States. To examine the association of mental health with everyday discrimination during the pandemic in a large and diverse cohort of the All of Us Research Program. Using repeated assessments in the early months of the pandemic, mixed-effects models were fitted to assess the associations of discrimination with depressive symptoms and suicidal ideation, and inverse probability weights were applied to account for nonrandom probabilities of completing the voluntary survey. The exposure and outcome measures were ascertained using the Everyday Discrimination Scale and the 9-item Patient Health Questionnaire (PHQ-9), respectively. Scores for PHQ-9 that were greater than or equal to 10 were classified as moderate to severe depressive symptoms, and any positive response to the ninth item of the PHQ-9 scale was considered as presenting suicidal ideation. A total of 62 651 individuals (mean [SD] age, 59.3 [15.9] years; female sex at birth, 41 084 [65.6%]) completed at least 1 assessment between May and July 2020. An association with significantly increased likelihood of moderate to severe depressive symptoms and suicidal ideation was observed as the levels of discrimination increased. There was a dose-response association, with 17.68-fold (95% CI, 13.49-23.17; P < .001) and 10.76-fold (95% CI, 7.82-14.80; P < .001) increases in the odds of moderate to severe depressive symptoms and suicidal ideation, respectively, on experiencing discrimination more than once a week. In addition, the association with depressive symptoms was greater when the main reason for discrimination was race, ancestry, or national origins among Hispanic or Latino participants at all 3 time points and among non-Hispanic Asian participants in May and June 2020. Furthermore, high levels of discrimination were as strongly associated with moderate to severe depressive symptoms as was history of prepandemic mood disorder diagnosis. In this large and diverse sample, increased levels of discrimination were associated with higher odds of experiencing moderate to severe depressive symptoms. This association was particularly evident when the main reason for discrimination was race, ancestry, or national origins among Hispanic or Latino participants and, early in the pandemic, among non-Hispanic Asian participants.

Trends in social exposure to SARS-Cov-2 in France. Evidence from the national socio-epidemiological cohort-EPICOV.

We aimed to study whether social patterns of exposure to SARS-CoV-2 infection changed in France throughout the year 2020, in light to the easing of social contact restrictions. A population-based cohort of individuals aged 15 years or over was randomly selected from the national tax register to collect socio-economic data, migration history, and living conditions in May and November 2020. Home self-sampling on dried blood was proposed to a 10% random subsample in May and to all in November. A positive anti-SARS-CoV-2 ELISA IgG result against the virus spike protein (ELISA-S) was the primary outcome. The design, including sampling and post-stratification weights, was taken into account in univariate and multivariate analyses. Of the 134,391 participants in May, 107,759 completed the second questionnaire in November, and respectively 12,114 and 63,524 were tested. The national ELISA-S seroprevalence was 4.5% [95%CI: 4.0%-5.1%] in May and 6.2% [5.9%-6.6%] in November. It increased markedly in 18-24-year-old population from 4.8% to 10.0%, and among second-generation immigrants from outside Europe from 5.9% to 14.4%. This group remained strongly associated with seropositivity in November, after controlling for any contextual or individual variables, with an adjusted OR of 2.1 [1.7-2.7], compared to the majority population. In both periods, seroprevalence remained higher in healthcare professions than in other occupations. The risk of Covid-19 infection increased among young people and second-generation migrants between the first and second epidemic waves, in a context of less strict social restrictions, which seems to have reinforced territorialized socialization among peers.

COVID-19 advanced respiratory care educational training programme for healthcare workers in Lesotho: an observational study

ObjectiveTo develop and implement a ‘low-dose, high-frequency’ (LDHF) advanced respiratory care training programme for COVID-19 care in Lesotho.DesignProspective pretraining–post-training evaluation.SettingLesotho has limited capacity in advanced respiratory care.ParticipantsPhysicians and nurses.InterventionsDue to...

COVID-19 Vaccinations: Perceptions and Behaviours in People with Primary Ciliary Dyskinesia.

Primary ciliary dyskinesia (PCD) is a rare genetic disease that causes recurrent respiratory infections. People with PCD may be at higher risk of severe coronavirus disease 2019 (COVID-19), and therefore vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important. We studied vaccination willingness, speed of vaccination uptake, side effects, and changes in social contact behaviour after vaccination in people with PCD. We used data from COVID-PCD, an international participatory cohort study. A COVID-19 vaccination questionnaire was emailed to participants in May 2021 and 423 participants from 31 countries replied (median age: 30 years, range 1–85 years; 261 (62%) female). Vaccination uptake and willingness were high, with 273 of 287 adults (96%) being vaccinated or willing to be in June 2021; only 4% were hesitant. The most common reason for hesitancy was fear of side effects, reported by 88%. Mild side effects were common, but no participant reported severe side effects. Half of the participants changed their social behaviour after vaccination by seeing friends and family more often. The high vaccination willingness in the study population might reflect the extraordinary effort taken by PCD support groups to inform people about COVID-19 vaccination. Clear and specific information and involvement of representatives is important for high vaccine uptake.

European Strategic Autonomy: The Test Case of Iran

Abstract The ideal of the European Union (EU) as a global peace and security actor is increasingly clashing with the reality of a multipolar world defined by militarised conflict, and a loosening of the formerly close trans-Atlantic relationship with the United States. European policy-makers have identified strategic autonomy as a possible remedy in the face of a growing number of internal and external security threats. This paper adds to the conceptualisation of strategic autonomy by contextualising its current usage and political genealogy. Empirically, European strategic autonomy is examined concerning the efforts to preserve the Iranian nuclear deal after the Trump administration had ceased US participation in May 2018. In particular, the paper assesses the European response to counter the re-imposed unilateral United States (US) sanctions against European individuals and entities by updating the so-called blocking regulation, and setting up a special purpose vehicle (spv) for facilitating trade with Iran. The results show that the European struggle toward achieving strategic autonomy has largely failed, but that it holds valuable lessons to approximate this ideal in the future.

Self-medication tendencies of patients visiting out-patient departments of Government homoeopathic medical colleges and hospitals in West Bengal, India

Background and aims: Self-medication is mostly prevalent in the low- and middle-income population segments of developing countries, thus reflecting the status of health services. Self-medication has frequently been held responsible for inducing drug resistance, higher cost of further treatment, and other complications. The World Health Organization (WHO) promotes self-medication in rural and remote areas to reduce the burden of health services. In this study, the researchers sought to establish the prevalence, consequences, and causes of self-medication. Methods: Multicenter, institution-based, cross-sectional study conducted with 456 participants in May, 2013 at the outpatient clinics of 2 Government homeopathic medical colleges in West Bengal, India. A pilot-tested structured questionnaire consisting of 12 self-administered questions in local vernacular Bengali was used; 8 were close-ended questions providing multiple answer options, while 4 were open-ended. Results: Overall, 12.7% of interviewees admitted to perform self-medication; 57.7% and 66.0% had appropriate knowledge of the medicines and dose regimens, respectively. Females (64.3%) predominated and self-medication was mostly found in age range 31-45 years old (32.5%). Conventional Western medicine (82.2%) was most preferred therapy, and fever (35.7%), hyperacidity (25.4%) and loose stool (24.3%) the most frequently reported complaints. The main causes for self-medication were feeling no need to consult doctor (32.5%), busy schedule (16.4%), family members advice (16.0%), over-the-counter (OTC) availability of medicines without prescription (12.5%), direct consumer pharmaceutical advertisement (12.1%), and high expenditure in private institutes (10.1%). The chi-square distribution of determinants across the two samples differed significantly. The tendency increased proportionately with literacy (Yates’ χ2=175.731; p=0.000) and poverty (Yates’ χ2=426.817; p=0.000). Conclusion: The results reflect the knowledge, attitude, and practice of self-medication among the participants. Further studies should be undertaken in larger samples and different populations.

Cohort profile: The Swiss Transplant Cohort Study (STCS): A nationwide longitudinal cohort study of all solid organ recipients in Switzerland

PurposeThe Swiss Transplant Cohort Study (STCS) is a prospective multicentre cohort study which started to actively enrol study participants in May 2008. It takes advantage of combining data from all...

To Use or Not to Use a COVID-19 Contact Tracing App: Mixed Methods Survey in Wales.

BackgroundMany countries remain in the grip of the COVID-19 global pandemic, with a considerable journey still ahead toward normalcy and free mobility. Contact tracing smartphone apps are among a raft of measures introduced to reduce spread of the virus, but their uptake depends on public choice.ObjectiveThe objective of this study was to ascertain the views of citizens in Wales on their intended use of a COVID-19 contact tracing smartphone app, including self-proposed reasons for or against use and what could lead to a change of decision.MethodsWe distributed an anonymous survey among 4000 HealthWise Wales participants in May 2020. We adopted a mixed methods approach: responses to closed questions were analyzed using descriptive and inferential statistics; open question responses were analyzed and grouped into categories.ResultsA total of 976 (24.4%) people completed the survey. Smartphone usage was 91.5% overall, but this varied among age groups. In total, 97.1% were aware of contact tracing apps, but only 67.2% felt sufficiently informed. Furthermore, 55.7% intended to use an app, 23.3% refused, and 21.0% were unsure. The top reasons for app use were as follows: controlling the spread of the virus, mitigating risks for others and for oneself, and increasing freedoms. The top reasons against app use were as follows: mistrusting the government, concerns about data security and privacy, and doubts about efficacy. The top response for changing one’s mind about app use from being willing to being unwilling was that nothing would; that is, they felt that nothing would cause them to become unwilling to use a contact tracing app. This was also the top response for changing one’s mind from being unwilling to being willing to use contact tracing apps. Among those who were unsure of using contact tracing apps, the top response was the need for more information.ConclusionsRespondents demonstrated a keenness to help themselves, others, society, and the government to avoid contracting the virus and to control its spread. However, digital inclusion varied among age groups, precluding participation for some people. Nonetheless, unwillingness was significant, and considering the nature of the concerns raised and the perceived lack of information, policy and decision-makers need to do more to act openly, increase communication, and demonstrate trustworthiness if members of the public are to be confident in using an app.

Do University Students Base Decisions to Engage in Sustainable Energy Behaviors on Affective or Cognitive Attitudes?

It is essential to understand the determinants of university students’ decisions to engage in sustainable energy behaviors, as this understanding has implications for the development of communication and education strategies to promote sustainable energy behaviors. The present study aims to investigate the impacts of affective and cognitive factors on sustainable energy behaviors among university students. It will explore the affective factors of self-responsibility and social norms and the cognitive factors of environmental concerns, perceived self-efficacy, perceived self-benefits, and action knowledge about sustainable energy behaviors. A simple random technique was used to select participants from undergraduate students at King Mongkut’s University of Technology Thonburi (KMUTT) in Bangkok, Thailand. Questionnaire surveys were completed by 426 participants in May and June 2020. Multiple regression analyses were used to test the ability of affective and cognitive variables to predict university students’ participation in sustainable energy behaviors. The results revealed that participation in sustainable energy behaviors was significantly impacted by the perceived benefit of sustainable energy behaviors, students’ concerns about climate change, perceived self-efficacy, and social norms; self-responsibility and action knowledge had no significant impact. These findings indicate that communication that focuses on climate change and approaches that enhance students’ self-efficacy and the perceived benefits of sustainable energy behaviors could help promote such behaviors among university students. The sustainable energy behaviors of other social groups, including students’ family members and colleagues and the general public, are also influential as they can motivate students to change their behavior.

P74 Diet Behavior During COVID: A Qualitative Study of Former Participants of a Food Security Intervention

<h3>Background</h3> The Georgia Food for Health program (GF4H) is a clinic-based nutrition education and food security intervention program that has demonstrated the ability to improve dietary behaviors. However, little is known about changes in behaviors during COVID-related lockdowns. <h3>Objective</h3> To characterize diet behavior changes experienced by former participants of a food security intervention during COVID-related lockdowns. <h3>Study Design & Setting</h3> We conducted semi-structured interviews by phone with 17 patient participants in May - June 2020 with program participants who had completed the program within the past 6 months. Participants were asked questions about the program, diet and stress-related behaviors, and changes in these behaviors within the COVID lockdown period. <h3>Participants</h3> Participants were mainly middle-aged (mean age 59 years), African American (100%), women (59%). Approximately half screened positive for food insecurity (47.1%). All participants were healthy at the time of the interview. <h3>Analysis</h3> Transcripts of interviews were analyzed for both apriori and emergent themes using thematic analysis. <h3>Results</h3> We identified 3 central themes. First, participants discussed changes in shopping behaviors to minimize time spent in stores using approaches like shopping lists to plan routes within the store or sending younger relatives to shop for them. Due to supply issues at stores, participants discussed adapting recipes to include available options. Second, participants discussed disinterest in cooking, a lack of motivation to engage in healthy eating strategies they had previously adopted, and anticipation of regretting these behaviors post-COVID. Third, participants were largely uncomfortable at the prospect of resuming in-person programming and preferred virtual options due to safety concerns. <h3>Conclusion</h3> Among former participants of the GF4H program, shopping and cooking behaviors shifted during the COVID-19 lockdown period to adapt to safety guidelines and to overcome supply issues. Motivation to engage in healthy cooking and eating behaviors was diminished. Ongoing program efforts should focus on virtual options to engage and re-engage participants.

Experiences of frontline Pakistani emigrant physicians combating COVID-19 in the United Kingdom: a qualitative phenomenological analysis

BackgroundThis study aims to explore the experiences, beliefs, feelings, and challenges faced by Pakistani migrant doctors working in the United Kingdom in times of the COVID-19 pandemic. The qualitative study aims to explore the lived experiences, beliefs, feelings, and challenges faced by Pakistani migrant physicians working in the United Kingdom during the COVID-19 pandemic.MethodsAn exploratory phenomenological approach was used to collate data on experiences expressed during the COVID-19 pandemic. Purposive and snowball sampling was used to target participants, which were doctors of Pakistani origin involved in the direct care and management of COVID-19 patients in different NHS hospitals of the United Kingdom. Semi-structured, in-depth telephonic interviews were conducted with study participants in May 2020. Data analysis was done parallel with data collection by using an inductive qualitative approach.ResultsWe recruited ten frontline physicians. Four theme categories emerged from the data analysis: 1) Working across borders and cultures, 2) Role of beliefs for coping with stress and fear, 3) Passion and profession, and 4) Scaffolding the Pakistani health system. Overall, the results show that the participants received limited professional support, in terms of counseling and psychological rehabilitation. Instead, they had to use self-management strategies to cope with the situation.ConclusionThe intensive work exhausted participants physically and emotionally. They were holding a lot of grief and hurt inside, but still, healthcare professionals showed the spirit of professional dedication to overcome difficulties. Although currently coping with their emotional problems, comprehensive professional support should be made available to cater to the wellbeing of frontline physicians.

A less objectionable greed? Work-life conflict and unjust pay during a pandemic

Perceptions of unjust pay represent a central feature in research on distributive justice. Prior studies document that work-life conflict (WLC) is a strong predictor of unjustly low pay. We extend that work by asking: Did the social and economic changes associated with the coronavirus pandemic 2019 (COVID-19) modify the relationship between WLC and perceptions of unjust pay? In September 2019, we collected data from a nationally representative sample of workers to profile the quality of work and economic life. Then, during a critical period of widespread economic and social shockwaves, we re-interviewed these same study participants in May 2020 to evaluate change. We observe that the strong positive association between WLC and unjustly low pay decreased overall in the population—but the strength and direction of that association differed significantly across several dimensions of social stratification. Specifically, we found a weaker relationship among visible minorities, younger workers, and individuals with lower socioeconomic status. We interpret these patterns as suggesting that—at least among more vulnerable groups—the “greed” represented in the process of work interfering with non-work was unevenly experienced during peak period of the COVID-19 pandemic.