ABSTRACT
With the arrival of COVID-19, several U.S. states enacted stay-at-home orders to mitigate spread, but the isolation of quarantine and the uncertainty surrounding the virus were likely to have a detrimental influence on mental health. This study investigates how people discussed COVID-19 in relation to mental health on Twitter. Using Crimson Hexagon, this research examines tweets (N = 2,199,625) for three months following the first confirmed case of COVID-19 in the United States and includes a quantitative analysis of the public's concern about the disease as well as a qualitative thematic analysis of conversations on the topic (n = 800). Results indicate that those who discuss mental health online behave as an active and aware public that recognizes how mental health can be affected during a health crisis. The quantitative analysis shows that when cases of the disease increased, mentions of depression, post-traumatic stress disorder, and psychologists also increased. Additionally, as deaths related to the disease increased, so did mentions of psychologists. Qualitative statistics indicate that this public makes a concerted effort to provide social support and solidarity for others. © 2023 (Jesse King, Audrey Halversen, Olivia Morrow, Whitney Westhoff, and Pamela Brubaker). Licensed under the Creative Commons Attribution Non-commercial No Derivatives (by-nc-nd). Available at http://ijoc.org.
ABSTRACT
Introduction. Patients receiving serial outpatient infusion treatment for lymphoma or breast cancer (BC) with potentially cardio-toxic chemotherapeutic regimens may experience declines in left ventricular ejection fraction (LVEF) and exercise capacity. This study sought to determine if a physical activity intervention (PAI) administered during cancer treatment could attenuate deterioration of exercise capacity and LVEF. Methods. Across two NCI funded cancer centers, we randomized (2:1) 34 participants to a homebased PAI or healthy living education intervention (HLI) within 6 weeks of initiating curative therapies for stage I-IV Hodgkin's, non-Hodgkin's lymphoma, or stage I-III BC (NCT01719562). Training programs were tailored by treatment and functional status and adapted for remote delivery during COVID-19. Exercise capacity was determined via cardiopulmonary exercise test (peak VO2 [ml/kg/min]) and LVEF (%) was determined by magnetic resonance imaging at baseline, 3, and 6 months. Separate linear mixed-effects regression models controlling for baseline values examined changes in peak VO and LVEF by time and treatment group. Results. Demographics were similar between the two arms (PAI vs. HLI, 52.4 [16.3] vs. 56.8 [12.7] years of age [SD];69% vs. 75% white;and 57.7% vs. 50% female). Peak VO 2increased at 3 (+1.15 ml/kg/min [CI: -1.46 - 3.77]) and 6 months (+3.88 ml/kg/min [CI: 0.79 - 6.96]) in the PAI arm, while the HLI arm increased slightly at 3- (+0.67 ml/kg/min [CI: -5.14 - 6.48]) but not 6 months (-0.83 ml/kg/min [CI: -5.99 - 4.33]). LVEF declined slightly at 3 months in the PAI (-2.29% [CI: -4.83 - 0.25]) but not HLI arm (3.05.% [CI: -2.49 - 8.60]), while at 6 months, the PAI arm had returned to baseline LVEF (-0.58% [CI: -4.30 - 3.14]) and the HLI arm declined slightly (-1.76% [CI: -7.23 - 3.71]). Conclusions. This pilot RCT suggests the importance and utility of home-based physical activity during cancer treatment in protecting against expected declines in exercise capacity and LVEF. These results highlight the need for larger randomized trials that examine the effects of lifestyle interventions administered during treatment to improve quality of life and to support long term cardiovascular health in cancer survivors.