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Background. Chlamydia, gonorrhea, and syphilis infections rose in the US for 6 consecutive years before the COVID-19 pandemic. Patterns of sexually transmitted infection (STI) testing during the COVID-19 pandemic have yet to be fully assessed. Methods. We performed a retrospective study of STI testing in the Veteran's Health Administration (VHA) healthcare system during each calendar year 2019-2021 using electronic health record data. We determined the number of chlamydia (CT) and gonorrhea (GC), and syphilis tests performed overall and in demographic groups defined by age, birth sex, self-reported race, region, and HIV status. Results. VHA performed 202,503 CT tests, 201,314 GC tests and 250,790 syphilis tests in 2019, followed by a 23% and 25% decrease in 2020 for CT/GC and syphilis testing, respectively. We observed decreases among all subgroups defined by age, sex, race, and geography. Race groups with the biggest decreases in 2020 include Asian Americans (-28%) and Hawaiian and Pacific Islanders (-27%). By 2021, overall testing rates demonstrated a partial recovery to 89.8% of their 2019 levels. Testing rates in 2021 in rural/ highly rural residents remained 17% below baseline, compared with 10% for urban dwellers. Veterans living in the Northeast, South, or Midwest had the least recovery among geographic regions (16%, 11% and 11% below baseline, respectively). People with HIV experienced a decline in CT/GC testing of 15% but by the end of 2021 this had recovered to 1.9% below baseline. Women experienced both a steeper drop and a smaller recovery in CT and GC testing relative to men Conclusion. After dramatic reductions in STI testing during the COVID-19 pandemic, rates returned to near-baseline levels nationally by 2021. Testing rates have lagged in some patient groups, most notably rural and highly rural populations, women, and Black and Asian American Veterans, placing them at risk for disparities in STI diagnosis, and therefore treatment. Testing rates in Veterans under age 25 years have reached or exceeded pre-pandemic levels. (Figure Presented).
ABSTRACT
Objective: To prospectively determine whether COVID-19 vaccination is associated with change in menstrual cycle length following vaccination. Material(s) and Method(s): We conducted a longitudinal analysis within a subgroup of 13,018 participants in the Apple Women's Health Study (AWHS) who enrolled between November 2019 and December 2021, having met the following eligibility criteria: were living in the U.S., met minimum age requirements for consent, were English speaking, actively tracked their menstrual cycles, and responded to the COVID-19 vaccination update survey. Cycles tracked when participants were not pregnant, lactating, or using hormonal contraceptives were included. We used conditional linear regression and multivariable linear mixed-effects models with random intercepts to estimate the covariate-adjusted difference in mean cycle length, measured in days, between pre-vaccination cycles and post-vaccination cycles within vaccinated participants, and between vaccinated and unvaccinated participants. We present Bonferroni-adjusted confidence intervals to account for multiple comparisons. Result(s): A total of 120,815 cycles (median = 10 cycles per participant;interquartile range: 4-21) from 9,295 women (8,129 vaccinated;1,160 unvaccinated) were included. Forty-eight percent of participants received the Pfizer-BioNTech vaccine, 32% received Moderna, and 7% received Johnson & Johnson/Janssen. We found no evidence of a difference between mean menstrual cycle length in the unvaccinated and vaccinated participants prior to vaccination (0.16 days, 95% CI: -0.44, 0.75). Among vaccinated women, COVID-19 vaccination was associated with a small increase in cycle length for cycles containing the first dose (0.47, 95% CI: 0.17, 0.76) and cycles containing the second dose (0.36, 95% CI: 0.06, 0.65) of Pfizer-BioNTech or Moderna vaccines compared with pre-vaccination cycles. Cycles containing the single dose of Johnson & Johnson/Janssen were, on average, 1.22 days longer (95% CI: 0.41, 2.03) than pre-vaccination cycles. Post-vaccination cycles returned to average pre-vaccination length, with a 0.11 (95% CI: -0.17, 0.38) day increase in mean cycle length in the first cycle following vaccination, 0.12 (95% CI: -0.15, 0.40) in the second, -0.22 (95% CI: -0.50, 0.05) in the third, and -0.25 (95% CI: -0.52, 0.02) in the fourth cycle post-vaccination. Conclusion(s): COVID-19 vaccination was associated with an immediate short-term increase in menstrual cycle length. However, the magnitude of this increase diminished in cycles following vaccination, and no association with cycle length persisted over time. Impact Statement: Menstrual cycle change following COVID-19 vaccination appears temporary and should not discourage women from becoming vaccinated. Copyright © 2022
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Objective: We sought to determine the emotional impact, stress, and burden of the COVID-19 pandemic on movement disorders patients. Background: The COVID-19 pandemic has caused stress for the whole population, as it is the only major incidence of a widespread infectious illness that most have experienced in their lifetime. The impact of COVID-19 on patients with chronic neurodegenerative disease, including movement disorders, is largely unknown. Design/Methods: Over 4 months (May to August 2021), subjects were asked to fill out a subjective questionnaire that asked whether neurological symptoms, relationships, mental health care, finances, or healthcare delays worsened during the COVID-19 pandemic, as well as the Pandemic Emotional Impact Scale (PEIS). The PEIS is a validated scale designed to measure the emotional impact of a worldwide pandemic. The scale has 16 questions, each of which is scored on a scale of 1 to 5, 5 being the worst. The two-sample t-test was used to obtain p-values at α=0.05. Results: The cohort had a mean age of 68.0 ± 10.5 years, with 54% males and 46% females. 62% of subjects had diagnoses of PD, and 38% had either ET, ataxia, or dystonia. The average disease duration for the cohort was 8.80 ± 9.47 years. The mean PEIS score for the cohort was 32.52 ± 12.61 (range 16-80). Higher (worse) PEIS scores were significantly associated with “personal financial loss” (p=0.0077), “worsening neurological symptoms” (p=0.0006), “strained relationships” (p=0.0021), “friends/family experiencing financial loss” (p=0.0006), “friends/family hospitalized” (p=0.0178), “delay in healthcare” (p < 0.0001), and “masks impacting health” (p = 0.0064). Conclusions: Although the emotional burden of COVID-19 was reasonably low in this cohort, patients were affected by financial burden, strained relationships, delays in healthcare, and mask wearing. The mental health and emotional burden of movement disorder patients should be carefully addressed.
ABSTRACT
Research problem: The use of virtual teams (VTs) has been growing steadily since the late 1990s. However, there is disagreement on how the virtuality of a team impacts the relationship of trust and team effectiveness. Some studies have suggested that the operationalization of the virtuality has been simplistic, with most researchers treating virtuality as a binary state. Recently, some researchers have sought to explore more complex conceptualizations of virtuality. Research question: How do dimensions of virtuality impact the relationship between intrateam trust and team effectiveness for virtual teams?Literature review: Researchers have been studying the dynamics of VTs for more than 20 years;however, the prevailing measure of virtuality is unidimensional. Following others, we employ a multidimensional measure of virtuality to model three interactions with the relationship between intrateam trust and team effectiveness. By reviewing relevant team effectiveness, intrateam trust, and virtuality literature, we build a model of team effectiveness based on three dimensions of virtuality. Methodology: A total of 230 subjects on 73 project teams were asked to record their interactions while working on a complex case assignment, allowing us to measure the three dimensions of virtuality. Results: Findings indicate that although Distance Virtuality and Member Virtuality moderate the relationship between intrateam trust and effectiveness, Time Worked Virtually does not, supporting the proposition that virtuality is a multidimensional construct. Conclusion: Differential findings support the multidimensional conceptualization of virtuality. We discuss several implications of our findings for virtual team managers, while paying attention to recent changes in team composition resulting from shelter-in-place orders associated with the COVID-19 pandemic. IEEE