Behavioral predictors associated with HIV screening needs in gay Korean men during the COVID-19 pandemic.

During the pandemic, the capacity of medical resources focused on testing, diagnosing and treating COVID-19 has severely limited public access to health care. In particular, HIV screening, for which homosexual males in Korea received free and anonymous testing at public health centers, was completely halted. This study investigated behavioral predictors related to the HIV screening needs of Korean male homosexuals during the pandemic. Data were collected by conducting a web survey targeting members of the largest homosexual portal site in Korea with support from the National Research Foundation of Korea (n = 1,005). The key independent variables are COVID-19-related characteristics and sexual risk behavior. The moderating variable is health information search behavior, and the dependent variable is the need for HIV screening. For a statistical analysis, a hierarchical multiple logistic regression analysis was conducted while controlling for potential confounding variables. According to the results of this study, the need for HIV screening was 0.928 times lower for older people (p<0.05, 95% CI = 0.966-0.998). However, if the respondent had a primary partner, the need for HIV screening was 1.459 times higher (p<0.01, 95% CI = 1.071-1.989). In addition, the need for screening was 1.773 times higher for those who preferred anal intercourse (p<0.01, 95% CI = 1.261-2.494) and 2.034 times higher (p<0.01, 95% CI = 1.337-3.095) if there was a history of being diagnosed with an STD. Finally, health information-seeking behavior was marginally significant. This study revealed that male Korean homosexuals who were young, preferred anal sex with a primary partner, and who had a history of a sexually transmitted disease had a high need for HIV screening at public health centers. They are more likely to be susceptible to HIV infection because they are usually consistent with gay men, characterized by risky behavior. Therefore, an intervention strategy that provides health information using a communication campaign is needed.

CRISIS AFAR: an international collaborative study of the impact of the COVID-19 pandemic on mental health and service access in youth with autism and neurodevelopmental conditions.

BACKGROUND: Heterogeneous mental health outcomes during the COVID-19 pandemic are documented in the general population. Such heterogeneity has not been systematically assessed in youth with autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDD). To identify distinct patterns of the pandemic impact and their predictors in ASD/NDD youth, we focused on pandemic-related changes in symptoms and access to services. METHODS: Using a naturalistic observational design, we assessed parent responses on the Coronavirus Health and Impact Survey Initiative (CRISIS) Adapted For Autism and Related neurodevelopmental conditions (AFAR). Cross-sectional AFAR data were aggregated across 14 European and North American sites yielding a clinically well-characterized sample of N = 1275 individuals with ASD/NDD (age = 11.0 ± 3.6 years; n females = 277). To identify subgroups with differential outcomes, we applied hierarchical clustering across eleven variables measuring changes in symptoms and access to services. Then, random forest classification assessed the importance of socio-demographics, pre-pandemic service rates, clinical severity of ASD-associated symptoms, and COVID-19 pandemic experiences/environments in predicting the outcome subgroups. RESULTS: Clustering revealed four subgroups. One subgroup-broad symptom worsening only (20%)-included youth with worsening across a range of symptoms but with service disruptions similar to the average of the aggregate sample. The other three subgroups were, relatively, clinically stable but differed in service access: primarily modified services (23%), primarily lost services (6%), and average services/symptom changes (53%). Distinct combinations of a set of pre-pandemic services, pandemic environment (e.g., COVID-19 new cases, restrictions), experiences (e.g., COVID-19 Worries), and age predicted each outcome subgroup. LIMITATIONS: Notable limitations of the study are its cross-sectional nature and focus on the first six months of the pandemic. CONCLUSIONS: Concomitantly assessing variation in changes of symptoms and service access during the first phase of the pandemic revealed differential outcome profiles in ASD/NDD youth. Subgroups were characterized by distinct prediction patterns across a set of pre- and pandemic-related experiences/contexts. Results may inform recovery efforts and preparedness in future crises; they also underscore the critical value of international data-sharing and collaborations to address the needs of those most vulnerable in times of crisis.

Benefits of Virtual Reality Program and Motor Imagery Training on Balance and Fall Efficacy in Isolated Older Adults: A Randomized Controlled Trial.

Background and Objectives: for isolated older adults, alternative training indoors to maintain balance is essential; however, related studies are lacking. To improve the balance of isolated older adults and reduce their fear of falling, we aimed to examine the balance-keeping effect of a virtual reality (VR) program and motor imagery training (MIT) and propose training that could improve physical activity among older adults. Methods: a total of 34 older adults admitted to a convalescent hospital were assessed. VR (n = 12) and MIT (n = 10) groups completed their assigned intervention in six weeks, whereas the control group (CG) (n = 12) did not. The follow-up was performed after two weeks. Results: in group × time interactions, body center movement area, open and closed eyes balance scores, and fall efficacy were significantly different (p < 0.05). In contrast with the VR group, the MIT group did not show a significant difference in the open or closed eyes balance scores depending on the period. However, there was a significant difference between the MIT group and CG in the open eyes balance score post-test (d = 1.13, 95% confidence interval, 0.40-12.33). Conclusions: we propose VR and MIT as training methods to prevent physical weakness in isolated older adults.

Neck Stabilization Exercises Enhance Respiratory Function after Stroke: Respiratory Function Index Change Trajectory Analyzed Using a Hierarchical Linear Model.

Background and Objectives: This study aimed to assess the effect of neck stabilization exercise on respiratory function in stroke patients through longitudinal observation and determine whether there is a difference in its effect based on the side of paralysis in the patients. It is difficult to observe the amount of change observed in individuals and groups as most intergroup comparison studies only use mean values. To address these shortcomings, this study adopted a hierarchical linear model (HLM) in our trajectory analysis. Materials and Methods: We conducted neck stabilization training three times a week for four weeks in a single group of 21 stroke patients. To evaluate respiratory function, their forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiration ratio (FEV1/FVC), and peak cough flow (PCF) were measured. Data analysis was performed using HLM 8.0. Results: A significant increase was found in the respiratory function after neck stabilization training (p < 0.05). While neck stabilization training overall was longitudinally effective, the growth rate of respiratory function in left-sided paralytic patients was less than the whole group value. Conversely, the growth rate of respiratory function in right-sided paralytic patients was greater than the whole group value. Conclusions: This study demonstrated that neck stabilization training is longitudinally effective in improving respiratory function in stroke patients. Additionally, the growth rate of respiratory function was greater in patients with right side paralysis than in patients with left side paralysis.

The Brief Observation of Symptoms of Autism (BOSA): Development of a New Adapted Assessment Measure for Remote Telehealth Administration Through COVID-19 and Beyond.

Interest in telehealth assessment for autism has increased due to COVID-19 and subsequent expansion of remote psychological services, though options that are easy for clinicians to adopt and available through the lifespan are limited. The Brief Observation of Symptoms of Autism (BOSA) provides a social context with standardized materials and activities that can be coded by clinicians trained in the Autism Diagnostic Observation Schedule. The current project examined psychometric properties to determine optimal use for each BOSA version. Three hundred and seven participants with 453 BOSAs were included to determine best performing items for algorithms, validity, sensitivity, specificity, recommended cut-offs, and proposed ranges of concern. While preliminary, the BOSA provides a promising new option for telehealth-administered assessment for autism.

Diagnostic Evaluations of Autism Spectrum Disorder during the COVID-19 Pandemic.

A global pandemic has significantly impacted the ability to conduct diagnostic evaluations for autism spectrum disorder (ASD). In the wake of the coronavirus, autism centers and providers quickly needed to implement innovative diagnostic processes to adapt in order to continue serve patient needs while minimizing the spread of the virus. The International Collaborative for Diagnostic Evaluation of Autism (IDEA) is a grassroots organization that came together to discuss standards of care during the pandemic and to provide a forum wherein providers communicated decisions. This white paper is intended to provide examples of how different centers adjusted their standard approaches to conduct diagnostic evaluations for ASD during the pandemic and to provide insight to other centers as they go through similar challenges.