Socioeconomic position and adverse childhood experiences as risk factors for health-related behaviour change and employment adversity during the COVID-19 pandemic: insights from a prospective cohort study in the UK.

BACKGROUND: Non-pharmaceutical interventions to reduce the spread of COVID-19 may have disproportionately affected already disadvantaged populations. METHODS: We analysed data from 2710 young adult participants of the Avon Longitudinal Study of Parents and Children. We assessed the associations of socioeconomic position (SEP) and Adverse Childhood Experiences (ACEs, e.g. abuse, neglect, measures of family dysfunction) with changes to health-related behaviours (meals, snacks, exercise, sleep, alcohol and smoking/vaping), and to financial and employment status during the first UK lockdown between March-June 2020. RESULTS: Experiencing 4+ ACEs was associated with reporting decreased sleep quantity during lockdown (OR 1.53, 95% CI: 1.07-2.18) and increased smoking and/or vaping (OR 1.85, 95% CI: 0.99-3.43); no other associations were seen between ACEs or SEP and health-related behaviour changes. Adverse financial and employment changes were more likely for people with low SEP and for people who had experienced multiple ACEs; e.g. a history of 4+ ACEs was associated with being furloughed or on other leave during lockdown (OR 1.92, 95% CI: 1.35-2.74). CONCLUSIONS: In this sample of young adults, there was little evidence that lockdown worsened inequalities in health-related behaviours. However, adverse financial and employment consequences of lockdown were more likely to be experienced by people who have already experienced socioeconomic deprivation or childhood adversity, thereby widening social inequalities and demonstrating the need for support into adulthood for those with a history of ACEs.

Assessing health-related behaviors among Jordanian children during COVID-19 pandemic: A cross-sectional study.

Background: The coronavirus disease identified in 2019 (COVID-19) led to extreme actions being taken by the governments to restrict the spread of this virus. Closure of schools, sport clubs and playgrounds were among these actions; children had to stay indoors and were not allowed to pursue their normal lifestyle activities. Objectives: To assess the differences in health-related behaviors among Jordanian school-aged children (6-16 years) before and during COVID-19 quarantine and to evaluate public's perception of the role of pharmacists regarding children's health-related behaviors management. Methods: A cross-sectional study was conducted from August 2020 to January 2021 using an anonymous web-based survey. The survey was developed based on previously published surveys. Evaluation of the validity and reliability of the survey were conducted by a professional committee of clinical pharmacists and a statistician. Results: A total of 230 children, aged 9.02± 2.977 participated in the study. Physical activity and healthy balanced meals decreased (less than 1 hr or 1-3 hrs/week vs 2 meals/day, p= <0.001), whereas daily screen time (1-3 hrs/week vs 4-6 hrs/week, p= <0.001), sleep hours (8-9 hrs/day vs 10-11 hrs/day, p= <0.001) and the ingestion of unhealthy snacks had increased (1-2 meals/day vs. 2-3 meals/day, p=<0.001). A positive perception of pharmacists' role during the pandemic was revealed. Conclusion: The present study showed that a significant change in children's health-related behavior happened during the COVID-19 pandemic. Such changes can lead to social, physical and mental health problems. The public perceived community pharmacists as trusted health care professionals during the pandemic.

[Physical activity and pulmonary rehabilitation]. / Activités physiques et réadaptation respiratoire.

INTRODUCTION: Physical activity in daily life (PA) in patients with chronic respiratory disease is reduced. Inactivity is associated with an increased risk of hospitalisation and mortality. Even though pulmonary rehabilitation (PR) is associated with improved quality of life (fewer symptoms, greater exercise capacity…), its benefits with regard to PA remain unclear. STATE OF THE ART: For each patient, it is important during a respiratory rehabilitation (RR) programme to evaluate PA and its determinants. Only programs aimed at improved self-management and including educational therapy (ETP) have shown a short-term increase of PA following PR. Several studies have reported better long-term adherence when professionals help the patient to construct a personalised PA project, with regular follow-up and an array of activities (local facilities, urban walking…) chosen by the patient and adapted to the environment. PERSPECTIVES: The ongoing SARS-CoV2 pandemic has highlighted the importance of human interaction, even at a distance using information and communication technologies, as a means of sustaining patient motivation. Future controlled and randomized studies should focus on the long-term impact on PA of innovative strategies in patients with chronic respiratory diseases. Moreover, it would be interesting to quantify the socioeconomic impact as well as the sustainable health benefits of the different strategies outlined in this review. CONCLUSION: It is not possible to offer a single solution likely to maintain RR benefits over an extended lapse of time. However, follow-up with an ETP and/or regular and customized support during the post-training period facilitates the long-term adoption of active behavior.

Impact of the first wave of COVID-19 pandemic on the Hungarian university students' social and health behaviour.

BACKGROUND: The COVID-19 pandemic brought quick, severe and unexpected changes to our everyday life and also changed the traditional education pattern of Semmelweis University in the middle of academic year 2019-2020. We explored adaptive changes in Hungarian students' behaviour and their time-budget in order to determine whether quarantine and/or fear of infection were responsible for these changes. METHODS: A self-administered online questionnaire was distributed to all students in the Hungarian language program (N = 7436) of Semmelweis University. Information was collected on basic demographic data, knowledge and attitude about COVID-19, methods of prevention as well as the students' behaviour before, during and after the first wave of the pandemic. Statistical analyses were processed using the IBM-SPSS 25.0 software package. RESULTS: The overall response rate was 11% (N = 816). Only complete responses were processed (55%, N = 447). Among these responders, 83% did not fear the pandemic. Those who greatly feared COVID-19 infection strictly kept all regulations. The number of non-smokers increased by the end of the first wave. The nutrition of 100 students (21%) became healthier and the lockdown reduced the level of physical activity. CONCLUSION: Social and health-related behaviour of medical students changed basically during the first wave of the pandemic and some changes remained after it in tobacco smoking, nutrition and sleeping habits. Time-budget of students changed significantly during the pandemic and did not return to the baseline values. Results of this study justify future multiple systematic research to analyse and better understand the short- and long-term effects of the current crisis.

Association between Big Five Personality Traits and Participation in Cardiac Rehabilitation in Japanese Patients with Cardiovascular Disease: A Retrospective Cohort Study.

Cardiac rehabilitation (CR) remains underutilised, despite its established clinical benefit. A personality traits assessment may help promote CR implementation, as they are determinants of health-related behaviour. This study aimed to examine the association between the Big Five personality traits and outpatient CR participation in patients with cardiovascular disease (CVD) after discharge. This retrospective cohort study included 163 patients aged <80 years, who underwent inpatient CR when hospitalised for CVD. The Big Five personality traits (conscientiousness, neuroticism, openness, extraversion, and agreeableness) of each patient were evaluated at discharge, using the Japanese version of the Ten-Item Personality Inventory. We examined the relationship of each personality trait with non-participation in outpatient CR and dropout within three months, using logistic regression analysis. Out of 61 patients who initiated the outpatient CR, 29 patients dropped out, leaving us with 32 subjects. The logistic regression analysis results showed that high conscientiousness was associated with non-participation in CR. The primary reason for this was a lack of motivation. Conversely, low conscientiousness and high openness were predictors of dropout. This study suggests that the assessment of the Big Five personality traits, especially conscientiousness and openness, can help improve health communication with patients to promote outpatient CR participation after discharge.