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The COVID-19 pandemic has impacted society: causing the collapse of health systems around the world, and also had a significant impact on the economy, personal care, mental health and the quality of life of the population. Few studies have been done about pandemic and the climacteric population, and the impact on quality of life and health. Our objective was to Investigate changes in the health and health care of climacteric women residing in Brazil during the pandemic period. Cross-sectional study with climacteric women aged between 40 and 70 years, residing in Brazil. The evaluation was carried out using a Google Docs electronic form with questions related to sociodemographic, clinical, gynecological data, treatments, access to health services and consultations, as well as changes in behavior. The Menopause Rating Scale - MRS was applied to assess climacteric symptoms, validated for Portuguese. Result(s): 419 women answered the questionnaire. More than 45% were between 51 and 60 years of age, 56.6% being married and residing in Brazilian capitals. 60% of participants reported weight gain during the pandemic. 50.8% of participants reported a decrease in the weekly practice of physical activity More than 80% reported worsening mental health during this period, and 66.1% had a change in their sleep pattern. More than half reported having difficulty accessing gynecological consultations. Women living in capital cities reported a greater increase in alcohol consumption (p=0.002). Food intake increased for 54.9%;the category of civil servant was associated with a significant increase in consumption in relation to other professions (p=0.038). Women whose family incomes changed during the pandemic had a higher prevalence of weight gain (p=0.033) and also had a higher occurrence of changes in sleep quality (72.6% vs. 61.5%;p=0.018). Women with a high school education had a higher occurrence of alterations in personal and health care outcomes (p<0.001). Conclusion(s): We observed an important reduction in the health care of climacteric women during the pandemic period. Changes in life habits, such as increased food consumption and reduced physical activity, were quite prevalent. There was a deterioration in mental health, with a high prevalence of anxiety symptoms and changes in sleep quality. Despite the attenuation of the pandemic, attention should be given to the health care of this population, as the changes may have repercussions for many years.Copyright © 2023
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BACKGROUND: The lockdown would become the primary strategy for facing covid-19 as it quickly mutates which might cause repeated pandemics;however, it negatively affects individuals' quality of life (QOL). The schizophrenia caregivers experience considerable stress. The research on the impact of the COVID-19 lockdown on QOL of schizophrenia caregivers is essential, especially for those who reside in rural areas. AIM: This study aimed to investigate the impact of lockdown-related COVID-19 on QOL among primary caregivers of schizophrenia patients living in a rural area. METHOD(S): This study recruited 204 primary caregivers (15-79 years). This study used the World Health Organization Quality of Life instrument (WHOQOL-BREF) to asses QOL's primary caregiver. Evaluate the possible change in caregivers' QOL before and during the COVID-19 lockdown using paired t-test for repeated measures. RESULT(S): The mean age of the caregivers was 46.61 years (SD = 12.79), ranging from 15 to 79 years, with a preponderance of male (54.5%), aged 38-47 years old (29.7%), married (81.2%), employed (57.4%), and had senior high school level of education (34.7%). Majority were parents (26.2%) of the ill relative, and took care of the patients more than 5 years (52.5%). There was a statistical difference (p < 0.05) in caregivers' QOL between before and during the COVID-19 lockdown, including in physical health, psychological, social relationships, and environment domain. CONCLUSION(S): Implementing a lockdown policy related to COVID-19 has negatively impacted the caregivers' QOL. The degradation of caregivers' QOL showed from before to during COVID-19 lockdown. Further study needs to explore the QOL of other mental illness caregivers regarding COVID-19 lockdown. This finding becomes a reference for a government to modify some policy-related lockdowns to minimize their negative impact.Copyright © 2023 Utomo Utomo, Eko Mulyadi, Endang Fauziyah.
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Aims: At our Trust, all severe inpatient hypoglycaemic episodes in individuals with diabetes (defined as a hypoglycaemic episode requiring injectable treatment) are reported to NaDIA-Harms (National Diabetes Inpatient Audit). We conducted a detailed review of the care of all these events to improve patient safety. In this study, we assessed the risk of 12-month mortality following an episode of severe inpatient hypoglycaemia. Method(s): Reportable NaDIA harms of patients admitted during the period 2018-2022 were recorded into a dataset. Applicable patient records were reviewed at 12 months following the event to see how many patients were deceased and details of comorbidities at the time of the severe hypoglycaemic episode were collected. Result(s): To date, of 107 inpatients who experienced a severe hypoglycaemic episode 55% were deceased within 12 months. In patients admitted during the peak of the Covid-19 pandemic recorded as year April 2020/March 2021, 80% of patients who had a NaDIA hypoglycaemic event died within 12 months. Conclusion(s): Mortality rate following an episode of inpatient hypoglycaemia appears to be several-fold higher than previous reported rates of 4.45%-22.1% for community-dwelling individuals who experience a severe hypoglycaemic event. This maybe partially explained by the increased frailty, polypharmacy and multimorbidity among this cohort, but there is evidence linking hypoglycaemia with cardiovascular mortality. Although no causality between severe inpatient hypoglycaemia and death can be inferred from this study because of the observational nature, it does highlight the importance preventing inpatient episodes of hypoglycaemia through effective monitoring and proactive treatment modification.
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The pandemic forced many education providers to pivot rapidly their models of education to increased online provision, raising concerns that this may accentuate effects of digital poverty on education. Digital footprints created by learning analytics systems contain a wealth of information about student engagement. Combining these data with student demographics can provide significant insights into the behaviours of different groups. Here we present a comparison of students' data from disadvantaged versus non-disadvantaged backgrounds on four different engagement measures. Our results showed some indications of effects of disadvantage on student engagement in a UK university, but with differential effects for asynchronously versus synchronously delivered digital material. Pre-pandemic, students from disadvantaged backgrounds attended more live teaching, watched more pre-recorded lectures, and checked out more library books than students from non-disadvantaged backgrounds. Peri-pandemic, where teaching was almost entirely online, these differences either disappeared (attendance and library book checkouts), or even reversed such that disadvantaged students viewed significantly fewer pre-recorded lectures. These findings have important implications for future research on student engagement and for institutions wishing to provide equitable opportunities to their students, both peri- and post-pandemic.
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Covid-19 heightened economic inequality across the U.S., especially for people who are disabled and non-white. These intersecting economic vulnerabilities open pathways to hunger. Using a survey from July 2020 (n = 2,043) in the Intermountain West, we find that economic inequality explained a substantial portion of food insecurity for people with disabilities. Racially stratified models show that people who were also non-white were more likely to be food insecure and receive differential protection from economic resources. Stronger social support will help mitigate food insecurity, yet such programs must grapple with the ways that ableism and racism intersect, especially during economic shock.Copyright © 2022 Taylor & Francis Group, LLC.
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The COVID-19 pandemic posed numerous challenges for instructors and students. Professors, for example, struggled to quickly and effectively migrate face-to-face courses to remote teaching modalities. What had not been anticipated, however, were the additional challenges to be managed when returning to face-to-face and in-person teaching. This reflective essay provides some insight into how faculty at the University of Puerto Rico attempted to modify teaching practices to re-engage disengaged students as they returned to the campus classroom. Also, recommendations about how to move forward by applying a pedagogy of renewal are made.
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This paper explores differences in 437 learners' "foreign language classroom anxiety" (FLCA) in in-person and online English as a Foreign Language (EFL) classes before the outbreak of the pandemic and during the first lockdown in spring 2020. Statistical analyses of data gathered with a web survey revealed a slight, yet significant drop in learners' overall FLCA in "emergency remote teaching." In order to obtain a more granular view, item-level analyses revealed that learners in online classes were significantly less worried about being outperformed by peers, suffered less from physical symptoms of anxiety when called on in class, and were less anxious when they were in fact well-prepared. Feeling embarrassed to volunteer answers was significantly higher in online classes. Interviews with 21 participants revealed that the interviewees mentioned anxiety-provoking aspects of the class considerably more frequently online than in in-person classes. However, the sources of anxiety in online classes differed from the ones in classes taught on-site. Thus, it seems that the newness of the setting foregrounded anxiety-provoking aspects specific to emergency remote teaching, making others fade into the background at the beginning of the pandemic.
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The COVID-19 pandemic has had far-reaching impacts on many aspects of life, including sexual behaviours and preferences. In this longitudinal study, the authors used attachment theory to investigate changes in an individual's sexual desire for their partner as well as changes in their sexual desire for someone other than their primary romantic partner (extradyadic desire) over the first wave of the pandemic in Canada. Based on past research that has shown that avoidant individuals tend to avoid intimacy, the authors reasoned that increased contact with their romantic partner due to physical distancing guidelines and lockdown rules would contribute to avoidant individuals' experiencing less sexual desire for their partner and greater extradyadic desire over time. In contrast, individuals high on attachment anxiety tend to seek proximity, especially during times of stress. The authors predicted that individuals' sexual desire for their partner would increase and their extradyadic desire would decrease. They tested these hypotheses using a cohabiting, dyadic sample (N = 308 individuals);study participants were contacted at 1-month intervals for three successive months and asked to complete an online survey. Our hypotheses were partially supported. As predicted, individuals high on attachment avoidance experienced higher levels of extradyadic desire, and individuals high on attachment anxiety reported lower extradyadic desire over time. Contrary to predictions, however, neither attachment pattern was associated with changes in sexual desire for the partner. The authors examine the theoretical implications of these findings, highlighting the need for a more fine-grained assessment of stress and the interaction between stress and attachment orientations in future research.Copyright © Sex Information and Education Council of Canada, 2023.
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Domestic violence against women is a major social problem in Bangladesh. This paper examines the determinants of domestic violence in Bangladesh during the COVID-19 pandemic. The project was carried out in selected areas of Khulna district of the country and followed survey research design. A total of 312 ever married female respondents who experienced domestic violence at any stage of their life were surveyed. The respondents were selected through simple random sampling as a semi-structured questionnaire/ interview schedules was used as the primary tool for data collection. The data were collected in two stages between the months of May-October, 2021 through face-to-face interviews. Results from the chi-square analysis show that, respondents' residence, educational status, age at first marriage, duration of marriage life, husband's income, husband's occupation, and a demand for dowry were all associated with domestic violence against women (p <.01). The study concludes that creation of awareness and empowerment of women through income generating activities particularly in the rural areas of Bangladesh is necessary to reduce the prevalence of domestic violence.Copyright © Nova Science Publishers, Inc.
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Education has gone through rapid changes during the emergency remote teaching period resulting by the COVID-19 pandemic. These changes, in part, have been associated with educational institutions attempting to implement a viable solution to the problem of distance education. Although organizational management theory literature suggests that great change in very little time results in a detrimental psychological phenomenon called change fatigue in employees and that this phenomenon has even been investigated in the context of teaching staff in the past;there have been no attempt at understanding change fatigue from a student perspective. This quantitative study attempts at proposing a structural equation model towards the understanding of how to change fatigue and other variables, namely, digital literacy, online learning attitude and school alienation that might have been influenced by it have affected teacher candidates after resuming face-to-face education followed by a 1.5 year of emergency remote teaching period. Results indicated that change fatigue predicts school alienation and yet;does not predict online learning attitude;hinting that there might be another category of alienating organizational change that universities have gone through that does not solely involve online education. Nevertheless, digital literacy is a beneficial skill for all students that helps bolster online learning attitudes and reduce overall school alienation.
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Drawing upon person-environment fit, specifically demands–abilities fit, this paper examines the impact of hospitality employees' cultural intelligence (CQ) on their voice behavior and job satisfaction. Data were collected from domestic contact employees working for restaurants in three major cities in the United States. The results of the PLS-SEM model show that CQ has a positive effect on employees' voice behavior through self-efficacy. Further, CQ has a positive effect on job satisfaction through a sequential mediation of self-efficacy and voice. This study contributes to the CQ and voice literature, utilizing CQ as a person's ability to meet job requirements. This study also has important practical implications for hospitality practitioners who depend on employee voice for the success of organizations in today's ever-changing global environment.
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Objectives: We estimated the cost-effectiveness of non-pharmaceutical interventions (NPI), vaccines, and the combination of NPI and vaccines in managing the COVID pandemic. Method(s): A dynamic transmission model was constructed to simulate the incidence of COVID infections and deaths among community-dwelling Singapore residents. Using this model, we compared the cost and outcomes of NPI (border control measures, safe distancing and mask wearing) versus no NPI in an unvaccinated and a vaccinated population. The analysis was conducted from the societal perspective over a one year time horizon, with data based on the COVID situation in Singapore during Jan 2021 to Dec 2021. Costs of vaccination, adverse events, masks, self-testing using rapid antigen tests, test-trace-isolate (TTI), outpatient visits, hospitalization, productivity loss and reduced sales receipt from retail and food and beverages industries were included. Health loss from adverse events, TTI and COVID infection and deaths were also included. Result(s): Among the scenarios compared, vaccination combined with NPIs yield the lowest cost (S$7.6 billion), while no vaccination with NPIs had the highest costs (S$49.1 billion). The largest loss in QALYs from the population was seen from the scenario without vaccination or NPIs. Using a dominance approach, vaccination combined with NPIs is cost saving with an ICER of -S$213 billion per QALY, compared to no vaccination with lockdown measures. The results show that NPIs alone without vaccination only delays transmission, but does not significantly change the total number of cases observed in the population. Vaccination is both cost saving and health saving as the difference in cases averted from vaccination and their associated costs, is far greater than the additional costs required to vaccinate the public. Conclusion(s): Both vaccination and NPI are critical strategies for managing the COVID pandemic. In the presence of vaccine, NPIs continue to offer benefits in terms of reduced number of infections and deaths.Copyright © 2023
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Objectives: To compare pregnancy loss rates, preterm birth rates and gestational age at delivery in women vaccinated against COVID-19 during pregnancy vs. those unvaccinated. Method(s): Data were captured from Dorsata Prenatal, an electronic medical record (EMR) system that captures obstetrical data for tens of thousands of pregnancies annually. Patients who delivered between February 11, 2021-June 2, 2022, were included. The vaccinated group included women who had at least one COVID-19 vaccination documented in their EMR between 30 days prior to pregnancy and delivery. The unvaccinated group included women without a COVID-19 vaccination documented. The primary outcome measure was gestational age (GA) at delivery. We analyzed the data using chi-square tests, with significance set at p<0.01. Result(s): A total of 51,994 pregnant women were identified-7,947 (15.3%) in the vaccinated group and 44,047 (84.7%) in the unvaccinated group. Vaccination rate varied by race (Asian: 19.7%;White: 17.3%;Black: 11.2%, P<0.001), ethnicity (Latino: 8.6%;Not-Latino: 18.7%;P<0.001), marital status (Married: 19.2%;Single: 8.8%;P<0.001), mother's age (>=35 years: 20.0%;<35 years 14.2%;P<0.001), and region (Northeast: 19.2%;South: 15.2%;West: 9.1%;P<0.001). The vaccinated group had significantly lower rate of preterm delivery (Gestational Age [GA]<37 weeks;vaccinated: 7.8% vs. unvaccinated: 9.6%;P<0.001), and significantly lower rates of pregnancy loss (GA<20 weeks;vaccinated: 1.1% vs. unvaccinated: 4.1%;P<0.001). Conclusion(s): This is one of the largest real-world studies to date in women who received the COVID-19 vaccination during pregnancy. Vaccination rates varied significantly across race/ethnicity. Vaccinated patients had lower preterm delivery and pregnancy loss rates compared with unvaccinated patients.Copyright © 2023
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Objectives: Self-perceptions of aging (SPA) have been shown to influence healthcare-seeking behaviors among middle-aged and older adults. Negative SPA may intensify the COVID-19 pandemic-related healthcare disruptions in this population. Therefore, this study seeks to evaluate the association between SPA and care deferrals among community-dwelling adults aged >=50 years in the US during the COVID-19 pandemic. Method(s): A cross-sectional study of the eligible sample was conducted using data from the 2020 wave of the Health and Retirement Study. SPA score was measured using a validated eight-item instrument with higher scores indicating negative SPA. The association between SPA and care deferrals during the COVID-19 pandemic was assessed using multivariable logistic regression adjusted for respondents' sociodemographic and clinical characteristics, past COVID-19-related experiences, and COVID-19 worry. Result(s): The final sample consisted of 4,153 community-dwelling adults aged >=50 years. 30% reported care deferrals during the COVID-19 pandemic. Among respondents who deferred care, the majority were aged 50-64 years (46.6%), females (65.4%), and White (64.5%). Most commonly reported care deferrals were dental appointments (74.5%) and physician visits (56.5%). Care deferrals were mainly due to clinic/office rescheduling or cancelling appointments (57.5%), respondent deciding the care could wait (33.8%), and COVID-19 fear (21.8%). Respondents reporting care deferrals reported higher mean SPA scores, indicating negative aging attitudes, compared those who did not defer care (Mean (SD): 3.24 (1.02) vs. 3.05 (1.04), p<0.001). After accounting for covariates, higher SPA scores were associated with significantly higher odds of care deferrals (aOR: 1.20, 95% CI: 1.11 - 1.30, p<0.001). Conclusion(s): This study found that negative SPA were associated with care deferrals during the COVID-19 pandemic among community-dwelling adults aged >=50 years. As healthcare delivery rebounds to pre-pandemic levels, the role of SPA in healthcare-seeking behaviors should be recognized. Health promotion efforts may target positive aging attitudes to encourage timely and proactive use of healthcare.Copyright © 2023
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Aims: During the COVID-19 pandemic, care for the elderly in the community was greatly limited. Accordingly, the demand for alternative community care have increased to cope with changing situations. In this study, we tried to find out whether the companion robot improved mood state and related problem in depressive or isolated community dwelling elderly. Method(s): For 186 community dwelling elderly who have received social welfare service due to depression or social isolation, we provided companion robot that could support their daily living. The robot was equipped with special program that could recognize and respond to the participant's own emotion. It was part of behavioural activation techniques which is one of powerful treatment for depression. The self-report questionnaires were used to measure changes in cognitive function, depression, suicidality, loneliness, resilience and satisfaction of life. Outcomes were measured before using companion robot and after 3 months, and we compared them. Result(s): The elderly using companion robot for 3 months showed improved cognitive function, depression (p < .001), suicidality (p < .001), and loneliness (p = .033) in the self-report questionnaire. Resilience (p = .749) and satisfaction of life (p = .246) were also improved but not reached significance. Conclusion(s): These findings showed that the use of companion robot with emotional recognition coaching program could help improve depression, cognitive function, loneliness and suicidal ideation. In particular, this effect was also useful for those who were diagnosed with depression. Also if we can put more techniques of behavioural activation programs into robot, it could be useful in community care for depressive and isolated elderly.
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Aims: The impacts of the coronavirus disease of 2019 (COVID-19) pandemic on mental health have been relatively severe. This study examined the influence of the COVID-19 especially on depression and suicidal ideation in community-dwelling elderly in Korea. Method(s): Data were employed from a survey on elderly mental health in Jeollanam-do (southwest province in Korea). A total of 2423 elderlies were recruited from 22 counties in Jeollanam-do between April and October 2021. We used self-reported questionnaires, including sociodemographic factors, COVID-19 related stress, suicidal ideation, Geriatric Depression Scale-Short Form Korean Version (GDS-SF). Logistic regression was performed to examine the factors on depression and suicidal ideation. Result(s): Of the 2423 subjects, 622 (25.7%) reported depressive symptoms and 518 (21.4%) reported suicidal ideation. The multivariate logistic regression analysis revealed that living alone, poor perceived health status, the worry of COVID-19 infection and restriction of daily activity due to COVID-19 pandemic were significantly associated with depression. Male sex, poor perceived health status, disability in house chores and depressive symptom are risk factors for suicidal ideation. Conclusion(s): These findings showed that increased risk factor for depression and suicidal ideation in community dwelling elderly during COVID-19 pandemic. We confirmed that feelings of isolation and negative perception of health were risk factors on depression in community dwelling elderly in the context of the COVID -19 pandemic. Also male, poor self-perceived health status, difficulty of independent living and worry and depression are increased the risk of suicidal ideation among the elderly.
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In February 2019, some six years after the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (LASPO) removed legal aid from a wide range of civil and family matters, the Government released its Post Implementation Review of the impact of LASPO and accompanying action plan. Publication is at a time when governmental policy extolling the virtues of mediation and online dispute resolution has the potential to have a profound effect on family law process. Against this background and having regard to the impact of the Covid-19 pandemic on the family justice system, this paper discusses the findings of the author's qualitative study on the experiences of litigants in person in civil and family courts. It suggests a typology of litigants in person, explains how and where litigants in person in child arrangements proceedings seek advice and the significant access to justice barriers arising from the compulsory requirement to attend a MIAM before commencing proceedings and attending the fact-finding stage without representation. Ultimately, the paper offers fresh evidence of the harsh realities of litigating without representation in the family court, which despite espousing an inquisitorial process, remains adversarial in character.
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Introduction: Historically, clinical trial patient populations have lacked adequate diversity while studies have shown that differences exist in the biological response of different ethnicities to various healthcare interventions. Minority populations have suffered higher rates of Covid-19 infection, hospitalization, and mortality than their non-Hispanic white counterparts. It is vital that Covid-19 treatment research is appropriately diverse. This paper aims to define the demographic characteristics of COVID-19 therapeutic clinical trials to date. Method(s): A literature search initially returned 117 unique publications, 67 of which met the inclusion criteria and were analyzed. Main variables of interest were reporting of demographic data, percent white, Black, and Asian, and type of study. Statistical analysis was carried out via Stata software. Result(s): Among analyzed studies, 74.63% reported demographics. The demographic representation was 78.87%, 12.27% and 8.86% for white, Black, and Asian populations. Among vaccine related studies, the representation for Black, Asian, and Hispanic individuals was 5.01%, 6.40%, and 13.71%. A qualitative analysis of outlier studies with high (>30%) Black populations revealed that none were vaccine related, 1/3 were in hospitalized patients, and none were related to pharmacologic interventions. Of the studies with low levels (<2%) of Black patients, 4/6 were vaccine related, none were in hospitalized patients, and all were related to pharmacologic interventions. Conclusion(s): This analysis reveals concerning trends in therapeutic clinical trial enrollment to date. In the context of yet another health insult that disproportionately affects minority populations, America's scientific community is not doing enough to produce equitable scientific evidence on Covid-19 treatment.
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This study investigated the effects of working in person during the COVID-19 pandemic on perceived job demands and resources for employees. The job demands-resources (JD-R) model of employee stress indicates that workplace stressors can result in various negative employee outcomes when not adequately buffered by job resources. We extended this model to working in person during the COVID-19 pandemic. We posited that two job demands related to working in person during the pandemic (i.e., the perceived risk of transmitting the disease and job insecurity) would directly influence employee stress. Moreover, we expected that these added job demands would negatively impact employee well-being when organizations do not provide adequate resources to mitigate the risk of disease transmission. Through the lens of pandemic, we contended that any workplace in which employees are susceptible to transmitting the disease may be considered a high-risk environment. Applying previous literature of occupational stress in high-risk workplaces, we discussed how the current health crisis in the United States may increase burnout for employees. To this end, we proposed a model of employee well-being, on which we conducted a path analysis to determine how working in person during the COVID-19 pandemic impacts one's occupational stress and burnout. Analyses indicated that our proposed model did not possess good fit. However, results supported the overall notion that job demands resulting from an increase in perceived risk of the pandemic does indeed increase general work stress, which in turn, increases employee burnout. Implications for reducing the harmful effects of job demands by providing resources which mitigate risk are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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This chapter examines the state of response and likely long-term implications across the continuum of place types for older adults, from independent housing to skilled nursing, with a focus on how physical settings and technological systems can empower autonomy and identity. It does so by adopting a person-environment (P-E) exchange framework as articulated by Chaudhury and Oswald (J Aging Stud 51:100821, 2019) This framework is structured in three sections: components of P-E interaction, P-E processes, and environment-related outcomes. Components of P-E interaction include individual characteristics, social factors, physical/built environments, and technological systems with this chapter focusing on the last two. These components form a milieu within which the dialectic interaction between agency and belonging occurs and ultimately informs assessments regarding autonomy and identity. Emergent themes discussed in this chapter include a heightened emphasis on inclusive housing models, age-friendly integration of technology, environmental flexibility in design and programming, and enhanced support for the needs of caregivers. Examining place change through an integrative P-E framework offers a lens to understanding what implications to agency and belonging might be tied to modifications in the physical and technological environment in response to COVID-19 and how that might inform outcomes related to autonomy and identity among older adults. The environmental responses to COVID-19 will accelerate the ability of independent housing to serve individuals longer in their homes and should promote a radical embrace of small house approaches to skilled care, thereby challenging assisted living as a place type altogether. (PsycInfo Database Record (c) 2023 APA, all rights reserved)