Insomnia among community members in Florida: Associations with demographics, health conditions, and social support.

Objectives: To identify associations between demographics, social determinants of health, health conditions, and reported history of insomnia. A cross-sectional study including 11,960 adult community members recruited through HealthStreet, a community outreach program at University of Florida. Methods: Health assessments were conducted via interviews. Participants reported their demographic background, level of social support, history of health conditions, and insomnia. Logistic regression was used to understand associations between risk factors and history of insomnia. Results: The prevalence of self-reported insomnia was 27.3%. Adults aged ≥ 65 years (OR = 1.16) and women (OR = 1.18) reported higher rates of insomnia than their counterparts. Black/African American individuals reported lower rates of insomnia (OR = 0.72) than White individuals. Individuals with food insecurity (OR = 1.53), a military history (OR = 1.30), lower social support (OR = 1.24), living alone (OR = 1.14), anxiety (OR = 2.33), cardiometabolic disease (OR = 1.58), and attention-deficit hyperactivity disorder (ADHD) (OR = 1.44) were significantly more likely to endorse insomnia compared with their counterparts. Depression (OR = 2.57) had the strongest association with insomnia. Conclusions: This study provides evidence regarding who is at greater risk for insomnia among a large community-based sample. Our findings highlight the importance of screening for insomnia, particularly among patients who experience food insecurity, are military veterans, have anxiety, depression, ADHD, or cardiometabolic disease, as well as those who live alone or have lower levels of social support. Future public health campaigns should provide education on insomnia symptoms, treatments, and evidenced-based sleep-promotion strategies.

A review of pooled-sample strategy: Does complexity lead to better performance?

The outbreak of coronavirus disease 2019 (COVID-19, caused by SARS-Cov-2) is a big challenge for global health systems and the economy. Rapid and accurate tests are crucial at early stages of this pandemic. Reverse transcription-quantitative real-time polymerase chain reaction is the current gold standard method for detection of SARS-Cov-2. It is impractical and costly to test individuals in large-scale population screens, especially in low- and middle-income countries due to their shortage of nucleic acid testing reagents and skilled staff. Accordingly, sample pooling, such as for blood screening for syphilis, is now widely applied to COVID-19. In this paper, we survey and review several different pooled-sample testing strategies, based on their group size, prevalence, testing number, and sensitivity, and we discuss their efficiency in terms of reducing cost and saving time while ensuring sensitivity. © 2022 The Authors. VIEW published by Shanghai Fuji Technology Consulting Co., Ltd, authorized by Professional Community of Experimental Medicine, National Association of Health Industry and Enterprise Management (PCEM) and John Wiley & Sons Australia, Ltd.

Alcohol use during COVID-19 in adults with severe untreated AUD.

Evidence demonstrating increased alcohol use during COVID-19 comes from low- to moderate-alcohol use samples and has yet to use adults with severe but untreated AUD. Using a community sample of adults with severe AUD, this exploratory, cross-sectional study examined associations of COVID-19 alcohol use. Participants were recruited for a phase-II RCT. Only baseline measures, completed prior to randomization, were analyzed in the present study. Key variables were alcohol consumption, COVID-19-related worries and experiences, and qualitative responses of 1) alcohol use and 2) positive changes during COVID-19. 176 pariticpants recruited since COVID-19 were on average 41.4 years old, 49.1% female, and 79% White. Participants drank alcohol nearly 23 of the past 30 days, consumed 7 standard drinks per drinking day, and nearly 90% reported increased alcohol use. More heavy episodic drinking was reported in the first six-months of COVID-19 and more COVID-related concerns in the most recent six-months. Participants reported drinking increased due to "more time on their hands", but the pandemic also "strengthened relationships". Results affirm an increase in alcohol use during COVID-19 in adults with severe, untreated AUD. Findings underscore the need to understand how alcohol use and pandemic-related circumstances may influence one another for adults with severe AUD.

Symptoms of anxiety/depression during the COVID-19 pandemic and associated lockdown in the community: longitudinal data from the TEMPO cohort in France

Introduction: The COVID-19 pandemic and associated preventive measures have an impact on the persons' mental health, including increasing risk of symptoms of anxiety and depression in particular. Individual experiencing mental health difficulties in the past could be especially vulnerable during lockdown, however, few studies have tested this empirically considering preexisting mental health difficulties using longitudinal data. Objective(s): The objective of this study is to examine the longitudinal association between preexisting symptoms of anxiety/depression and symptoms of anxiety/depression during lockdown due to the COVID-19 pandemic in a community sample. Method(s): Seven waves of data collection were implemented from March-May 2020. Generalized estimation equations models were used to estimate the association between preexisting symptoms of anxiety/depression and symptoms of anxiety/depression during lockdown among 662 mid-aged individuals from the French TEMPO cohort. Result(s): We found an elevated odds ratio of symptoms of anxiety/ depression (OR=6.73 95% [CI=4.45-10.17]) among individuals experiencing such symptoms prior lockdown. Furthermore, the odds of symptoms of anxiety/depression during lockdown was elevated among women (OR=2.07 [95% CI=1.32-3.25]), subjects with low household income (OR=2.28 [1.29-4.01]) and persons who reported loneliness (OR=3.94 [2.47-6.28]). Conclusion(s): This study demonstrates a strong relationship between preexisting symptoms of anxiety/depression and anxiety/depression during the COVID-19 outbreak among mid-aged French adults. The findings underline the role of preexisting symptoms of anxiety/depression as a vulnerability factor of anxiety/depression during lockdown. Furthermore, the study shows that loneliness is independently associated with symptoms of anxious/depression, when controlling for prior anxiety/ depression symptoms.

Sleep Pattern Changes and the Level of Fatigue Reported in a Community Sample of Adults During COVID-19 Pandemic.

Purpose: The study aimed to (a) assess the sleep pattern changes and the level of fatigue among COVID positive adults (b) determine the association of sociodemographic and lifestyle factors (age, gender, marital status, occupation, income, exercise, nap, diet, and comorbidities) on sleep pattern and level of fatigue c) examine the relationship between sleep and fatigue, and between sleep problems, sleep quality and fatigue, among a community sample of COVID-19 affected adults. Methods: A non-experimental, descriptive, cross-sectional survey design was used. Participants were adults, between 18 and 63 years (n = 782), who tested positive for COVID-19 infection using RT-PCR or Antigen test, confined to home quarantine/under observation, and without any complications. Data was collected using the socio-demographic-sleep and related activity questionnaire, Fatigue Assessment Scale, and Sleep Quality Scale. Results: A majority of the participants reported either mild to moderate sleep quality problems (97.31%) and 377 of them (48.21%) reported fatigue levels. A significant association between sleep quality and fatigue with gender, and lifestyle factors such as sleep duration, food intake, napping, exercise pattern, and influence of COVID-19 on livelihood after being affected with COVID-19, and time of experiencing sleep problems after COVID-19 infection (all, p ˂ 0.01) were observed, as well as age with sleep quality. Poor sleep quality and fatigue were significantly correlated with each other, and also with sleep problems before being affected with COVID-19 (p = 0.000). Conclusions: The study has shown that COVID-19 has an effect on an individual's demographic factors and a multitude of lifestyle factors, and highlights the need for post-COVID-19 monitoring even after recovery from the disease.

Genomic surveillance of SARS-CoV-2 in Ghana: Leveraging a national influenza platform

Introduction/ Background: Genomic surveillance of SARS-CoV-2 is crucial for monitoring the spread of the disease and guiding public health decisions but the capacity for SARSCoV- 2 sequencing in Africa remains low. This research aims to increase the genomic contribution from the Africa and gain insights of the SARS-CoV-2 infections in Ghana and Africa. Methods: We utilised samples from two sources;firstly, community surveillance undertaken using the Ghana Influenza Surveillance Network and secondly imported cases of SARS-CoV-2 detected in travellers. A total of 457 patients from Ghana, collected from 1st April 2020 to 31st August 2021, were sequenced using Oxford Nanopore Technology sequencing and the ARTIC tiled amplicon method. The sequence lineages were typed using Pangolin and the phylogenetic analysis was carried out using IQtree and TreeTime. Results: We detected three waves of SARS-CoV-2 infections in Ghana. The first wave of infection was mainly contained in the Greater Accra, later spreading to other regions in the second and third wave. B.1 and B.1.1. were the most prevalent lineages in wave one, while the B.1.1.7/alpha variant is responsible for the second wave. An investigation into the lineages detected in Ghana led us to discover that B.1.1.318 (which contains the E484K mutation shown to impact antibody recognition) has a high cumulative prevalence rate in a number of neighbouring West African countries, suggesting that there might be a regional circulation. Impact: The high-quality sequences produced from this study were submitted to the largest open-access SARSCoV- 2 sequence database, increasing the genomic contribution from Africa. By sequencing both community samples and imported cases in Ghana, the study revealed an insight into the SARS-CoV-2 epidemiology in Ghana and West Africa. Conclusion: This study not only informed us of the epidemiological characteristics of the SARS-CoV-2 outbreaks in Ghana, but also shed light on the epidemiological trends of neighbouring countries that may have less sequencing capacity, highlighting the important role of pathogen genomic sequencing in cross-border and regional disease surveillance.

COVID-RELATED DISTRESS AND DISRUPTIONS IN OVARIAN CANCER SURVIVORS

Background: The objective of this study was to determine how levels of distress and disruption during the COVID-19 pandemic compared between ovarian cancer survivors and a community sample;how clinical and demographic characteristics of survivors were related to COVID-related distress and disruption;and if perceived stress, depression, and emotional well-being at cancer diagnosis predicted COVID-related distress during the first year of the pandemic. Methods: Ovarian cancer patients (N=90) who were part of 3 ongoing studies completed COVID surveys through mail and on REDCAP between 6/20 and 12/20. Responses were compared to those of community females (N=1110) who participated in a COVID survey mailed to an Iowa Statewide Voter Registration-based sample between 8/20 and 12/20. Pre-COVID data on perceived stress, depression, and emotional well-being (EWB) from ovarian cancer patients at the time of diagnosis was available for 30 long-term (≥4 yrs) and 60 shorter-term (<4 yrs) survivors. Hierarchical regressions examined whether psychosocial features at diagnosis, controlling for age, stage, total COVID disruption (healthcare, financial, and daily-life), and time since diagnosis, predicted COVID-related distress. Results: Compared to the community sample, ovarian cancer survivors reported lower levels of healthcare disruption (p=.016), financial hardship (p<.001), and distress (p=.009), but no difference in disruption of daily activities (p=.089). Among survivors, there were no differences in distress or total COVID-related disruptions based on stage or time since diagnosis (all p values ≥0.10). Younger survivors (<63 yr median) showed significantly greater distress (p=.009) and disruption (p=.001) than older survivors. Adjusting for covariates, perceived stress (β=.237, p=.006) and EWB (β= -.338, p<.001) at diagnosis were significant predictors of total COVID-related distress, whereas depression was not. Conclusions: Surprisingly, cancer survivors reported fewer COVID-related disruptions and distress compared to a community sample. Older patients reported less distress and disruptions during COVID, but stage and time since diagnosis were not associated with these factors. The relationship between distress and well-being at diagnosis and COVID-related distress suggests the possibility of identifying patients particularly at-risk during environmental challenges.

COVID-19 HISTORY REPORTED BY MEN WHO HAVE SEX WITH MEN (MSM) IN THE UK IN A LARGE, COMMUNITY SURVEY ('RIISH-COVID')

Introduction As COVID-19 has deepened health inequalities, we examine the COVID-19 experience of MSM as a population disproportionately affected by poor-health. Methods An online cross-sectional survey of MSM recruited via social media and dating applications for 3 weeks in November/December 2021. Questions included those on COVID-19 experience addressing: COVID-19 test history;when (if ever) tested positive;self-perception of ever having had COVID-19 and long-COVID. Logistic regression was used to assess sociodemographic and behavioural characteristics associated with these outcomes. Results Among 1,038 participants (median age: 41;88.1% white ethnicity): most reported ever testing for COVID-19 (95.0%;n=987), while 19.6% (193/987) reported a positive result [8.1% (80/987) testing positive since August 2021]. In those without a prior positive test (n=793) or testing history (n=52), an additional 148 participants reported self-perceived COVID, resulting in 32.8% (341/1038) with a COVID-19 history. In these, one-quarter (25.2%;86/341) reported long- COVID (8.3%;86/1038 of all) and 4.1% (14/341) hospitalisation history for COVID-related symptoms (1.8%;19/1038 of all). COVID-19 history was associated with residence in England (aOR:1.52,95%CI:1.02-2.28), degree-level education (aOR:1.33;95%CI:1.01-1.75), and vaccination status (aOR:2.98,95%CI:1.61-5.53, none/one dose vs. boosted). Long-COVID was associated with hospitalisation history (aOR:3.21;95%CI:1.09-9.45) and degree-level education (aOR:0.56;95%CI:0.36-0.99). Conclusion In this large community sample, one in five MSM reported testing positive for COVID-19, and one-third had a COVID-19 history. There was no evidence of age or ethnicityrelated inequalities, although long-COVID appears to exceed general population estimates. Continued monitoring of long- COVID in MSM is warranted as COVID-19 infections in the UK continue to increase.

PARENT AND CHILD MENTAL HEALTH TRAJECTORIES APRIL- OCTOBER 2020: STRICT LOCKDOWN VS NO LOCKDOWN IN AUSTRALIA

Background: To control a second wave of COVID-19 outbreak, the state of Victoria in Australia experienced one of the world's first long and strict lockdowns over July-October 2020, while the rest of Australia experienced 'COVID-normal' with minimal restrictions. Objectives: To (1) investigate trajectories of parent/child MH outcomes in Victoria vs non-Victoria and (2) identify baseline demographic, individual and factors related to COVID-19 associated with MH trajectories. Methods: An online community sample of 2004 Australian parents of a child aged 0-18 years with rapid repeated assessment over 14 time points from April 2020 to May 2021. Measures assessed parent MH (Depression, Anxiety and Stress Scales-21), child depression symptoms (13-item Short Mood and Feelings Questionnaire) and child anxiety symptoms (4 items from the Brief Spence Children's Anxiety Scale). Findings: MH trajectories shadowed COVID-19 infection rates. Victorians reported a peak in MH symptoms at the time of the second-wave lockdown compared to other states. Key baseline predictors, including parent and child loneliness (standardised regression coefficient (β) = 0.09- 0.46), parent/child diagnoses (β = 0.07-0.21), couple conflict (β = 0.07-0.18), and COVID-19 stressors, such as worry/concern about COVID-19, illness and loss of job (β = 0.12-0.15)), predicted elevated trajectories. Conclusion: Our findings provide evidence of worse trajectories of parent and child MH symptoms associated with a second COVID-19 outbreak involving strict lockdown in Victoria, compared to non-locked states in Australia. We identified several baseline factors that may be useful in detecting high-risk families who are likely to require additional support early in future lockdowns.

THE IMPACT OF THE COVID-19 PANDEMIC ON CHILDREN AND THEIR PARENTS ACROSS COMMUNITY SAMPLES AND IN SPECIFIC MENTAL HEALTH POPULATIONS

Background: There is increasing recognition of the mental health (MH) impacts associated with COVID-19 for children and their families. Objectives: This symposium will examine the long-term MH impacts associated with COVID-19 across communitybased samples, children attending child and youth mental health services (CYMS) and children with attention-deficit/ hyperactivity disorder (ADHD). Methods: The first presentation will feature the COVID-19 unmasked study, a cohort study assessing MH in young children and their parents at four time points during the pandemic. The second presentation will focus on the COVID-19 Pandemic Adjustment Survey, which has tracked the MH of children and parents over 14 time points from April 2020 to May 2021. The final two presentations will focus on specific populations including the impact of COVID-19 on community CYMHS services (e.g. impacts on symptoms for children already in treatment and the demand for MH care both in CYMHS and emergency settings: presentation 3). The final presentation will report on the COVID-19 ADHD survey, which has surveyed families at five time points over the pandemic. Findings: Across all studies, there was evidence of MH impacts associated with COVID-19 restrictions for children aged from 0 to 18 years, and their caregivers, across both community samples and specific MH subgroups. The study in the CYMHS setting found a 50% increase in referrals and acute presentations when comparing January to December 2019 to January to December 2020. Conclusion: Increased resources and supports are needed to address the MH needs of children and their caregivers during the ongoing COVID-19 pandemic.

Development of the Indian scale of the fear of COVID-19.

BACKGROUND: The first human case of COVID-19, the disease caused by the novel coronavirus causing COVID-19, subsequently named SARS-CoV-2 was reported by the officials in Wuhan City, China, in December 2019. In India, on January 31, 2020, the first case of COVID-19 was reported. MATERIALS AND METHODS: The Indian scale of fear related to COVID-19 (ISF-C19) Scale was developed in Hindi and was rated by two raters. Then, it was applied on twenty individuals (ten males and ten females) as a pilot study. The study had been conducted in Eastern India, in the state of Jharkhand. ISF-C19 was completed by 118 participants (females - 75; males - 43), aged 18 years or older from the community, and the subjective well-being was assessed. The psychometric properties of this instrument were investigated. Safety measures (i.e., mask, maintaining distance, gloves, and sanitizers) were taken throughout the data collection period. RESULTS: Findings suggested that this scale has adequate sampling, adequate interitem reliability coefficient, and higher overall scores on the ISF-C19 indicated more severe fear related to COVID-19. CONCLUSION: In light of the current scenario of the emerging cases in India, there is an urgent need to develop a scale related to COVID-19 as there is no published Indian standardized scale before this recent outbreak of pandemic. Considering the current scenario, this scale is useful to assess the fear related to COVID-19.