Positron Emission Tomography with Computed Tomography in Evaluations of Classical Fever of Unknown Origin and Length of Hospitalization: A 10-Year Medical Record Review of a Tertiary Hospital

Background: Positron emission tomography with computed tomography (PET/CT) has proven its value for the differential diagnosis of fever of unknown origin (FUO). However, the extent to which PET/CT during FUO evaluation can shorten the length of hospital stay (LOS) remains unclear. Materials and Methods: A retrospective review of the medical records over a 10-year period from January 2009 to December 2018 of a tertiary university hospital was performed. The inclusion criteria were symptoms with fever persisting for >3 weeks before admission, as defined in classical FUO. Medical records in which PET/CT was performed after the final diagnosis, such as neoplastic causes, were excluded. Moreover, in the neoplasm category evaluated using PET/CT, only diagnostic PET/CT cases were enrolled;PET/CT cases for confirming metastasis or staging were excluded. Final diagnoses were categorized as infection, neoplasm, noninfectious non-neoplastic inflammatory disorder, miscellaneous, and uncategorizable. Each category was separated into evaluation with and without PET/CT for statistical analyses. Results: In total, 91 patients underwent evaluation for FUO and about one in three underwent PET/CT. Overall LOS was not different between the PET/CT and non-PET/CT groups;however, there were differences in LOS within the categories. For infectious causes, the mean LOS was 21.1 and 11.1 days in the PET/CT and non-PET/CT groups, respectively (P = 0.022). For neoplastic causes, the mean LOS was 11.4 and 36.0 days in the PET/CT and non-PET/CT Conclusion: Most patients with FUO were aged 50 - 60 years, and their family and work roles were crucial. A lower LOS may benefit both the patients' families and society at large. Interestingly, PET/CT may contribute to shortening the LOS during FUO evaluation when the causes are neoplastic, by approximately 24 days.

Association between psychological distress trajectories from adolescence to midlife and mental health during the pandemic: evidence from two British birth cohorts.

BACKGROUND: This paper examined whether distinct life-course trajectories of psychological distress from adolescence to midlife were associated with poorer mental health outcomes during the pandemic. METHODS: We present a secondary analysis of two nationally representative British birth cohorts, the 1958 National Child Development Study (NCDS) and 1970 British Cohort Study (BCS70). We used latent variable mixture models to identify pre-pandemic longitudinal trajectories of psychological distress and a modified Poisson model with robust standard errors to estimate associations with psychological distress, life satisfaction and loneliness at different points during the pandemic. RESULTS: Our analysis identified five distinct pre-pandemic trajectories of psychological distress in both cohorts. All trajectories with prior symptoms of psychological distress irrespective of age of onset, severity and chronicity were associated with a greater relative risk of poorer mental health outcomes during the pandemic and the probability of poorer mental health associated with psychological distress trajectories remained fairly constant. The relationship was not fully attenuated when most recent pre-pandemic psychological distress and other midlife factors were controlled for. CONCLUSIONS: Whilst life-course trajectories with any prior symptoms of psychological distress put individuals at greater risk of poor mental health outcomes during the pandemic, those with chronic and more recent occurrences were at highest risk. In addition, prior poor mental health during the adult life-course may mean individuals are less resilient to shocks, such as pandemics. Our findings show the importance of considering heterogeneous mental health trajectories across the life-course in the general population in addition to population average trends.

Benefit-finding buffers the effects of home confinement and centralized quarantine (HCCQ) on late midlife and older adults' mental health during the COVID-19 pandemic.

Objective: Older adults' well-being may suffer due to prolonged social isolation leading to loneliness and increased stress during the COVID-19 pandemic. The current study aimed to address the role of benefit-finding, defined as the capacity to derive meaning and positive aspects from stressful situations, in late midlife and older adults' adaptation to the effects of home confinement and centralized quarantine (HCCQ).Methods: 421 participants aged 50 or above in mainland of China participated in an online survey to study the effects of HCCQ on loneliness, stress, anxiety, depression and life satisfaction, as well as the moderating role of benefit-finding.Results: Correlational analysis showed that a history of HCCQ was basically unrelated to any outcome. However, the effect actually varied by levels of benefit-finding. Among late midlife and older people with lower benefit-finding, those who had experienced HCCQ reported more loneliness, perceived stress, as well as more anxiety and depressive symptoms; no such relationships were found when benefit-finding was moderate or high.Conclusion: The findings extended our understanding of the role of benefit-finding in buffering the negative impact of adversity. By mitigating the effects of prolonged social isolation, benefit-finding served as a protective factor in late midlife and older people's adaptation to the sequelae of this pandemic.

Sober Curiosity: A Qualitative Study Exploring Women's Preparedness to Reduce Alcohol by Social Class.

BACKGROUND: Urgent action is required to identify socially acceptable alcohol reduction options for heavy-drinking midlife Australian women. This study represents innovation in public health research to explore how current trends in popular wellness culture toward 'sober curiosity' (i.e., an interest in what reducing alcohol consumption would or could be like) and normalising non-drinking could increase women's preparedness to reduce alcohol consumption. METHODS: Qualitative interviews were undertaken with 27 midlife Australian women (aged 45-64) living in Adelaide, Melbourne and Sydney in different social class groups (working, middle and affluent-class) to explore their perceptions of sober curiosity. RESULTS: Women were unequally distributed across social-classes and accordingly the social-class analysis considered proportionally the volume of data at particular codes. Regardless, social-class patterns in women's preparedness to reduce alcohol consumption were generated through data analysis. Affluent women's preparedness to reduce alcohol consumption stemmed from a desire for self-regulation and to retain control; middle-class women's preparedness to reduce alcohol was part of performing civility and respectability and working-class women's preparedness to reduce alcohol was highly challenging. Options are provided for alcohol reduction targeting the social contexts of consumption (the things that lead midlife women to feel prepared to reduce drinking) according to levels of disadvantage. CONCLUSION: Our findings reinstate the importance of recognising social class in public health disease prevention; validating that socially determined factors which shape daily living also shape health outcomes and this results in inequities for women in the lowest class positions to reduce alcohol and related risks.

Home drinking practices among middle-class adults in midlife during the COVID-19 pandemic: Material ubiquity, automatic routines and embodied states.

INTRODUCTION: Harmful drinking is increasing among mid-life adults. Using social practice theory, this research investigated the knowledge, actions, materials, places and temporalities that comprise home drinking practices among middle-class adults (40-65 years) in Aotearoa New Zealand during 2021-2022 and post the COVID-19 pandemic lockdowns. METHODS: Nine friendship groups (N = 45; 26 females, 19 males from various life stages and ethnicities) discussed their drinking practices. A subset of 10 participants (8 female, 2 male) shared digital content (photos, screenshots) about alcohol and drinking over 2 weeks, which they subsequently discussed in an individual interview. Group and interview transcripts were thematically analysed using the digital content to inform the analysis. RESULTS: Three themes were identified around home drinking practices, namely: (i) alcohol objects as everywhere, embedded throughout spaces and places in the home; (ii) drinking practices as habitual, automatic and conditioned to mundane everyday domestic chores, routines and times; and (iii) drinking practices intentionally used by participants to achieve desired embodied states to manage feelings linked to domestic and everyday routines. DISCUSSION AND CONCLUSIONS: Alcohol was normalised and everywhere within the homes of these midlife adults. Alcohol-related objects and products had their own agency, being entangled with domestic routines and activities, affecting drinking in both automatic and intentional ways. Developing alcohol policy that would change its ubiquitous and ordinary status, and the 'automatic' nature of many drinking practices, is needed. This includes restricting marketing and availability to disrupt the acceptability and normalisation of alcohol in the everyday domestic lives of adults at midlife.

The covid-19 pandemic and the usability of telehealth in a midlife women's health integrated care program.

BACKGROUND: Telehealth has emerged as an alternative to conventional, face-to-face visits, and the COVID pandemic has hastened its introduction. Telephone appointments make use of an easy-to-use and accessible technology. AIM: To investigate the usability of telephone-based telehealth in a women's health outpatient clinic and whether this may be affected by the severity of the COVID pandemic. METHOD: A telephone survey was prepared to explore two usability domains: interaction quality (4 items) and satisfaction, preference and future use (6 items). Women were selected from two periods during the COVID pandemic when the infection rates were high and low. RESULTS: The survey was completed by 106 women (60 when the prevalence of COVID was high, mean age 53.58 years, and 46 when it was low, mean age 48.59 years) out of the 153 women who had a telephone appointment. The severity of the COVID pandemic showed an effect on responses. Women were less enthusiastic about using the telephone during the period of low COVID prevalence, as shown by lower scores on 3 of the 4 items of the first domain [I had enough time; I would have understood better in person; I would have expressed myself better in person (p < 0.001 for comparison between groups on each of the 3 items)], and on 4 of the 6 items in the second domain [satisfied with quality of care (p < 0.001), or with the information received (p = 0.018); use of telephone in future (p < 0.001); preference to try other technologies in future (p < 0.001)]. Overall, women expressed a preference for in-person visits regardless of COVID prevalence rates. CONCLUSION: Telephone calls were a feasible alternative to face-to-face visits in a women's health outpatient clinic, but the pandemic pressure modified usability parameters. Respondents preferred in-person visits at any pandemic stage.

Telehealth uptake among middle-aged and older Americans during COVID-19: chronic conditions, social media communication, and race/ethnicity.

OBJECTIVES: This study investigated whether and to what extent constructs of the protection motivation theory of health (PMT)-threat appraisal (perceived vulnerability/severity) and coping appraisal (response efficacy and self-efficacy)-are related to telehealth engagement during the COVID-19 pandemic, and how these associations differ by race/ethnicity among middle-aged and older Americans. METHODS: Data were from the 2020 Health and Retirement Study. Multivariable ordinary least-squares regression analyses were computed adjusting for health and sociodemographic factors. RESULTS: Some PMT constructs are useful in understanding telehealth uptake. Perceived vulnerability/severity, particularly comorbidity (b = 0.13, 95% confidence interval (CI) [0.11, 0.15], p < 0.001), and response efficacy, particularly participation in communication via social media (b = 0.24, 95% CI [0.21, 0.27], p < 0.001), were significantly and positively associated with higher telehealth uptake during the COVID-19 pandemic among middle-aged and older Americans. Non-Hispanic Black adults were more likely to engage in telehealth during the pandemic than their non-Hispanic White counterparts (b = 0.20, 95% CI [0.12, 0.28], p < 0.001). Multiple moderation analyses revealed the significant association between comorbidity and telehealth uptake was similar across racial/ethnic groups, whereas the significant association between social media communication and telehealth uptake varied by race/ethnicity. Specifically, the association was significantly less pronounced for Hispanic adults (b = -0.11, 95% CI [-0.19, -0.04], p < 0.01) and non-Hispanic Asian/other races adults (b = -0.13, 95% CI [-0.26, -0.01], p < 0.05) than it was for their non-Hispanic White counterparts. CONCLUSION: Results suggest the potential of using social media and telehealth to narrow health disparities, particularly serving as a bridge for members of underserved communities to telehealth uptake.

In the midst of a pandemic, more introverted individuals may have a mortality advantage.

Purpose: We investigated whether the relationship between extroversion and mortality changed during the COVID-19 pandemic. Methods: Midlife Americans were surveyed in 1995-96 with mortality follow-up through December 31, 2020. We used a Cox model to estimate age-specific mortality controlling for sex, race/ethnicity, the period trend in mortality, an indicator for the pandemic period (Mar-Dec 2020), extroversion, and an interaction between extroversion and the pandemic indicator. Results: Prior to the pandemic, extroversion was associated with somewhat lower mortality (HR = 0.93 per SD, 95% CI 0.88-0.97), but the relationship reversed during the pandemic. Extroversion was associated with greater pandemic-related excess mortality (HR = 1.29 per SD, 95% CI 1.002-1.67). That is, compared with persons who were more introverted, those who were highly extroverted suffered a bigger increase in mortality during the pandemic relative to pre-pandemic mortality levels. Conclusions: The slight mortality advantage enjoyed by more extroverted Americans prior to the pandemic disappeared during the first 10 months of the COVID-19 pandemic. We suspect that the mortality benefit of introversion during the pandemic is largely a result of reduced exposure to the risk of infection, but it may also derive in part from the ability of more introverted individuals to adapt more easily to reduced social interaction without engaging in self-destructive behavior (e.g., drug and alcohol abuse).

The Impact of the COVID-19 Pandemic on Trajectories of Well-Being of Middle-Aged and older Adults: A Multidimensional and Multidirectional Perspective.

The COVID-19 pandemic has resulted in profound changes of individuals' everyday lives. Restrictions in social contacts and in leisure activities and the threatening situation of a spreading virus might have resulted in compromised well-being. At the same time, the pandemic could have promoted specific aspects of psychosocial well-being, e.g., due to intensified relationships with close persons during lockdown periods. We investigated this potentially multidimensional and multi-directional pattern of pandemic-specific change in well-being by analyzing changes over up to 8 years (2012-2020) in two broad well-being domains, hedonic well-being (life satisfaction) and eudaimonic well-being (one overarching eudaimonic well-being indicator as well as environmental mastery, personal growth, positive relations with others, and self-acceptance), among 423 adults who were aged 40-98 years in 2012. By modelling longitudinal multilevel regression models and allowing for a measurement-specific intra-individual deviation component from the general slope in 2020, i.e. after the pandemic outbreak, we analyzed potential normative history-graded changes due to the pandemic. All mean-level history-graded changes were nonsignificant, but most revealed substantial interindividual variability, indicating that individuals' pandemic-related well-being changes were remarkably heterogeneous. Only for personal growth and self-acceptance, adding a pandemic-related change component (and interindividual variability thereof) did not result in a better model fit. Individuals with poorer self-rated health at baseline in 2012 revealed a pandemic-related change toward lower life satisfaction. Our findings suggest that not all well-being domains - and not all individuals - are equally prone to "COVID-19 effects", and even pandemic-associated gains were observed for some individuals in certain well-being domains.

Designing of Latent Dirichlet Allocation Based Prediction Model to Detect Midlife Crisis of Losing Jobs due to Prolonged Lockdown for COVID-19

The sudden outbreak of the virus COVID-19 has created a pandemic situation worldwide. Humankind has not experienced such a danger caused by this disease in the past hundred years. Apart from all the health issues, the pandemic has created an immense impact on social life, economics, mental peace, and all aspects of human life. Prolonged quarantine is creating uncertainties;death tolls are creating fear. According to the World Health Organization, this public health emergency is likely to create anxiety, loneliness, depression, fear of losing jobs, being economically unstable, and committing suicide. In our present discussion, we prepare a statistical record using data collected from all over the world to find the intensity of mental disorder caused by this pandemic. Now we aim at finding the polarity of the specified term used by social media users. We aim to formulate a highly efficient mechanism that will detect depressive sentences more accurately. In our work, we try to formulate an optimal mechanism implementing the Latent Dirichlet Allocation approach to modify our findings and prove through a comparative study that depression affects the highest among people age 40−50. We experience that this age group is highly devastated in fear of losing jobs because of to this pandemic. The standard psychiatric symptom of lack of self-dignity and self-confidence that can happen to a human at the middle age is proliferated due to extended lockdown and its after effects. There is much research in sentiment analysis, which shows us the impact of COVID-19 in recent days. Surprisingly, recognizing symptoms of the midlife crisis in the pandemic situation of COVID-19 is yet to achieve. © 2022 Elsevier Inc. All rights reserved.

LABOUR, SELF-CARE AND RESPITE: NEOLIBERAL RATIONALITIES IN SLEEP CRISIS RHETORIC

This article tracks the emergence of sleep discourse in the past ten years in the USA, illustrating a democratisation of this rhetoric insofar as it has begun to interpellate populations beyond midlife women. Despite the sociological and demographic inequities associated with sleep deficits in marginalised populations, the much vaunted 'sleep crisis' is more widely appreciated as a distinct self-care frontier. Such behavioural scripts resonate with exaltations of the self as resilient entrepreneurial problem-solver and are linked to the broader positioning of self-care as salve for the injuries of neoliberalism. Beginning with sleep's ties to women's wellness and consumerist culture writ large, we apprehend sleep as an economy, one with staggering new commercial dimensions. Sleep remedies tend to be focused narrowly on the acquisition of products and technologies (sleep sprays, essential oils and melatonin gummies, blackout curtains, premium bedding, sleep apps, sound machines, adult sleep coaches), all of which come under consideration here. The investigation then turns to the heightened attention paid to the experience of sleep during COVID-19, discusses how sleep discourse articulates to and with a sense of ambivalent dispossession from work regimes and, finally, argues that the sleep crisis has been leveraged to intensify neoliberal brutalities.

A cross sectional survey of 504 women regarding perceived risk factors and barriers to follow healthy lifestyle and association with sociodemographic factors and menopausal symptoms.

BACKGROUND AND AIMS: Midlife women undergoing menopausal transition are predisposed to weight gain. Weight gain in midlife is driven by two modifiable risk factors: menopausal symptom's severity and lifestyle practices. The independent and interactive nature of menopausal symptoms and lifestyle practices as risk factors of weight gain has not been investigated yet. This study was undertaken to study menopausal symptoms and lifestyle practices as risk factors for weight gain in midlife women and identify midlife -related barriers in managing corrective lifestyle practices. METHODS: In this cross-sectional study, menopausal symptom severity and lifestyle practices such as diet, exercise, and sleep were assessed using a pre-validated and reliable questionnaire on a convenience sample of midlife women (43-55 years) via an interview schedule. The association of lifestyle practices and its barriers with socio-demographics and menopausal symptoms were analysed. RESULT: A total of 504 women (mean age: 47.3 ± 4.1 years) were recruited. More than half of them followed corrective dietary practices, but only one-fourth engaged in moderate-intensity exercises. Total menopausal symptom severity was associated with increased food intake (P < 0.001), joint pain with limited physical activity and hot flashes and emotional volatility with sleep disturbances (P < 0.01). Demographic variables such as education, economic and employment status were associated with unhealthy lifestyle practices. CONCLUSION: Assessment of menopausal symptoms and lifestyle practices as risk factors and associated barriers must be the pivotal component to devise comprehensive women-centric weight management modules. Similar studies should be carried out in future when there is no clear effect of COVID19 on lifestyle factors.

A longitudinal analysis of the relationship between housing insecurity and physical health among midlife and aging adults in the United States.

Rationale: A large body of work demonstrates the impact of housing instability on health by exploring the effects of evictions and homelessness on psychological wellbeing of young adults and children. However, limited research leverages national longitudinal data to examine whether and how experiences of a range of housing insecurity events, rather than just eviction or homelessness, affect physical health among midlife and older adults. Objective: The current study examines (1) prevalence of housing insecurity among midlife and older adults by age and race, (2) linkages between housing insecurity experiences and facets of physical health, and (3) age and race moderations on these effects. Method: This study employs regression models to examine whether experiences of housing insecurity affect self-rated physical health and chronic physical conditions among midlife and older adults (N = 2598) leveraging two waves of the National Study of Midlife in the United States (MIDUS). Results: Models revealed that housing insecurity experiences predicted poorer self-rated physical health and additional chronic conditions, even when controlling for previous physical health. Moderation analyses indicated that housing insecurity has a stronger relationship with chronic conditions among midlife adults as compared to older adults, and among Black adults as compared to white adults. These results suggest that experiences of housing insecurity leave adults vulnerable to compromised physical health, and that housing insecurity experiences may be particularly detrimental to the health of midlife Black adults. Conclusions: This research adds to the extant literature by introducing a comprehensive measure of housing insecurity experiences, and contributes to a life course perspective regarding how housing insecurity can affect physical health. This research has implications for policy that addresses housing insecurity as a public health concern, especially in the aftermath of the 2008 recession and the economic and housing crisis caused by the COVID-19 pandemic.

Double shifts, double trouble: Alcohol as a problematic panacea for working mothers.

Alcohol consumption among midlife women has become an area of research focus. We suggest it is important to examine the social roles that many midlife women take on - specifically working mothers. Working mothers balance both employment and the unequal burden of caring/domestic duties, leading to 'double shifts' of paid and unpaid labor. This creates unique stresses that may impact their drinking. This is particularly important as a growing number of mothers re-enter the workforce after childbirth. In this commentary, we suggest that working mothers' drinking tends to be overlooked or even endorsed as a means of managing the gendered stresses they face - stresses which have been exacerbated during the pandemic. We highlight the dearth of literature focusing on the drinking patterns, practices, and motives of working mothers and argue that gendered expectations placed on working mothers may be an increasingly important social determinant of health among this group.

"Post-lockdown Depression": Adaptation Difficulties, Depressive Symptoms, and the Role of Positive Solitude When Returning to Routine After the Lifting of Nation-Wide COVID-19 Social Restrictions.

Objectives: The aim of the current study was to identify difficulties in adapting to normal life once COVID-19 lockdown has been lifted. Israel was used as a case study, as COVID-19 social restrictions, including a nation-wide lockdown, were lifted almost completely by mid-April 2021, following a large-scale vaccination operation. Methods: A sample of 293 mid-age and older Israeli adults (M age = 61.6 ± 12.8, range 40-85 years old) reported on return-to-routine adaptation difficulties (on a novel index), depression, positive solitude, and several demographic factors. Results: Of the participants, 40.4% met the criteria of (at least) mild depressive symptoms. Higher levels of adaptation difficulties were related to higher ratios of clinical depressive symptoms. This link was moderated by positive solitude. Namely, the association between return-to-routine adaptation difficulties and depression was mainly indicated for individuals with low positive solitude. Conclusions: The current findings are of special interest to public welfare, as adaptation difficulties were associated with higher chance for clinical depressive symptoms, while positive solitude was found to be as an efficient moderator during this period. The large proportion of depressive symptoms that persist despite lifting of social restrictions should be taken into consideration by policy makers when designing return-to-routine plans.

A comparison of stress, symptoms, physical activity, and adiposity among women at midlife before and during the pandemic.

BACKGROUND: The COVID-19 pandemic presented challenges that disproportionately impacted women. Household roles typically performed by women (such as resource acquisition and caretaking) became more difficult due to financial strain, fear of infection, and limited childcare options among other concerns. This research draws from an on-going study of hot flashes and brown adipose tissue to examine the health-related effects of the COVID-19 pandemic among 162 women aged 45-55 living in western Massachusetts. METHODS: We compared women who participated in the study pre- and early pandemic with women who participated mid-pandemic and later-pandemic (when vaccines became widely available). We collected self-reported symptom frequencies (e.g., aches/stiffness in joints, irritability), and assessments of stress, depression, and physical activity through questionnaires as well as measures of adiposity (BMI and percent body fat). Additionally, we asked open-ended questions about how the pandemic influenced women's health and experience of menopause. Comparisons across pre-/early, mid-, and later pandemic categories were carried out using ANOVA and Chi-square analyses as appropriate. The Levene test for homogeneity of variances was examined prior to each ANOVA. Open-ended questions were analyzed for yes/no responses and general themes. RESULTS: Contrary to our hypothesis that women would suffer negative health-related consequences during the COVID-19 pandemic, we found no significant differences in women's health-related measures or physical activity across the pandemic. However, our analysis of open-ended responses revealed a bi-modal distribution of answers that sheds light on our unexpected findings. While some women reported higher levels of stress and anxiety and lower levels of physical activity, other women reported benefitting from the remote life that the pandemic imposed and described having more time to spend on physical activity or in quality time with their families. CONCLUSIONS: In this cross-sectional comparison of women during the pre-/early, mid-, and later-pandemic, we found no significant differences across means in multiple health-related variables. However, open-ended questions revealed that while some women suffered health-related effects during the pandemic, others experienced conditions that improved their health and well-being. The differential results of this study highlight a need for more nuanced and intersectional research on risk, vulnerabilities, and coping among mid-life women.

The Social Data Foundation model: Facilitating health and social care transformation through datatrust services

Turning the wealth of health and social data into insights to promote better public health, while enabling more effective personalized care, is critically important for society. In particular, social determinants of health have a significant impact on individual health, well-being, and inequalities in health. However, concerns around accessing and processing such sensitive data, and linking different datasets, involve significant challenges, not least to demonstrate trustworthiness to all stakeholders. Emerging datatrust services provide an opportunity to address key barriers to health and social care data linkage schemes, specifically a loss of control experienced by data providers, including the difficulty to maintain a remote reidentification risk over time, and the challenge of establishing and maintaining a social license. Datatrust services are a sociotechnical evolution that advances databases and data management systems, and brings together stakeholder-sensitive data governance mechanisms with data services to create a trusted research environment. In this article, we explore the requirements for datatrust services, a proposed implementation—the Social Data Foundation, and an illustrative test case. Moving forward, such an approach would help incentivize, accelerate, and join up the sharing of regulated data, and the use of generated outputs safely amongst stakeholders, including healthcare providers, social care providers, researchers, public health authorities, and citizens.

Pain experiences among women in midlife with existing health conditions: changes across pre-COVID-19, stay-at-home orders, and initial reopening.

OBJECTIVE: To examine the pain experiences of women in midlife with existing health conditions, including changes from prior to the COVID-19 pandemic through the first 6 months of the crisis. DESIGN: Women ages 40-60 with health conditions (e.g., hypertension; N = 35, MBMI = 32.2 kg/m2) were prompted to complete 5 surveys per day for 5 days at 3 time points: pre-COVID-19, during stay-at-home orders, and at initial reopening. MAIN OUTCOME MEASURES: Pain occurrence (yes/no), number of locations, and intensity. RESULTS: Women reported pain at 35% of surveys, particularly after waking and before bed compared to the middle of the day. The occurrence of pain decreased over time, whereas pain intensity decreased between pre-COVID-19 and stay-at-home orders but then remained stable. The number of pain locations decreased between stay-at-home orders and reopening, and pain was more variable during the pandemic than prior to its onset (srs = 0.24-0.32). CONCLUSION: Women experienced decreased pain frequency and intensity from prior to during the COVID-19 pandemic, though pain was less predictable during (vs. prior to) the pandemic. This information may be useful for informing care in this at-risk group, to prevent the development of chronic pain.

The Case of Australia: Trust During Pandemic Uncertainty—A Qualitative Study of Midlife Women in South Australia

Government responses to COVID-19 have dramatically altered the social quality of daily circumstances. Consequently, theoretical questions about social cohesion require recalibration as we explore new models of social quality. Central to this article is trust, one of the fundamental tenets of social cohesion. We present data from interviews with 40 women in midlife (45–64 years) regarding their everyday experiences of “life in lockdown” during the pandemic. Key themes focus on women’s (dis)trust in individuals (e.g., politicians, public health experts, family, themselves) and systems (e.g., politics, medicine, the media). This study provides insights into the differential impact of the pandemic in shaping public trust and hence social cohesion—in authority, institutions, and “each other”—with important lessons for how future efforts can rebuild trust in post-pandemic times.

Changes in Life Circumstances and Mental Health Symptoms during the COVID-19 Pandemic among Midlife Women with Elevated Risk for Cardiovascular Disease.

Cardiovascular disease (CVD) remains the leading cause of death among women. During midlife (ages 40-60), universal aging processes, sex-specific factors such as menopause, psychological distress, and conditions such as hypertension substantially increase women's risk for CVD. The onset of the COVID-19 pandemic has impacted employment, social interactions, caregiving responsibilities, and overall well-being worldwide; however, little research has investigated how COVID-19 has affected women in midlife. The present study was designed to determine how COVID-19 has affected women in midlife with elevated risk for CVD, by examining changes in their mental health symptoms and life domains across three time points: prior to COVID-19 (2019), during stay-at-home orders (April-June 2020), and during initial reopening (August 2020). Women in midlife with one or more CVD risk conditions (e.g., hypertension; n = 35) responded to questions related to COVID-19, changes in life circumstances, and mental health symptoms at each time point. Findings showed meaningful changes in caregiving, medical visits, and employment status, as well as significant changes in depression and sleep quality scores across time. However, the findings also showed that women were distressed prior to COVID-19 and did not exhibit changes in perceived stress, body dissatisfaction, or anxiety symptoms over time. Findings from this study highlight the impact of the COVID-19 pandemic on an at-risk group of women, which may be used to help guide future health promotion efforts specifically tailored to this population.