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1.
Frontiers in Sustainable Cities ; 4, 2022.
Article in English | Scopus | ID: covidwho-1879483

ABSTRACT

Post-apartheid South Africa is characterized by the proliferation of public protests, which occur in various contexts. These include urban riots that are typically carried out by individuals who live in residential areas who are relatively politically, socially, and economically marginalized. In this perspective, the study seeks to navigate the nexus between urban riots and criminal activities in Gauteng and KwaZulu-Natal provinces of South Africa. This will be performed by looking at the recent urban violence that erupted in Johannesburg and Durban cities of South Africa following the arrest of the former president of South Africa Jacob Zuma on 7 July for contempt of court. As a result of the incarceration of Zuma, his supporters took to the streets to demand for his release, ending in protests which quickly evolved into widespread lootings, vandalism, and an outbreak of violence that denoted elements of criminality. The two provinces, Gauteng (the country's economic hub) and KwaZulu-Natal (on the east coast), bore the brunt of this violence. What began as a call for the release of Jacob Zuma transpired into something that was heavily coordinated, controlled and, to a larger extent, dangerous, and perhaps the worst post-apartheid urban riot. However, behind these riots, there are seeds of discontents that triggered these violent riots and these include: the frustrations of hungry and cold people whose prospects were already constrained by the coronavirus disease-2019 (COVID-19) pandemic, rising inequality between rich and poor, unemployment, intra-party tensions, and ANC-factionalism, including stereotypical Zulu nationalism and racial tensions in South Africa. On the other hand, the riots that occurred in both KwaZulu-Natal and Gauteng were accompanied by criminality such as looting, torching, and burning of private and public properties and, to a larger degree, murder of civilians. Findings are that the urban riots in both Gauteng and KwaZulu-Natal provinces have resulted in human (in)securities such as exacerbation of poverty, food and fuel shortages, effects on the health sector (amid the COVID-19 crisis), loss of lives, and increase in unemployment. Methodologically, the study relies on a mixed method of research and content analysis. Copyright © 2022 Mongale.

2.
Pakistan Armed Forces Medical Journal ; 72, 2022.
Article in English | ProQuest Central | ID: covidwho-1876781

ABSTRACT

Objective: To assess the current habits of personal hygiene practices, to determine the role of demographic characteristics in personal hygiene practices and to identify barriers to sustainable behavioral change during COVID-19 pandemic in general communities of Rawalpindi. Study Design: A cross sectional mixed method study. Place and Duration of Study: Different communities of Rawalpindi city, from Aug 2020 to Apr 2021. Methodology: Non-probability consecutive sampling was used. Both qualitative and quantitative data (sample size;n=400) was collected for understanding of the barriers in sustainability of modified behaviour during and after COVID-19. Results: Out of 400 respondents, 43% were in the age group of 15-30 years while 30% were between 31-45 years. More than half 65% of them were males and 35% females. About 98% of the respondents practice frequent hand washing, 87% uses hand sanitizers, 75% wear masks, 67% practice social distancing and 95% cover their mouth during coughing and sneezing. The educational and occupational status of the respondents was significantly associated with personal hygiene and lifestyle change behaviour. About 391 respondents 391 (97%) were used to practice hand washing, 350 (87.3%) hand sanitizer 301 (75%) wear masks outside home. About 269 (67%) practice social distancing and 382 (95%) cover their mouth while coughing/sneezing. Conclusion: Sustainable behaviour change for positive health and reduced transmission of communicable diseases is possible, if the nature of human beings and the cultural and religious beliefs that define them are taken into account.

3.
Sensors ; 22(10):3621, 2022.
Article in English | ProQuest Central | ID: covidwho-1871477

ABSTRACT

This study aims to assess the perspectives and usability of different consumer sleep technologies (CSTs) that leverage artificial intelligence (AI). We answer the following research questions: (1) what are user perceptions and ideations of CSTs (phase 1), (2) what are the users’ actual experiences with CSTs (phase 2), (3) and what are the design recommendations from participants (phases 1 and 2)? In this two-phase qualitative study, we conducted focus groups and usability testing to describe user ideations of desires and experiences with different AI sleep technologies and identify ways to improve the technologies. Results showed that focus group participants prioritized comfort, actionable feedback, and ease of use. Participants desired customized suggestions about their habitual sleeping environments and were interested in CSTs+AI that could integrate with tools and CSTs they already use. Usability study participants felt CSTs+AI provided an accurate picture of the quantity and quality of sleep. Participants identified room for improvement in usability, accuracy, and design of the technologies. We conclude that CSTs can be a valuable, affordable, and convenient tool for people who have issues or concerns with sleep and want more information. They provide objective data that can be discussed with clinicians.

4.
Diabetic Medicine ; 39(SUPPL 1):80-81, 2022.
Article in English | EMBASE | ID: covidwho-1868614

ABSTRACT

Introduction: People with diabetes are particularly at high risk of becoming seriously unwell after contracting covid-19 infection. We do not fully understand underlying factors contributing to such risk/their respective contributions to outcomes. Methods: This population-based study included people living in the Greater Manchester conurbation with a recorded diagnosis of type 1 diabetes and type 2 diabeetes +subsequent covid-19 infection. Each individual with type 1 diabetes (n = 862)/ type 2 diabetes (n = 13,225) was matched with 3 covid-19 infected non-diabetes controls. Results: For type 1 diabetes individuals, the hospital admission rate in the first 28 days after covid-19 positive test was 10%vs4.7% in age/gender-matched controls (relative risk [RR] 2.1). For type 2 diabetes individuals, the hospital admission rate in the first 28 days after a covid-19 positive test was 16.3%vs11.6% in age/gender-matched controls(RR 1.4). Average Townsend score was higher in type 2 diabetes (1.8) vs matched controls(0.4), with a higher proportion of type 2 diabetes people in the top 2 quintiles of greatest disadvantage(p < 0.001). Within the group of covid-19 infected type 1 diabetes affected individuals, factors influencing the likelihood of admission included;age/body mass index (BMI)/ hypertension/ HbA1c/low HDL-cholesterol/ lower estimated glomerular filtration rate(eGFR)/COPD/being of African/ mixed ethnicity. In covid-19 infected type 2 diabetes individuals, factors potentially related to a higher admission rate included;age/Townsend Index/co-morbidity with COPD/asthma and severe mental illness(SMI)+lower eGFR. Metformin prescription lowered the admission likelihood. Conclusion: In a UK population, we have confirmed significantly higher likelihood of admission in people with diabetes following covid-19 infection. Several factors mediate the increased likelihood of hospital admission including metformin. For type 2 diabetes, the majority of factors related to increased admission rate are common to the general population but more prevalent in type 2 diabetes.

5.
Diabetic Medicine ; 39(SUPPL 1):13, 2022.
Article in English | EMBASE | ID: covidwho-1868593

ABSTRACT

Introduction: In this study we set out to determine the relative likelihood of death following covid-19 infection in people with type 2 diabetes when compared to those without type 2 diabetes. Methods: Analysis of digital health record data was performed relating to people living in the Greater Manchester conurbation (population 2.82 million) who had a recorded diagnosis of type 2 diabetes and subsequent covid-19 confirmed infection. Each individual with type 2 diabetes (n = 13,807) was matched with three covid-19 infected non-diabetes controls (n = 39583). Results: For type 2 diabetes individuals, their mortality rate after a covid-19 positive test was 7.7% vs 6.0% in matched controls;the relative risk (RR) of death was 1.28. From univariate analysis performed within type 2 diabetes individuals, likelihood of death following covid-19 recorded infection was lower in people taking metformin, sodium glucose cotransporter-inhibitor 2(SGLT-2i) or glucagon-like peptide-1( GLP-1) agonist. A lower estimated glomerular filtration rate (eGFR) was associated with a higher mortality rate, as was hypertension history. Likelihood of death following covid-19 infection was also higher in those people with diagnosis of COPD/severe enduring mental illness, and in people taking aspirin/ clopidogrel/insulin. Smoking in people with type 2 diabetes significantly increased mortality rate. In combined analysis of type 2 diabetes patients/controls, multiple regression modelling indicated that factors independently relating to higher likelihood of death (accounting for 26% of variance) were: type 2 diabetes/age/ malegender/social deprivation (higher Townsend index). Conclusion: Following confirmed infection with covid- 19 a number of factors are associated with mortality in type 2 diabetes individuals. Prescription of metformin, SGLT-2is or GLP-1 agonists + non-smoking status associated with reduced risk of death for people with type 2 diabetes. Age/male sex/social disadvantage associated with an increased risk of death.

6.
Health Place ; 76: 102830, 2022 May 24.
Article in English | MEDLINE | ID: covidwho-1867174

ABSTRACT

Patterns of exposure and policies aiming at reducing physical contact might have changed the social distribution of COVID-19 incidence over the course of the pandemic. Thus, we studied the temporal trends in the association between area-level deprivation and COVID-19 incidence rate by Basic Health Zone (minimum administration division for health service provision) in Madrid, Spain, from March 2020 to September 2021. We found an overall association between deprivation and COVID-19 incidence. This association varied over time; areas with higher deprivation showed higher COVID-19 incidence rates from July to November 2020 and August-September 2021, while, by contrast, higher deprivation areas showed lower COVID-19 incidence rates in December 2020 and July 2021.

7.
Stud Health Technol Inform ; 294: 701-702, 2022 May 25.
Article in English | MEDLINE | ID: covidwho-1865435

ABSTRACT

In this study we examined the correlation of COVID-19 positivity with area deprivation index (ADI), social determinants of health (SDOH) factors based on a consumer and electronic medical record (EMR) data and population density in a patient population from a tertiary healthcare system in Arkansas. COVID-19 positivity was significantly associated with population density, age, race, and household size. Understanding health disparities and SDOH data can add value to health and the creation of trustable AI.


Subject(s)
COVID-19 , COVID-19/epidemiology , Delivery of Health Care , Hospitals, State , Humans , Population Density , Rural Population , Social Determinants of Health
8.
Acta Universitatis Lodziensis. Folia Sociologica ; - (80):105, 2022.
Article in English | ProQuest Central | ID: covidwho-1863485

ABSTRACT

This study aimed to assess the social impact of COVID-19 on chronic kidney disease patients, a vulnerable population, by analysing the social problems that emerged and aggravated during the pandemic's first phase. 117 CKD patients on treatment, referred to Social Work, participated in this study. New referrals were 37.6%, and 62.4% were aggravated situations, presenting mostly economic deprivation or lack of income, unemployment, and social isolation. The social intervention complexity was higher among those with aggravated social problems. The results allow social workers to plan interventions focused on the most relevant emerging issues in a pandemic challenging context.Alternate :Celem prezentowanego badania była ocena społecznego wpływu pandemii COVID-19 na pacjentów z przewlekłą chorobą nerek, populację szczególnie narażoną na liczne powikłania w przypadku zarażenia się wirusem SARS-CoV-2. Autorzy skupili się na analizie problemów społecznych, które pojawiły się i nasiliły w pierwszej fazie pandemii. W badaniu wzięło udział 117 pacjentów leczonych w CKD, skierowanych do otrzymania pomocy socjalnej. Zaobserwowano wzrost liczby osób kierowanych do otrzymania pomocy. Nowych zgłoszeń było 37,6%, a 62,4% z nich związane było z pogorszeniem społeczno-ekonomicznej sytuacji pacjenta – głównie deprywacją ekonomiczną lub brakiem dochodów, bezrobociem i izolacją społeczną. Złożoność interwencji socjalnej była wyższa wśród osób z nasilonymi problemami społecznymi. Wyniki otrzymanych badań mają nie tylko walor naukowy, lecz także praktyczny – pozwalają pracownikom socjalnym na planowanie pomocy skoncentrowanej na najistotniejszych problemach pojawiających się w kontekście wyzwań pandemicznych.

9.
Front Med (Lausanne) ; 9: 774773, 2022.
Article in English | MEDLINE | ID: covidwho-1862615

ABSTRACT

Background: The incidence and severity of coronavirus disease 19 (COVID-19) is substantially higher in men. Sex hormones may be a potential mechanism for differences in COVID-19 outcome in men and women. We hypothesized that men treated with androgen deprivation therapy (ADT) have lower incidence and severity of COVID-19. Methods: We conducted an observational study of male Veterans treated in the Veterans Health Administration from February 15th to July 15th, 2020. We developed a propensity score model to predict the likelihood to undergo Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) testing. We performed multivariable logistic regression modeling adjusted with inverse probability weighting to examine the relationship between ADT and COVID-19 incidence. We conducted logistic regression analysis among COVID-19 patients to test the association between ADT and COVID-19 severity. Results: We identified a large cohort of 246,087 VA male patients who had been tested for SARS-CoV-2, of whom 3,057 men were exposed to ADT, and 36,096 men with cancer without ADT. Of these, 295 ADT patients and 2,427 cancer patients not on ADT had severe COVID-19 illness. In the primary, propensity-weighted comparison of ADT patients to cancer patients not on ADT, ADT was associated with decreased likelihood of testing positive for SARS-CoV-2 (adjusted OR, 0.88 [95% CI, 0.81-0.95]; p = 0.001). Furthermore, ADT was associated with fewer severe COVID-19 outcomes (OR 0.72 [95% CI 0.53-0.96]; p = 0.03). Conclusion: ADT is associated with reduced incidence and severity of COVID-19 amongst male Veterans. Testosterone and androgen receptor signaling may confer increased risk for SARS-CoV-2 infection and contribute to severe COVID-19 pathophysiology in men.

10.
Economica ; 89(S1):S160-S177, 2022.
Article in English | ProQuest Central | ID: covidwho-1861299

ABSTRACT

Changes in the structure of work and families over the last four decades have increased many labour market inequalities. Growing earnings inequality, adverse labour market ‘shocks’ for the low‐educated, and geographically concentrated pockets of deprivation are among the most evident of these in Britain. The decade since the financial crisis has brought these inequalities into sharper focus, and the Covid‐19 pandemic has further exacerbated labour market inequality. The object of this paper is to highlight the key role played by poor wage progression for lower‐ and middle‐educated workers in understanding inequality in the labour market and for designing effective policy responses. It is unlikely that we can address all the concerns about low wages, wage progression and earnings inequality through the tax and welfare system alone. The challenge is how best to balance tax and welfare benefit policy with other policies, such as human capital policies, the minimum wage and labour market regulation. The results point to a mix of policies that aim to enhance wage progression for the lower‐educated within a welfare system that supports low‐earning families and provides a minimum wage floor for hourly wages.

11.
BMC Public Health ; 22:1-12, 2022.
Article in English | ProQuest Central | ID: covidwho-1857750

ABSTRACT

Background Globally, substance use is a leading contributor to the burden of disease among young people, with far reaching social, economic and health effects. Following a finding of harmful alcohol use among 5-8-year-old children in Mbale District, Uganda, this study aims to investigate community members’ views on early childhood substance use among children below the age of 10 years. Methods In 2016, we conducted eight focus group discussions with 48 parents and 26 key informant interviews with teachers, health workers, alcohol distributors, traditional healers, religious leaders, community leaders and youth workers. We used thematic content analysis. Four participants and two research assistants reviewed and confirmed the findings. Results Alcohol in everyday life: ‘Even children on laps taste alcohol’: Almost all participants confirmed the existence of and concern for substance use before age 10. They described a context where substance use was widespread in the community, especially intake of local alcoholic brews. Children would access substances in the home or buy it themselves. Those living in poor neighbourhoods or slums and children of brewers were described as particularly exposed. Using substances to cope: ‘We don’t want them to drink’: Participants explained that some used substances to cope with a lack of food and resources for childcare, as well as traumatic experiences. This made children in deprived families and street-connected children especially vulnerable to substance use. Participants believed this was a result of seeing no alternative solution. Conclusions To our knowledge, this is the first study to describe the context and conditions of childhood substance use before age 10 in Mbale District, Uganda. The study shows that community members attributed early childhood substance use to a social context of widespread use in the community, which was exacerbated by conditions of material and emotional deprivation. These social determinants for this practice deserve public health attention and intervention.

12.
Epidemiologia & Prevenzione ; 46(1-2):34-46, 2022.
Article in English | Web of Science | ID: covidwho-1856462

ABSTRACT

BACKGROUND: the levels of anti-SARS-CoV-2 antibodies after the second vaccine dose decline in the following months;an additional vaccine dose (booster) is able to swiftly restore the immune system, significantly reducing the risk of severe disease. In the winter of 2021, a new, particularly infectious variant made the need to increase booster coverage in the population even more urgent. OBJECTIVES: to present, using real data, an evaluation of the effectiveness of the booster dose in reducing severe disease caused by SARS-CoV-2 infection in terms of COVID-19 hospitalization and intensive care admission, and all-cause mortality. DESIGN: descriptive study of vaccination uptake;associative study of the factors linked with uptake of vaccination and COVID-19 symptoms;associative study of vaccine effectiveness against hospital admission and mortality. SETTING AND PARTICIPANTS: population residing in the Milan and Lodi provinces (Lombardy Region, Northern Italy), eligible for anti-SARS-COV-2 vaccination, with subjects aged >= 19 years alive as at 01.10.2021, not residing in nursing homes, followed-up until 31.12.2021. MAIN OUTCOME MEASURES: COVID-19 symptoms, hospitalization, intensive care hospitalization, and all-cause mortality in the period 01.10.2021-31.12.2021. RESULTS: the cohort included 2,936,193 patients as of 01.10.2021;at the end of the observation period (31.12.2021), 378,616 (12.9%) were unvaccinated, 60,102 (2.0%) had received only 1 dose and had not had the disease, 68,777 (2.3%) had received only 1 dose and had had the disease, 412,227 (14.0%) were fully vaccinated with 2 doses less than 4 months earlier, 198,459 (6.8%) had received 2 doses [4,5) months earlier, 439,363 (15.0%) had received 2 doses [5,6) months earlier, 87,984 (3.0%) had received 2 doses [6,7) months earlier, 74,152 (2.5%) had received 2 doses more than 7 months earlier, 62,614 (2.1%) had received 2 doses and had had the disease, and, finally, 1,153,899 (39.3%) had received a booster shot. In the study period (01.10.2021-31.12.2021), characterized by a very high prevalence of the omicron variant, 121,620 cases (positive antigen/molecular test), 3,661 hospitalizations for COVID-19, 162 intensive care admissions for COVID-19, and 7,508 deaths from all causes were identified. Compared to unvaccinated subjects, subjects who received a booster had half the risk of being symptomatic, and had half the risk of experiencing fatigue, muscle aches, and dyspnoea. In comparison with boosted subjects, unvaccinated subjects had a 10-fold risk of hospitalization, a 9-fold risk of intensive care, and a 3-fold risk of dying. CONCLUSIONS: this work highlights the effectiveness of vaccination in reducing serious adverse events in boosted subjects and the need to implement specific policies of engagement to bring subjects who received their second dose earliest to get a booster.

13.
Inzinerine Ekonomika-Engineering Economics ; 33(2):132-142, 2022.
Article in English | Web of Science | ID: covidwho-1856167

ABSTRACT

Food Insecurity (FI) is a complex phenomenon, therefore the traditional approach to its analysis, based on the rigid dichotomization between the food-secure and the food-insecure can oversimplify the real picture. The study proposes to consider FI as a degree rather than as an attribute. To do this, it employs a fuzzy approach widely applied in multidimensional poverty analysis. The study aims to identify correlates of FI in the V4 countries using the zero-inflated beta regression model. This model enables to understand the mechanisms behind the risk and the severity of FI in V4. The analysis based on the FIES data collected in the Gallup World Poll for 2018 indicates the role of income, household composition, and social capital as important correlates of FI. The risk of FI was also affected by age, level of education, gender, marital and employment status. Moreover, the study finds that the food insecurity profile exhibits country-specific effects.

14.
European Journal of Inflammation ; 20, 2022.
Article in English | EMBASE | ID: covidwho-1854581
15.
Journal of Occupational Science ; : 16, 2022.
Article in English | Web of Science | ID: covidwho-1852775

ABSTRACT

Background: In Ireland, stringent restrictions were implemented to protect nursing home residents from contracting COVID-19. There is limited empirical research on how restrictions impacted residents' occupational engagement or well-being. This study explored the impact of COVID-19 restrictions on the occupational engagement of nursing home residents and considered implications for occupational science. Methods: Using qualitative descriptive design, semi-structured telephone interviews were conducted with five residents in one nursing home. Two online focus groups were conducted with seven nursing home staff working across five sites. Data were analysed using interpretive thematic analysis. Results: Three overarching themes emerged regarding residents' occupational engagement. 'Loss of valued occupation' related to residents' reduced engagement in social and leisure occupations, with an erosion of the quality and meaning of their routine daily activities. 'Counting the costs of restrictions on residents' well-being' revealed profound impacts on residents' physical and mental health, including reduced mobility, weight loss, reduced independence, low mood and increased fear, anxiety, and frustration. 'Finding resilience in the face of adversity' indicated some hopeful adaptive and coping strategies among residents. Conclusions and implications: This study brings an occupational perspective to the impact of COVID-19 on nursing home residents by highlighting issues beyond infection control and virus transmission. Findings contribute to occupational science knowledge by highlighting issues of occupational deprivation, occupational disruption and reduced occupational choice, and ripple effects on well-being. Nursing home residents' perspectives must be prioritised in future research and policy decision-making in responding and adapting to pandemics.

16.
Jurnal Ners ; 17(1):67-73, 2022.
Article in English | Scopus | ID: covidwho-1847935

ABSTRACT

Introduction: During the COVID-19 pandemic, many individuals were concerned about being infected. Meanwhile, the older people felt isolated due to the detrimental effect on their mental and physical health. Therefore, this study aimed to identify the mental health issues suffered by the older people during the COVID-19 pandemic, the implication for sleep deprivation, loss of appetite, and psychosomatic complaints. Methods: This was a descriptive-analytic study using a cross-sectional approach to find the mental health impact of the COVID-19 pandemic. The population of this study was older people (those aged ≥60 years) living in urban areas in West Java and Jakarta. The sample size was measured with the Lemeshow formula using a 95% confidence interval. A total of 259 older people participated in this study in cluster random sampling selection. Questionnaires were distributed to study participants consisting of sociodemographic characteristics, general anxiety disorder, history of chronic illness, COVID-19 related psychological concern, self-reported losing appetite, self-reported sleep deprivation and psychosomatic assessment. Statistical analysis used descriptive and logistic regression analysis. Results: The average age of study participants is 65.3 years old (SD ± 6.8;min-max = 60 to 89 years old). Multivariable logistic regression model showed that sleep deprivation is significantly associated with non-college education background (OR = 2.28;95% CI = 1.23 to 4.61), anxiety (OR = 7.09;95% CI = 3.57 to 14.08), and the existence of chronic illness (OR = 2.75;95% CI = 1.44 to 5.26). Subsequently, the psychosomatic symptom was associated with anxiety (OR = 5.27;95% CI = 2.75 to 10.11) and chronic illness (OR = 2.80;95%CI = 1.47 to 5.32). Loss appetite was associated with non-college education background (OR = 2.50;95% CI = 1.16 to 5.41), anxiety (OR = 10.41;95% CI = 5.01 to 21.63), and the existence of chronic illness (OR = 3.60;95% CI = 1.72 to 7.55). The analysis showed that none of the COVID-19 related fear is associated with a sleep disorder, loss of appetite, and psychosomatic symptoms. Conclusions: Sociodemographic factors, anxiety and medical factors contribute to the risk of mental health issues in older adults during the COVID-19 pandemic, implication for sleep deprivation, loss of appetite, and psychosomatic complaints. © 2022 Jurnal Ners.

17.
Education in the Asia-Pacific Region ; 65:87-94, 2022.
Article in English | Scopus | ID: covidwho-1844328

ABSTRACT

In the current socioeconomic and epidemiological conditions, the use of distance learning technologies in Russia is increasing. The application of distance learning in higher education institutions during the COVID-19 pandemic and the analysis of the results of the survey of satisfaction of teachers and students with organizational, content, and technical parameters of such training allowed the authors to identify aspects indicating the manifestation of such a phenomenon as educational deprivation. The research aims to summarize the opinions of teachers and students of a pedagogical university, indicating the limitation of social and educational functions of distance learning during the professional training of future teachers. The paper summarizes the results of a survey of teachers and students at a pedagogical university held in November 2020. Analyzing some parameters in the answers, interpreted as states of deprivation, allows us to improve distance learning technologies further and prevent possible negative consequences of emerging limitations. The survey is used as a method of socio-psychological research. The authors use general scientific methods of analysis, generalization, and the mathematical method of calculating the percentage ratio to process the obtained data. The research results show the directions for further improvement of distance learning technologies used in professional training. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

18.
Journal of Occupational Science ; 2022.
Article in English | Scopus | ID: covidwho-1839880

ABSTRACT

Previous occupational science and occupational therapy literature has framed the consequences of occupational deprivation in relation to its long-term health and societal effects;however, the COVID-19 pandemic has illuminated the swift and life-threatening repercussions of occupational deprivation and the structural factors that perpetuate it for marginalized populations. In this discussion paper, we show how the intentional design of prisons around occupational deprivation has made incarcerated individuals particularly vulnerable to infection during the COVID-19 pandemic. We argue that public health recommendations designed to control the spread of disease, which require people to adapt their occupations and engage in health preserving occupations, conflict with the structure of prisons. On that basis, we propose the need for a broader understanding of occupational deprivation and the life-threatening effects it can have. We further argue for an expansion of existing conceptualizations to consider the immediacy of the consequences of occupational deprivation. We suggest that this more comprehensive understanding will provide a stronger foundation and greater urgency for advocacy efforts aimed at making structural changes. © 2022 The Journal of Occupational Science Incorporated.

19.
J Med Internet Res ; 24(4): e32570, 2022 04 08.
Article in English | MEDLINE | ID: covidwho-1834151

ABSTRACT

BACKGROUND: The recent shift to video care has exacerbated disparities in health care access, especially among high-need, high-risk (HNHR) adults. Developing data-driven approaches to improve access to care necessitates a deeper understanding of HNHR adults' attitudes toward telemedicine and technology access. OBJECTIVE: This study aims to identify the willingness, access, and ability of HNHR veterans to use telemedicine for health care. METHODS: WWe designed a questionnaire conducted via mail or telephone or in person. Among HNHR veterans who were identified using predictive modeling with national Veterans Affairs data, we assessed willingness to use video visits for health care, access to necessary equipment, and comfort with using technology. We evaluated physical health, including frailty, physical function, performance of activities of daily living (ADL) and instrumental ADL (IADL); mental health; and social needs, including Area Deprivation Index, transportation, social support, and social isolation. RESULTS: The average age of the 602 HNHR veteran respondents was 70.6 (SD 9.2; range 39-100) years; 99.7% (600/602) of the respondents were male, 61% (367/602) were White, 36% (217/602) were African American, 17.3% (104/602) were Hispanic, 31.2% (188/602) held at least an associate degree, and 48.2% (290/602) were confident filling medical forms. Of the 602 respondents, 327 (54.3%) reported willingness for video visits, whereas 275 (45.7%) were unwilling. Willing veterans were younger (P<.001) and more likely to have an associate degree (P=.002), be health literate (P<.001), live in socioeconomically advantaged neighborhoods (P=.048), be independent in IADLs (P=.02), and be in better physical health (P=.04). A higher number of those willing were able to use the internet and email (P<.001). Of the willing veterans, 75.8% (248/327) had a video-capable device. Those with video-capable technology were younger (P=.004), had higher health literacy (P=.01), were less likely to be African American (P=.007), were more independent in ADLs (P=.005) and IADLs (P=.04), and were more adept at using the internet and email than those without the needed technology (P<.001). Age, confidence in filling forms, general health, and internet use were significantly associated with willingness to use video visits. CONCLUSIONS: Approximately half of the HNHR respondents were unwilling for video visits and a quarter of those willing lacked requisite technology. The gap between those willing and without requisite technology is greater among older, less health literate, African American veterans; those with worse physical health; and those living in more socioeconomically disadvantaged neighborhoods. Our study highlights that HNHR veterans have complex needs, which risk being exacerbated by the video care shift. Although technology holds vast potential to improve health care access, certain vulnerable populations are less likely to engage, or have access to, technology. Therefore, targeted interventions are needed to address this inequity, especially among HNHR older adults.


Subject(s)
Telemedicine , Veterans , Activities of Daily Living , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Health Services Accessibility , Humans , Male , Middle Aged , Veterans/psychology
20.
Curr Psychol ; : 1-11, 2021 Nov 19.
Article in English | MEDLINE | ID: covidwho-1827088

ABSTRACT

We examined pathways from pre-existing psychosocial and economic vulnerability to mental health difficulties and stress in families during the COVID-19 pandemic. Data from two time points from a multi-cohort study initiated during the COVID-19 pandemic were used. Parents of children 6-18 years completed questionnaires on pre-COVID-19 socioeconomic and demographic factors in addition to material deprivation and stress due to COVID-19 restrictions, mental health, and family functioning. Youth 10 years and older also completed their own measures of mental health and stress. Using structural equation modelling, pathways from pre-existing vulnerability to material deprivation and stress due to COVID-19 restrictions, mental health, and family functioning, including reciprocal pathways, were estimated. Pre-existing psychosocial and economic vulnerability predicted higher material deprivation due to COVID-19 restrictions which in turn was associated with parent and child stress due to restrictions and mental health difficulties. The reciprocal effects between increased child and parent stress and greater mental health difficulties at Time 1 and 2 were significant. Reciprocal effects between parent and child mental health were also significant. Finally, family functioning at Time 2 was negatively impacted by child and parent mental health and stress due to COVID-19 restrictions at Time 1. Psychosocial and economic vulnerability is a risk factor for material deprivation during COVID-19, increasing the risk of mental health difficulties and stress, and their reciprocal effects over time within families. Implications for prevention policy and parent and child mental health services are discussed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-021-02459-z.

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