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Background: Patients undergoing cancer treatment and people with a history of cancer constitute a high-risk patient group in the COVID-19 pandemic. In this study, we aimed to evaluate the life effect of the COVID-19 pandemic on the treatment processes of cancer patients receiving radiotherapy at our hospital's Radiation Oncology Clinic. Methods: Sociodemographic data, COVID-19 pandemic awareness, vaccination and disease transmission of the Radiation Oncology Clinic's patients were administered with a written questionnaire that includes the effects of the pandemic on the treatment between 1st and 30th June of 2021. Results: 7 (13.2%) of the patients had COVID-19 infection during the treatment processes, the in-home index was 4 (57%) due to contact with the case (p<0.001). 4 of the patients (7.5%) stated that they had experienced disruptions in their treatment processes caused by the health institution and 4 of the patients (7.5%) stated that they had experienced disruptions in their treatment processes caused by personal anxiety and anxiety during the pandemic process. 8 patients (15%) stated that they had concerns that they would receive incomplete treatment due to the pandemic process, while one patient (1.9%) stated that they had received psychological support and psychiatric medication due to this anxiety and fear. 9 patients (17%) stated that the covid-19 pandemic had a negative effect on oncological disease treatment processes. Conclusion: It is important that the treatment and follow-up of cancer patients, who are a at-risk group for COVID-19 infection, should continue without interruption, accompanied by up-to-date national and international guidelines.
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The decisions of whether and how to evacuate during a climate disaster are influenced by a wide range of factors, including emergency messaging, social influences, and sociodemographics. Further complexity is introduced when multiple hazards occur simultaneously, such as a flood evacuation taking place amid a viral pandemic that requires physical distancing. Such multihazard events can necessitate a nuanced navigation of competing decision-making strategies wherein a desire to follow peers is weighed against contagion risks. To better understand these trade-offs, we distributed an online survey during a COVID-19 pandemic surge in July 2020 to 600 individuals in three midwestern and three southern states in the United States with high risk of flooding. In this paper, we estimate a random parameter discrete choice model in both preference space and willingness-to-pay space. The results of our model show that the directionality and magnitude of the influence of peers' choices of whether and how to evacuate vary widely across respondents. Overall, the decision of whether to evacuate is positively impacted by peer behavior, while the decision of how to evacuate (i.e., ride-type selection) is negatively impacted by peer influence. Furthermore, an increase in flood threat level lessens the magnitude of peer impacts. In terms of the COVID-19 pandemic impacts, respondents who perceive it to be a major health risk are more reluctant to evacuate, but this effect is mitigated by increased flood threat level. These findings have important implications for the design of tailored emergency messaging strategies and the role of shared rides in multihazard evacuations. Specifically, emphasizing or deemphasizing the severity of each threat in a multihazard scenario may assist in: (1) encouraging a reprioritization of competing risk perceptions;and (2) magnifying or neutralizing the impacts of social influence, thereby (3) nudging evacuation decision-making toward a desired outcome. © 2022 American Society of Civil Engineers.
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This study aims to investigate the correlation between psychological distress and weight change in Malaysian young adults after the pandemic-led lockdowns. Socio-demographics, body height, body weight during the Movement Control Order 3.0 (MCO 3.0), and post-lockdown body weight (as of January 2022) were self-reported by the young adults. Psychological distress was assessed using a validated 21-item Depression, Anxiety, and Stress Scale (DASS-21). Of the 536 young adults, 54.1% experienced mild to extremely severe anxiety, 47.0% suffered mild to extremely severe depression, and 30.0% experienced mild to extremely severe stress in the post-lockdown pandemic phase. In reference to absolute weight change, 50.6% of the young adults gained weight due to confinement, with an average weight gain of 3.41 ± 2.49 kg. Conversely, 32.0% of the young adults had a lighter weight during the MCO 3.0 than before, with an average weight loss of 3.96 ± 2.76 kg. Additionally, the trajectory in body weight was also expressed in relative weight change. Findings revealed that 23.1% of the young adults gained weight in the post-lockdown pandemic phase, with an average relative weight gain of 9.04 ± 3.90%. On the contrary, approximately one-fifth (17.4%) of the young adults lost weight, with an average relative weight loss of −8.57 ± 2.79%. There were no significant correlations (p> 0.05) between depression, anxiety, and stress with absolute or relative weight change, even after controlling for the socio-demographic variation among young adults. The federal government of Malaysia should take necessary actions to alleviate the psychological impact of the COVID-19 pandemic and reiterate the importance of sustaining a healthy body weight in young adults.
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Rapid development and distribution of vaccines have been a hallmark of the battle against COVID-19. While the efficacy, clinical trials, adverse health effects, and sociodemographic and clinical factors determining the distribution of vaccines have been studied extensively, there has been little effort to design cost-effective vaccine provisioning schemes. We introduce a vaccine provisioning scheme that leverages coalitional game theory to improve the cost of vaccines while meeting the epidemiological demand of neighboring zones. The proposed approach incentivizes bulk purchases by groups (or coalitions) of zones at lower prices while penalizing large coalitions to avoid logistical challenges. Moreover, it enables the policymaker to model the vaccine demand of zones based on their epidemiological profiles, such as susceptible, infected numbers or population density, or a combination thereof. We carry out experiments using the SEIRD (susceptible, exposed, infected, recovered, death) epidemic model as well as the daily confirmed cases in the five boroughs of New York City to show the efficacy of the approach. © 2022 IEEE.
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Background: Incidence of cancer is constantly increasing in the United States, and Puerto Rico is no exception. The island is currently experiencing low birth rates, signifying that its population is primarily composed of aging citizens that experience a growing need for access to healthcare and medical literature, especially in those with cancer. In this study, we aimed to characterize an aging Puerto Rican cohort with a diagnosis of cancer. Method(s): A questionnaire with sociodemographic and medical inquiries was administered to participants receiving an mRNA vaccine at a COVID-19 vaccination clinic between December 2020 and June 2021. Participants of age 60+ with a diagnosis of cancer, along with their comorbidities, were identified. Multivariate analyses were executed. This study is IRB approved. Result(s): A total of 100 aging participants with a diagnosis of cancer were included: 55 were female and 45 were male, with a mean age of 72.70+/-8.07 (age range: 61-95). When assessing race, participants identified as follows: 68% White, 23% Black or African American, 8% other race, and 1% American Indian or Alaska Native. Concerning ethnicity, 97% identified as Hispanic or Latino, while 3% did not regard themselves as such. When evaluating the cancer diagnoses provided, 27% of female participants had breast cancer and 7% had some form of gynecologic malignancy. Whereas, in males, 42% indicated a diagnosis of prostate cancer. Regarding concomitant comorbidities, 45% of participants had hypertension, 30% had diabetes mellitus, 18% had hypothyroidism, 15% had asthma, and 3% had chronic obstructive pulmonary disease. There was no statistically significant difference when comparing sex and prevalence of concomitant diabetes mellitus or hypertension (p=0.2125). There was also no statistically significant difference when assessing racial identity and presence of concomitant diabetes mellitus or hypertension (p=0.7373). Out of 91 participants who answered the health insurance inquiry, 82% possessed private insurance, 13% had public insurance, and 4% did not have insurance. There was no statistically significant difference when assessing private, public, or no health insurance status and the presence of concomitant diabetes mellitus or hypertension (p=0.9086). Conclusion(s): Data evidenced a diverse aging Puerto Rican cohort with cancer, showing a predominance in prostate cancer in men and breast cancer in women. Analysis suggested that the presence of concomitant diabetes mellitus or hypertension in an aging population with cancer was not linked to sex or racial identity. Additionally, the type or lack of health insurance did not influence the prevalence of concomitant diabetes mellitus or hypertension. Characterizing the aging Hispanic population in Puerto Rico and the United States is important, as these studies could be beneficial in the future approach, understanding and treatment of this population with historically limited medical data available.
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Background: Human Papillomavirus (HPV)-associated cancers disproportionately impact Latinos. While data for English-speaking (ES) and Spanish-speaking (SS) Latinos is usually aggregated, differences in acculturation, sociodemographic characteristics, and health behaviors make it important to understand the factors impacting HPV vaccination among these groups separately. This understanding is crucial to improving HPV vaccination disparities as COVID-19 vaccinations have exacerbated issues of vaccine hesitancy and medical mistrust. Method(s): Self-administered online surveys examining HPV vaccine hesitancy in an urban, diverse community with low HPV vaccine uptake were completed by parents of adolescents (N=357) in English or Spanish. Bivariate logistic regression analyses were conducted to understand if medical mistrust, vaccine hesitancy, HPV knowledge, healthcare utilization and sociodemographic factors impact adolescent HPV vaccine uptake among ES and SS parents of Latino adolescents ages 12-17. Factors significant at p<.01 in the bivariate analyses were included in multivariable logistic regression models for each group. Result(s): 136 parents of adolescents aged 12-17 identified as Latino;56% completed the survey in English and 44% in Spanish. Bivariate analyses found significant associations between decreased HPV vaccine uptake and male parent/caregiver sex, higher HPV vaccine hesitancy, higher HPV knowledge, male adolescent sex, not receiving the flu vaccine and not receiving a provider recommendation to vaccinate against HPV among ES parents. In SS parents, parents aged 41-50 (compared to <40) and higher medical mistrust were associated with higher HPV vaccination;while male adolescent gender, not receiving TDAP immunization, and not receiving a provider recommendation to vaccinate against HPV were associated with lower HPV vaccine uptake. Multivariable regression models found that adolescents of ES parents were less likely to have initiated the HPV vaccine series if the parent/caregiver was male (OR=0.07, 95% CI:0.03,1.28), had higher HPV knowledge (OR=0.53, 95% CI:0.29,0.96), and did not receive a provider recommendation to vaccinate against HPV (OR=0.12, 95% CI:0.003,0.55). SS parents with higher medical mistrust (OR=7.27, 95% CI:1.14,46.41) and those aged 41-50 compared to parents younger than 40 (OR=18.19, 95% CI:0.28,407.78) were more likely to have adolescents who initiated the HPV vaccine series, while those without a provider recommendation to vaccinate had lower odds of HPV vaccine uptake (OR=0.004, 95% CI:<0.01,0.11). Discussion(s): Aligned with the literature, provider recommendation to vaccinate against HPV significantly impacted vaccination behavior among ES and SS parents. Interventions should focus on improving provider recommendations and communications with Latino parents of adolescents. More research should explore the surprising associations between higher medical mistrust and higher odds of HPV vaccination among SS parents, and more HPV knowledge and lower odds of HPV vaccination among ES parents.
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In this study, our goal is to identify potentially vulnerable communities that could be subject to ongoing or compounding impacts from the pandemic and/or that may experience a slower recovery due to sociodemographic factors. For this purpose, we compiled information from multiple databases related to sociodemographic and health variables. We used a ranking-based method to integrate them and develop new combined indices. We also investigated a time-dependent correlation between vulnerability components and COVID-19 statistics to understand their time-dependent relationship. We ultimately developed pandemic vulnerability indices by combining CDC's social vulnerability index, our newly developed composite health vulnerability index, and COVID-19 impact indices. We also considered additional assessments include expected annual loss due to natural hazards and community resilience. Potential hot spots (at the county level) were identified throughout the United States, and some general trends were noted. Counties with high COVID-19 impact indices and higher values of the pandemic vulnerability indices were primarily located in the southern United States or coastal areas in the Eastern and Southwestern United States at the beginning of the COVID-19 pandemic. Over time, the computed pandemic vulnerability indices shifted to higher values for counties in the southern and north-central United States, while values calculated for the northwestern and northeastern communities tended to decrease.
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In light of global climate change and the biodiversity crisis, making cities more resilient through an adjusted design of urban green and blue spaces is crucial. Nature-based solutions help address these challenges while providing opportunities for nature experiences, and providing cultural ecosystem services that support public health. The COVID-19 pandemic and its associated stressors highlighted the interrelated socio-ecological services provided by nature-based solutions like urban green and blue spaces.This pan-European study therefore aimed to enhance the socio-ecological understanding of green and blue spaces to support their design and management. Using an online survey, green and blue space preferences, usage, and pandemic-related changes in greenspace visit and outdoor recreation frequencies were examined.Greenspace visit and outdoor recreation frequencies were associated with respondents' (N = 584 from 15 countries) geographical location, dominant type of neighbourhood greenspace and greenspace availability during the pandemic, but not greenspace perceptions or sociodemographic background.Greenspace visit and outdoor recreation frequencies were generally high;however, Southern Europeans reported lower greenspace visit and outdoor recreation frequencies both before and during the pandemic than Northern Europeans. Many Southern Europeans also reported having few neighbourhood greenspaces and low greenspace availability during the pandemic.The most common outdoor recreational activity among respondents before the pandemic was walking or running with the most frequently stated purpose of time spent outdoors being restorative in nature (i.e. relaxing or calming down). Most Europeans had positive perceptions of green and blue spaces with preferences for structurally diverse and natural or unmanaged green elements.This highlights the importance of accessible green and blue spaces both in everyday life and during times of crisis. Stakeholders, their preferences, and regional and cultural differences should be included in the co-design of urban green and blue spaces to maximize their potential for both people and nature.Read the free Plain Language Summary for this article on the Journal blog.
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Introduction: Individuals with developmental coordination disorder frequently report emotional and functional difficulties. A stressful era as COVID-19 pandemic may enhance emotional load. The present study aimed to (1) examine the emotional distress and quality of life among adults with developmental coordination disorder during COVID-19 as compared to typical controls, and (2) examine the relationships between these factors in adults with developmental coordination disorder. Method: Participants were 317 adults, aged 18–66, recruited during the first year of COVID-19: 227 were included in the developmental coordination disorder group, and 90 in the control group (normal motor performance) based on the Adult Developmental Co-ordination Disorders/Dyspraxia Checklist cutoff score. Participants completed a sociodemographic health status/daily life under COVID-19 questionnaire and self-reports about their emotional status (depression, anxiety, stress) and a quality of life. Results: The developmental coordination disorder group had significantly greater depression, anxiety, stress, and lower quality of life. Participants with developmental coordination disorder who were infected by COVID-19 or reported reduction of working hours due to COVID-19 had the lowest social and environmental quality of life. Depression significantly predicted reduced quality of life and mediated between developmental coordination disorder severity and quality of life. Conclusions: Prevention and intervention programs for adults with developmental coordination disorder should be elaborated, with reference to emotional load and to implications on daily life, especially in times of crisis, like COVID-19.
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Background: One of the non-pharmaceutical strategies adopted by various governments to control the spread of COVID-19 is mobility restriction (MR), popularly known as a lockdown. Evidence shows that MR has some unintended consequences, such as increased cases of domestic violence, rape, pornography, sex chats, incest, and other unhealthy sexual behaviors (SBs). Methods: The study examined the influence of MR on SB in Owerri via a cross-sectional quantitative approach. A total of 425 interviewees were randomly chosen among people of a reproductive age. Data were analyzed using univariate, bivariate, and multivariate levels of analysis. Results: A significant relationship exists between selected socio-demographic characteristics, such as age and marital status, and the ability of people to cope with sexual abstinence. Results from the logistic regression analysis further illustrated this observation as during MR people were twice as likely to engage in prolific sex chats that could spur other harmful SBs. Conclusion: It is recommended that people should be allowed to determine whether they would like to stay with their partners in subsequent lockdowns, or otherwise, to prevent some of the unpleasant SBs recorded.