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This chapter explores the organizations, campaigns, and movements that advocate for gender equity in medicine, equity in specialties with the highest percentages of individuals who identify as women, and those which support women in pediatrics such as the work of the Federation of Pediatric Organizations (FOPO). It discusses these in the context of disparities in compensation, promotions, and research, the disproportionate effects of COVID on women in medicine, as well as the compounded effects of intersectionality in pediatrics. It also reviews studies that raise awareness of gender-based concerns in pediatrics like the Pediatric Life and Career Experience Study (PLACES) study and delves into one of the most recently launched pediatric advocacy groups, ADVANCE PHM. Through these avenues, there has been an increase in the awareness of gender equity and humanization of a profession that has historically had standards that are difficult to live up to and do not reflect the full potential of women who enter the profession. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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PurposeThe purpose of this study is to examine if public policy satisfaction is related with perceived financial security. The public policy examined is an emergency income policy in Brazil.Design/methodology/approachThe authors used a questionnaire to interview a random sample of 235 single-parent women who received Emergency Aid (EA) resources in Brazil during the pandemic. The questionnaire included measures of financial security, financial anxiety, financial resilience and profile aspects. The authors applied a multiple regression approach to identify the determinants of financial security during the pandemic.FindingsOur findings show that factors such as satisfaction with the emerging income policy and financial resilience are positively related to perceived financial security. Financial anxiety, financial fragility and job loss in the pandemic are negatively related with perceived financial security.Research limitations/implicationsWhile our results correspond to a random probabilistic sample of women residing in southern Brazil, they may not be generalizable to Brazil as a whole.Practical implicationsThis study provides evidence of the financial situation in the pandemic for the lives of economically vulnerable women. The research encourages government and financial institutions to understand the unique challenges faced by vulnerable populations during the pandemic and analyzes the direct results of EA. The study contributes to the establishment of policies to support vulnerable populations, encouraging security and financial resilience.Originality/valueThis research is innovative in its analysis of women's financial situations during the pandemic, taking into consideration both behavioral aspects and profiles. Our focus on a specific case of emergency income policy adds to the understanding of the relation of such policies on vulnerable populations.
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Objective: The purpose of this review is to define the feeling of loneliness within a couple while taking into consideration the factors that lead a person to feel lonely in a couple or in a romantic relationship. Our goal is to understand the effects of the feeling of loneliness on these individuals during the global health crisis brought on by COVID-19 and to take these factors into account in designing effective therapeutic care. The different manifestations of loneliness in a couple should also be highlighted. Method(s): We used the PRISMA methodology to select the relevant studies. The keywords ("Solitude" or "Loneliness") and ("Couple" or "Married" or "Partnership") allowed us to select 19 references dealing with the theme. We conducted searches of the following databases: "Cairn", "PsychInfo and Psycarticle", "PubMed and Medline", "ScienceDirect" and finally, "Web of Science" in order to find articles covering a ten-year period. Result(s): There are different definitions for the subjective experience of loneliness. The review of the literature highlights the fact that loneliness can lead to positive or negative psychological consequences (it can lead to the development of creative capacity or, on the contrary, result in depression in some cases). Attachment patterns have been shown to be the basis for the tolerance of feelings of loneliness. Indeed, an anxious attachment would encourage the couple to avoid the feeling of loneliness. According to the literature, this defensive mechanism of seeking presence in the couple would make it possible to limit the impact of loneliness. This solitude depends on the level of relational quality within the couple. A poor relational quality would lead to greater loneliness and would impact intimate relationships. Loneliness is supposedly not experienced in the same way by men and women: Men seem to be more protected by marriage while women's level of loneliness may be higher because of the household chores they have to do. Men and women would nevertheless remain subject to the phenomena of contamination, i.e., when one of the partners feels lonely, the other will also be lonely. However, it seems that marriage protects against feelings of loneliness and its negative consequences. Loneliness does not have only negative effects. It can be beneficial for developing creativity and finding oneself. The periods of confinement during the COVID-19 crisis provided people with an increase in the amount of time they didn't normally have on a daily basis. This may have been beneficial for some people and can be associated with positive emotions. Individuals who spent the lockdowns with others felt less alone and experienced less psychological distress. However, confinements did produce some negative effects on couples. The increased stress of the pandemic and the constant proximity led to an increase in spousal abuse. The consequences of confinement for couples whose relationships were already troubled resulted in frequent separation and/or divorce. The potential for conflict was related to limited financial resources, not working, and the significant risk of contracting SARS COV-2. Conclusion(s): The articles dealing with the feeling of loneliness that we reviewed presented quantitative methods to the detriment of qualitative aspects and focused largely on the negative aspects of the feeling of loneliness. Other academic disciplines, such as sociology, demonstrate a lack of understanding concerning what is at stake with the feeling of loneliness. The articles intersect and tend to highlight the attachment relationships that are formed in childhood as a determining factor in the feeling of solitude later in life. The quality of the relationship, gender, and marital status are also factors to be considered. Loneliness has a clear influence on the well-being of the relationship but it is not an individual characteristic of the relationship itself. It finally appears as an individual characteristic with an impact on the assessment of the quality of the relationship and on the appreciatio of the spouse.Copyright © 2023 Elsevier Masson SAS
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The objective of this research is to offer a trajectory of the factors that determine that Mexican heads of families decide to participate in the most visible informal microenterprise sector;before and during COVID-19. The data from the National Household Income and Expenditure Survey (ENIGH) and prepared by the National Institute of Statistics, Geography and Informatics (INEGI) of Mexico have been used and a Heckit model has been applied for its treatment and analysis. The findings show that income is the main cause of the informal economy of the heads of family, thus confirming the choice as a solution to economic difficulties. In addition, it is shown that there is a labor supply that excludes the demand with a higher educational level. In addition, informal enterprises are identified by higher remuneration for time spent, flexibility and reduction in working time, participation of more household members, and lower remuneration for women.
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International news representations of the COVID-19 crisis are particularly salient in shaping public health responses. Therefore, women's differential experiences are important to highlight in order to develop gender-responsive programming and strategies to improve global health outcomes. Informed by work on feminist political economy, this content analysis investigates how women are discursively framed during the pandemic by analyzing digital reports from three major television news channels (based in China, Qatar, and the United States). The aim is to evaluate the extent to which international media coverage reinforces gender and other power differentials within and across countries and shapes public understanding of the direct and indirect effects of the disease on women. Study findings indicate women's limited visibility in COVID-19 news and differences in framing across and within sources. The need for international media to give voice to and consider in depth the way structurally reproduced inequalities facilitate public health crises as well as the disparate effects on the health of intersecting groups including but not limited to women, people of color, gender minorities, and those located in lower income countries is reinforced in this work. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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In 1990, the seroprevalence of antibody against hepatitis C virus (anti- HCV) in Taiwan was first documented to be 0.95% in volunteer blood donors, 90% in hemophiliacs, and 81% in parenteral drug abusers. The risk factors for HCV infection in Taiwan include iatrogenic transmission (medical injection, hemodialysis, acupuncture, and blood transfusion), tattooing, and sexual transmission. The long-term risk of hepatic and non-hepatic diseases has been well-documented by REVEL-HCV study. A national program of antiviral therapy for chronic viral hepatitis was launched in Taiwan in 2003. Mortality rates of end-stage liver diseases decreased continuously from 2000-2003 to 2008-2011 in all age and gender groups. When the World Health Assembly adopted the Global Health Sector Strategy on Viral Hepatitis in 2016, National program to eliminate hepatitis C was very carefully evaluated. It became a consensus to reach the WHO's 2030 goals in 2025. Taiwan Hepatitis C Policy Guideline 2018-2025 was approved and published at the beginning of 2019. There are triple focuses of hepatitis C elimination in Taiwan including (1) therapy spearheads prevention, (2) screening supports therapy, and (3) prevention secures outcome. A total of US$1.7 billion will be allocated from 2017 to 2025 for the elimination of HCV. The coverage of HCV screening and treatment has been increasing significantly since 2017. The HCV screening coverage was almost 100% for dialytic patients, 96% for HIV-infected patients, 65% for patients under opioid substitution treatment, 63% for patients in the pre-end-stage renal disease care program, 57% for patients in the early chronic kidney disease care program, 52% for patients in diabetes care program, 39% for prisoners, and 38% for adults aged 45-79 years old in the general population by April 30, 2020. The budget to cover the cost of DAA increased from US$101 million in 2017 to US$219 million in 2019. The number of chronic hepatitis C patients receiving DAA therapy increased from 9,538 in 2017, 19,549 in 2018, to 45,806 in 2019. However, the number of DAA-treated CHC patients reduced to 36,159 in 2020 and 20,559 in 2021 due to the COVID-19 pandemic. The cure rate based on SVR12 was 96.8% in 2017, 97.4% in 2018, over 98.6% after 2019. It is expected that Taiwan will achieve WHO's HCV elimination goal by 2025.
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COVID-1 9 led to an extraordinary increase in both telework and remote work, exposing some of the fragilities and loopholes of the Portuguese applicable regulation and leading the Portuguese Parliament to approve a new law on teleworking in the form of an amendment to the Labour Code aimed at extending the protection of teleworkers. This paper intends to analyse this new regulation implemented by Law No. 83/2021 of 6 December regarding its concept and scope of application;the telework agreement and the principle of volunteering;teleworkers' rights and employers' duties related to equipment, tools and teleworking-related expenses;employers' duty to abstain from any contact during rest periods;privacy and data protection;health, safety and work-related accidents;and the right to telework, namely for work-life balance reasons. The final objective is to provide a critical overview of the legal regulation, assessing its strengths and weaknesses.
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Background/Aims Baricitinib is the most common Janus Kinase inhibitor (JAKi) used in the treatment of rheumatological conditions. Whilst randomised controlled trials have demonstrated the efficacy and safety profile of baricitinib, real-world data on the experience of JAKi use in clinical practice is lacking. The aim of this analysis was to evaluate baricitinib use in a real-world patient population in South London. Methods We looked at two rheumatology departments in South London (St George's Hospital;a tertiary teaching centre and Kingston Hospital;a district general hospital). All patients prescribed baricitinib between January 2017 to June 2022 were included. A retrospective assessment of electronic patient notes was performed to evaluate disease activity (determined by DAS-28 scores at baseline, 3-6 months and presently);adverse effects including side effects, rates of and reasons for discontinuation;and prescribing practice, including previous use of other biological disease modifying anti-rheumatic drugs (bDMARDs). Baseline data including age, gender, co-morbidities and rheumatological diagnoses were also included. Results 233 patients were included in this evaluation, with seropositive rheumatoid arthritis being the most common diagnosis (58%) and with a significant female population (87%). Baricitinib improved average DAS-28 scores from 5.75 (range 3.57-8.3) at baseline to 3.23 (range 0.28-7.49) at 3-6 months post-baricitinib, with the most recent DAS-28 score of 2.90 (range 0.56-6.77). Rates of adverse effects were low as shown in Table 1. Baricitinib was discontinued in 60/233 patients, with average duration to discontinuation of 9.5 months. The most common reasons for discontinuation were: ineffective disease control (28/60), recurrent bacterial infection (5/60), deranged liver function (3/60) and venous thromboembolism (2/60). Eight patients died whilst taking baricitinib. Where documented, the causes of death were Covid-19 (4/8) and malignancy (1/8). 110 out of 233 patients had received other bDMARDs before starting baricitinib. Documented reasons for baricitinib choice over tumour necrosis factor inhibitors (TNFi) included: previous lack of response to TNFi (89/233), contra-indication to TNFi (11/233) and preference of oral route (10/ 233). Conclusion Our real-world study of JAKi use shows that baricitinib is efficacious in the treatment of rheumatological conditions. Moreover, baricitinib is well tolerated, with low rates of adverse effects and subsequent discontinuation. (Table Presented).
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Background: 5-20% of people living with HIV (PLWH) are co-infected with Hepatitis B (HBV) and coinfection is associated with an increased risk of cirrhosis and hepatocellular carcinoma (HCC), incidence of which is 5 to 6 times higher. COVID-19 led to a lapse in surveillance of this population, warranting a reassessment. Method(s): BHIVA and EACS guidelines were combined to create a standard to audit against. All people under the care of the HIV team with co-infection were included, and analysed for the prior six months. Local ethics approval was granted. The results were then presented to clinicians, and local guidelines created to reflect the most recent research on co-infection which were shared with the department. A re-audit was then conducted against the modified guidelines. Result(s): 42 people were living with co-infection of HBV and HIV, with a 50:50 gender split;32 were of Black African ethnicity (76%). The median age was 50.5. Nobody had a HBV resistance profile done at baseline. 3 people did not have suppressed HIV viral load (VL), and 8 people did not have a suppressed HBV VL. In the previous 6 months only 26 (62%) had had a HBV VL, 20 (48%) had had an alfa-fetoprotein (AFP) check, and 21 (36%) had had an ultrasound liver. An US had been requested in 21 (50%) of patients. 100% were on a tenofovir-containing drug regimen. Following presentation and rewriting of guidelines, performance of investigations improved. An US had been requested in 26 (62%) cases although only performed in 16 (38%) and an AFP had been measured in 25 (60%). Vaccination of partners had also improved. Conclusion(s): The provision of care of those with coinfection was significantly impacted by the COVID pandemic, but reinforcement of information, and re-issuing of guidelines improved patient care. Attendance of appointments for blood tests and scans remains a major challenge for improving patient care. Literature aimed at our local population to reinforce the importance of HCC screening is being developed.
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Intro: Different vaccines against COVID-19 have been approved by the World Health Organization (WHO) at different stages, however, limited data is available on long-term kinetics of antibodies induced by vaccines. This study was performed to investigate the persistence and dynamicity of BBV-152 (Covaxin)- and AZD1222 (Covishield)-induced immunoglobulin-G (IgG) antibodies over the year and neutralizing antibodies' status after the one-month post booster dose. Method(s): This 52-week longitudinal cohort study documented antibody persistence and neutralizing antibody status among 278 health-care workers (HCWs) from four different healthcare and research facilities in Odisha, enrolled in January 2021 and continued until March 2022. An automated chemiluminescence immune assay (CLIA) platform from Abbott Diagnostics was used to quantify IgG antibodies against SARS-CoV-2's spike receptor-binding domain (RBD) and a surrogate virus neutralization test (sVNT) was performed by enzyme-linked immunosorbent assay (ELISA). If any participants developed any symptoms of COVID-19, nasopharyngeal swabs were collected and sent to ICMR- RMRC, Bhubaneswar for RT-PCR confirmation. Finding(s): Among the 243 participants, 119 HCWs (48.97%) were Covaxin recipients and the remaining 124 (51.02%) were Covishield recipients. During the seven follow- ups, 104 participants (42.79%) were identified as vaccine breakthrough cases. In 139 non-infected HCWs, the median antibody titer significantly waned after ten months of double dose, both for Covaxin (342.7 AU/mL at DD1 vs 43.9 AU/mL at DD10) and Covishield (2325.8 AU/mL at DD3 vs 595.2 AU/mL at DD10). No statistically significant differences in antibody titers were observed based on age, gender, comorbidities, and blood groups. The median inhibition activity of sVNT was increased significantly for Covaxin and Covishield booster recipients. Among the booster dose recipients, 24 had breakthrough cases by the Omicron variant. Conclusion(s): Results of this longitudinal cohort study can be used to implement vaccination strategies and could also aid in tracking and designing vaccine mandates to minimize vaccine escape.Copyright © 2023
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The COVID-19 pandemic has uncovered the critical nature of social care for modern societies and the moral dilemmas related to the organisation of care, specifically in terms of frail adults. The scarcity of personnel in nursing homes challenged the possibility of adequate care, spurring debates on both the dignity of dependent people and end-of-life treatments. While 'classical' social care policies already stimulate conflicts about the 'right way' of caring, non-classical care policies, such as assisted dying, are particularly contested. We advance existing research by analysing public attitudes on both care policies jointly and, hence, integrate the literature on morality policy and social care. Based on multi-level analyses, combining individual-level with macro-level data from 34 countries, we uncover that gender and religious identity drive deviating attitudes in both fields, while long-term care expenditure mitigates scepticism among Catholics but less so among Muslims.
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Technology-facilitated gender-based violence (GBV) has become an increasing issue in recent years, especially during the COVID-19 pandemic which prompted a significant rise in online activity. In addition to amplifying traditional forms of abusive behaviours such as stalking, bullying and sexual harassment, information and communication technologies have facilitated new manifestations of violence such as image-based abuse, doxing, gendertrolling, impersonation and hacking, among others. Women, children, sexual, religious and ethnic minorities, and other vulnerable groups are particularly vulnerable to elevated risks of experiencing violence. Based on findings from a scoping review, this article discusses how certain key stakeholders - identified as technology companies, government and legal systems, and social support systems - are used in the help-seeking process by those who have experienced technology-facilitated GBV. We seek to highlight particular nuances which key actors must consider when addressing technology-facilitated GBV and summarise gaps and propose recommendations to inform policy and programming efforts in low-and middle-income countries across Asia.
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Despite their effectiveness in minimizing the spread of infection, movement restrictions adopted during the Coronavirus disease 2019 (COVID-19) pandemic have not been without their health-related consequences, including decreases in physical activity and increases in sedentary behavior. This study aimed to investigate differences in stress and sense of community among Korean citizens in various age groups according to the degree of their participation in physical activity during the COVID-19 pandemic. We analyzed data collected during the Social Survey of Busan Metropolitan City 2020, the population of which included all household members over the age of 15. Data for a total of 33,082 participants (male = 15,129;female = 17,953) were extracted using a two-stage cluster sampling method. Age, stress level, and sense of community were analyzed using independent t-tests, while the frequency of participation in physical activity was analyzed using a Mann-Whitney U test. Differences in stress level and community consciousness according to the frequency of physical activity were examined via multivariate analysis of variance. Variables exhibiting significant differences were evaluated for differences between groups through Scheffe's post hoc analysis. First, stress levels were higher among female adolescents than male adolescents. Among adults and older adults, men exhibited higher overall stress levels than women, whereas sense of community was stronger in women than men. Second, male adolescents in the regular physical activity participation group showed lower levels in some factors of stress than those in the nonparticipating group. Finally, a higher frequency of participation in physical activity among adults and older adults was associated with lower stress and higher sense of community, regardless of gender. In conclusion, regular participation in physical activity should be considered when designing strategies for managing stress and promoting social relationships at the national and individual levels during COVID-19 and any similar pandemics in the future.Copyright ©2023 The Author(s). Published by MRE Press.
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AIM: The objective is to explore the general perception, knowledge, and attitude of people in Saudi Arabia toward the COVID-19 vaccination. METHOD(S): An observational and cross-sectional study was conducted with 332 Saudi adult population attending primary health centers in King Abdul-Aziz Medical City, Riyadh, Saudi Arabia, between May and July2021 using a self-administered questionnaire. All adults, equal, or older than 18 years old of both genders during the period of the study were included and the only exclusion criteria are the age and patient with psychiatric disorder. We use convenience-sampling technique, due to the difficulty to generate sampling frame. Data are going to be entered and analyzed using Statistics Package for the Social Science version 21 software in August 2021. RESULT(S): Majority of participants (93.4%) had good knowledge about COVID-19 vaccines, regarding attitude more than 50% have positive attitude toward vaccination. Despite this high level on acceptance 48.5% of the participant in this study disclosed that they are not aware of vaccine side effects. With regard to perception, 66.9% of our study subjects believed that vaccination is necessary to eradicate COVID-19 pandemic. Furthermore, 72.4% thought that everyone should be vaccinated, starting with general public 74.5%, then health worker 57.9%. CONCLUSION(S): Almost most of Saudi population aware about the COVID-19 vaccines. Most Saudi people knew about it through media. A long-term side effect of getting vaccines is the main obstacles toward vaccine acceptance.Copyright © 2023, Scientific Foundation SPIROSKI. All rights reserved.
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One of the negative impacts of COVID-19 lockdown was a drastic global increase in gender-based violence against women and girls. Therefore, this paper is an investigation on gender-based violence against women and girls during the lockdown, its causes, ethical implications and recommendations, with insights from African nations. The paper condemns gender-based violence as unethical as it violates the principle of human dignity. Recommendations on how to curb the menace both at sundry and pandemic period are nonetheless made. The work is qualitative research sourcing its data from library materials, reported cases and interviews. All the data collected in the course of this study are interpreted with the application of hermeneutics, critical analysis and logical reasoning.
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This paper reports the results of a study to determine whether the emotional impact of online education during the pandemic affected male and female students differently. We see these results as an important contribution to the redesign of courses either for online classes generally or for more urgent applications should a similar event occur. In general, we found that females were more likely to be prone to detrimental emotions than males – stress, negative feelings about the online learning experience, and the need to vent their frustrations. Males on the other hand were more positive about the online learning experience and less likely to vent. © (2022) by Association for Information Systems (AIS) All rights reserved.
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ABSTRACT Objective: to discuss the process of allowing blood donation by the LGBTQIAP+ community by the Federal Supreme Court in contrast to the Legislation of the Regulatory Agency for Blood and Blood Components. Method: this is a reflective study, considering the principles and concepts of Pierre Bourdieu's symbolic capital as a theoretical-methodological framework. Analysis was carried out in documents that dealt with the permission of blood donation by gay and bisexual men, such as bills, FSC decisions and media materials relevant to the proposed theme. Results: we argue that two historical events were decisive for the vote on the act of unconstitutionality by the Federal Supreme Court: the mobilization of lesbian, gay, bisexual and transgender social movements and the coronavirus pandemic. Conclusion: validation of the right to blood donation contributes to the exercise of citizenship of lesbian, gay, bisexual and transgender people.
RESUMEN Objetivo: discutir el proceso de autorización de la donación de sangre por parte de la comunidad LGBTQIAP+ por parte del Supremo Tribunal Federal en contraste con la Legislación de la Agencia Reguladora de Sangre y Hemoderivados. Método: estudio reflexivo, considerando los principios y conceptos del capital simbólico de Pierre Bourdieu como marco teórico-metodológico. El análisis se llevó a cabo en los documentos que trataban sobre el permiso de donación de sangre por parte de hombres homosexuales y bisexuales, como proyectos de ley, decisiones del STF y materiales de prensa relevantes para el tema propuesto. Resultados: argumentamos que dos hechos históricos fueron decisivos para la votación del acto de inconstitucionalidad por parte del Supremo Tribunal Federal: la movilización de los movimientos sociales de lesbianas, gays, bisexuales y transexuales y la pandemia del coronavirus. Conclusión: la validación del derecho a la donación de sangre contribuye al ejercicio de la ciudadanía de las personas lesbianas, gays, bisexuales y transgénero.
RESUMO Objetivo: discutir o processo de permissão da doação de sangue pela comunidade LGBTQIAP+ pelo Supremo Tribunal Federal em contraponto à Legislação da Agência Reguladora de Sangue e Hemoderivados. Método: estudo do tipo reflexivo, considerando os princípios e conceitos do capital simbólico de Pierre Bourdieu como referencial teórico-metodológico. A análise foi realizada nos documentos que tratavam da permissão da doação de sangue por homens gays e bissexuais tais como: projetos de lei, decisões do STF e materiais de mídias pertinentes ao tema proposto. Resultados: argumentamos que dois eventos históricos foram decisivos para a votação do ato de inconstitucionalidade pelo Supremo Tribunal Federal: a mobilização dos movimentos sociais de Lésbicas, Gays, Bissexuais e Transgênero e a Pandemia de Coronavírus. Conclusão: a validação do direito à doação de sangue contribui para o exercício da cidadania das pessoas Lésbicas, Gays, Bissexuais e Transgênero.
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The COVID-19 pandemic has caused many changes in educational settings which have been quite demanding. Shifting to online education has resulted in many erratic changes for students, which could have threatened their learning motivation. Therefore, this study examined perceived challenges, learning motivation and academic procrastination during the COVID-19 pandemic among 458 students of public and non-public universities in Albania, and the data were collected through online questionnaires. The findings reveal a strong relationship between academic procrastination, perceived challenges and learning motivation. Furthermore, a multiple linear regression model revealed that academic procrastination was influenced by perceived challenges and motivation. Sociodemographic variables, such as age and gender, were examined. The results are relevant for understanding learning motivational processes and critical variables that influence students' procrastination, academic achievement and adjustment. © 2023 Blerina Reci Xhakolli and Oriola Hamzallari.
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Purpose: It is unknown whether certain populations of athletes benefit more from returning to sport following COVID-19 restrictions than others. The purpose of this study was to determine whether socioeconomic status (SES), race, or gender moderate the benefits of returning to sports during COVID-19. Method(s): Adolescents who participated in sports before COVID-19 reported sport participation, anxiety (GAD-7), and depression (PHQ-9) inMay 2021. The interactions of return to sport (yes [PLY], no [DNP]) and (1) sex, (2) race (white, nonwhite), and (3) SES (low vs high county household income) to predict anxiety and depression were evaluated, adjusted for age, school instruction, and concern about COVID-19. Result(s): Four thousand eight hundred seventy-four participants were included (16.1 +/- 1.3 years;52% female;PLY = 4456;DNP = 418). DNP had greater symptoms of anxiety (7.8 60.6 v 5.6+/-0.5, P<0.001) and depression (8.8+/-0.6 v 5.76 0.6, P < 0.001) and had significantly more non-white athletes (36% v 19%, P < 0.001), but no significant differences were identified with respect to gender, instructional delivery method, median county household income, or age. Compared with white athletes, adolescent athletes from racial minority groups who returned to sports had relatively greater decreases in anxiety (interaction estimate (b) = -1.18 +/- 0.6, P = 0.036) and depression (b=-1.19+/-0.6, P=0.045). Similarly, athletes from counties with lower household incomes who returned to sports had relatively greater decreases in anxiety (b= -1.23 +/-0.5, P = 0.017) and depression (b=-1.21+/-0.6, P=0.032). The benefits of returning to sports for female athletes were similar to male athletes with respect to anxiety (b = -0.16 +/-0.5, P = 0.76) and depression (beta = 0.49 +/- 0.6, P = 0.37). Conclusion(s): In this nationwide sample of adolescent athletes, returning to sport during COVID-19 was associated with significant mental health benefits for adolescent athletes. However, the greatest benefits were seen among athletes from racial minority groups and areas of lower household income. No differences in the mental health benefits of returning to sports were identified between male and female athletes. Significance: Restriction from sports may disproportionately impact the mental health of certain groups of adolescent athletes. Expanding access to sports for traditionally underserved groups can potentially provide significant mental health benefits.
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Background/Aims In the recent past, there has been growing research interest in COVID- 19 vaccines and their impact on the disease dynamics of rheumatic and musculoskeletal diseases (RMDs). The intersection of COVID-19 and autoimmunity has led to the theoretical possibility of flare-ups of autoimmune diseases with COVID vaccines. This study was conducted to evaluate the occurrence and the nature of flare-ups following the COVID vaccination on patients with RMDs. Methods This cross-sectional analytical study was conducted at Ragama Rheumatology and Rehabilitation Hospital, Sri Lanka involving 248 clinic patients using a structured questionnaire. Results The mean age of the study population was 52.69 and 75.4% were females. 12 patients (4.7%) reported flare symptoms following 1st dose of vaccination. Of them, 67% were females and 41.7% were within the 40-45 years age group. 75% of patients have experienced the onset of the flare symptoms following 1 week of the vaccination and 41.7% of symptoms have lasted more than 8 weeks. 66.7% who had this flare have received Sinopharm, while 25% received Covishield. In this flare 58.3% got polyarthritis,16.7% monoarthritis, 8.3% oligoarthritis and 16.7% generalized rash. By contrast, 42 (16.9%) patients who received the 2nd dose of the vaccine had flare symptoms. 90.5% of this population were females and 38.1% were within the 50-59 years age group. 42% got flare following 1st week of the vaccination and 57% of symptoms have lasted more than 8 weeks. 5 patients who had flare symptoms following the first dose reported having flare after the 2nd dose too. None of the flare symptoms following 1st or 2nd dose of the vaccinations needed hospitalization. Interestingly gender (p=0.012), use of methotrexate (p=0.043), and the presence of flare to the first dose (p=0.02) were found to be significantly correlated with the occurrence of flare symptoms following 2nd dose of vaccination. Conclusion This study reveals a considerable incidence of non-severe RMD flareups following COVID vaccination, mainly with the 2nd dose. Further studying on the effects of repeated and periodic COVID vaccination among patients with RMDs is timely to reassure and to improve vaccine acceptance in this group of patients.