Demographic, clinical and genetic factors associated with COVID-19 disease susceptibility and mortality in a Kurdish population.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a devastating pandemic that causes disease with a variability in susceptibility and mortality based on variants of various clinical and demographic factors, including particular genes among populations. OBJECTIVES: Determine associations of demographic, clinical, laboratory, and single nucleotide polymorphisms in the ACE2, TMPRSS2, TNF-α, and IFN-γ genes to the incidence of infection and mortality in COVID-19 patients. DESIGN: Prospective cohort study SETTINGS: Various cities in the Kurdistan Region of Iraq. PATIENTS AND METHODS: This prospective cohort study compared laboratory markers (D-dimer, tumor necrosis factor-alpha [TNF-α], interferon-gamma [IFN-γ], C-reactive protein [CRP], lymphocyte and neutrophil counts) between COVID-19 patients and healthy controls. DNA was extracted from blood, and genotypes were done by Sanger sequencing. MAIN OUTCOME MEASURES: Single nucleotide polymorphisms of the ACE2, TMPRSS2, TNF-α, and IFN-γ genes and demographic characteristics and laboratory markers for predicting mortality in COVID-19. SAMPLE SIZE: 203 (153 COVID-19 patients, 50 health control subjects). RESULTS: Forty-eight (31.4%) of the COVID-19 patients died. Age over 40 and comorbidities were risk factors for mortality, but the strongest associations were with serum IFN-γ, the neutrophil-to-lymphocyte ratio (NLR), and serum TNF-α. The AA genotype and A allele of TMPRSS2 rs2070788 decreased while the GA genotype and A allele of TNF-α increased susceptibility to COVID-19. Patients with the GA genotype of TNF-α rs1800629 had shorter survival times (9.9 days) than those carrying the GG genotype (18.3 days) (P<.0001 by log-rank test). The GA genotype versus the GG genotype was associated with higher levels of serum TNF-α. The GA genotype increased mortality rates by up to 3.8 fold. The survival rate for COVID-19 patients carrying the IFN-γ rs2430561 TT genotype (58.5%) was lower than in patients with the TA and AA genotypes (80.3%). The TT genotype increased the risk of death (HR=3.664, P<.0001) and was linked to high serum IFN-γ production. Olfactory dysfunction was a predictor of survival among COVID-19 patients. CONCLUSIONS: Age older than 40, comorbidities, the NLR and particular genotypes for and the IFN-γ and TNF-α genes were risk factors for death. Larger studies in different populations must be conducted to validate the possible role of particular SNPs as genetic markers for disease severity and mortality in COVID-19 disease. LIMITATIONS: Small sample size. CONFLICT OF INTEREST: None.

Occupational health: the role of demographic factors in the condition of increased risk.

OBJECTIVES: The paper analyses the impact of socio-demographic characteristics of the employees in conditions of uncertainty in the organizations. MATERIAL AND METHODS: The study was conducted on a sample of 210 employees using the Mental Health Inventory - 38 (MHI-38), Satisfaction with life scale (SWLS), and the Center for Epidemiological Studies - Depression (CES-D). RESULTS: The results showed that female respondents had significantly higher scores on ANX (t = 2,278, p < 0.05), while male employees had higher scores on life satisfaction (t = 2.103, p < 0.05). Older employees have a higher tendency for loss of emotional-behavioral control (F = 4.427, p < 0.05). Respondents who have satisfying living standards have also higher scores on SWLS (t = 2.257, p < 0.05). Respondents who have dissatisfying living standard have higher scores on generally positive affect (t = 3.152, p < 0.01), life satisfaction (t = 3.571, p < 0.01), psychological distress (t = 2.929, p < 0.01) and loss of emotional- behavioral control (t = 2.361, p < 0.05). Employees with different levels of educational background have similar tendencies in life satisfaction, mental health, and depressive symptoms (p > 0.05). CONCLUSIONS: The study showed that the specific socio-demographic profile of the employees is related to higher levels of mental health issues. Specifically, the mental health of female and older employees have been especially affected and disturbed by uncertain conditions. The results can be potentially used both in the terms of designing activities that support the mental health of the population, as well as in relation to the mental health of employees. Int J Occup Med Environ Health. 2023;36(2):250-62.

Clinical and Socio-Demographic Variables Associated With Long COVID-19: A Cross-Sectional Study.

Considering the importance of long COVID-19 (LC), this study aimed to investigate the relationship between clinical/sociodemographic factors and LC symptoms (LCS). This online cross-sectional study was conducted on 308 people infected with COVID-19 in Alborz, Iran, from April 1 to June 1, 2022. Multivariable logistic regression models were applied to measure the association between the LCS with other variables. Overall, 76.6% of participants had at least one LCS. Results from the multivariate logistic regression analysis showed that females (crude odds ratio [OR] [95% confidence interval (CI)]: 2.725 [1.42, 5.22]), educated persons (3.747 [1.58, 8.84]), people with a higher number of COVID-19 reinfection (2.280 [1.30, 3.97]), having an underlying disease (1.996 [1.01, 3.93]), and COVID-19 severity (3.321 [1.037, 10.635]) had higher odds of LC than others (all p < .05). Study findings provide additional clinical/sociodemographic data on risk for LC. These data may inform future research and clinical practice for potential risk identification and early intervention.

Random forest regression on joint role of meteorological variables, demographic factors, and policy response measures in COVID-19 daily cases: global analysis in different climate zones.

Different sources of factors in environment can affect the spread of COVID-19 by influencing the diffusion of the virus transmission, but the collective influence of which has hardly been considered. This study aimed to utilize a machine learning algorithm to assess the joint effects of meteorological variables, demographic factors, and government response measures on COVID-19 daily cases globally at city level. Random forest regression models showed that population density was the most crucial determinant for COVID-19 transmission, followed by meteorological variables and response measures. Ultraviolet radiation and temperature dominated meteorological factors, but the associations with daily cases varied across different climate zones. Policy response measures have lag effect in containing the epidemic development, and the pandemic was more effectively contained with stricter response measures implemented, but the generalized measures might not be applicable to all climate conditions. This study explored the roles of demographic factors, meteorological variables, and policy response measures in the transmission of COVID-19, and provided evidence for policymakers that the design of appropriate policies for prevention and preparedness of future pandemics should be based on local climate conditions, population characteristics, and social activity characteristics. Future work should focus on discerning the interactions between numerous factors affecting COVID-19 transmission.

Responses to a COVID-19 vaccination intervention: Qualitative analysis of 17K unsolicited SMS replies.

The development of effective interventions for COVID-19 vaccination has proven challenging given the unique and evolving determinants of that behavior. A tailored intervention to drive vaccination uptake through machine learning-enabled personalization of behavior change messages unexpectedly yielded a high volume of real-time short message service (SMS) feedback from recipients. A qualitative analysis of those replies contributes to a better understanding of the barriers to COVID-19 vaccination and demographic variations in determinants, supporting design improvements for vaccination interventions. OBJECTIVE: The purpose of this study was to examine unsolicited replies to a text message intervention for COVID-19 vaccination to understand the types of barriers experienced and any relationships between recipient demographics, intervention content, and reply type. METHOD: We categorized SMS replies into 22 overall themes. Interrater agreement was very good (all κpooled > 0.62). Chi-square analyses were used to understand demographic variations in reply types and which messaging types were most related to reply types. RESULTS: In total, 10,948 people receiving intervention text messages sent 17,090 replies. Most frequent reply types were "already vaccinated" (31.1%), attempts to unsubscribe (25.4%), and "will not get vaccinated" (12.7%). Within "already vaccinated" and "will not get vaccinated" replies, significant differences were observed in the demographics of those replying against expected base rates, all p > .001. Of those stating they would not vaccinate, 34% of the replies involved mis-/disinformation, suggesting that a determinant of vaccination involves nonvalidated COVID-19 beliefs. CONCLUSIONS: Insights from unsolicited replies can enhance our ability to identify appropriate intervention techniques to influence COVID-19 vaccination behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Adapting the ethical review process for COVID-19 research: reviewers’ perspectives from Pakistan

Background:Research ethics committees (RECs) globally have adapted their responses to provide timely reviews of research proposals in the wake of the COVID-19 pandemic. The REC of the National Bioethics Committee (NBC) of Pakistan has followed suit.Aims:To explore perceptions of NBC-REC reviewers who reviewed COVID-19 research proposals while describing the newly instituted Rapid Turnaround Review (RTR) system.Methods:This cross-sectional study used 3 methods of data collection: a demographic questionnaire filled in by permanent members and co-opted reviewers; qualitative in-depth interviews conducted with both groups; and document review related to COVID-19 research proposals.Results:Eight permanent members and 3 co-opted members participated. Under the RTR system, the time for review was established as 72 hours after receipt of the proposal. The Committee reviewed 55 projects over 10 months. Participants described numerous strengths of the new system, including introduction of online discussions via Zoom as well as presence of co-opted members leading to learning opportunities, particularly for junior members. The RTR system also allowed NBC-REC to gain recognition it had not enjoyed previously. Challenges identified by respondents included initial difficulty in initiating the system and tighter deadlines that may have compromised review quality. Poor scientific quality of proposals, compounded by external pressures to provide rapid approval, added to reviewers’ frustrations. While fruitful, the RTR system was considered unsustainable beyond a public health emergency.Conclusion:Adaptation of ethical review processes is essential in emergencies; however, existing guidelines have to be modified to suit contextual needs.

Clinical and epidemiological characteristics of the first 150 patients with COVID-19 in Lebanon: a prospective descriptive study

Background: Clinical features of confirmed COVID-19 cases cover a wide spectrum. Aims: To study the clinical, radiological and virological features of the first 150 patients with COVID-19 in Lebanon. Methods: Our university hospital was designated as the primary COVID-19 care centre in Lebanon. Between 21 February 2020, the date of the first confirmed case of COVID-19 in Lebanon, and 3 April 2020, our team treated 150 patients diagnosed with COVID-19. In this prospective descriptive study, we present our experience in treating these patients, specifically the diagnostic criteria, outcome, and demographic, clinical, radiological and biological characteristics. Results: Ninety-five (63.33%) of the patients were male and 55 (36.67%) were female. Most patients (58%) were aged > 50 years, and 8 (5.33%) were healthcare workers. Diagnosis was based on reverse transcription polymerase chain reaction, and patients were classified as mild, moderate or critical. Fifteen (10%) patients had a critical presentation and fever was the most prominent symptom at presentation. One hundred and thirty-eight (92%) patients underwent radiological evaluation. The most common laboratory findings were lymphocytopenia (34.38%), followed by neutropenia (28.13%), but leukocytosis was not prevalent (1.56%). Old age and comorbidity were significant indicators in patient risk stratification. Chest computed tomography was an invaluable method of diagnosis and management. Our radiological findings were consistent with the published literature. Conclusion: Our study underlines the variable presentation of COVID-19, the difference in severity, and the diverse methods of diagnosis. This suggests the need for a tailored approach, taking into consideration the wide spectrum of presentation.

COVID-19 vaccination dynamics in the US: coverage velocity and carrying capacity based on socio-demographic vulnerability indices in California's pediatric population.

Introduction: COVID-19 vaccine inequities have been widespread across California, the United States, and globally. As COVID-19 vaccine inequities have not been fully understood in the youth population, it is vital to determine possible factors that drive inequities to enable actionable change that promotes vaccine equity among vulnerable minor populations. Methods: The present study used the social vulnerability index (SVI) and daily vaccination numbers within the age groups of 12-17, 5-11, and under 5 years old across all 58 California counties to model the growth velocity and the anticipated maximum proportion of population vaccinated. Results: Overall, highly vulnerable counties, when compared to low and moderately vulnerable counties, experienced a lower vaccination rate in the 12-17 and 5-11 year-old age groups. For age groups 5-11 and under 5 years old, highly vulnerable counties are expected to achieve a lower overall total proportion of residents vaccinated. In highly vulnerable counties in terms of socioeconomic status and household composition and disability, the 12-17 and 5-11 year-old age groups experienced lower vaccination rates. Additionally, in the 12-17 age group, high vulnerability counties are expected to achieve a higher proportion of residents vaccinated compared to less vulnerable counterparts. Discussion: These findings elucidate shortcomings in vaccine uptake in certain pediatric populations across California and may help guide health policies and future allocation of vaccines, with special emphasis placed on vulnerable populations, especially with respect to socioeconomic status and household composition and disability.

Comparison of demographic and clinical characteristics between pandemic and pre-pandemic period in non-COVID intensive care units: a retrospective study.

BACKGROUND: A major problem of the coronavirus pandemic is the increase of patients requiring intensive care unit (ICU) sup-port in an extremely limited period of time. As a result, most countries have prioritized coronavirus disease 2019 (COVID-19) care in ICUs and take new arrangements to increase hospital capacity in emergency department and ICUs. This study aimed to evaluate the changes in the number, clinical and demographic characteristics of patients hospitalized in non-COVID ICUs during the COVID-19 pandemic period compared to the previous year (pre-pandemic period), and to reveal the effects of the pandemic. METHODS: Hospitalized patients in non-COVID ICUs of our hospital between 11 March 2019 and 11 March 2021 were included in the study. The patients were divided into two groups according to date of the start of the COVID period. Patient data were scanned and recorded retrospectively from hospital information system and ICU assessment forms. Information regarding demographics (age and gender), comorbidities, COVID 19 polymerase chain reaction result, place of ICU admission, the diagnoses of patients admitted to ICU, length of ICU stay, Glasgow coma scale and mortality rates, and the Acute Physiology and Chronic Health Evaluation II score were collected. RESULTS: A total of 2292 patients were analyzed, including 1011 patients (413 women and 598 men) in the pre-pandemic period (Group 1) and 1281 patients (572 women and 709 men) in the pandemic period (Group 2). When the diagnoses of patients admitted to ICU were compared between the groups, there was a statistically significant difference between post-operation, return of spon-taneous circulation, intoxication, multitrauma, and other reasons. In the pandemic period, the patients had a statistically significant longer length of ICU stay. CONCLUSION: Changes were observed in the clinical and demographic characteristics of patients hospitalized in non-COVID-19 ICUs. We observed that the length of ICU stay of the patients increased during the pandemic period. Due to this situation, we think that intensive care and other inpatient services should be managed more effectively during the pandemic.

Hesitant or not: A cross-sectional study of socio-demographics, conspiracy theories, trust in public health information, social capital and vaccine hesitancy among older adults in Ghana.

Vaccination is an effective strategy to reduce the coronavirus disease 2019 (COVID-19) burden, but its effectiveness hinges on timely vaccine uptake. Addressing concerns among vaccine-hesitant individuals is critical to preventing the immunization program from failing. This study analyzes the determinants of vaccine hesitance among older adults (aged 50 years and older) in Ghana. We adopted a cross-sectional survey with a quantitative approach that accessed data from 400 older adults from the Accra and Kumasi metropolitan areas using purposive and snowball sampling techniques. Multivariate logistic regressions were used to estimate the socio-demographic, social capital, conspiracy theories about COVID-19, and public health information factors associated with vaccine hesitance within the sample. The study found that only minority (5%) of respondents had been vaccinated, with 79% indicating willingness to be vaccinated. The study found that females (AOR: 0.734, CI: 0.019-0.036, p = .027) and those who have retired (AOR: 0.861, CI: 0.003-0.028, p = .034) were significantly less likely to engage in COVID-19 vaccine hesitance. Furthermore, the study revealed that participants who trust public health information (AOR: 0.065, CI: 0.022-0.049, p = .031) and have social capital (AOR: 0.886, CI: 0.017-0.032, p = .001) were significantly less likely to present COVID-19 vaccine hesitance. Finally, participants who believe in conspiracy theories about COVID-19 and vaccines (AOR: 3.167, CI: 1.021-2.043, p = .004) were significantly more likely to engage in COVID-19 vaccine hesitance. Efforts to convey vaccination benefits and address issues through evidence-based information are needed to strengthen and preserve the public's trust in vaccines in Ghana.

Trajectory and Demographic Correlates of Antibodies to SARS-CoV-2 Nucleocapsid in Recently Infected Blood Donors, United States.

We evaluated antibodies to the nucleocapsid protein of SARS-CoV-2 in a large cohort of blood donors in the United States who were recently infected with the virus. Antibodies to the nucleocapsid protein of SARS-CoV-2 indicate previous infection but are subject to waning, potentially affecting epidemiologic studies. We longitudinally evaluated a cohort of 19,323 blood donors who had evidence of recent infection by using a widely available serologic test to determine the dynamics of such waning. We analyzed overall signal-to-cutoff values for 48,330 donations (average 2.5 donations/person) that had an average observation period of 102 days. The observed peak signal-to-cutoff value varied widely, but the waning rate was consistent across the range, with a half-life of 122 days. Within the cohort, only 0.75% of persons became seronegative. Factors predictive of higher peak values and longer time to seroreversion included increasing age, male sex, higher body mass index, and non-Caucasian race.

Objective and subjective cognition in survivors of COVID-19 one year after ICU discharge: the role of demographic, clinical, and emotional factors.

BACKGROUND: Intensive Care Unit (ICU) COVID-19 survivors may present long-term cognitive and emotional difficulties after hospital discharge. This study aims to characterize the neuropsychological dysfunction of COVID-19 survivors 12 months after ICU discharge, and to study whether the use of a measure of perceived cognitive deficit allows the detection of objective cognitive impairment. We also explore the relationship between demographic, clinical and emotional factors, and both objective and subjective cognitive deficits. METHODS: Critically ill COVID-19 survivors from two medical ICUs underwent cognitive and emotional assessment one year after discharge. The perception of cognitive deficit and emotional state was screened through self-rated questionnaires (Perceived Deficits Questionnaire, Hospital Anxiety and Depression Scale and Davidson Trauma Scale), and a comprehensive neuropsychological evaluation was carried out. Demographic and clinical data from ICU admission were collected retrospectively. RESULTS: Out of eighty participants included in the final analysis, 31.3% were women, 61.3% received mechanical ventilation and the median age of patients was 60.73 years. Objective cognitive impairment was observed in 30% of COVID-19 survivors. The worst performance was detected in executive functions, processing speed and recognition memory. Almost one in three patients manifested cognitive complaints, and 22.5%, 26.3% and 27.5% reported anxiety, depression and post-traumatic stress disorder (PTSD) symptoms, respectively. No significant differences were found in the perception of cognitive deficit between patients with and without objective cognitive impairment. Gender and PTSD symptomatology were significantly associated with perceived cognitive deficit, and cognitive reserve with objective cognitive impairment. CONCLUSIONS: One-third of COVID-19 survivors suffered objective cognitive impairment with a frontal-subcortical dysfunction 12 months after ICU discharge. Emotional disturbances and perceived cognitive deficits were common. Female gender and PTSD symptoms emerged as predictive factors for perceiving worse cognitive performance. Cognitive reserve emerged as a protective factor for objective cognitive functioning. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04422444; June 9, 2021.

Complete childhood vaccination and associated factors among children aged 12-23 months in Dabat demographic and health survey site, Ethiopia, 2022.

INTRODUCTION: Childhood immunization is one of the most cost-effective public health strategies to prevent children's mortality and morbidity from infectious diseases, but the Covid-19 pandemic and associated disruptions have strained health systems, and worldwide 25 million children missing out on vaccination in 2021. Of the 25 million, more than 60% of these children live in 10 countries including Ethiopia. Therefore, this study aimed to assess complete childhood vaccination coverage and associated factors in the Dabat district. METHOD: A community-based cross-sectional study was conducted from December 10/2020 to January 10/2021Gregorian Calendar. The data for this study was extracted from information collected for the assessment of maternal, Neonatal, and Child Health and health services utilization in the Dabat demographic and health survey site. Vaccine-related data were collected using an interviewer-administered questionnaire. An adjusted odds ratio with a 95% confidence interval was used to identify the presence and the direction of the association. RESULTS: Based on vaccination cards and mothers/caretakers' recall 30.9% (95%CI: 27.9-34.1%) of children aged 12-23 months in the Dabat district were completely immunized. Urban residency [AOR 1.813, 95% CI: (1.143, 2.878)], delivered in the health facility [AOR = 5.925, 95% CI: (3.680, 9.540)], ANC follow-up during their pregnancy [AOR 2.023, 95% CI: (1.352, 3.027)], rich wealth index [AOR = 2.392, 95% CI: (1.296, 4.415)], and parity [AOR 2.737, 95% CI: (1.664, 4.500)] were significantly associated with complete child vaccination. RECOMMENDATION AND CONCLUSION: Complete vaccination coverage among children aged 12-23 months in the Dabat district was lower than the Global vaccine plan and Ethiopian ministry of health goal in 2020. Therefore, Health care providers and other stakeholders should mobilize the community to improve mothers' health-seeking behavior toward pregnancy follow-up and health facility delivery to improve childhood vaccination. Besides, expanding the service to remote areas are necessary to increase the immunization access.

Changes in COVID-19-related mortality across key demographic and clinical subgroups in England from 2020 to 2022: a retrospective cohort study using the OpenSAFELY platform.

BACKGROUND: COVID-19 has been shown to differently affect various demographic and clinical population subgroups. We aimed to describe trends in absolute and relative COVID-19-related mortality risks across clinical and demographic population subgroups during successive SARS-CoV-2 pandemic waves. METHODS: We did a retrospective cohort study in England using the OpenSAFELY platform with the approval of National Health Service England, covering the first five SARS-CoV-2 pandemic waves (wave one [wild-type] from March 23 to May 30, 2020; wave two [alpha (B.1.1.7)] from Sept 7, 2020, to April 24, 2021; wave three [delta (B.1.617.2)] from May 28 to Dec 14, 2021; wave four [omicron (B.1.1.529)] from Dec 15, 2021, to April 29, 2022; and wave five [omicron] from June 24 to Aug 3, 2022). In each wave, we included people aged 18-110 years who were registered with a general practice on the first day of the wave and who had at least 3 months of continuous general practice registration up to this date. We estimated crude and sex-standardised and age-standardised wave-specific COVID-19-related death rates and relative risks of COVID-19-related death in population subgroups. FINDINGS: 18 895 870 adults were included in wave one, 19 014 720 in wave two, 18 932 050 in wave three, 19 097 970 in wave four, and 19 226 475 in wave five. Crude COVID-19-related death rates per 1000 person-years decreased from 4·48 deaths (95% CI 4·41-4·55) in wave one to 2·69 (2·66-2·72) in wave two, 0·64 (0·63-0·66) in wave three, 1·01 (0·99-1·03) in wave four, and 0·67 (0·64-0·71) in wave five. In wave one, the standardised COVID-19-related death rates were highest in people aged 80 years or older, people with chronic kidney disease stage 5 or 4, people receiving dialysis, people with dementia or learning disability, and people who had received a kidney transplant (ranging from 19·85 deaths per 1000 person-years to 44·41 deaths per 1000 person-years, compared with from 0·05 deaths per 1000 person-years to 15·93 deaths per 1000 person-years in other subgroups). In wave two compared with wave one, in a largely unvaccinated population, the decrease in COVID-19-related mortality was evenly distributed across population subgroups. In wave three compared with wave one, larger decreases in COVID-19-related death rates were seen in groups prioritised for primary SARS-CoV-2 vaccination, including people aged 80 years or older and people with neurological disease, learning disability, or severe mental illness (90-91% decrease). Conversely, smaller decreases in COVID-19-related death rates were observed in younger age groups, people who had received organ transplants, and people with chronic kidney disease, haematological malignancies, or immunosuppressive conditions (0-25% decrease). In wave four compared with wave one, the decrease in COVID-19-related death rates was smaller in groups with lower vaccination coverage (including younger age groups) and conditions associated with impaired vaccine response, including people who had received organ transplants and people with immunosuppressive conditions (26-61% decrease). INTERPRETATION: There was a substantial decrease in absolute COVID-19-related death rates over time in the overall population, but demographic and clinical relative risk profiles persisted and worsened for people with lower vaccination coverage or impaired immune response. Our findings provide an evidence base to inform UK public health policy for protecting these vulnerable population subgroups. FUNDING: UK Research and Innovation, Wellcome Trust, UK Medical Research Council, National Institute for Health and Care Research, and Health Data Research UK.

The socio-demographic profile associated with perinatal depression during the COVID-19 era.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has caused an increase in perinatal depression. The aim of this research was to identify which sociodemographic variables are related to the increase in perinatal depression due to the pandemic. In addition to estimating to what extent they predict perinatal depression, differentiating the prenatal and postnatal periods. METHODS: The sample consisted of 3,356 subjects, 1,402 in the prenatal period and 1,954 in the postnatal period. The Edinburgh Postnatal Depression Scale was used to assess depressive symptomatology. A subset of 14 questions was included to collect demographic data. Items from the Spanish version of the Coronavirus Perinatal Experiences Survey were also included. RESULTS: Experiencing the change of environment due to COVID-19 as negative and having a history of mental health predict perinatal depression, otherwise having higher education decreases the risk. In the prenatal stage having symptoms compatible with COVID-19 is a predictor of perinatal depression and having more than 3 years living together with the partner and being a housewife decreases the risk. In the postnatal stage being unemployed is a predictor of prenatal depression and being a first-time mother decreases the risk. CONCLUSIONS: This study highlights the relevance of sociodemographic status. It is essential to be aware of the risk factors of perinatal depression, to make adequate prevention, and to create health policies to alleviate the consequences of the pandemic.

Demographic differences in services utilization across in-person (2019), telehealth (2020), and hybrid (2021) outpatient substance use services in New York.

OBJECTIVES: Many outpatient substance use programs have experienced in-person, remote/telehealth, and hybrid models of care since the 2020 Covid-19 Pandemic. Changes in treatment models naturally affect service utilization and may affect treatment trajectories. Currently, limited research examines the implications of different health care models on service utilization and patient outcomes in substance use treatment. Here, we reflect on the implications of each model from a patient-centered care approach and review the implications on service utilization and outcomes. METHODS: We employed a retrospective, observational, longitudinal, cohort design to explore differences in demographic characteristics and service utilization among patients receiving in-person, remote, or hybrid services across four substance use clinics in New York. We reviewed admission (N = 2238) and discharge (N = 2044) data from four outpatient SUD clinics within the same health care system across three cohorts (2019, in-person; 2020, remote; 2021, hybrid). RESULTS: Patients discharged in 2021 (hybrid) had significantly more median total treatment visits (M = 26, p ≤ 0.0005), a longer course of treatment (M = 154.5 days, p ≤ 0.0001), and more individual counseling sessions (M = 9, p ≤ 0.0001) compared to the other two cohorts. Demographic analyses indicate more ethnoracial diversity (p = 0.0006) among patients admitted in 2021, compared to the other two cohorts. Over time, the proportion of individuals being admitted with a co-existing psychiatric disorder (2019, 49 %; 2020; 55.4 %, 2021, 54.9 %) and no prior mental health treatment (2019, 49.4 %; 2020, 46.0 %; 2021, 69.3 %) increased (p = 0.0001). Admissions in 2021 were more likely to be self-referred (32.5 %, p < 0.0001), employed full-time (39.5 %, p = 0.01), and have higher educational attainment (p = 0.0008). CONCLUSION: During hybrid treatment in 2021, patients from a wider range of ethnoracial backgrounds were admitted and retained in care, patients with higher socioeconomic status (who were previously less likely to enter treatment) were admitted, and fewer individuals left against clinical advice (compared to the remote 2020 cohort). More patients successfully completed treatment in 2021. Service utilization, demographic, and outcome trends support a hybrid model of care.

Demographic changes in Australia's regulated health professions: 6-year trends.

Objective Studies of Australian health workforce demographics tend to be limited to single professions, a set geographic area, or based on incomplete data. This study aims to comprehensively describe changes to the demographic characteristics of Australia's regulated health professions over 6 years. Methods Data were sourced from the Australian Health Practitioner Regulation Agency (Ahpra) registration database, and a retrospective analysis of 15 of the 16 regulated health professions between 1 July 2015 and 30 June 2021 was conducted. Variables including profession, age, gender and state/territory locations for the practitioners' principal places of practice were analysed descriptively and via appropriate statistical tests. Results Changes in age, gender representation, and place of practice varied significantly and in different ways across the 15 professions. The total number of registered health practitioners increased by 141 161 (22%) from 2016 to 2021. The number of registered health practitioners per 100 000 population increased by 14% from 2016, with considerable variation across the professions. In 2021, women accounted for 76.3% of health practitioners across the 15 health professions, a significant increase of 0.5% points since 2016. Conclusions Changes to demographics, especially in ageing workforces and feminising professions, can have implications for workforce planning and sustainability. Future research could build on this demographic trend data by investigating causes or undertaking workforce supply or demand modelling.

The Relative Contributions of Center Demographic, Director, Parental, Social, Environmental, and Policy Factors to Changes in Outdoor Play in Childcare Centers During the COVID-19 Pandemic.

BACKGROUND: The primary objective of this study was to investigate the relative contributions of factors from multiple social-ecological levels in explaining outdoor play changes in childcare centers during the COVID-19 pandemic. METHODS: In Alberta, Canada, licensed childcare center directors (n = 160) completed an online questionnaire. For outcomes, changes in the frequency and duration of outdoor play in childcare centers during COVID-19 compared to before COVID-19 were measured. For exposures, center demographic, director, parental, social, environmental, and policy-level factors were measured. Hierarchical regression analyses were conducted separately for winter (December-March) and nonwinter months (April-November). RESULTS: In most instances, factors at each social-ecological level explained a statistically significant amount of unique variance in changes in outdoor play in childcare centers during COVID-19. Full models accounted for more than 26% of the variance in the outcomes. Changes in parental interest in outdoor play was the most consistent correlate of changes in the frequency and duration of outdoor play in both winter and nonwinter months during COVID-19. In terms of changes in the duration of outdoor play, social support from the provincial government, health authority, and licensing, and changes in the number of play areas in licensed outdoor play spaces were also consistent correlates in both winter and nonwinter months during COVID-19. CONCLUSIONS: Factors from multiple social-ecological levels uniquely contributed to changes in outdoor play in childcare centers during the COVID-19 pandemic. Findings can help inform interventions and public health initiatives related to outdoor play in childcare centers during and after the ongoing pandemic.

Impact of Human Mobility on COVID-19 Transmission According to Mobility Distance, Location, and Demographic Factors in the Greater Bay Area of China: Population-Based Study.

BACKGROUND: Mobility restriction was one of the primary measures used to restrain the spread of COVID-19 globally. Governments implemented and relaxed various mobility restriction measures in the absence of evidence for almost 3 years, which caused severe adverse outcomes in terms of health, society, and economy. OBJECTIVE: This study aimed to quantify the impact of mobility reduction on COVID-19 transmission according to mobility distance, location, and demographic factors in order to identify hotspots of transmission and guide public health policies. METHODS: Large volumes of anonymized aggregated mobile phone position data between January 1 and February 24, 2020, were collected for 9 megacities in the Greater Bay Area, China. A generalized linear model (GLM) was established to test the association between mobility volume (number of trips) and COVID-19 transmission. Subgroup analysis was also performed for sex, age, travel location, and travel distance. Statistical interaction terms were included in a variety of models that express different relations between involved variables. RESULTS: The GLM analysis demonstrated a significant association between the COVID-19 growth rate ratio (GR) and mobility volume. A stratification analysis revealed a higher effect of mobility volume on the COVID-19 GR among people aged 50-59 years (GR decrease of 13.17% per 10% reduction in mobility volume; P<.001) than among other age groups (GR decreases of 7.80%, 10.43%, 7.48%, 8.01%, and 10.43% for those aged ≤18, 19-29, 30-39, 40-49, and ≥60 years, respectively; P=.02 for the interaction). The impact of mobility reduction on COVID-19 transmission was higher for transit stations and shopping areas (instantaneous reproduction number [Rt] decreases of 0.67 and 0.53 per 10% reduction in mobility volume, respectively) than for workplaces, schools, recreation areas, and other locations (Rt decreases of 0.30, 0.37, 0.44, and 0.32, respectively; P=.02 for the interaction). The association between mobility volume reduction and COVID-19 transmission was lower with decreasing mobility distance as there was a significant interaction between mobility volume and mobility distance with regard to Rt (P<.001 for the interaction). Specifically, the percentage decreases in Rt per 10% reduction in mobility volume were 11.97% when mobility distance increased by 10% (Spring Festival), 6.74% when mobility distance remained unchanged, and 1.52% when mobility distance declined by 10%. CONCLUSIONS: The association between mobility reduction and COVID-19 transmission significantly varied according to mobility distance, location, and age. The substantially higher impact of mobility volume on COVID-19 transmission for longer travel distance, certain age groups, and specific travel locations highlights the potential to optimize the effectiveness of mobility restriction strategies. The results from our study demonstrate the power of having a mobility network using mobile phone data for surveillance that can monitor movement at a detailed level to measure the potential impacts of future pandemics.

Telehealth for opioid use disorder: retention as a function of demographics and rurality.

Background: Despite lifesaving medications such as buprenorphine and methadone, the majority of individuals with opioid use disorder (OUD) face access barriers to evidence-based treatment. COVID-19 era regulatory reforms have shown that telehealth can improve access to care, although disparities in clinical outcomes are likely to persist.Objective: We aimed to analyze 180-day and 365-day retention in treatment with buprenorphine for OUD overall and by demographics, hypothesizing that retention would be lower among racial/ethnic minorities and rural patients.Methods: We analyzed data from a cohort of individuals with OUD enrolled in treatment from April 1, 2020 to September 30, 2021, in Pennsylvania and New York using a virtual-first telehealth OUD treatment platform to assess rates of 180-day and 365-day retention. Associations between demographic characteristics and retention were assessed using unadjusted and adjusted logistic regression models.Results: Among 1,378 patients (58.8% male), 180-day retention was 56.4%, and 365-day retention was 48.3%. Adjusted analyses found that only an association between older age and greater odds of 180-day retention was significant (aOR for patients aged 30-50 vs. <30: 1.83 [1.37-2.45]). There were no significant associations between sex, race/ethnicity, state, or rurality with retention.Conclusion: While we were unable to control for socioeconomic variables, we found retention within telehealth services for buprenorphine was high irrespective of geography or race/ethnicity, but disparities with age indicate a subset of patients who may benefit from more intensive services early in care.