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1.
Front Public Health ; 10: 838606, 2022.
Article in English | MEDLINE | ID: covidwho-1776043

ABSTRACT

Background: Social unrest affects people's health and well-being. People's health-related needs during social unrest are concerns in both research and clinical practice. This study aimed to build and test a framework to describe and understand the health status and needs of people with post-traumatic stress disorder (PTSD) during social unrest. Methods: This study was a cross-sectional survey. A total of 460 people who had experienced post-traumatic distress as a result of the social unrest in 2019 and 2020 were included. A conceptual model comprised four essential areas, namely posttraumatic distress symptoms, participation restrictions, perceived stigma and functional disability, was built from literature. Part 1 validated four instruments that evaluate and define the factor structure of these four areas, In Part II, structural equation modeling was used to test and validate a combined model. Results: Factors underlying the four areas were defined. Analysis using structural equation modeling confirmed a best fit of the model. PTSD symptoms, perceived stigma and participation restriction during social unrest contributed significantly to functional disability; PTSD symptoms exerted a direct effect on participation restriction and perceived stigma; and the effect of PTSD symptoms on functional disability was mediated through its influence on perceived stigma during social unrest. Conclusions: A community-based inclusive approach is essential to understand the holistic needs of people with PTSD during social unrest. To improve health and well-being in addition to evaluating mental health impacts, considering interactions with the rapid change and stressful social environment is essential.


Subject(s)
Civil Disorders , Stress Disorders, Post-Traumatic , Cross-Sectional Studies , Factor Analysis, Statistical , Humans , Latent Class Analysis
2.
Front Public Health ; 9: 640226, 2021.
Article in English | MEDLINE | ID: covidwho-1760275

ABSTRACT

Background: Acculturation profiles and their impact on telomere length among foreign-born Hispanics/Latinos living in the United States (US) are relatively unknown. The limited research available has linked acculturation with shortened telomere length. Objectives: To identify acculturation profiles among a US representative sample of Hispanics/Latinos and to then examine telomere length differences between profiles. Methods: We conducted a latent class analysis among a non-institutionalized US-representative sample of Hispanics/Latinos using the 1999-2002 National Health and Nutrition Examination Survey (N = 2,292). The latent variable of acculturation was assessed by length of time in the US and language used as a child, read and spoken, usually spoken at home, used to think, and used with friends (i.e., Spanish and/or English). Telomere length assessed from leukocytes was used as the distal continuous outcome. Results: We identified five profiles: (1) low acculturated [33.2% of sample]; (2) partially integrated [18.6% of sample]; (3) integrated [19.4% of sample]; (4) partially assimilated [15.1% of sample]; and (5) assimilated [13.7% of sample]. Acculturation profiles revealed nuanced differences in conditional probabilities with language use despite the length of time spent in the US. While telomere length did vary, there were no significant differences between profiles. Conclusion: Profiles identified revealed that possible life-course and generational effects may be at play in the partially assimilated and assimilated profiles. Our findings expand public health research using complex survey data to identify and assess the dynamic relationship of acculturation profiles and health biomarkers, while being among the first to examine this context using a person-centered approach.


Subject(s)
Acculturation , Child , Humans , Latent Class Analysis , Nutrition Surveys , Telomere , Telomere Shortening , United States
3.
PLoS One ; 17(3): e0263568, 2022.
Article in English | MEDLINE | ID: covidwho-1753186

ABSTRACT

BACKGROUND: COVID-19 is a new pandemic that poses a threat to people globally. In Ethiopia, where classrooms are limited, students are at higher risk for COVID-19 unless they take consistent preventative actions. However, there is a lack of evidence in the study area regarding student compliance with COVID-19 preventive behavior (CPB) and its predictors. OBJECTIVE: This study aimed to assess CPB and its predictors among students based on the perspective of the Health Belief Model (HBM). METHOD AND MATERIALS: A school-based cross-sectional survey was conducted from November to December 2020 to evaluate the determinants of CPB among high school students using a self-administered structured questionnaire. 370 participants were selected using stratified simple random sampling. Descriptive statistics were used to summarize data, and partial least squares structural equation modeling (PLS-SEM) analyses to evaluate the measurement and structural models proposed by the HBM and to identify associations between HBM variables. A T-value of > 1.96 with 95% CI and a P-value of < 0.05 were used to declare the statistical significance of path coefficients. RESULT: A total of 370 students participated with a response rate of 92%. The median (interquartile range) age of the participants (51.9% females) was 18 (2) years. Only 97 (26.2%), 121 (32.7%), and 108 (29.2%) of the students had good practice in keeping physical distance, frequent hand washing, and facemask use respectively. The HBM explained 43% of the variance in CPB. Perceived barrier (ß = - 0.15, p < 0.001) and self-efficacy (ß = 0.51, p <0.001) were significant predictors of student compliance to CPB. Moreover, the measurement model demonstrated that the instrument had acceptable reliability and validity. CONCLUSION AND RECOMMENDATIONS: COVID-19 prevention practice is quite low among students. HBM demonstrated adequate predictive utility in predicting CPBs among students, where perceived barriers and self-efficacy emerged as significant predictors of CPBs. According to the findings of this study, theory-based behavioral change interventions are urgently required for students to improve their prevention practice. Furthermore, these interventions will be effective if they are designed to remove barriers to CPBs and improve students' self-efficacy in taking preventive measures.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/methods , Students/psychology , Adolescent , COVID-19/psychology , Cross-Sectional Studies , Ethiopia/epidemiology , Female , Health Behavior , Health Belief Model , Health Knowledge, Attitudes, Practice , Humans , Latent Class Analysis , Male , Reproducibility of Results , Self Efficacy , Surveys and Questionnaires , Young Adult
4.
Alcohol Clin Exp Res ; 46(3): 434-446, 2022 03.
Article in English | MEDLINE | ID: covidwho-1741317

ABSTRACT

BACKGROUND: We conducted a longitudinal study to examine person-centered heterogeneity in problem drinking risk during the 2019 Coronavirus disease (COVID-19) pandemic. We aimed to differentiate high- from low-risk subgroups of drinkers during the pandemic, to report on the longitudinal follow-up of the baseline sample reported in Wardell et al. (Alcohol Clin Exp Res, 44, 2020, 2073), and to examine how subgroups of drinkers differed on coping-related and pre-pandemic alcohol vulnerability factors. METHODS: Canadian alcohol users (N = 364) were recruited for the study. Participants completed surveys at four waves (spaced 3 months apart), with the first being 7 to 8 weeks after the COVID-19 state of emergency began in Canada. The data were analyzed using a parallel process latent growth class analysis followed by general linear mixed models analysis. RESULTS: We found evidence for three latent classes: individuals who increased drinking (class 1; n = 23), low-risk drinkers (class 2; n = 311), and individuals who decreased drinking (class 3; n = 30). Participants who increased (vs. those who decreased) problem drinking during the pandemic struggled with increasing levels of social disconnection and were also increasingly more likely to report drinking to cope with these issues. Those in the increasing class (relative to low-risk drinkers) reported increasing levels of depression during the study. Relative to low-risk drinkers, participants in the increasing class had higher pre-pandemic AUDIT scores, greater frequency of solitary drinking, and higher alcohol demand. Interestingly, participants in the decreasing class had the highest pre-pandemic AUDIT scores. CONCLUSIONS: We examined longitudinal data to identify subgroups of drinkers during the pandemic and to identify factors that may have contributed to increased problem drinking. Findings suggest that while most of the sample did not change their alcohol use, a small portion of individuals escalated use, while a small portion decreased their drinking. Identifying the vulnerability factors associated with increased drinking could aid in the development of preventative strategies and intervention approaches.


Subject(s)
Alcohol Drinking/epidemiology , Alcohol Drinking/psychology , COVID-19/psychology , Adult , Canada/epidemiology , Female , Humans , Latent Class Analysis , Longitudinal Studies , Male , Risk Factors
5.
Soc Sci Med ; 296: 114767, 2022 03.
Article in English | MEDLINE | ID: covidwho-1730110

ABSTRACT

RATIONALE: COVID-19 vaccine hesitancy presents significant challenges for public health. OBJECTIVE: Vaccine hesitancy among middle-aged and older adults has been a significant barrier in Singapore's battle against COVID-19. We hypothesize that the trust middle-aged and older adults place in various sources of information influences vaccine hesitancy, and that distinct typologies of trust can be identified to better inform targeted health communication efforts. METHOD: Data from a nationally representative panel survey of Singaporeans aged 56-75 (N = 6094) was utilized. Modules fielded in August and November 2020, and June 2021 were analyzed, assessing social networks, trust in sources of information, and vaccination status respectively. Predictors of vaccination status were first examined. Latent class analysis was then used to identify typologies of trust in various sources of information. RESULTS: Trust in formal sources of information (e.g government sources) is found to predict vaccination status among respondents. Contrary to expectations, trust in social media and informal sources (family and friends), and perceived social support did not predict vaccination status. Latent class analysis identified 4 typologies of respondents based on their patterns of trust in these sources. Significantly, it is found that a portion of respondents with low trust in formal sources of information have high trust in informal sources. The four distinct typologies of trust in sources of information are also found to predict vaccination status. CONCLUSIONS: Because trust in formal sources of information influences vaccination status, authorities should build trust in such sources to encourage vaccination against COVID-19. However, health communication strategies with middle-aged and older adults who have low levels of trust in the formal sources may be more effective if authorities leveraged alternative channels such as informal sources, including the social networks of such individuals. Overall, the findings suggest the need for targeted communication strategies to encourage vaccination.


Subject(s)
COVID-19 , Health Communication , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Cross-Sectional Studies , Humans , Latent Class Analysis , Middle Aged , SARS-CoV-2 , Singapore/epidemiology , Trust , Vaccination
6.
Int J Environ Res Public Health ; 19(4)2022 02 10.
Article in English | MEDLINE | ID: covidwho-1690260

ABSTRACT

This study aims to investigate the relationships between COVID-19-related psychological distress, social media addiction, COVID-19-related burnout, and depression. The research, which was designed according to the relational survey model, was conducted with the participation of 332 school principals and teachers who received graduate education in the field of educational administration. Research data were collected through online surveys and then structural equation modeling (SEM) was used to test and analyze the proposed hypotheses. The study's findings revealed that COVID-19-related psychological distress strongly predicted COVID-19-related burnout. In this context, as the psychological distress associated with COVID-19 increased, the sense of burnout associated with COVID-19 also increased. However, it was found that burnout associated with COVID-19 significantly and positively predicted depression. SEM results revealed that COVID-19-related psychological distress directly affected COVID-19-related burnout, depression, and social media addiction. In addition, it was determined that an indirect effect of COVID-19-related burnout and social media addiction exists in the relationship between COVID-19-related psychological distress and depression.


Subject(s)
Burnout, Professional , COVID-19 , Psychological Distress , Burnout, Professional/epidemiology , Burnout, Professional/psychology , Burnout, Psychological/psychology , COVID-19/epidemiology , Depression/epidemiology , Humans , Internet Addiction Disorder , Latent Class Analysis , SARS-CoV-2 , School Teachers/psychology , Schools , Surveys and Questionnaires
7.
Int J Environ Res Public Health ; 19(3)2022 Feb 06.
Article in English | MEDLINE | ID: covidwho-1674633

ABSTRACT

The purpose of this study was to identify the latent class for changes in health behavior due to COVID-19, reveal the characteristics of participants by type, and identify predictive factors for these types. The participants of this study were office workers between the ages of 40 and 60 and secondary data from the 2020 Community Health Survey of G city was utilized. Latent class analysis was performed on physical activities such as walking and exercise, eating fast food or carbonated drinks, eating delivered food, drinking alcohol, and smoking. Three types of health behavior changes due to COVID-19 were found: (1) decrease in all health behavior type, (2) increase in fast food and delivered food type, and (3) increase in smoking maintenance type. Second, the variables predicting the three types after controlling for general characteristics were health problems, social distancing among the COVID-19 quarantine rules, refraining from going out, and meeting with friends and neighbors and had an impact on COVID-19 life. It is necessary to strengthen non-face-to-face health promotion activities along with quarantine rules for COVID-19. In addition, there is a need for a health management plan for people with non-visible risk factors such as obesity and high blood pressure.


Subject(s)
COVID-19 , Adult , Health Behavior , Humans , Latent Class Analysis , Middle Aged , Quarantine , Republic of Korea , SARS-CoV-2
8.
J Relig Health ; 61(2): 1684-1702, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1669905

ABSTRACT

The purpose of this study was to examine if religiousness has a mediation influence on the link between psychological resilience and fear of COVID-19. Data were collected from 372 participants by using the convenience sampling method. There is a positive significant relationship between psychological resilience and religiousness, a negative significant relationship between religiousness and fear of COVID-19, a negative significant relationship between psychological resilience and a fear of COVID-19. This study was tested with structural equation modeling and bootstrapping was applied. Significant relationships were found between psychological resilience, fear of COVID-19 and religiousness. In addition, it was found that religiousness had a mediating effect on the relationship between psychological resilience and fear of COVID-19. These results suggest that the inverse relationship between psychological resilience and fear of COVID-19 is at least partly explained by level of religiousness.


Subject(s)
COVID-19 , Resilience, Psychological , Fear , Humans , Latent Class Analysis , Turkey/epidemiology
9.
Schizophr Res ; 241: 122-129, 2022 03.
Article in English | MEDLINE | ID: covidwho-1665455

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, an increase in paranoid thinking has been reported internationally. The development of the Pandemic Paranoia Scale (PPS) has provided a reliable assessment of various facets of pandemic paranoia. This study aimed to (i) identify classes of individuals with varying levels of general paranoia and pandemic paranoia, and (ii) examine associations between classification and worry, core beliefs, and pro-health behaviours. METHODS: An international sample of adults (N = 2510) across five sites completed the Revised-Green Paranoid Thoughts Scale and the PPS. Latent class analysis (LCA) was conducted using these two paranoia variables. Classes were compared on trait worry (Penn State Worry Questionnaire), beliefs about self/others (Brief Core Schema Scales), and pro-health behaviour. RESULTS: Three latent classes emerged: Class 1 with low R-GPTS and PPS scores, Class 2 with a high R-GPTS score and a moderate PPS score, and Class 3 with high R-GPTS and PPS scores. Compared to Class 1, Classes 2-3 were associated with more worry and negative self- and other-beliefs. Class 3 was further characterised by greater positive-self beliefs and less engagement in pro-health behaviours. Engagement in pro-health behaviours was positively correlated with interpersonal mistrust and negatively correlated with paranoid conspiracy and persecutory threat. CONCLUSIONS: Individuals with a general paranoia tendency were more likely to respond to the global health threats in a suspicious and distrusting way. Our findings suggested that worry and negative self/other beliefs may contribute to not just general paranoia but also pandemic paranoia. The preliminary finding of a link between pro-health behaviours and interpersonal mistrust warrants further examination.


Subject(s)
COVID-19 , Pandemics , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Humans , Latent Class Analysis , Paranoid Disorders/diagnosis , Paranoid Disorders/epidemiology
10.
Int J Environ Res Public Health ; 19(3)2022 Jan 18.
Article in English | MEDLINE | ID: covidwho-1643598

ABSTRACT

It is well acknowledged that the roles of both school administrators and teachers have changed due to the global education crisis caused by COVID-19. During this challenging and critical period, it is essential to investigate how those working in the education sector who undertake strategic tasks for sustainable education are affected by the new conditions brought about by the COVID-19 pandemic. This study investigates the interrelationships between COVID-19 quality of life, loneliness, happiness, and Internet addiction. The research was designed according to the relational survey model, was conducted with 432 school administrators and teachers working in K-12 schools. The research data was collected through online questionnaires, and structural equation modelling (SEM) was used to test and analyze proposed hypotheses. The study's results revealed a positive relationship between the COVID-19 related quality of life and loneliness, and that loneliness significantly positively predicts Internet addiction. In this context, due to the impact of COVID-19 on the life quality, the participants' loneliness levels significantly increased, and this increase in loneliness caused them to become addicted to using the Internet. Interestingly, it was also determined that a positive relationship exists between loneliness and happiness and that as the loneliness of individuals increased, their level of happiness also increased. In many studies conducted prior to the COVID-19 pandemic, a negative relationship was revealed between loneliness and happiness. In the current study conducted during the pandemic, the relationship between the two variables was positive. SEM results revealed that COVID-19 directly affects the quality of life, Internet addiction, loneliness, and happiness of school administrators and teachers. Furthermore, it was determined that Internet addiction indirectly affects the relationship between loneliness and happiness.


Subject(s)
COVID-19 , Quality of Life , Happiness , Humans , Internet , Internet Addiction Disorder , Latent Class Analysis , Loneliness , Pandemics , SARS-CoV-2 , Schools
11.
Work ; 71(1): 19-29, 2022.
Article in English | MEDLINE | ID: covidwho-1636625

ABSTRACT

BACKGROUND: Virtual meetings have been widely utilized during the COVID-19 pandemic. OBJECTIVE: The purpose of this study was to explore the influence of organizational commitment on the perceived effectiveness of virtual meeting by Filipino professionals during the COVID-19 pandemic. METHODS: A total of 513 Filipino professionals answered an online questionnaire which covered four latent variables: organizational commitment to virtual meetings, attitude toward virtual meetings, perceived effectiveness of virtual meeting as collaboration tool, and perceived effectiveness of virtual meeting as a social tool. Structural Equation Modeling (SEM) was utilized to analyze the causal relationships between the latent variables construct. RESULTS: SEM showed that organizational commitment to virtual meeting during the COVID-19 pandemic influenced the positive attitude of the employees which subsequently led to the perceived effectiveness of virtual meeting as a collaboration and social tool. CONCLUSIONS: This study is the first study that analyzed the influence of organizational commitment on the perceived effectiveness of virtual meeting during the COVID-19 pandemic in the Philippines. Our SEM construct can be applied and extended further, particularly in analyzing factors influencing the perceived effectiveness of virtual meeting during the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Humans , Latent Class Analysis , Pandemics/prevention & control , SARS-CoV-2 , Surveys and Questionnaires
12.
BMC Psychiatry ; 21(1): 548, 2021 11 09.
Article in English | MEDLINE | ID: covidwho-1599455

ABSTRACT

BACKGROUND: Premenstrual Syndrome (PMS) is a cyclic sequence of physical and behavioral symptoms that arise in the second half of the menstrual cycle. The extreme type of PMS is Premenstrual Dysphoric Disorder (PMDD). The current study aims at examining 1) the effects of childhood maltreatment and current life's stressful events on PMDD, and 2) the mediating role of depression in these associations among Lebanese university female students. METHODS: This cross-sectional study was conducted between February and March 2021 during the COVID-19 pandemic. Lebanese students were recruited using a snowball technique from all national universities in Lebanon via an auto-administrated online survey. Structural equation modeling was performed to examine the structural relationship between childhood maltreatment and life's stressful events, depression and PMDD. RESULTS: Higher life's stressful events (Beta = 0.18; p < 0.001), physical (Beta = 0.19; p < 0.001), sexual (Beta = 0.18; p < 0.001) and psychological (Beta = 0.33; p < 0.001) abuse were significantly associated with higher depression. Moreover, higher sexual (Beta = 0.11; p = 0.021) and psychological (Beta = 0.11; p = 0.040) abuse and higher depression (Beta = 0.37; p < 0.001) were significantly associated with higher PMDD. The indirect relationships between psychological abuse/sexual abuse, depression and PMDD showed that depression mediated the association between both psychological (Beta = 0.22; p = 0.001) and sexual (Beta = 0.38; p = 0.004) abuse and PMDD. CONCLUSION: This work presents a unique analysis using the structural equation model that enlightens the effect of childhood maltreatment, particularly sexual and psychological abuse on PMMD symptoms, with depression playing the role of a mediating factor. It would be interesting to test, in future studies, whether there are other mediating factors besides depression that could be indirect indicators of PMDD.


Subject(s)
COVID-19 , Child Abuse , Premenstrual Dysphoric Disorder , Adult , Child , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Latent Class Analysis , Pandemics , Premenstrual Dysphoric Disorder/epidemiology , SARS-CoV-2 , Students , Universities
13.
Int J Environ Res Public Health ; 19(1)2021 12 23.
Article in English | MEDLINE | ID: covidwho-1580846

ABSTRACT

In order to prevent the spread of coronavirus disease 2019 (COVID-19), 52.4% of the world population had received at least one dose of a vaccine at17 November 2021, but little is known about the non-pharmaceutical aspect of vaccination. Here we empirically examine the impact of vaccination on human behaviors and COVID-19 transmission via structural equation modeling. The results suggest that, from a non-pharmaceutical perspective, the effectiveness of COVID-19 vaccines is related to human behaviors, in this case, mobility; vaccination slows the spread of COVID-19 in the regions where vaccination is negatively related to mobility, but such an effect is not observed in the regions where vaccination and mobility have positive correlations. This article highlights the significance of mobility in realizing the effectiveness of COVID-19 vaccines; even with large-scale vaccination, non-pharmaceutical interventions, such as social distancing, are still required to contain the transmission of COVID-19.


Subject(s)
COVID-19 , COVID-19 Vaccines , Humans , Latent Class Analysis , SARS-CoV-2 , Vaccination
14.
Int J Environ Res Public Health ; 18(24)2021 12 16.
Article in English | MEDLINE | ID: covidwho-1580734

ABSTRACT

Service satisfaction with public policies is an important component of public service quality management, which is of great significance to the improvement of public service quality. Based on an online questionnaire survey and in combination with the characteristics of public policies and services, in this study the influencing factors of residents' satisfaction with COVID-19 pandemic prevention services were analyzed with structural equation modeling. The results reveal that the data fit the model well, and all the hypotheses formulated in this study were supported. Among the factors that were found to directly affect residents' satisfaction with pandemic prevention services, perceived quality (PQ) has the greatest impact on satisfaction, followed by the disaster situation (DS) and policy expectation (PE). The observed variables that have significant impacts on the latent variables were also explored. Regarding the main findings, the residents who were seriously affected by the pandemic tended to have lower satisfaction with the policies and services provided by the government. Moreover, the improvement of PQ was found to significantly increase pandemic prevention service satisfaction (SS). Finally, the residents with a good psychological status during the pandemic were found to have higher satisfaction. According to the results, implications for the prevention and control practices of similar public health emergencies are proposed.


Subject(s)
COVID-19 , Personal Satisfaction , China , Humans , Latent Class Analysis , Pandemics , Patient Satisfaction , SARS-CoV-2
15.
J Med Internet Res ; 23(2): e22841, 2021 02 23.
Article in English | MEDLINE | ID: covidwho-1574897

ABSTRACT

BACKGROUND: Misdiagnosis, arbitrary charges, annoying queues, and clinic waiting times among others are long-standing phenomena in the medical industry across the world. These factors can contribute to patient anxiety about misdiagnosis by clinicians. However, with the increasing growth in use of big data in biomedical and health care communities, the performance of artificial intelligence (Al) techniques of diagnosis is improving and can help avoid medical practice errors, including under the current circumstance of COVID-19. OBJECTIVE: This study aims to visualize and measure patients' heterogeneous preferences from various angles of AI diagnosis versus clinicians in the context of the COVID-19 epidemic in China. We also aim to illustrate the different decision-making factors of the latent class of a discrete choice experiment (DCE) and prospects for the application of AI techniques in judgment and management during the pandemic of SARS-CoV-2 and in the future. METHODS: A DCE approach was the main analysis method applied in this paper. Attributes from different dimensions were hypothesized: diagnostic method, outpatient waiting time, diagnosis time, accuracy, follow-up after diagnosis, and diagnostic expense. After that, a questionnaire is formed. With collected data from the DCE questionnaire, we apply Sawtooth software to construct a generalized multinomial logit (GMNL) model, mixed logit model, and latent class model with the data sets. Moreover, we calculate the variables' coefficients, standard error, P value, and odds ratio (OR) and form a utility report to present the importance and weighted percentage of attributes. RESULTS: A total of 55.8% of the respondents (428 out of 767) opted for AI diagnosis regardless of the description of the clinicians. In the GMNL model, we found that people prefer the 100% accuracy level the most (OR 4.548, 95% CI 4.048-5.110, P<.001). For the latent class model, the most acceptable model consists of 3 latent classes of respondents. The attributes with the most substantial effects and highest percentage weights are the accuracy (39.29% in general) and expense of diagnosis (21.69% in general), especially the preferences for the diagnosis "accuracy" attribute, which is constant across classes. For class 1 and class 3, people prefer the AI + clinicians method (class 1: OR 1.247, 95% CI 1.036-1.463, P<.001; class 3: OR 1.958, 95% CI 1.769-2.167, P<.001). For class 2, people prefer the AI method (OR 1.546, 95% CI 0.883-2.707, P=.37). The OR of levels of attributes increases with the increase of accuracy across all classes. CONCLUSIONS: Latent class analysis was prominent and useful in quantifying preferences for attributes of diagnosis choice. People's preferences for the "accuracy" and "diagnostic expenses" attributes are palpable. AI will have a potential market. However, accuracy and diagnosis expenses need to be taken into consideration.


Subject(s)
Artificial Intelligence , Diagnosis , Patient Preference , Physicians , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , China , Choice Behavior , Diagnostic Techniques and Procedures/economics , Female , Health Expenditures , Humans , Latent Class Analysis , Logistic Models , Male , Middle Aged , Pandemics , SARS-CoV-2 , Surveys and Questionnaires , Time Factors , Young Adult
16.
Am J Orthopsychiatry ; 92(1): 121-132, 2022.
Article in English | MEDLINE | ID: covidwho-1574342

ABSTRACT

Information is needed on the relationship between coronavirus disease (COVID-19) social distancing restrictions and their relationship with mental health. In particular, there is limited investigation into how COVID-related adversities have positively mobilized individuals. We use latent class analysis (LCA) to identify subtypes of positive and negative aspects of the experience of COVID-19 social distancing and the association of these subtypes with mental health. We conduct an online survey of COVID-19 and mental health with 3,183 adults residing in Quebec, Canada, during the first wave of the epidemic. We use LCA to identify subtypes of positive and negative aspects of social distancing. We use logistic and linear regression to estimate the associations between class membership and self-reported impact of COVID-19 on mental health and scores on the Hopkins Symptom Checklist-10 (HSCL-10). We identify five classes of individuals in regards to perceived positives and negatives of social distancing related to COVID-19, named Low Impact, Freedom/Flexibility, Safety, Family/Home, and Hardships. Sociodemographic variables including age, gender, race/ethnicity, and self-reported mental health prior to COVID are associated with class assignment. Latent classes are associated with both outcomes (p < .001). Individuals in the Hardships class have greater odds of reporting a significant impact of COVID-19 on mental health, OR = 2.09, 95% CI = [1.53, 2.86], p < .001, and have higher scores on the HSCL-10, ß = .32, 95% CI = [.23, .42], p < .001, than those individuals in the Low Impact group after adjusting for sociodemographic characteristics. Gender, age, and self-reported mental health prior to COVID-19 are independently associated with both outcomes (p < .001). We discuss study implications for public health programming and interventions to promote the mental health of at-risk populations during the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
COVID-19 , Mental Health , Adult , Humans , Latent Class Analysis , Physical Distancing , SARS-CoV-2 , Self Report
17.
J Adolesc Health ; 70(1): 48-56, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1559813

ABSTRACT

PURPOSE: This study characterized the unobserved patterns in crisis response among youth in the U.S. from March to December 2020 and determined the characteristics of vulnerable subgroups who were at increased risk for suicide due to the pandemic. METHODS: A latent class analysis of crisis support-seeking from a national text-based crisis platform, (n = 179,497, aged 24 years or younger) for 11 crisis concerns (e.g., depression, anxiety/stress, suicidal thoughts, isolation, abuse, bereavement, relationships) was performed on three study periods: (1) January 2017 to December 2020, (2) prepandemic: 1 January 2017 to 12 March 2020, and (3) pandemic: 13 March to 20 December 2020. Demographic characteristics (age, race/ethnicity, sexual orientation, and gender identity) were used as predictors for class membership using the three-step method. RESULTS: Four latent classes were identified: (1) depression/isolation/self-harm (D/I/S) (18,694 texters, 10.4%), (2) interpersonal stress/mood-anxiety (I/M) (32,640 texters, 18.2%), (3) suicidal thoughts/depressed (S/D) (34,067, 19.0%), and (4) adjustment/stress (A/S) (94,096 texters, 52.4%). During the pandemic, an increase in suicidal thoughts and active rescues occurred in the D/I/S and S/D higher-risk subclasses. Characteristics of vulnerable groups in higher-risk classes since the pandemic included children, LGBTQ, American Indian, White, Black, Asian, female, and gender-nonconforming youth. CONCLUSIONS: Results identified a strong association with class membership in more severe risk classes during the pandemic and an increase in suicidal help-seeking, particularly among children and LGBTQ youth. Low-cost and targeted crisis text-based platforms for support-seeking in youth may be one potential safety net strategy to address the effects of the COVID-19 pandemic on mental health in youth.


Subject(s)
COVID-19 , Adolescent , Child , Female , Gender Identity , Humans , Latent Class Analysis , Male , Pandemics , SARS-CoV-2 , Suicidal Ideation
18.
Am J Respir Crit Care Med ; 204(11): 1274-1285, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1546620

ABSTRACT

Rationale: Two distinct subphenotypes have been identified in acute respiratory distress syndrome (ARDS), but the presence of subgroups in ARDS associated with coronavirus disease (COVID-19) is unknown. Objectives: To identify clinically relevant, novel subgroups in COVID-19-related ARDS and compare them with previously described ARDS subphenotypes. Methods: Eligible participants were adults with COVID-19 and ARDS at Columbia University Irving Medical Center. Latent class analysis was used to identify subgroups with baseline clinical, respiratory, and laboratory data serving as partitioning variables. A previously developed machine learning model was used to classify patients as the hypoinflammatory and hyperinflammatory subphenotypes. Baseline characteristics and clinical outcomes were compared between subgroups. Heterogeneity of treatment effect for corticosteroid use in subgroups was tested. Measurements and Main Results: From March 2, 2020, to April 30, 2020, 483 patients with COVID-19-related ARDS met study criteria. A two-class latent class analysis model best fit the population (P = 0.0075). Class 2 (23%) had higher proinflammatory markers, troponin, creatinine, and lactate, lower bicarbonate, and lower blood pressure than class 1 (77%). Ninety-day mortality was higher in class 2 versus class 1 (75% vs. 48%; P < 0.0001). Considerable overlap was observed between these subgroups and ARDS subphenotypes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR cycle threshold was associated with mortality in the hypoinflammatory but not the hyperinflammatory phenotype. Heterogeneity of treatment effect to corticosteroids was observed (P = 0.0295), with improved mortality in the hyperinflammatory phenotype and worse mortality in the hypoinflammatory phenotype, with the caveat that corticosteroid treatment was not randomized. Conclusions: We identified two COVID-19-related ARDS subgroups with differential outcomes, similar to previously described ARDS subphenotypes. SARS-CoV-2 PCR cycle threshold had differential value for predicting mortality in the subphenotypes. The subphenotypes had differential treatment responses to corticosteroids.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , COVID-19/drug therapy , Latent Class Analysis , Respiratory Distress Syndrome/drug therapy , Aged , COVID-19/complications , Cohort Studies , Female , Humans , Male , Middle Aged , Respiratory Distress Syndrome/classification , Respiratory Distress Syndrome/etiology , Retrospective Studies
19.
J Womens Health (Larchmt) ; 31(3): 321-330, 2022 03.
Article in English | MEDLINE | ID: covidwho-1541501

ABSTRACT

Background: For faculty in academic health sciences, the balance between research, education, and patient care has been impeded by the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to identify personal and professional characteristics of faculty to understand the impact of the pandemic on faculty and consequent policy implications. Methods: A 93-question survey was sent to faculty at a large urban public university and medical center. Demographic, family, and academic characteristics, work distribution and productivity before and during the pandemic, stress, and self-care data information were collected. Latent class analysis (LCA) was performed to identify classes of faculty sharing similar characteristics. Comparisons between latent classes were performed using analysis of variance and chi-square analyses. Results: Of 497 respondents, 60% were women. Four latent classes of faculty emerged based on six significant indicator variables. Class 1 individuals were more likely women, assistant professors, nontenured with high work and home stress; Class 2 faculty were more likely associate professors, women, tenured, who reported high home and work stress; Class 3 faculty were more likely men, professors, tenured with moderate work, but low home stress; and Class 4 faculty were more likely adjunct professors, nontenured, and had low home and work stress. Class 2 reported significantly increased administrative and clinical duties, decreased scholarly productivity, and deferred self-care. Conclusions: The pandemic has not affected faculty equally. Early and mid-career individuals were impacted negatively from increased workloads, stress, and decreased self-care. Academic leaders need to acknowledge these differences and be inclusive of faculty with different experiences when adjusting workplace or promotion policies.


Subject(s)
COVID-19 , Career Mobility , Faculty, Medical , Female , Humans , Latent Class Analysis , Male , Pandemics , SARS-CoV-2 , Work-Life Balance
20.
Work ; 70(2): 365-376, 2021.
Article in English | MEDLINE | ID: covidwho-1538351

ABSTRACT

BACKGROUND: Dentistry is one of the highest risk occupations that face COVID-19, especially in countries that are severely affected by the pandemic, such as Indonesia. OBJECTIVE: The purpose of the study was to determine factors influencing job satisfaction among dentists during the new normal of COVID-19 pandemic in Indonesia by utilizing the Structural Equation Modeling (SEM) approach. METHODS: A total of 310 Indonesian dentists voluntary completed an online questionnaire, which contained 58 questions. Several latent variables such as perceived severity of COVID-19, staff cooperation and management commitment, personal protective equipment, job stress, working hours, income, and overall job satisfaction were analyzed simultaneously. RESULTS: SEM revealed perceived severity of COVID-19 had significant effects on job stress (ß:0.394, p = 0.025) and the utilization of personal protective equipment (ß:0.757, p = 0.001). Subsequently, job stress (ß:-0.286, p = 0.001), working hours (ß:0.278, p = 0.018), income (ß:0.273, p = 0.003), personal protective equipment (ß:0.145, p = 0.038), and staff cooperation & management commitment (ß:0.091, p = 0.002) were found to have significant effects on overall job satisfaction. In addition, management & staff cooperation was found to have a significant association with job stress reduction (ß:-0.319, p = 0.003) which subsequently led to higher satisfaction. CONCLUSIONS: The current study is one of the first that analyzed job satisfaction among dentists in Indonesia during the global COVID-19 pandemic. The integrated latent variables can be applied and extended to evaluate job satisfaction among dentists during the COVID-19 pandemic in other countries. Finally, this study contributed as a theoretical foundation for policymakers to enhance the job satisfaction of dentists during the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Dentists , Humans , Indonesia/epidemiology , Job Satisfaction , Latent Class Analysis , SARS-CoV-2 , Surveys and Questionnaires
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