Self-reported health behaviors and risk perceptions following the COVID-19 vaccination rollout in the USA: an online survey study.

OBJECTIVES: Concerns have been raised that mass vaccination campaigns might lead to reduced engagement with other recommended health behaviors. We assessed self-reported behaviors and risk perceptions following the COVID-19 vaccine rollout in the USA. STUDY DESIGN: Between December 2, 2020, and March 23, 2021, we conducted three online survey studies with US adult respondents. METHODS: Respondents self-reported their COVID-19 vaccination status, their frequency of engaging in risk-increasing behaviors and wearing a mask when in public places, and their COVID-19 risk perceptions (i.e., perceived likelihood of getting COVID-19 and of being hospitalized if they got COVID-19). RESULTS: Our analytical sample included 832 respondents who had completed the first and final surveys and had received either 0 or 2 doses of a COVID-19 vaccine. Most respondents were non-Hispanic White (75%), male (77%), and US Veterans (64%), with the median age between 55 and 74 years. Overall, respondents reported frequently wearing masks when in public and rarely engaging in risk-increasing behaviors. Regardless of vaccination status, respondents reported more frequently engaging in risk-increasing behaviors and lower risk perceptions in March 2021 than in December 2020. Mask wearing did not change over the study period, with vaccinated respondents consistently reporting more frequent mask wearing than unvaccinated respondents. CONCLUSIONS: Taken together, our findings indicate that the COVID-19 vaccine rollout in the USA did not result in the rapid abandonment of protective behaviors or dramatic uptake of risk-increasing behaviors. Additional studies are needed to monitor how mass vaccination might impact public behaviors and risk perceptions as coverage widens.

Management of advanced ovarian cancer in South West Wales - a comparison between primary debulking surgery and primary chemotherapy treatment strategies in an unselected, consecutive patient cohort.

OBJECTIVES: This study represents the first reported outcomes for patients with advanced ovarian cancer (AOC) in South-West Wales undergoing treatment with primary debulking surgery or primary chemotherapy respectively. METHODS: This is a retrospective study of consecutive, unselected patients with advanced ovarian, fallopian tube or primary peritoneal cancer (FIGO III/IV) presenting to a regional cancer centre between October 2007 and October 2014. Patients were identified from Welsh Cancer Services records and relevant data was extracted from electronic National Health Service (NHS) databases. Main outcome measures were median overall survival (OS), progression free survival (PFS) and perioperative adverse events. Hazard ratio estimation was carried out with Cox Regression analysis and survival determined by Kaplan-Meier plots. RESULTS: Of 220 women with AOC, 32.3% underwent primary debulking surgery (PDS) and 67.7% primary chemotherapy and interval debulking (PCT-IDS). Patients were often elderly (median age 67 years) with a poor performance status (26.5% PS >1). Complete cytoreduction (0cm residual) was achieved in 32.4% of patients in the PDS group and in 50.0% of patients undergoing IDS. Median OS for all patients was 21.9 months (PDS: 27.0 and PCT-IDS: 19.2 months; p >0.05) and median PFS was 13.1 months (PDS: 14.3 months and PCT-IDS: 13.0 months; p >0.05). Median overall and progression free survival for patients achieving complete cytoreduction were 48.0 and 23.2 months respectively in the PDS group and 35.4 months and 18.6 months in the IDS group (p >0.05). CONCLUSION: This retrospective study of an unselected, consecutive cohort of women with AOC in South West Wales shows comparable survival outcomes with recently published trials, despite the relatively advanced age and poor performance status of our patient cohort. Over the seven-year study period, our data also demonstrated a non-significant trend towards improved survival following primary surgery in patients who achieved maximal cytoreduction. Our future aim therefore is to examine and develop the role of extended surgery in these patients.

Relationships between self-reported physical activity and physical fitness in active men.

We examined relationships between self-reported physical activity and physical fitness in a group of 202 male military officers, 36 to 51 years of age. Physical activity was estimated from the Minnesota Leisure Time Physical Activity Questionnaire and classified as heavy, moderate, or light depending on the intensity of individual activities. Directly measured components of physical fitness included aerobic capacity (treadmill walking peak VO2), body composition (densitometry), muscle strength (isokinetic mode), and flexibility (bend-and-reach test). Both total and heavy activity were significantly (P < .05) related to aerobic capacity, body fat, fat-free mass, upper body strength, and flexibility. Moderate and light activity were not related to the fitness measures. We divided subjects into quartiles of physical activity and corrected the fitness measures for age and cigarette smoking status. Subjects with more total and heavy activity had higher aerobic capacity and lower body fat; subjects with more heavy activity also had greater upper body strength. Again, moderate and low activity were not related to any fitness measure. These data indicate that heavy physical activity is related to various components of physical fitness even after correction for age and smoking status in a group of men who are healthy, generally very active, and fit.

Physiologic benefits of a stress reduction program for healthy middle-aged Army officers.

Stress reduction programs (SRPs) can reduce morbidity and mortality in patients with coronary artery disease (CAD). This study evaluated the effect of an SRP on metabolic and hormonal risk factors for CAD. Twenty army officers participating in an SRP, Group I, and a comparison group of seventeen SRP nonparticipants, Group C, volunteered to undergo measurement of dehydroepiandrosterone-sulfate (DHEA-S), cortisol, DHEA-S/cortisol ratio, testosterone, apolipoprotein-A1, apolipoprotein-B, triglycerides, cholesterol, fibrinogen, and leukocyte count both before and after the SRP period. No differences in the changes in biochemical risk factors for CAD were found between participant and nonparticipant except for DHEA-S. While Group C had a marked reduction in DHEA-S levels, Group I had a small increase. Previous studies indicate DHEA-S is inversely associated with extent of CAD and age-adjusted DHEA-S levels below 3.78 mumol/l confer an increased risk for CAD mortality. SRP participation appears to effect DHEA-S levels, possibly partially accounting for the benefits observed in SRPs among CAD patients.

Psychological and behavioral benefits of a stress/type A behavior reduction program for healthy middle-aged army officers.

Twenty army officers who participated in a stress/type A behavior reduction program and a comparison group of 17 officer nonparticipants volunteered to undergo a battery of psychological and behavioral tests before and after the program. Following the program, participants displayed a significantly greater reduction in average daily caloric intake and levels of perceived stress, anxiety, hostility, depression, psychological distress, and type A behavior as compared to the officers who did not participate in it. Given the fact that most of these psychological and behavioral factors have been found in previous studies to be related to an increased risk for coronary artery disease, it seems that the changes reported by the participants in the program are potentially healthful.

Physiological factors in infantry operations.

Male infantry soldiers (n = 34) were studied before, during, and after a 5-day simulated combat exercise. During the exercise, subjects were rated on their field performance by senior infantry non-commissioned officers. Prior to the exercise, direct measures of body composition and maximal oxygen uptake were obtained. Before and after the exercise the Army Physical Fitness Test and various measures of anaerobic capacity (Wingate and Thorstensson tests) and muscular strength (isometric and isokinetic) were obtained. Results showed no significant decrement in field performance during the exercise. Upper-body anaerobic capacity and strength declined following the exercise, although the results for upper-body strength were not consistent on all measures. Field performance was significantly correlated with measures of upper-body anaerobic capacity and strength. Upper-body strength and anaerobic capacity appear to be important for infantry operations and subject to declines during combat operations.

Reduction in type A behavior in healthy middle-aged American military officers.

One hundred eighteen senior officer-students of the U.S. Army War College who were healthy but exhibited type A behavior volunteered to be randomly selected and enrolled into (1) a section of 62 officers who received group type A behavior counseling for 9 months and (2) a control section of 56 officers who received no counseling of any kind. Marked or profound reduction in type A behavior at the end of 9 months was observed in 41.9% of the 62 participants who initially were enrolled to receive type A counseling; marked or profound reduction in type A behavior, however, was observed in only 8.9% of the 56 initially enrolled control subjects. No adverse effects on the military leadership qualities of type A counseled participants were observed by their classmates. Serum total cholesterol and plasma high-density lipoprotein (HDL) cholesterol measurements were obtained monthly. The serum cholesterol of the total cohort of subjects rose significantly during a month of considerable emotional tension and stress. Those subjects who underwent a profound reduction in the intensity of their type A behavior pattern also exhibited a significantly lower serum cholesterol value as the study continued than those subjects who exhibited no change in their type A behavior. No significant changes in plasma HDL cholesterol concentrations were observed in the total cohort during the above-mentioned period of stress, nor were any differences in this particular measurement noted between the type A counseled and the control participants.