ABSTRACT
BackgroundDiscrimination has been identified as an important determinant of negative mental health outcomes. This study determined the association between the experience of COVID-19-related discrimination and psychological distress among healthcare workers (HCWs) in Japan. MethodsThis cross-sectional study conducted a health survey among 5,703 HCWs of six national medical and research centers in Japan from October 2020 to March 2021. COVID-19-related discrimination was defined either when participants or their family members were badmouthed or when they felt discriminated against in some way. We used the Kessler Psychological Distress Scale (K6) to assess the presence of severe psychological distress ([≥]13 points). We used logistic regression models to examine the association between discrimination and psychological distress. We also identified job-related factors associated with discrimination. ResultsOf the participants, 484 (8.4%) reported COVID-19-related discrimination and 486 (8.5%) had severe psychological distress. HCWs who were female vs. male (odds ratio [OR]=1.41, 95% confidence interval [CI]=1.28-1.55), had high vs. low viral exposure (OR=2.31, 95%CI=1.81-2.93), and worked for more than 10 hours/day vs. <8 hours/day (OR=1.42, 95%CI=1.35-1.49) were more likely to have experienced COVID-19-related discrimination. The OR (95%CI) of severe psychological distress was 1.83 (1.29-2.59) among those who experienced discrimination. The analysis was stratified by sociodemographic and job-related factors and the associations trended in the same direction across subgroups. ConclusionExperience of COVID-19-related discrimination was associated with severe psychological distress among HCWs. During the pandemic, effective measures should be taken to prevent the development of negative mental health outcomes in HCWs who experience discrimination.
ABSTRACT
Election campaigns and polling stations might be areas of potential infections; however, it is unknown whether elections can impact the spread of coronavirus disease (COVID-19). This study aimed to evaluate the association between election process and COVID-19 infection in Japan. Quasi-experimental design using time-series COVID-19 cases data with an election intervention. We chose the cities where elections for major and/or city/ward assembly members were held in 2021 January in Japan. The study period for each city spans one weeks before the start date of the election campaign and three weeks after the voting day (36 days). The daily number of patients testing positive for COVID-19. We used Poisson regression analysis with sandwich estimator to evaluate the association between election and the spread of COVID-19 infections. For Miyakojima City, we assessed the relationship between election and COVID-19 infections by using the Box-Jenkins autoregressive integrated moving average (ARIMA) model. We also estimated the instantaneous reproduction number (Rt) in the city. There were 17 cities that met the inclusion criteria. In all models with three types of different lag effects (i.e., 4, 9, and 14 days), election was not a significant predictor of COVID-19 infections in the 17 cities. For Miyakojima City, the autoregressive integrated moving average (0, 0, 0) with a lag of 14 (=14) was the best model. The partial coefficient ({omega}) of the election was 11.91 (95% confidence interval: 3.10-20.72, P<0.001), indicating that the election was associated with an increase in the number of COVID-19 cases 14 days after the election campaign (mean: 12 cases/day). Rt hovered far above 1 during and after the election campaign in Miyakojima. Although elections were associated with an increased number of COVID-19 cases in Miyakojima, this association was not verified in the analysis including all 17 cities. Therefore, if preventive measures prescribed by election guidelines are followed, elections do not necessarily relate to a spread of COVID-19 as long as the election process does not involve activities necessitating close contact.
ABSTRACT
BACKGROUND@#How community-based group resistance exercises affect the transition from robustness to frailty remains unclear. Thus, we conducted a retrospective cohort study to determine whether the trajectory from robustness to frailty over age differed depending on the duration of participation in group exercises.@*METHODS@#We analyzed the Kihon Checklist (KCL) score of community-dwelling elderly residents of Sumoto city, Hyogo prefecture, who participated in community-based group resistance exercises between April 2010 and December 2019. Finally, 2567 older individuals were analyzed using multilevel modeling. The explanatory variables of interest were the frailty score measured using the KCL for each individual, where 0-3, 4-7, and ≥8 points denoted robustness, pre-frailty, and frailty, respectively. We considered age, sex, systolic blood pressure, pulse, duration of participation, and change in KCL score from baseline as possible confounders. Participants were classified as follows based on the duration of participation in the exercises: <3 times, short-term participation group; 4-6 times; mid-term participation group; and 7-13 times, long-term participation group. The mean duration from the baseline physical test for the total sample was 2.35 years (SD=2.51).@*RESULTS@#The participants' mean total KCL score at baseline was 4.9±3.7. Multilevel modeling analysis revealed that the KCL scores changed by 0.82 points for each additional year of age (p<0.001) and changed by - 0.93 points for long-term participate group (p<0.001). The Estimated Marginal Means (EMM) of the KCL score was 3.98 (95%CI: 3.69, 4.28) points in the short-term participation group and was significantly worse than that of the long-term participation group at 70 years of age (p=0.001). The EMM was 4.49 (95%CI: 4.24, 4.74) at 75 years of age in the mid-term participation group and was significantly worse than that of the long-term participation group. The EMM was 3.87 (95%CI: 3.57, 4.16) in the long-term participation group and significantly better than that of the short-term (p<0.001) and mid-term (p=0.002) participation groups.@*CONCLUSION@#Participation in community-based group resistance exercises prolongs the transition from robustness to frailty. The improved KCL scores at baseline in the long-term participation group remained in the robust range at 75 years of age, which suggests the importance of initiating participation before the onset of functional decline.
