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1.
Heliyon ; 10(10): e31328, 2024 May 30.
Article in English | MEDLINE | ID: mdl-38818142

ABSTRACT

Although the COVID-19 mortality rate is declining, the number of individuals dealing with persistent COVID-19 symptoms is increasing worldwide, making long COVID a global public health concern. People with long COVID (long haulers) often deal with physical and mental stressors. Long haulers' psychological resilience could play a key role in coping with these stressors in intercorrelation with psychosocial resources. The current study aims to test a hypothesized relationship between social support and its functions (i.e., instrumental and emotional) and the resilience of long haulers through serial mediation by personal mastery and self-esteem. A cross-sectional and self-administered online survey was conducted among 460 individuals with long COVID recruited from COVID-19 Facebook support groups in the United States. Analyzing data indicated a positive correlation between social support and the resilience of long haulers. Structural equation modeling suggested that self-esteem and personal mastery fully mediated the association between social (instrumental) support and resilience. Personal mastery also mediated the association between self-esteem and resilience in social (instrumental) support models. However, in the emotional support model, the indirect effect was non-significant for the mediation by personal mastery and self-esteem. Findings suggest that social support, mainly instrumental support, may protect long haulers by promoting their resilience through self-esteem and personal mastery. This study emphasizes the importance of including social support services in designing programs for COVID-19 long haulers.

2.
Res Sq ; 2024 Mar 29.
Article in English | MEDLINE | ID: mdl-38586017

ABSTRACT

Introduction: The accessibility of social media (e.g., Facebook groups) presents long-haulers with the ability to connect with others with similar experiences and symptomology that are likely outside of their physical social networks. Social media sites may serve as promising platforms for research recruitment, public health campaigns, or interventions. The present study aims to assess, and comprehensively present, the effectiveness of a low-cost approach to recruitment through groups on Facebook within the context of a broader study of COVID-19 long-haulers. Methods: Facebook groups were searched using a variety of COVID-related terminology and included if they were in English, COVID-19 specific, public, and have or were approaching 1,000 or more members. Group administrators were either contacted for permission to post recruitment materials or posts were made and left pending administrator approval, depending on group settings. Group members were able to follow a link to the online survey platform (i.e., RedCap) where they provided informed consent and completed an online assessment of their COVID-19 experiences and psychosocial wellbeing. Upon survey completion participants were able to opt-in to a raffle-based incentive. The characteristics of the Facebook groups and demographic background of participants were assessed. Findings: Contacting administrators and posts made between January and March of 2022 within 17 COVID-19 specific groups yielded a sample size of 460 long-haulers. The groups relied upon for recruitment had a mean size of 21,022 (SD=45,645.3), most had three or more administrators (43%), and a majority were state specific (60%). The long-hauler participants enrolled from the posts had an average age of 32 years (SD=6.19), approximately split between men (48.91%) and women (50.22%), a majority white (70%), having earned a bachelor's or postgraduate degree (63.48%), and reporting an annual income between $50,000 and $100,000 (56.09%). Discussion: The present study presents strengths and recommendations for survey recruitment through Facebook groups as a low-cost recruitment strategy that is easily targeted to populations with a specific health condition and allows users to complete online psycho-behavioral assessments off-site on a HIPPA compliant survey platform.

3.
AIDS Care ; : 1-10, 2024 Apr 16.
Article in English | MEDLINE | ID: mdl-38623601

ABSTRACT

This study examined associations between perceived discrimination, treatment adherence self-efficacy, and depressive symptoms among people living with HIV (PLHIV) in the Southern United States. Cross-sectional survey data were collected from 402 PLHIV who self-reported on interpersonal discrimination experiences based on HIV status, sexuality, gender, income, and living condition. Participants also reported on adherence self-efficacy and depressive symptoms. We employed K-means clustering to identify groups based on discrimination experiences, and logistic regressions to examine group differences on adherence self-efficacy and depressive symptoms. Results suggested three groups: a cluster with high perceived discrimination across all identities/conditions (n = 41; 11%; Cluster 1); a cluster with high perceived discrimination based on HIV status, income, and living condition (n = 49; 13%; Cluster 2); and a cluster with low perceived discrimination across all identities/conditions (n = 288; 76%; Cluster 3). Compared to Cluster 3, Cluster 1 and 2 had 2.22 times (p = .037) and 3.98 times (p<.001) greater odds of reporting depressive symptoms. Compared to Cluster 3, Cluster 2 had 3.40 times (p = .003) greater odds of reporting lower adherence self-efficacy. Findings demonstrate the need for individual-level support for PLHIV with discrimination histories, and broader efforts to end the stigma, discrimination, and marginalization of PLHIV based on HIV status and other characteristics.

4.
AIDS Behav ; 28(5): 1673-1683, 2024 May.
Article in English | MEDLINE | ID: mdl-38334862

ABSTRACT

Prescription opioid misuse (POM) among people living with HIV (PLWH) is a serious concern due to risks related to dependence and overdose, and PLWH may be at higher risk for POM due to psychosocial stressors including psychological distress. However, scant POM research has examined the role of HIV-related stigma (e.g., internalized stigma, enacted stigma) in POM among PLWH. Guided by minority stress theory, this study examined a hypothesized serial mediation among enacted stigma, internalized stigma, psychological distress, and POM within a sample of Chinese PLWH with pain symptoms enrolled in a wave (between November 2017 and February 2018) of a longitudinal cohort study in Guangxi (n = 116). Models were tested individually for six enacted stigma experiences, controlling for key demographic and health-related variables (e.g., CD4 + count). Results showed HIV-related workplace discrimination was the most common stigma experience (12%,) and 10.3% of PLWH reported POM. Indirect effect analyses showed that internalized stigma was indirectly associated with POM through psychological distress. Internalized stigma and psychological distress mediated the association between workplace discrimination and POM. Family discrimination, gossip, and healthcare discrimination were directly associated with POM. This study suggests that Chinese PLWH may engage in POM to cope with psychological distress that is rooted in HIV-related stigma and highlights the important context of workplace discrimination for PLWH. Implications for interventions to reduce POM among PLWH are discussed.


Subject(s)
East Asian People , HIV Infections , Opioid-Related Disorders , Psychological Distress , Social Stigma , Humans , Male , HIV Infections/psychology , Female , Adult , China/epidemiology , Middle Aged , Opioid-Related Disorders/psychology , Opioid-Related Disorders/epidemiology , Longitudinal Studies , Prescription Drug Misuse/psychology , Prescription Drug Misuse/statistics & numerical data , Analgesics, Opioid/therapeutic use , Stress, Psychological/psychology , Stress, Psychological/epidemiology
5.
J Cardiovasc Magn Reson ; 25(1): 74, 2023 Dec 07.
Article in English | MEDLINE | ID: mdl-38057820

ABSTRACT

BACKGROUND: Concerns about COVID-19 vaccination induced myocarditis or subclinical myocarditis persists in some populations. Cardiac magnetic resonance imaging (CMR) has been used to detect signs of COVID-19 vaccination induced myocarditis. This study aims to: (i) characterise myocardial tissue, function, size before and after COVID-19 vaccination, (ii) determine if there is imaging evidence of subclinical myocardial inflammation or injury after vaccination using CMR. METHODS: Subjects aged ≥ 12yrs old without prior COVID-19 or COVID-19 vaccination underwent two CMR examinations: first, ≤ 14 days before the first COVID-19 vaccination and a second time ≤ 14 days after the second COVID-19 vaccination. Biventricular indices, ejection fraction (EF), global longitudinal strain (GLS), late gadolinium enhancement (LGE), left ventricular (LV) myocardial native T1, T2, extracellular volume (ECV) quantification, lactate dehydrogenase (LDH), white cell count (WCC), C-reactive protein (CRP), NT-proBNP, troponin-T, electrocardiogram (ECG), and 6-min walk test were assessed in a blinded fashion. RESULTS: 67 subjects were included. First and second CMR examinations were performed a median of 4 days before the first vaccination (interquartile range 1-8 days) and 5 days (interquartile range 3-6 days) after the second vaccination respectively. No significant change in global native T1, T2, ECV, LV EF, right ventricular EF, LV GLS, LGE, ECG, LDH, troponin-T and 6-min walk test was demonstrated after COVID-19 vaccination. There was a significant WCC decrease (6.51 ± 1.49 vs 5.98 ± 1.65, p = 0.003) and CRP increase (0.40 ± 0.22 vs 0.50 ± 0.29, p = 0.004). CONCLUSION: This study found no imaging, biochemical or ECG evidence of myocardial injury or inflammation post COVID-19 vaccination, thus providing some reassurance that COVID-19 vaccinations do not typically cause subclinical myocarditis.


Subject(s)
COVID-19 , Myocarditis , Humans , Myocarditis/chemically induced , Myocarditis/diagnostic imaging , COVID-19 Vaccines/adverse effects , Contrast Media/adverse effects , Prospective Studies , Troponin T , Magnetic Resonance Imaging, Cine/adverse effects , COVID-19/prevention & control , COVID-19/complications , Predictive Value of Tests , Gadolinium , Magnetic Resonance Imaging/methods , Ventricular Function, Left , Magnetic Resonance Spectroscopy , Inflammation/complications , Vaccination/adverse effects
6.
J Pers Med ; 13(12)2023 Nov 24.
Article in English | MEDLINE | ID: mdl-38138870

ABSTRACT

Given the high death rate caused by high-risk prostate cancer (PCa) (>40%) and the reliability issues associated with traditional prognostic markers, the purpose of this study is to investigate planning computed tomography (pCT)-based radiomics for the long-term prognostication of high-risk localized PCa patients who received whole pelvic radiotherapy (WPRT). This is a retrospective study with methods based on best practice procedures for radiomics research. Sixty-four patients were selected and randomly assigned to training (n = 45) and testing (n = 19) cohorts for radiomics model development with five major steps: pCT image acquisition using a Philips Big Bore CT simulator; multiple manual segmentations of clinical target volume for the prostate (CTVprostate) on the pCT images; feature extraction from the CTVprostate using PyRadiomics; feature selection for overfitting avoidance; and model development with three-fold cross-validation. The radiomics model and signature performances were evaluated based on the area under the receiver operating characteristic curve (AUC) as well as accuracy, sensitivity and specificity. This study's results show that our pCT-based radiomics model was able to predict the six-year progression-free survival of the high-risk localized PCa patients who received the WPRT with highly consistent performances (mean AUC: 0.76 (training) and 0.71 (testing)). These are comparable to findings of other similar studies including those using magnetic resonance imaging (MRI)-based radiomics. The accuracy, sensitivity and specificity of our radiomics signature that consisted of two texture features were 0.778, 0.833 and 0.556 (training) and 0.842, 0.867 and 0.750 (testing), respectively. Since CT is more readily available than MRI and is the standard-of-care modality for PCa WPRT planning, pCT-based radiomics could be used as a routine non-invasive approach to the prognostic prediction of WPRT treatment outcomes in high-risk localized PCa.

7.
J Orthop Translat ; 43: 14-20, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37920546

ABSTRACT

Introduction: The COVID-19 pandemic has caused high mortality rates in hip fracture patients, but data for Asian patients are lacking. Whilst Cycle threshold (Ct) values and D-dimer have been reported as predictors of mortality in COVID-19 patients, their prognostic roles in those with concomitant hip fracture remain unknown. The objectives of this study were to i) assess the clinical outcomes of COVID-19 hip fractures patients in the Chinese population, ii) identify risk factors of mortality and complications, and iii) determine the prognostic roles of Ct values and D-dimer levels. Methodology: This cohort study was conducted during the 5th wave of the COVID-19 pandemic. Inclusion criteria were 1) hip fracture 2) â€‹≥ â€‹60 years old 3) low-energy trauma. Outcomes were 90-day all-cause mortality, complications, length of stay, discharge destination and mobility status. Logistic regression analysis was performed to identify risk factors for mortality and complications. Subgroup analysis was performed for patients with Ct â€‹< â€‹30 and Ct â€‹> â€‹30, comparing their outcomes of operations performed within 48 â€‹h vs beyond 48 â€‹h. Results: 159 hip fracture patients were included, 42 patients were COVID-19 positive. COVID-19 group had significantly higher 90-day mortality rates (21.4% vs 9.4%), complication rates (45.2% vs 28.2%) and longer length of stay (17.06 vs 10.84 nights). COVID-19 was an independent risk factor for mortality and complications. Amongst the COVID-19 group, risk factors for poor outcomes were advanced age, steroids use, conservative treatment and American Society of Anaesthesiologists (ASA) score ≥ 3. Conservative treatment was associated with higher mortality (OR â€‹= â€‹16.00; p â€‹= â€‹0.025) in COVID-19 hip fracture patients. There was no significant difference between Ct values â€‹< â€‹30 and >30 regarding mortality and complication rate. D-dimer and timing to operation did not affect outcomes. Conclusions: Patients with concomitant COVID-19 and hip fracture are at high risk of mortality and complications. Ct values and D-dimer levels have no prognostic roles for hip fracture outcomes. Early operative treatment is recommended as soon as patients are medically fit.

8.
Development ; 150(22)2023 Nov 15.
Article in English | MEDLINE | ID: mdl-37882771

ABSTRACT

During meiosis, germ cell and stage-specific components impose additional layers of regulation on the core cell cycle machinery to set up an extended G2 period termed meiotic prophase. In Drosophila males, meiotic prophase lasts 3.5 days, during which spermatocytes upregulate over 1800 genes and grow 25-fold. Previous work has shown that the cell cycle regulator Cyclin B (CycB) is subject to translational repression in immature spermatocytes, mediated by the RNA-binding protein Rbp4 and its partner Fest. Here, we show that the spermatocyte-specific protein Lut is required for translational repression of cycB in an 8-h window just before spermatocytes are fully mature. In males mutant for rbp4 or lut, spermatocytes enter and exit meiotic division 6-8 h earlier than in wild type. In addition, spermatocyte-specific isoforms of Syncrip (Syp) are required for expression of CycB protein in mature spermatocytes and normal entry into the meiotic divisions. Lut and Syp interact with Fest independent of RNA. Thus, a set of spermatocyte-specific regulators choreograph the timing of expression of CycB protein during male meiotic prophase.


Subject(s)
Drosophila Proteins , Meiosis , Animals , Male , Meiosis/genetics , Spermatogenesis/physiology , Prophase , Mitosis , Spermatocytes/metabolism , Drosophila/genetics , Cyclin B/genetics , Cyclin B/metabolism , Drosophila Proteins/metabolism
9.
Arthrosc Tech ; 12(8): e1399-e1408, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37654874

ABSTRACT

Hallux valgus is one of the most common foot and ankle conditions faced by orthopaedic surgeons. Surgical correction of hallux valgus is frequently indicated for symptomatic deformity. Recently, the endoscopic technique of hallux valgus correction has been reported, which is basically an endoscopic approach to the classic distal soft tissue procedure. In this technical note, the technical details of the modified endoscopic distal soft tissue procedure with medial metatarsosesamoid ligament and intermetatarsal ligament augmentation is described. In this modified technique, the intact intermetatarsal ligament, plantar capsule of the first metatarsophalangeal joint (including the sesamoid apparatus), and medial metatarsosesamoid ligament form a soft tissue envelop that can wrap around the first metatarsal head to stabilize the first metatarsal in the reduced position.

10.
PLoS One ; 18(8): e0289413, 2023.
Article in English | MEDLINE | ID: mdl-37535623

ABSTRACT

BACKGROUND: Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers. METHODS: In January-March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors. RESULTS: In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors (ßs = 0.38 to .68, ps < 0.001), while psychosocial factors were negatively associated with substance use behaviors (ßs = -0.61 to -0.43, ps < 0.001). CONCLUSION: Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.


Subject(s)
COVID-19 , Substance-Related Disorders , Humans , Female , Adult , Male , Pandemics , COVID-19/epidemiology , Substance-Related Disorders/psychology , Anxiety/epidemiology , Social Support
11.
AIDS Behav ; 27(12): 4052-4061, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37392272

ABSTRACT

Previous research has documented that HIV-related stigma (e.g., internalized and anticipated stigma) is detrimental to the mental health of people living with HIV (PLWH). However, longitudinal data on the bidirectional relationship between HIV-related stigma and depression symptoms are limited. The purpose of this study was to examine the bidirectional association among internalized and anticipated HIV stigma and depression symptoms among Chinese PLWH. A four-wave longitudinal design (6 months intervals) was employed among 1,111 Chinese PLWH (Mage = 38.58, SD = 9.16, age range: 18-60 years; 64.1% men). The bidirectional model was examined using a random-intercept cross-lagged panel model (RI-CLPM), which evaluated the within- and between-person effects of study variables. At the within-person level, results indicated that depression symptoms at T2 mediated the linkage between internalized HIV stigma at T1 and anticipated HIV stigma at T3, and that anticipated HIV stigma at both T2 and T3 mediated the relationship between depression symptoms at the previous time point and internalized HIV stigma at the subsequent time point. Furthermore, a bidirectional association was found between anticipated HIV stigma and depression symptoms across four waves. At the between-person level, internalized and anticipated HIV stigma were significantly associated with depression symptoms. This study highlights the complex interplay between different forms of HIV-related stigma and mental health problems among PLWH and underscores the importance of considering the bidirectional relationship between the development of psychopathology and stigmatization process in clinical practice.

12.
BMJ Qual Saf ; 32(9): 517-525, 2023 09.
Article in English | MEDLINE | ID: mdl-37164639

ABSTRACT

BACKGROUND: Low-value use of laboratory tests is a global challenge. Our objective was to evaluate an intervention bundle to reduce repetitive use of routine laboratory testing in hospitalised patients. METHODS: We used a stepped-wedge design to implement an intervention bundle across eight medical units. Our intervention included educational tools and social comparison reports followed by peer-facilitated report discussion sessions. The study spanned October 2020-June 2021, divided into control, feasibility testing, intervention and a follow-up period. The primary outcomes were the number and costs of routine laboratory tests ordered per patient-day. We used generalised linear mixed models, and analyses were by intention to treat. RESULTS: We included a total of 125 854 patient-days. Patient groups were similar in age, sex, Charlson Comorbidity Index and length of stay during the control, intervention and follow-up periods. From the control to the follow-up period, there was a 14% (incidence rate ratio (IRR)=0.86, 95% CI 0.79 to 0.92) overall reduction in ordering of routine tests with the intervention, along with a 14% (ß coefficient=-0.14, 95% CI -0.07 to -0.21) reduction in costs of routine testing. This amounted to a total cost savings of $C1.15 per patient-day. There was also a 15% (IRR=0.85, 95% CI 0.79, 0.92) reduction in ordering of all common tests with the intervention and a 20% (IRR=1.20, 95% CI 1.10 to 1.30) increase in routine test-free patient-days. No worsening was noted in patient safety endpoints with the intervention. CONCLUSIONS: A multifaceted intervention bundle using education and facilitated multilevel social comparison was associated with a safe and effective reduction in use of routine daily laboratory testing in hospitals. Further research is needed to understand how system-level interventions may increase this effect and which intervention elements are necessary to sustain results.


Subject(s)
Diagnostic Tests, Routine , Quality Improvement , Humans , Hospitalization
13.
AIDS Behav ; 27(10): 3508-3514, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37074629

ABSTRACT

Prescription opioid misuse (POM) is a concern in people living with HIV (PLWH). Pain interference is a robust factor, and its influences would occur through anxiety and resilience. Limited POM studies attend to Chinese PLWH. This study examined POM and its underlying psychological mechanism using data of PLWH with pain (n = 116) from a cohort study in Guangxi. The PROCESS macro was employed to examine a hypothesized moderated mediation model among pain interference, resilience, anxiety, and POM. Results showed 10.3% PLWH engaged in past-three-month POM. After controlling for demographics, HIV-related clinical outcomes, and pain severity, anxiety mediated the association between pain interference and POM (ß = 0.46, 95% CI = 0.01 to 10.49), and the mediation was moderated by resilience (moderated mediation index = - 0.02, 95% CI = - 0.784 to - 0.001). Chinese PLWH seem to misuse opioids to cope with pain-related anxiety. Resilience appears to offer protection.


Subject(s)
HIV Infections , Opioid-Related Disorders , Humans , Cohort Studies , East Asian People , China/epidemiology , HIV Infections/complications , HIV Infections/drug therapy , HIV Infections/epidemiology , Anxiety/epidemiology , Opioid-Related Disorders/complications , Opioid-Related Disorders/epidemiology , Pain
14.
bioRxiv ; 2023 Feb 17.
Article in English | MEDLINE | ID: mdl-36824933

ABSTRACT

During meiosis, germ cell and stage-specific components impose additional layers of regulation on the core cell cycle machinery to set up an extended G2 period termed meiotic prophase. In Drosophila males, meiotic prophase lasts 3.5 days, during which spermatocytes turn up expression of over 3000 genes and grow 25-fold in volume. Previous work showed that the core cell cycle regulator Cyclin B (CycB) is subject to translational repression in immature Drosophila spermatocytes, mediated by the RNA-binding protein Rbp4 and its partner Fest. Here we show that another spermatocyte-specific protein, Lut, is required for translational repression of cycB in an 8-hour window just before spermatocytes are fully mature. In males mutant for rbp4 or lut , spermatocytes enter and exit the meiotic divisions 6-8 hours earlier than in wild-type. In addition, we show that spermatocyte-specific isoforms of Syncrip (Syp) are required for expression of CycB protein and normal entry into the meiotic divisions. Both Lut and Syp interact with Fest in an RNA-independent manner. Thus a complex of spermatocyte-specific regulators choreograph the timing of expression of CycB protein during male meiotic prophase. SUMMARY STATEMENT: Expression of a conserved cell cycle component, Cyclin B, is regulated by multiple mechanisms in the Drosophila male germline to dictate the correct timing of meiotic division.

15.
J Med Internet Res ; 25: e40789, 2023 02 24.
Article in English | MEDLINE | ID: mdl-36826990

ABSTRACT

BACKGROUND: Artificial intelligence (AI)-based chatbots can offer personalized, engaging, and on-demand health promotion interventions. OBJECTIVE: The aim of this systematic review was to evaluate the feasibility, efficacy, and intervention characteristics of AI chatbots for promoting health behavior change. METHODS: A comprehensive search was conducted in 7 bibliographic databases (PubMed, IEEE Xplore, ACM Digital Library, PsycINFO, Web of Science, Embase, and JMIR publications) for empirical articles published from 1980 to 2022 that evaluated the feasibility or efficacy of AI chatbots for behavior change. The screening, extraction, and analysis of the identified articles were performed by following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS: Of the 15 included studies, several demonstrated the high efficacy of AI chatbots in promoting healthy lifestyles (n=6, 40%), smoking cessation (n=4, 27%), treatment or medication adherence (n=2, 13%), and reduction in substance misuse (n=1, 7%). However, there were mixed results regarding feasibility, acceptability, and usability. Selected behavior change theories and expert consultation were used to develop the behavior change strategies of AI chatbots, including goal setting, monitoring, real-time reinforcement or feedback, and on-demand support. Real-time user-chatbot interaction data, such as user preferences and behavioral performance, were collected on the chatbot platform to identify ways of providing personalized services. The AI chatbots demonstrated potential for scalability by deployment through accessible devices and platforms (eg, smartphones and Facebook Messenger). The participants also reported that AI chatbots offered a nonjudgmental space for communicating sensitive information. However, the reported results need to be interpreted with caution because of the moderate to high risk of internal validity, insufficient description of AI techniques, and limitation for generalizability. CONCLUSIONS: AI chatbots have demonstrated the efficacy of health behavior change interventions among large and diverse populations; however, future studies need to adopt robust randomized control trials to establish definitive conclusions.


Subject(s)
Artificial Intelligence , Health Promotion , Humans , Health Promotion/methods , Health Behavior , Delivery of Health Care , Software
16.
Psychol Health ; 38(9): 1174-1193, 2023.
Article in English | MEDLINE | ID: mdl-34892991

ABSTRACT

OBJECTIVE: College students are vulnerable to psychological distress during COVID-19 due to pandemic-related stressors. In response to psychological distress, college students engage in various coping behaviors, such as self-care behaviors and substance use. The transactional model of stress and coping depicts a cognitive appraisal process in the stress-coping association. Psychological resilience is an essential factor for the cognitive appraisal. This study aimed to investigate the mediation effects of resilience on psycho-behavioral health in response to COVID-19 stressors. DESIGN: Longitudinal data were collected from 1,225 Chinese college students via web-based anonymous surveys at wave 1 (T1, between Jan 31 and Feb 11, 2020) and wave 2 (T2, between Mar 20 and Apr 3, 2020). MAIN OUTCOME MEASURES: Participants reported their COVID-19 stressors (T1), resilience (T1), psychological distress (depression and anxiety; T2), and coping behaviors (self-care behaviors, drinking, and smoking; T2). Path analysis was used for data analyses. RESULTS: Resilience mediated the association between COVID-19 stressors and psychological distress. Resilience together with psychological distress mediated the association of COVID-19 stressors with self-care behaviors or drinking. CONCLUSIONS: Resilience appears to offer protection that promotes psycho-behavioral health in college students in the face of COVID-19 stressors. Interventions for college students should attend to resilience.

17.
Appl Psychol Health Well Being ; 15(3): 938-956, 2023 08.
Article in English | MEDLINE | ID: mdl-36415123

ABSTRACT

Peer victimization is detrimental to child mental health. Research has indicated a reciprocal relationship between peer victimization and mental health problems. Yet limited evidence was from children and adolescents in China. The present study used the random intercepts cross-lagged panel model (RI-CLPM) to examine both between-person and within-person associations between peer victimization and depressive symptoms among Chinese children and adolescents. Participants were 1205 Chinese students (Mage = 11.27 years; ranged from 9 to 15 years; SD = 1.75; 55% boys) who completed four surveys (Time 1 to Time 4) between 2017 and 2019 on demographics, peer victimization, and depressive symptoms. At the between-person level, peer victimization was positively associated with depressive symptoms. Controlling for between-person effects, RI-CLPM suggested positive within-person effects from peer victimization to depressive symptoms across adjacent waves. The model also suggested a positive within-person effect from Time 2 depressive symptoms to Time 3 peer victimization. The multi-group analysis showed that these effects did not differ by gender, age, or subjective socioeconomic status. Peer victimization and depression appear to be reciprocally related at the transitioning period between late childhood and early adolescence in Chinese students. Mental health interventions should attend to peer victimization for children and adolescents in China.


Subject(s)
Bullying , Depression , Adolescent , Child , Female , Humans , Male , Crime Victims/psychology , Depression/epidemiology , Depression/etiology , Depression/psychology , East Asian People , Longitudinal Studies , Peer Group , Aggression/psychology , Bullying/psychology
18.
medRxiv ; 2022 Nov 24.
Article in English | MEDLINE | ID: mdl-36451878

ABSTRACT

Background: Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers. Methods: In January - March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors. Results: In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors ( ß s = .38 to .68, p s < .001), while psychosocial factors were negatively associated with substance use behaviors ( ß s = -.61 to -.43, p s < .001). Conclusion: Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.

19.
Pediatr Clin North Am ; 69(4): 807-818, 2022 08.
Article in English | MEDLINE | ID: mdl-35934501

ABSTRACT

The nonmedical use of prescription drugs (NMUPD) is a public health crisis. In 2020, more Americans died of drug overdose than in any prior year, and the nonmedical use of opioids and other prescription drugs contributed significantly to that total. Young adults and adolescents report the highest rates of NMUPD, relative to other age groups. This article provides a narrative review of interventions for young adults and adolescents to prevent NMUPD, including interventions directed at the individual, family or other small group, and community. The interventions reviewed included those that were delivered in person and via technology.


Subject(s)
Adolescent Behavior , Prescription Drug Misuse , Prescription Drugs , Adolescent , Analgesics, Opioid , Behavior Therapy , Humans , Prescription Drug Misuse/prevention & control , United States , Young Adult
20.
Article in English | MEDLINE | ID: mdl-35897448

ABSTRACT

Persistent COVID-19 symptoms (long COVID) may bring challenges to long haulers' social lives. Females may endure more profound impacts given their special social roles and existing structural inequality. This study explores the effects of long COVID on the social life of female long haulers. We conducted semi-structured interviews via Zoom between April and June 2021 with 15 female long haulers in the United States, purposely recruited from Facebook and Slack groups and organization websites related to long COVID. Interviews were audio-recorded and transcribed verbatim with consent. The interview data were managed using MAXQDA and examined by thematic analysis. Long COVID negatively affected female long haulers' social lives by causing physical limitations, economic issues, altered social relationships, social roles' conflicts, and social stigma. Long COVID prevented female long haulers' recovery process. Physical limitations altered their perceptions on body, and family-work conflicts caused tremendous stress. They also experienced internalized stigma and job insecurities. This study provides insights into challenges that COVID-19 female long haulers could face in their return to normal social life, underscoring the vulnerability of females affected by long COVID due to significant alterations in their social lives. Shifting to new methods of communication, especially social media, diminished the adverse effects of long COVID (e.g., social isolation).


Subject(s)
COVID-19 , COVID-19/complications , Female , Humans , Qualitative Research , Social Stigma , Post-Acute COVID-19 Syndrome
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