Perceived Stress, Knowledge, and Preventive Behaviors in Indian versus US-based Participants During COVID-19: A Survey Study.

Rationale: India and the USA, the worst affected countries by COVID-19, experienced very different pandemic courses. By 2020, COVID-19 cases had steadily declined in India, whereas the fight continued in the US. The people of India and the USA perhaps perceived threats very differently, influenced by their knowledge, available healthcare facilities, and social security. We conducted an online survey study to compare COVID-related perceptions between Indian participants (IND-P) and US-based participants (US-P). Methods: COVID-related perceptions such as stress, knowledge, and preventive behaviors were measured with specific questionnaires, and normalized scores were computed. T-tests were used to compare the perception scores, while the Kruskal-Wallis-H (KWH) tests were used to compare socioeconomic distributions between participants from two countries. Generalized linear model (GLM) adjusted for sociodemographic confounders estimated the association between the country of residence and COVID-perception. Results: The IND-P (N = 242) were younger and male-dominated compared with the US-P (N = 531) (age: KWH = 97.37, p < 0.0001, gender: KWH = 140.38, p < 0.0001). Positive attitudes toward preventive guidelines were associated with higher perceived risk and stress (r = 0.35, p < 0.001, and r = 0.21, p < 0.001, respectively) but not with the knowledge (r = -0.05, p = 0.14). Compared with the US-P, the IND-P had lower knowledge (5.19 ± 1.95 vs. 7.82 ± 1.35; t-test: p < 0.0001), higher stress (7.01 ± 1.51 vs. 6.07 ± 1.61; t-test: p < 0.0001), and better adherence to preventive guidelines (8.84 ± 1.30 vs. 8.34 ± 2.09; t-test: p = 0.0006). GLM demonstrated a significant association between the country and COVID-perception scores. Conclusion: The IND-P experienced higher stress and perceived threat during COVID-19 than the US-P, perhaps due to a lack of faith in the healthcare system and insecurity. Despite lower knowledge, the IND-P had better acceptance of preventive guidelines than the US-P.

The Association Between Female Smoking and Childhood Asthma Prevalence-A Study Based on Aggregative Data.

Aims: Socioeconomic and environmental factors influence childhood asthma prevalence across the world. In-depth epidemiological research is necessary to determine the association between asthma prevalence and socio-environmental conditions, and to develop public health strategies to protect the asthmatic children against the environmental precipitators. Our research was based on aggregative data and sought to compare the asthma prevalence between children of two different age-groups across the world and to identify the association among the key socio-environmental conditions with increased childhood asthma prevalence. Method: We included forty countries with available data on various socio-environmental conditions (2014-2015). Childhood asthma prevalence of two different age groups (6-7 and 13-14 years) were obtained from global asthma report 2014. Because of significant diversities, the selected countries were divided into two groups based on human developmental index (HDI), a well-recognized parameter to estimate the overall socioeconomic status of a country. Robust linear regression was conducted using childhood asthma prevalence as the dependent variable and female smoking prevalence, tertiary school enrollment (TSE), PM10 (particulate matter ≤10 µm in diameter) and gross domestic product (GDP) as predictors. Results: Asthma prevalence was not different between two age groups. Among all predictors, only female smoking prevalence (reflecting maternal smoking) was associated with asthma prevalence in the countries with lower socio-economic conditions (HDI), but not in the higher HDI group. The results were unchanged even after randomization. Conclusions: Childhood asthma prevalence did not change significantly with age. Female smoking may have a positive correlation with childhood asthma prevalence in lower HDI countries.