关键词： Illicit drugs   cannabis   SARS-CoV-2   gay and bisexual men   syndemics   PSYCHOSOCIAL HEALTH-PROBLEMS   HIV RISK   ANAL INTERCOURSE   MARIJUANA USE   BISEXUAL MEN   GAY   MSM   PARTNERS   PEOPLE  

摘要： Studies conducted early in the COVID-19 pandemic - before vaccines were widely available - indicated that drug use may have declined among sexual minority men (SMM). This study evaluated drug use trends in the second year of the pandemic. Cross-sectional responses from cisgender SMM living in the US and recruited online (n = 15,897) were grouped for analyses: Time 1: 3/1/2021-5/30/2021; Time 2: 6/1/2021-8/31/2021; Time 3: 9/1/2021-11/30/2021; and Time 4: 12/1 2021-2/28/2022. Results of multivariable models indicated that illicit drug use (excluding cannabis) increased at Times 2 (OR = 1.249, p < .001), 3 (OR = 1.668, p < .001), and 4 (OR = 1.674, p < .001) compared to Time 1. In contrast, cannabis use was relatively stable over time. Rates did not differ significantly among Times 1, 2, and 4. While rates of COVID-19 vaccination increased over time, illicit drug use was negatively associated with the odds of vaccination (OR = 0.361, p < .001). These findings highlight the need for ongoing attention to the risks drug use poses among SMM. Illicit drug use - a long-standing health disparity among SMM - increased significantly across the second year of the pandemic. Because they are less likely to be vaccinated, SMM who use illicit drugs may be at greater risk of COVID-19 infection or complications.

关键词： HIV   ART adherence   adolescents   anxiety   COVID-19   verbal aggression   SELF-REPORT MEASURES   MENTAL-HEALTH   MEDICATION ADHERENCE   INTERVENTION   PREVENTION   ADULTS   IMPACT  

摘要： Adolescents living with HIV (ALHIV) have poorer adherence to antiretroviral treatment (ART). This study investigates the interconnectivity of stressors induced by the COVID-19 pandemic, anxiety and family dynamics on adolescents' adherence to ART. A telephone survey was conducted among 196 South African ALHIV previously enrolled in support groups. Generalized structural equations modeling was used to understand how pandemic-related stressors affected ART adherence. Respondents reported experiencing life stressors since the implementation of COVID-19 restrictions, including doing worse at school (32%), loss of household income (44%) and less food available (38%). Forty-two percent reported greater verbal aggression from adults at home and 60% experienced anxiety. The structural equations model demonstrated a direct path from experiencing life stressors to increased verbal aggression from caregivers, which led to anxiety and ultimately, poorer ART adherence. Each stressor experienced increased the odds of experiencing verbal aggression by 51% (OR=1.51, 95%CI=1.14-2.00) which, in turn, increased the odds of having anxiety four-fold (OR=4.1, 95%C =2.16-7.76). Anxiety was associated with a 74% reduction in the odds of being fully ART adherent (OR=0.26, 95%CI=0.08-0.81). COVID-19-induced stressors exacerbated the mental and physical vulnerability of ALHIV. Findings elucidate how both discord at home and anxiety can result in poorer ART adherence.

关键词： COVID-19   Infection rate   Case mortality rate   Extreme bounds analysis   Cumulative density function   I10   I19  

摘要： Purpose The primary objective of this paper is to explore the robust determinants influencing the infection rate and case mortality rate of COVID-19 in both developing and developed economies. The analysis is conducted using a dataset encompassing 148 countries. Design/methodology/approach To achieve this goal, empirical testing utilizes the Sala-i-Martin version of extreme bounds analysis, a method grounded in the cumulative density function. This approach allows for a comprehensive exploration of potential determinants. Findings The analysis results reveal that, to a large extent, distinct factors contribute to the infection and mortality rates in developed and developing countries. Notwithstanding these differences, certain common factors emerge, such as the risk environment, the number of tests conducted per million people and the percentage of the population over 65. Originality/value Despite acknowledging the potential limitations inherent in official data, this study concludes that the presented results offer valuable insights. The identified determinants, both unique and common, contribute to understanding the dynamics of COVID-19 in diverse economic settings. The information gleaned from this research holds significance for decision-makers involved in combating the ongoing pandemic.

关键词： Brain anatomy   Post-COVID-19 condition   MRI   Fatigue   Texture   Microstructure   MULTIPLE-SCLEROSIS   CROSS-VALIDATION   WHITE-MATTER   BRAIN   LESIONS  

摘要： Post-acute COVID syndrome (PACS) is a global health concern and is often associated with debilitating symptoms. Post-COVID fatigue is a particularly frequent and troubling issue, and its underlying mechanisms remain incompletely understood. One potential contributor is micropathological injury of subcortical and brainstem structures, as has been identified in other patient populations. Texture-based analysis (TA) may be used to measure such changes in anatomical MRI data. The present study develops a methodology of voxel-wise TA mapping in subcortical and brainstem regions, which is then applied to T1-weighted MRI data from a cohort of 48 individuals who had PACS (32 with and 16 without ongoing fatigue symptoms) and 15 controls who had cold and flu-like symptoms but tested negative for COVID-19. Both groups were assessed an average of 4-5 months post-infection. There were no significant differences between PACS and control groups, but significant differences were observed within the PACS groups, between those with and without fatigue symptoms. This included reduced texture energy and increased entropy, along with reduced texture correlation, cluster shade and profile in the putamen, pallidum, thalamus and brainstem. These findings provide new insights into the neurophysiological mechanisms that underlie PACS, with altered tissue texture as a potential biomarker of this debilitating condition.

关键词： COVID-19   information source trust   public health   vaccination  

摘要： BACKGROUND:Public response to the COVID-19 pandemic has underscored the importance of trust, particularly among minority populations. Several factors might affect vaccine safety trust, including source trustworthiness. Using data from the Puerto Rico Community Engagement Alliance, we assessed the association between trust in information sources and the COVID-19 vaccine in a sample of Hispanic adults. METHODS:A cross-sectional survey-based study was conducted from November 2021 to March 2022. Participants were telephone-interviewed to assess sociodemographic, clinical, and COVID-19-related variables. Vaccine trust was assessed by how confident respondents were regarding COVID-19 vaccine safety. Trust in COVID-19 information sources was assessed by asking respondents how much they trusted selected sources of information to provide accurate information about COVID-19, including the US and Puerto Rico governments, Centers for Disease Control and Prevention (CDC), health care professionals, and traditional media (television/radio/newspaper/internet). Logistic regression models estimated the odds ratio (OR, 95% CI) of COVID-19 vaccine trust based on trust in information sources. RESULTS:A total of 200 adults aged ≥21 years completed the telephone interview. While most of the study sample (97.5%) had been inoculated with at least one dose of the COVID-19 vaccine, 86% trusted in the COVID-19 vaccine's safety. After adjusting for age and sex, participants who attested greater trust in their healthcare professionals (OR=1.99, 95% CI=0.71, 5.62), the US government (OR=2.44, 95% CI=0.69, 8.68), and the CDC (OR=8.18, 95% CI=2.97, 22.57) reported increased vaccine trust as compared to those not having great confidence in these entities. CONCLUSION:These findings support that trust in information provided by the CDC is positively associated with COVID-19 vaccine trust. Acknowledging predictors of trust regarding COVID-19 vaccination could help address factors that affect vaccine c

关键词： health service utilization   self-care behavior   reasoned action approach   online medical consultation   subgroups analysis   vulnerable population   COVID-19   PHYSICAL-ACTIVITY   MANAGEMENT   POPULATION   OUTBREAK   LOCKDOWN   IMPACTS   OBESITY   STYLE   RISK   TIME  

摘要： Background: The reallocation of health resources, epidemic prevention and control measures during the COVID-19 pandemic triggered widespread restricted health service utilization, some residents and patients tried positive self-care behavior to maintain their health, yet the efficacy of this intervention remains unclear. Object: Based on the reasoned action approach (RAA) theory, this study aimed to investigate the correlation between self-care behavior and restricted health service utilization among adults in China, trying to discover the vulnerable groups and external and intrinsic factors that affect self-care behavior among Chinese adults. Methods: Data on demographics, socioeconomic, health status, and self-care behavior were collected in "The Early China COVID-19 Survey," a cross-sectional anonymous online survey of the general population in China. Self-care behavior was measured by four indicators: weight control (WC), physical activity (PA), prevention behavior (PB), and online medical consultation (OMC). The multiple linear models and binary logistic regression were used to examine whether restricted health service utilization (RHSU) is associated with self-care behaviors; also, adjusted multivariate logistic regression was used to analyze subgroup heterogeneity. Results: In total, 8,428 adult participants completed the survey, the mean OMC score was 1.51 (SD 1.34), the mean PB score was 18.17 (SD 3.44), and the proportion of participants who engaged in WC and PA was 42.30 and 62.57%, respectively. According to the multiple regression model, the RHSU was significantly positively correlated with all four indicators of self-care (WC: OR = 1.34, p < 0.001, PA: OR = 1.34, p < 0.05, MC: OR = 1.30, p < 0.001, PB: coef = 0.16, p < 0.05). We also observed some significant differences in the intensity of this relationship by subgroup analysis, precisely, OMC (high vs. moderate vs. low infection-risk level: OR = 1.48; 1.41; 1.19, p < 0.1), PA (male vs. female: OR = 1

关键词： Mobile learning   Chinese language   Online learning   COVID-19   Behavioral intention   Unified Theory of Acceptance and Use of Technology (UTAUT)   TECHNOLOGY ACCEPTANCE MODEL   INFORMATION-TECHNOLOGY   FIT INDEXES   BEHAVIORAL INTENTION   EDUCATION   PHONES  

摘要： PurposeThis study aims to improve the Unified Theory of Acceptance and Use of Technology (UTAUT) model by examining technological anxiety and other influential factors on international students' adoption of mobile learning (m-learning) during COVID-19 emergency remote teaching (ERT).Design/methodology/approachThis study utilized the modified UTAUT framework to test hypotheses through a cross-sectional survey method. Participants were university students studying Chinese as a foreign language who were selected using a convenience sampling approach. An online questionnaire was then administered. The data collected from the surveys were analyzed using the partial least squares method with SmartPLS 4 *** study examined 16 hypotheses and found support for six of them. The results confirmed that performance expectancy (PE) is a significant predictor of behavioral intention (BI), and anxiety influences both PE and effort expectancy. The negative effect of social influence on anxiety was found to be significant, while facilitating conditions had a negative impact on learners' self-efficacy. The model fit indices indicated a good overall fit for the *** limitations/implicationsThis study presents a valuable contribution to the literature on m-learning in emergency education by incorporating technological anxiety into the enhanced UTAUT model. Examining the relationships between the key factors of the model provides a better understanding of learners' intentions and can inspire researchers to establish new theoretical foundations to evaluate the roles of these factors in diverse educational *** implicationsThe study found that performance expectations are linked to learners' intentions, and anxiety indirectly affects BIs to use mobile learning platforms. Thus, these platforms should be designed to meet learners' expectations with minimum effort and eliminate anxiety triggers to facilitate ease of use. Language curriculum developers a

关键词： Antipsychotics   psychotic disorders   acute inpatient psychiatry   COVID-19   electronic medical records   PSYCHIATRIC-DISORDERS   MENTAL-DISORDERS   RISK   ILLNESS  

关键词： post-acute covid-19 syndrome  

摘要： A recent review of 38 studies found considerable differences among 6 major definitions of post-COVID-19 condition, also known as long COVID, underscoring the "innovative yet fragmented nature of long COVID care models and the critical need for a standardized definition to effectively identify affected patients and evaluate treatment models," the authors of a linked editorial wrote in Annals of Internal Medicine.