Impact of COVID-19 on people with asthma: a mixed methods analysis from a UK wide survey

IntroductionThe impact of acute COVID-19 on people with asthma appears complex, being moderated by multiple interacting disease-specific, demographic and environmental factors. Research regarding longer-term effects in this group is limited. We aimed to assess impacts of COVID-19 and predictors of persistent symptoms, in people with asthma.MethodsUsing data from an online UK-wide survey of 4500 people with asthma (median age 50–59 years, 81% female), conducted in October 2020, we undertook a mixed methods analysis of the characteristics and experience of those reporting having had COVID-19.ResultsThe COVID-19 group (n=471, 10.5%) reported increased inhaler use and worse asthma management, compared with those not reporting COVID-19, but did not differ by gender, ethnicity or household income. Among the COVID-19 group, 56.1% reported having long COVID, 20.2% were ‘unsure’. Those with long COVID were more likely than those without long COVID to describe: their breathing as worse or much worse after their initial illness (73.7% vs 34.8%, p<0.001), increased inhaler use (67.8% vs 34.8%, p<0.001) and worse or much worse asthma management (59.6% vs 25.6%, p<0.001). Having long COVID was not associated with age, gender, ethnicity, UK nation or household income.Analysis of free text survey responses identified three key themes: (1) variable COVID-19 severity, duration and recovery; (2) symptom overlap and interaction between COVID-19 and asthma; (3) barriers to accessing healthcare.ConclusionsPersisting symptoms are common in people with asthma following COVID-19. Measures are needed to ensure appropriate healthcare access including clinical evaluation and investigation, to distinguish between COVID-19 symptoms and asthma.

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A mixed methods study to evaluate the impact of a student-run clinic on undergraduate medical education

BMC Medical Education ◽

10.1186/s12909-021-02621-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nathan G. Rockey ◽

Taylor M. Weiskittel ◽

Katharine E. Linder ◽

Jennifer L. Ridgeway ◽

Mark L. Wieland

Keyword(s):

Mixed Methods ◽

Patient Care ◽

Social Factors ◽

Healthcare Access ◽

Community Services ◽

Student Understanding ◽

Learning Objectives ◽

Barriers To Healthcare ◽

The Impact ◽

Barriers To Healthcare Access

Abstract Background The purpose of this study was to evaluate the extent to which a longitudinal student-run clinic (SRC) is meeting its stated learning objectives, including providing critical community services and developing physicians who more fully appreciate the social factors affecting their patients’ health. Methods This was a mixed methods program evaluation of an SRC at Mayo Clinic Alix School of Medicine (MCASOM). A survey was conducted of medical students who had participated in the clinic and seven interviews and three focus groups were conducted with SRC patients, students, faculty, staff, and board members. Transcripts were coded for systematic themes and sub-themes. Major themes were reported. Survey and interview data were integrated by comparing findings and discussing areas of convergence or divergence in order to more fully understand program success and potential areas for improvement. Results Greater than 85% of student survey respondents (N = 90) agreed or strongly agreed that the SRC met each of its objectives: to provide a vital community service, to explore social determinants of health (SDH), to understand barriers to healthcare access and to practice patience-centered examination. Qualitative data revealed that the SRC contextualized authentic patient care experiences early in students’ medical school careers, but the depth of learning was variable between students. Furthermore, exposure to SDH through the program did not necessarily translate to student understanding of the impact of these social factors on patient’s health nor did it clearly influence students’ future practice goals. Conclusions The MCASOM SRC experience met core learning objectives, but opportunities to improve long-term impact on students were identified. Participation in the SRC enabled students to engage in patient care early in training that is representative of future practices. SRCs are an avenue by which students can gain exposure to real-world applications of SDH and barriers to healthcare access, but additional focus on faculty development and intentional reflection may be needed to translate this exposure to actionable student understanding of social factors that impact patient care.

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Impact Evaluation of Raskin Program using Matching Method: Case of IFLS 5

JEJAK ◽

10.15294/jejak.v11i1.9192 ◽

2018 ◽

Vol 11 (1) ◽

pp. 207-223

Author(s):

Endiarjati Dewandaru Sadono

Keyword(s):

Propensity Score ◽

Propensity Score Matching ◽

Family Life ◽

Household Income ◽

Impact Evaluation ◽

Matching Method ◽

Indonesia Family Life Survey ◽

Small Benefit ◽

Using Data ◽

The Impact

Beras untuk Keluarga Miskin (RASKIN) program has been applied since 1998 and has been renamed as Beras Sejahtera (RASTRA) in early 2017, but their effectiveness is still debatable. This study tries to evaluate the impact of RASKIN program on household income. Using data from 3,745 households in Indonesia Family Life Survey (IFLS) 5 that has been estimated using propensity score matching, this study has identified precisely that RASKIN program has a negative and significant effect on household income. This happens because the benefits that reveived by Rumah Tangga Sasaran (RTS) are very small. The small benefit is affected by the amount of rice received, frequency and price that have been paid to get RASKIN is not in accordance with the guidelines. The result of this study is along with previous studies, where the amount and price of rice that distributed through RASKIN program is not exactly correct. Therefore, there must be a change in program format, not just renaming from RASKIN to RASTRA only.

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The Impact of Education on Household Income in Rural Vietnam

International Journal of Financial Studies ◽

10.3390/ijfs8010011 ◽

2020 ◽

Vol 8 (1) ◽

pp. 11 ◽

Cited By ~ 1

Author(s):

Hung Van Vu

Keyword(s):

Quantile Regression ◽

Household Income ◽

Living Standard ◽

Regression Analyses ◽

Poor Households ◽

Quantile Regression Analysis ◽

Research Findings ◽

Using Data ◽

The Impact ◽

Positive Effect

Using data from the 2018 Vietnam Household Living Standard Survey, our study investigates the impact of education on household income in rural Vietnam. Both mean and quantile regression analyses were employed to analyze the impact of education. We found that education has a positive effect on the household income after controlling for various factors in the models. However, quantile regression analysis reveals that the effect of schooling years increases with quantiles, suggesting that education bring higher returns for richer households. We also found that households with the heads having higher qualifications or vocational education tend to earn higher income levels. Combined together, these findings imply that while education was found to increase household income, it increases income inequality in rural Vietnam. Our research findings suggest that improving the access of poor households to better education is expected to increase their income and reduce inequality in rural Vietnam.

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Assessing the perceived impact of post Minamata amalgam phase down on oral health inequalities: a mixed-methods investigation

BMC Health Services Research ◽

10.1186/s12913-019-4835-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

V. R. Aggarwal ◽

S. Pavitt ◽

J. Wu ◽

B. Nattress ◽

P. Franklin ◽

...

Keyword(s):

Mixed Methods ◽

Oral Health ◽

Qualitative Study ◽

Health Services ◽

Health Inequalities ◽

Dental Amalgam ◽

Free Text ◽

Oral Health Services ◽

Phase Out ◽

The Impact

Abstract Background Data from countries that have implemented a complete phase out of dental amalgam following the Minamata agreement suggest increased costs and time related to the placement of alternatives with consumers absorbing the additional costs. This aim of this study was to investigate the impact of a complete phase out of dental amalgam on oral health inequalities in particular for countries dependent on state run oral health services. Methods A mixed methods component design quantitative and qualitative study in the United Kingdom. The quantitative study involved acquisition and analysis of datasets from NHS Scotland to compare trends in placement of dental amalgam and a survey of GDPs in Yorkshire, UK. The qualitative study involved analysis of the free text of the survey and a supplementary secondary analysis of semi-structured interviews and focus groups with GDPs (private and NHS), dental school teaching leads and NHS dental commissioners to understand the impact of amalgam phase down on oral health inequalities. Results Time-trends for amalgam placement showed that there was a significant (p < 0.05) reduction in amalgam use compared with composites and glass ionomers. However dental amalgam still represented a large proportion (42%) of the restorations (circa 1.8 million) placed in the 2016–2017 financial year. Survey respondents suggest that direct impacts of a phase down were related to increased costs and time to place alternative restorations and reduced quality of care. This in turn would lead to increased tooth extractions, reduced access to care and privatisation of dental services with the greatest impact on deprived populations. Conclusion Amalgam is still a widely placed material in state run oral health services. The complete phase down of dental amalgam poses a threat to such services and threatens to widen oral health inequalities. Our data suggest that a complete phase out is not currently feasible unless appropriate measures are in place to ensure cheaper, long-lasting and easy to use alternatives are available and can be readily adopted by primary care oral health providers.

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Rapid mixed-methods assessment of COVID-19 impact on Latinx sexual minority men and Latinx transgender women

PLoS ONE ◽

10.1371/journal.pone.0244421 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244421

Author(s):

Sarah MacCarthy ◽

Max Izenberg ◽

Joanna L. Barreras ◽

Ron A. Brooks ◽

Ana Gonzalez ◽

...

Keyword(s):

Mixed Methods ◽

Sexual Minority ◽

Healthcare Access ◽

Transgender Women ◽

Medical Attention ◽

Computer Assisted ◽

Hiv Knowledge ◽

Sexual Minority Men ◽

Minority Men ◽

The Impact

We conducted a rapid, mixed-methods assessment to understand how COVID-19 affected Latinx sexual minority men (LSMM) and transgender women (LTGW). Using a computer-assisted telephone interviewing software, one interviewer called 52 participants (randomly sampled from a larger HIV prevention pilot study aiming to increase HIV knowledge and testing frequency; n = 36 LSMM and n = 16 LTGW) between 04/27/20-05/18/20. We quantified core domains using the Epidemic-Pandemic Impacts Inventory scale and provided important context through open-ended qualitative questions assessing: 1) COVID-19 infection history and experiences with quarantine; 2) Health and healthcare access; 3) Employment and economic impact of COVID-19. Participants reported increases in physical conflict or verbal arguments with a partner (13.5%) or other adult(s) (19.2%) due to stressors associated with the safer-at-home order. Participants also reported increased alcohol consumption (23.1%), problems with sleep (67.3%) and mental health (78.4%). Further, disruptions in access to Pre-Exposure Prophylaxis or PrEP–a daily pill to prevent HIV–occurred (33.3% of 18 participants who reported being on PrEP). Many said they received less medical attention than usual (34.6%), and LTGW reported delays in critical gender-affirming hormones/procedures. Half of the participants lost their jobs (50.0%); many undocumented participants relayed additional financial concerns because they did not qualify for financial assistance. Though no COVID-19 infections were noted, COVID-19 dramatically impacted other aspects of health and overall wellbeing of LSMM and LTGW. Public health responses should address the stressors faced by LSMM and LTGW during the COVID-19 pandemic and the impact on wellbeing.

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Impact of Preclinical Labor and Delivery Shadowing on Student Perceptions of Obstetrics and Gynecology as a Specialty and Possible Career: A Prospective Cohort

American Journal of Perinatology Reports ◽

10.1055/s-0039-1695747 ◽

2019 ◽

Vol 09 (04) ◽

pp. e361-e365

Author(s):

Sarah K. Dotters-Katz ◽

Marcela C. Smid ◽

Sara Tinkham ◽

Alice Chuang

Keyword(s):

Student Perceptions ◽

Prospective Cohort ◽

Obstetrics And Gynecology ◽

Free Text ◽

Student Interest ◽

Labor And Delivery ◽

The People ◽

Team Interactions ◽

Survey Responses ◽

The Impact

Objective The purpose of this study was to determine the impact of preclinical shadowing on student interest and perceptions of obstetrics and gynecology (OBGYN). Methods We enrolled a prospective cohort of preclinical medical students who shadowed on labor and delivery (L&D). Students sent electronic surveys a week prior (presurvey), the week after (postsurvey), and three months after shadowing (far-survey). Responses compared using descriptive statistics. We analyzed common themes of free text responses. Results From July 2016 to April 2017, 41 students shadowed on L&D; 81% were female. Eighty percent responded to at least one survey, 37% completed all surveys, (presurvey: 76%, postsurvey: 51%, and far-survey: 46%). Prior to shadowing, 10% (3/31) planed a career in OBGYN compared with 24% (5/21) after shadowing (p = 0.42). Over 50% of students described the people and procedures as altering their perceptions of OBGYN in a positive way. Common themes explaining this change included: culture (n = 4), team interactions (n = 4), seeing deliveries (n = 3), and hands-on experiences (n = 3). Three months after shadowing, 79% described the experience as very worthwhile. Eighty-nine percent would recommend the experience to a friend not interested in OBGYN and 100% stated they would shadow again. Discussion Although shadowing may not increase students' desire to pursue OBGYN, it is nearly universally felt to be worthwhile and improves perceptions of the field.

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Implications of less tail end water on livelihoods of small farmers in Pakistan

Outlook on Agriculture ◽

10.1177/0030727016689735 ◽

2017 ◽

Vol 46 (1) ◽

pp. 36-43 ◽

Cited By ~ 1

Author(s):

Akhter Ali ◽

Dil Bahadur Rahut ◽

Muhammad Imtiaz

Keyword(s):

Water Availability ◽

Water Scarcity ◽

Household Income ◽

Water Source ◽

Land Rent ◽

Absolute Deviation ◽

Canal Irrigation ◽

Using Data ◽

The Impact ◽

Poverty Levels

In Pakistan, about 80% of the cropped area is irrigated using canal irrigation, and water availability is closely linked to the location of the farm. Using data collected from 950 farmers through a field survey covering four provinces (Punjab, Sindh, Khyber Pakhtunkhwa and Balochistan), this study aimed to assess the impact of location, that is, ‘head’ versus ‘tail’ on water availability and its impact on crop yield, household income, food security and poverty levels. The censored least absolute deviation was used to estimate farmer participation in water markets, and the propensity score matching was used to assess impacts on yield of wheat and rice, household income and poverty levels as well as land rent and water scarcity. The results show that farmers situated at the head of the water source have higher wheat and rice yields in the range of 2–3 maunds per acre. Household income levels are higher in the range of PKR 8455–14,673, and poverty levels are lower (+3% to 5%). The land rent at the head is higher compared to the tail while water scarcity is also less at the head. The study indicated that farmers’ status plays a major role in land location and access to irrigation water.

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Impact of Living Alone on Depressive Symptoms in Older Korean Widows

10.20944/preprints201709.0075.v1 ◽

2017 ◽

Author(s):

Gyeong-Suk Jeon ◽

Choi Kyungwon ◽

Cho Sung-Il

Keyword(s):

Depressive Symptoms ◽

Socioeconomic Factors ◽

Household Income ◽

Social Ties ◽

Negative Impact ◽

Secondary Analysis ◽

Living Alone ◽

Using Data ◽

The Individual ◽

The Impact

We examined the relationship between living alone and the prevalence of depressive symptoms in older Korean widows and assessed the individual contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. The study was a secondary analysis using data from widows 65 years of age and older who participated in the Living Profiles of Older People Survey (LPOPS). A logistic regression analysis was used to evaluate the contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. Working status and equivalent household income were significantly associated with depressive symptoms in both those living with others and those living alone. Adjustment for health status and social ties did not change the impact of living alone on the prevalence of depressive symptoms. However, adjustment for equivalent household income eliminated the negative association between living alone and depressive symptoms. Our findings indicate that economic resources are more important than health and social ties for alleviating the negative impact of living alone on the development of depressive symptoms in older widows.

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Accessibility in Aotearoa: A Mixed-Methods Study of Low-Emissions Transport Demand in the Greater Wellington Region

10.26686/wgtn.17150837 ◽

2021 ◽

Author(s):

◽

Han Ling Petredean

Keyword(s):

Land Use ◽

Mixed Methods ◽

Central Government ◽

Transport Policy ◽

Transport Sector ◽

Imminent Threat ◽

Survey Responses ◽

Policy And Planning ◽

National Road ◽

The Impact

<p>Like many nations, Aotearoa New Zealand’s land-use and transport development has prioritised planning for mobility, movement, over accessibility, access. This has contributed to an auto-centric transportation system and a high national road emissions profile. In light of the imminent threat of catastrophic climate change, a low-emissions transport sector transition is needed. Understanding how and why people travel is a critical prerequisite for achieving this shift. Planners and policymakers increasingly recognise that transport demand is fundamentally influenced by the desire for access over movement. An accessibility-based framework aligns with this interpretation and supports analysing personal and contextual drivers of transport demand. Policymakers tasked with promoting a low-emissions transport sector transition are seeking to identify existing low-emissions transport uptake constraints and potential avenues for their improvement. Using a mixed-methods approach, this thesis addresses an existing gap in the literature by analysing low-emissions transport demand in the Greater Wellington Region (GWR), informed by an accessibility-based framework. Survey responses supplied quantitative data on user-based needs, abilities, and attitudes towards GWR low-emissions transport options. Practicality – the degree to which a transport option facilitates access in reasonable time, at reasonable cost, and with reasonable ease – was found to be the strongest predictor of ability to use low-emissions transport. Qualitative data was also collated from stakeholders knowledgeable of transport policy and planning at the local, regional, and central government level. This provided insight into GWR low-emissions transport supply and oversight, as well as the impact of land-use policies, transport policy and funding structures, and governance agendas and capabilities. These findings support augmenting low-emissions transport with an accessibility orientation, but also reveal the challenges of doing so within current governance structures.</p>

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Nutrition inequities in Canada

Applied Physiology Nutrition and Metabolism ◽

10.1139/h10-002 ◽

2010 ◽

Vol 35 (2) ◽

pp. 172-179 ◽

Cited By ~ 27

Author(s):

Valerie Tarasuk ◽

Sandra Fitzpatrick ◽

Heather Ward

Keyword(s):

Household Income ◽

Canadian Community Health Survey ◽

Education Level ◽

Food Groups ◽

Income Adequacy ◽

Community Health Survey ◽

Health Significance ◽

Adults And Children ◽

Using Data ◽

The Impact

In Canada, increased morbidity and shorter life expectancy have been found among those with lower incomes and lower levels of education, but there has been little examination of socioeconomic variation in food and nutrient intake. Using data from the 2004 Canadian Community Health Survey, we examined the relationship between household income and education level and adults’ and children’s intakes of energy, fibre, micronutrients, and number of servings consumed of food groups from Canada’s Food Guide. To explore the public health significance of observed associations, we estimated the prevalence of inadequacy for selected nutrients for adults, stratifying by household income, education level, and sex. We found that a higher household income adequacy and (or) higher levels of education were associated with increased consumption of milk and alternatives, and vegetables and fruit, and significantly higher vitamin, mineral, and fibre intakes among both adults and children. The prevalence of inadequate nutrient intakes among adults was higher among adults with the lowest level of income adequacy or educational attainment, compared with others. Our results suggest that the nutritional quality of Canadians’ food intakes is, in part, a function of their social position. The impact of policy and program interventions needs to be examined across socioeconomic strata to ensure that actions reduce rather than exacerbate nutrition inequities.

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