Predictors of COVID-19 Related Stress Among Custodial Grandmothers

This paper examined predictors of COVID-19 stressors among 316 custodial grandmothers raising school-aged grandchildren using regression. Grandmothers, who were participants in two nationwide behavioral RCTs, completed an online questionnaire in Spring 2020. Predictors included grandmother demographics, depressive symptoms, perceived caregiving stress and reward, stress management strategies, and grandchild factors. Outcomes included grandmothers’ stress related to using bad coping habits (r2=.24), grandchildren’s remote learning(r2=.39), household conflict (r2=.29), COVID-19 fear and uncertainty (r2=.28), and finances(r2=.24). Regression results indicated that grandmothers’ pre-existing depressive symptoms predicted all outcomes except remote learning stress. Higher caregiving stress was associated with all outcomes, except concerns about using bad coping habits. Grandmothers with less perceived access to care reported greater concern about bad coping habits and remote learning stress, while minority grandmothers reported more financial stress and COVID-19 fear and uncertainty. Findings suggest that the COVID-19 pandemic has compounded the stress experienced by already burdened custodial grandmothers.

An Analysis of Urban Ecological Knowledge and Behaviour in Wellington, New Zealand

<p>The majority of the worlds' population now live in urban areas, with urban areas growing at a faster rate than other land use types. Most urban residents are concentrated in neighbourhoods of low biodiversity, and there are concerns about urban residents' disconnection from nature. A lack of ecological knowledge and pro-environmental behaviour has conservation implications. I surveyed Wellington households (n=453) and investigated possible predictors of residents' ecological knowledge about birdlife, bird feeding, and tree planting connected to birdlife. Three measures of knowledge were tested, species freelisting, neighbourhood bird knowledge, and photo identification. Key predictors of higher levels of ecological knowledge were increased frequencies of visiting local and regional parks, higher levels of garden space, and higher educational qualifications. However, all models had low predictive power. Species richness and perceived access to greenspaces were not significant predictors of ecological knowledge. Residents had a lower knowledge of native birdlife compared with exotic species across all measures. Forty-two percent of respondents fed birds, 10% targeting native species, and 36% planted trees for birdlife. Knowledge of neighbourhood birds and garden size were key predictors for each. This study shows the importance of urban greenspaces for ecological knowledge and behaviour, and efforts should be made to encourage visits to greenspaces.</p>

An Analysis of Urban Ecological Knowledge and Behaviour in Wellington, New Zealand

<p>The majority of the worlds' population now live in urban areas, with urban areas growing at a faster rate than other land use types. Most urban residents are concentrated in neighbourhoods of low biodiversity, and there are concerns about urban residents' disconnection from nature. A lack of ecological knowledge and pro-environmental behaviour has conservation implications. I surveyed Wellington households (n=453) and investigated possible predictors of residents' ecological knowledge about birdlife, bird feeding, and tree planting connected to birdlife. Three measures of knowledge were tested, species freelisting, neighbourhood bird knowledge, and photo identification. Key predictors of higher levels of ecological knowledge were increased frequencies of visiting local and regional parks, higher levels of garden space, and higher educational qualifications. However, all models had low predictive power. Species richness and perceived access to greenspaces were not significant predictors of ecological knowledge. Residents had a lower knowledge of native birdlife compared with exotic species across all measures. Forty-two percent of respondents fed birds, 10% targeting native species, and 36% planted trees for birdlife. Knowledge of neighbourhood birds and garden size were key predictors for each. This study shows the importance of urban greenspaces for ecological knowledge and behaviour, and efforts should be made to encourage visits to greenspaces.</p>

Comparing User Perceptions of Surgical Environments: Simulations in a High-Fidelity Physical Mock-Up Versus a Postoccupancy Evaluation

Objective: The purpose of this study was to compare perceptions and behaviors of end users participating in simulations in a high-fidelity physical mock-up of an operating room (OR) prototype with the perceptions and behaviors of end users in the built out ORs postoccupancy. Background: Simulation-based evaluations of high-fidelity physical mock-ups of proposed layouts are increasingly being conducted during the facility design process to understand impacts on workflow and potential adverse patient safety outcomes. Nevertheless, it is unclear to what extent user experiences in these simulated healthcare spaces are similar to those in built and occupied healthcare environments. Methods: Using interviews, surveys, and observations, this study compared user evaluations in a high-fidelity physical mock-up of an OR with user evaluations of the built and occupied OR postoccupancy. Workflow disruptions were also analyzed using video recordings for a simulated pediatric surgery and five pediatric surgeries in the actual OR. Results: This study found that user perceptions and behavior in the two types of environments were mostly similar with regard to perceived support for the location of surgeon workstation, perceived space and task performance, perceived access to storage locations, boom setup, and OR cleanability. Participant’s ratings differed for supportiveness of the mobile Circulating Nurse (CN) workstation, maneuvering booms, and environmental disruptions. Conclusion: Simulation-based evaluations are extremely beneficial during the design process and can provide valuable input to design teams as well as clinical teams about workflow and safety issues that allow design issues to be addressed before construction.

Contact With Nature as a Mental Health Buffer for Lower Income Communities During the COVID-19 Pandemic

Despite a growing number of research outputs on the importance of nature contact during the COVID-19 pandemic, we know of no longitudinal research conducted prior to and during the pandemic among low-income and minority ethnicity populations, i.e., those that might be most affected. Furthermore, we have scant information about how and to what degree contact with nature might protect mental health or mitigate worsening of mental health during the pandemic. We filled these gaps using a subset of a longitudinal study of n = 86 individuals in low-income, predominantly African American, neighborhoods in Detroit, MI, USA. The study addressed the following research questions: (1) did self-reported use and perceived value of nature change during, vs. prior to, the pandemic; (2) did perceived access to outdoor spaces buffer people against mental health issues such as stress, anxiety and depression symptoms; or (3) did objectively measured quality of nature views from home buffer people against mental health issues, taking into account relevant covariates and pandemic experiences (e.g., loss of employment, death of a friend/relative)? While attitudes to nature improved slightly from pre- to during the pandemic, we also observed significant decreases in most types of outdoor physical activity and passive enjoyment of nature (e.g., smelling plants/rain). We found a positive association between visibility of greenspace and perceived stress and anxiety, which not only contradicts previous research findings, but was especially surprising given that overall there was a decrease in perceived stress from 2019–2020. We did not detect associations between perceived access/use of nature and mental health. However, higher depressive symptoms were associated with exposure to more COVID-19-related stressors (lost employment, death of friends from COVID-19, etc.). Taken together, our results indicate that COVID-19 may serve to prolong or exacerbate mental health issues, rather than create them, in this population and that low quality greenspace may perhaps limit the ability for nature view to buffer mental health during the pandemic.

Impact of Local Flavored Tobacco Sales Restrictions on Policy-Related Attitudes and Tobacco Product Access

Background As of September 2020, more than 300 state and local jurisdictions restrict the sales of flavored tobacco, with some including menthol. Aims o evaluate the impact of local ordinances restricting the sale of flavored tobacco, we surveyed Californians regarding policy support and perceived access to flavored tobacco. Methods In 2019, we conducted an online survey of 3,075 California youth and young adults recruited via social media, about half of whom lived in a policy jurisdiction. Logistic regressions assessed differences on propensity score–weighted outcomes, policy support, and perceived access. Results Most respondents indicated agreement with almost all policy support statements. Although policy respondents were less likely than rest-of-California respondents to report perceived difficulty in buying flavored cigars, flavored vape users in policy jurisdictions were more likely than those in the rest of California to report perceived difficulty in buying flavored e-liquid. Regardless of jurisdiction, certain priority subgroups were significantly more likely to report perceived difficulty in accessing flavored cigars, flavored vaping products, flavored e-liquid, and menthol cigarettes. Discussion With some exceptions, these findings demonstrate that among vape users in policy jurisdictions and priority subgroups, there is a higher likelihood of reporting perceived difficulty to access flavored tobacco products. Conclusions Findings might be an early indication of shifts in social norms about flavored tobacco products in California, which could gain traction as local sales restriction ordinances proliferate throughout the state and a statewide flavored-tobacco sales restriction goes into effect.

Perceived Access to Health Care Services and Relevance of Telemedicine during the COVID-19 Pandemic in Germany

During the COVID-19 pandemic in Germany, non-pharmaceutical interventions were imposed to contain the spread of the virus. Based on cross-sectional waves in March, July and December 2020 of the COVID-19 Snapshot Monitoring (COSMO), the present study investigated the impact of the introduced measures on the perceived access to health care. Additionally, for the wave in December, treatment occasion as well as utilization and satisfaction regarding telemedicine were analysed. For 18–74-year-old participants requiring medical care, descriptive and logistic regression analyses were performed. During the less strict second lockdown in December, participants reported more frequently ensured access to health care (91.2%) compared to the first lockdown in March (86.8%), but less frequently compared to July (94.2%) during a period with only mild restrictions. In December, main treatment occasions of required medical appointments were check-up visits at the general practitioner (55.2%) and dentist (36.2%), followed by acute treatments at the general practitioner (25.6%) and dentist (19.0%), treatments at the physio-, ergo- or speech therapist (13.1%), psychotherapist (11.9%), and scheduled hospital admissions or surgeries (10.0%). Of the participants, 20.0% indicated utilization of telemedical (15.4% telephone, 7.6% video) consultations. Of them, 43.7% were satisfied with the service. In conclusion, for the majority of participants, access to medical care was ensured during the COVID-19 pandemic; however, access slightly decreased during phases of lockdown. Telemedicine complemented the access to medical appointments.

Cervical cancer risk and access: Utilizing three statistical tools to assess Haitian women in South Florida

Although decreasing rates of cervical cancer in the U.S. are attributable to health policy, immigrant women, particularly Haitians, experience disproportionate disease burden related to delayed detection and treatment. However, risk prediction and dynamics of access remain largely underexplored and unresolved in this population. This study seeks to assess cervical cancer risk and access of unscreened Haitian women. Extracted and merged from two studies, this sample includes n = 346 at-risk Haitian women in South Florida, the largest U.S. enclave of Haitians (ages 30–65 and unscreened in the previous three years). Three approaches (logistic regression [LR]; classification and regression trees [CART]; and random forest [RF]) were employed to assess the association between screening history and sociodemographic variables. LR results indicated women who reported US citizenship (OR = 3.22, 95% CI = 1.52–6.84), access to routine care (OR = 2.11, 95%CI = 1.04–4.30), and spent more years in the US (OR = 1.01, 95%CI = 1.00–1.03) were significantly more likely to report previous screening. CART results returned an accuracy of 0.75 with a tree initially splitting on women who were not citizens, then on 43 or fewer years in the U.S., and without access to routine care. RF model identified U.S. years, citizenship, and access to routine care as variables of highest importance indicated by greatest mean decreases in Gini index. The model was .79 accurate (95% CI = 0.74–0.84). This multi-pronged analysis identifies previously undocumented barriers to health screening for Haitian women. Recent US immigrants without citizenship or perceived access to routine care may be at higher risk for disease due to barriers in accessing U.S. health-systems.