Aging Through the Time of COVID-19: Healthcare Access for Older Adults Living With Chronic Conditions

Chronic conditions require on-going continuous management and preventive treatment. Over 80% of adults aged 65 and older have multiple chronic conditions. Concerns have arisen about how the COVID-19 pandemic is affecting the management of chronic conditions. Delay, avoidance, and poor management of healthcare during the COVID- 19 pandemic may increase the risk of unnecessary hospitalizations and mortality. This study aims to understand the impact of COVID-19 on healthcare access in a U.S. sample of Americans 50 years of age or older. Participants completed an online survey about healthcare access and other risk factors during the COVID-19 pandemic. Multinomial regression analysis examined the results of two key access points: healthcare provider /doctor (n=468) and medication (n=754). One-half (56%) of those who needed access to a provider were able to be seen. Participants who were older, had multiple chronic conditions, and those with a provider were more likely to have access. However, when individuals with more chronic conditions did not have access, they indicated that this lack of access was due to COVID-19. When not receiving access to medications, unemployed participants attributed the lack of access more often to COVID-19 than other reasons. These findings demonstrate an important lack of access to providers and medication among older adults during the pandemic. In multivariate models, this lack of access was most often due to COVID-19, in addition to traditional factors such as insurance, employment, and medical and behavioral comorbidity. Interventions are needed to lower access barriers to care even further during COVID-19.

Racism and Confederate Monument Construction: Temporal Regimes Distinguishing the 1900s, 1960s, and Contemporary Decades

The bulk of Confederate monuments were constructed by White southerners in the early 1900s, but some were built much later. Recent research has assessed average relationships across the decades, but comparable evidence for distinct peaks in construction is lacking. My objective is to determine whether the timing of monument construction is connected to unique social contexts, particularly different manifestations of racism. I use multinomial regression analysis and a rich dataset spanning the U.S. South. Results confirm the central role of the United Daughters of the Confederacy (UDC), but also suggest stronger attachments to slavery and greater reliance on lynching increase the risk of erecting a monument in the early 1900s. In contrast, the resurgence of construction in the 1960s is unrelated to the presence of a UDC chapter and positively related to the presence of an National Association for the Advancement of Colored People (NAACP) chapter. Construction in the decades after the 1960s shift again, suggesting the renewed importance of the UDC (in addition to the location of Civil War battles), but no role of racialized dynamics. Results suggest three distinct regimes of Confederate monument construction that broadly reflect the structural racism that dominated the early 1900s; the group threat/countermovement dynamics of the 1960s; and the “colorblind” era of racism associated with contemporary decades. This research contributes to knowledge of the factors associated with Confederate monument construction and provides a foundation for public and academic discussions of how racism is intertwined with these divisive public symbols.

Potential Protection of Pre-Existent Antibodies to Human Coronavirus 229E on COVID-19 Severity

The causes of the broad spectrum of severity in COVID-19 are unknown. A protective effect through humoral immunity from previous infections by viruses of the SARS-CoV-2 family could explain a mild form of this disease. This study aimed to address whether the presence of antibodies against human seasonal coronaviruses (HCoVs) could prevent severe manifestations of COVID-19. A cross-sectional study was carried out in 165 participants. The presence of pre-existent antibodies against the seasonal HCoV-OC43, HCoV-HKU1, HCoV-229E, and HCoV-NL63 were detected. From all of the seasonal HCoVs studied, it was only found that being seropositive to HCoV-229E presented an association (p = 0.012) with developing mild clinical symptoms of COVID-19 or being asymptomatic. Multinomial regression analysis showed that being seropositive to HCoV-229E is associated with mild or moderate clinical symptoms for COVID-19. Statistical analysis also showed that being female is associated with being asymptomatic for SARS-CoV-2 infection or developing mild COVID-19. A subgroup analysis taking only seropositive to HCoV-229E revealed that females are more likely to develop asymptomatic SARS-CoV-2 infection (OR = 27.242, 95% CI 2.092–354.706, p = 0.012). Our results suggest that previous infections by HCoV-229E could prevent more serious clinical manifestations of COVID-19, but these are not the only variables that influence this event.

Sleeping pattern and activities of daily living modulate protein expression in AMD

Degeneration of macular photoreceptors is a prominent characteristic of age-related macular degeneration (AMD) which leads to devastating and irreversible vision loss in the elderly population. In this exploratory study, the contribution of environmental factors on the progression of AMD pathology by probing the expression of candidate proteins was analyzed. Four hundred and sixty four participants were recruited in the study comprising of AMD (n = 277) and controls (n = 187). Genetics related data was analyzed to demonstrate the activities of daily living (ADL) by using regression analysis and statistical modeling, including contrast estimate, multinomial regression analysis in AMD progression. Regression analysis revealed contribution of smoking, alcohol, and sleeping hours on AMD by altered expression of IER-3, HTRA1, B3GALTL, LIPC and TIMP3 as compared to normal levels. Contrast estimate supports the gender polarization phenomenon in AMD by significant decreased expression of SLC16A8 and LIPC in control population which was found to be unaltered in AMD patients. The smoking, food habits and duration of night sleeping hours also contributed in AMD progression as evident from multinomial regression analysis. Predicted model (prediction estimate = 86.7%) also indicated the crucial role of night sleeping hours along with the decreased expression of TIMP-3, IER3 and SLC16A8. Results revealed an unambiguous role of environmental factors in AMD progression mediated by various regulatory proteins which might result in intermittent AMD phenotypes and possibly influence the outcome of anti-VEGF treatment.

Longitudinal stent elongation or shortening after deployment in the coronary arteries: which is dominant?

Background Stent manufacturers always record stent shortening data while they do not record stent elongation data. The aim of this study is to identify both stent shortening and elongation occurring after deployment in the coronary arteries and know their percentage. Results The length of coronary stents was measured by intravascular ultrasound (IVUS) by (1) edge-to-edge (E-E) length, measured from the appearance of the first distal strut to the last proximal strut, and (2) area-to-area (A-A) length, measured from the first distal struts seen at more than one IVUS quadrant to the last proximal struts seen at more than one IVUS quadrant. Stent shortening was defined as both E-E and A-A lengths were shorter than the manufacturer box-stated length (shortened group). Stent elongation was defined as both E-E and A-A lengths were longer than the manufacturer box-stated length (elongated group), otherwise unchanged group. Consecutive 102 stents deployed in ischemic patients were included. Stent elongation was detected in 67.6% (69 stents), and shortening was detected in 15.7% (16 stents), while unchanged stents were detected in 16.7% (17 stents). Although the 3 groups had similar box-stated length and predicted foreshortened length, they had significantly different measurements by IVUS, p<0.001 for each comparison. Differences from box-stated length were 1.9±1.4mm, −1.4±0.4mm, and 0.4±0.3mm, respectively, p<0.001. The elongated group had significantly longer differences from the corresponding box-stated and predicted foreshortened lengths, while the shortened group had significantly shorter differences from the corresponding box-stated length and similar foreshortened length. By multinomial regression analysis, the plaque-media area and stent deployment pressure were the independent predictors of the stent length groups, p=0.015 and p=0.026, respectively. Conclusions Change in stent length is not only shortening—as mentioned in the manufacturer documents—but also stent elongation. Stent elongation is dominant, and the most important predictors of longitudinal stent changes are plaque-media area and stent deployment pressure.

Vnímané překážky vstupu do psychoterapie

Objectives. The study aimed to explore which barriers adult people perceive when deciding whether to enter psychotherapy and how these barriers influence their decision to start psychotherapy. Sample and setting. The sample consisted of 392 adult respondents who considered entering individual psychotherapy during the last five years. They completed a questionnaire on perceived barriers to entering psychotherapy, the phase of decision-making, and the severity of psychological symptoms. Hypotheses. This was an exploratory study with the following questions: a) What is the perceived importance of specific barriers to entering psychotherapy? b) What groups (principal components) of barriers to entering psychotherapy can be identified? c) What is the relationship between the perceived importance of barriers and the decision to enter psychotherapy? Statistical analysis. The number of barriers was reduced using PCA. The relationship of the decision-making phase to other variables was explored via multinomial regression analysis. Results. The most severe barrier to entering psychotherapy were price, reluctance to express emotions in front of others and the assumption that one’s problems were not as severe as the problems of people in psychotherapy. Respondents who decided not to enter psychotherapy were older, expressed more distrust of psychotherapy, and perceived it as more stigmatizing than those who contacted a therapist. Respondents who decided to enter psychotherapy (but who had not contacted a therapist) had less severe symptoms and perceived psychotherapy as more stigmatizing than those who contacted a therapist. Study limitations. Limits of the study include a non-representative sample and the time window used for the retrospective rating of symptoms and barriers.

Assessment of the Quality of Life during COVID-19 Pandemic: A Cross-Sectional Survey from the Kingdom of Saudi Arabia

The COVID-19 outbreak emerged as an ongoing crisis at the beginning of the year 2020. Its horrific manifestation at the community level significantly affects various dimensions of the quality of life (QoL) of all individuals. The study aimed to examine some of the predictors of the QoL during the first wave of the COVID-19 pandemic in Saudi Arabia. A cross-sectional online survey questionnaire was used to gather data on the participants’ sociodemographic backgrounds, physical health status, psychological reactions, and QoL. We adapted 12 items from the World Health Organization Quality of Life Instruments (WHOQOL-BREF) to assess the QoL. The Depression, Anxiety and Stress Scale–21 (DASS-21) was used to assess depression, anxiety, and stress. The median and inter-quartile range were used to describe the QoL scores. A multinomial regression analysis was computed between QoL score quartiles and associated factors, and the statistical significance was set at p < 0.05. The results of the multinomial regression analysis demonstrated that males (OR = 1.96; 95% CI = 1.31–2.94); participants aged 26 to 35 years (OR = 5.1; 95% CI = 1.33–19.37); non-Saudi participants (OR = 1.69; 95% CI = 1.06–2.57); individuals with chronic diseases (OR = 2.15; 95% CI = 1.33–3.48); those who lost their job (OR = 2.18; 95% CI = 1.04–4.57); and those with depression (OR = 5.70; 95% CI = 3.59–9.05), anxiety (OR = 5.47; 95% CI = 3.38–8.84), and stress (OR = 6.55; 95% CI = 4.01–10.70) were more likely to be in the first quartile of the QoL scores. While the full model predicting the total QoL score was statistically significant (R2 = 0.962, F (750, 753) = 16,705.4, p < 0.001), the three QoL dimensions explained 0.643, 0.283, and 0.036 of the variability in environmental, social, and religious/spiritual dimensions, respectively. The COVID-19 pandemic has significantly influenced various aspects of individuals’ QoL, as well as their physical and psychological health. Community-based interventions are needed to mitigate the pandemic’s negative effects and enhance the health and QoL of the general population.

The development of constructions from the right edge: a multinomial regression analysis of clitic left and right dislocation in child French

The aim of the present research is to investigate the development of left and right dislocation in child French through a corpus study of three children until age 2;7 from the corpus of Lyon (Demuth & Tremblay, 2008). We extracted a total of 704 dislocations and analysed their syntactic properties. We show that (i) right dislocations are more frequent than left dislocations and (ii) left dislocations are significantly more complete than right dislocations (fewer omissions of verbs or pronouns). We compare these results to the hypothesis of Freudenthal, Pine, Jones & Gobet (2015, 2016) according to which some properties of child language can be explained by a learning mechanism from the right edge of the sentences from the input. We will show that this hypothesis can explain the general trend found in our data, but it is not sufficient to account for the entire development of dislocation in French.

Multinomial Regression Analysis if Yam (Dioscorea Spp.) Consumers’ Preferences and Varietal Diversification Pattern in Nigeria

Multinomial regression analysis of yam consumers’ preference and varietal diversification in the yam production system in Nigeria was the thrust of this investigation. Five major yam farming communities were sampled randomly to get 200 respondents (suppliers and consumers) of yam. Parametric and non-parametric tests were employed to analyze the primary data collected with the questionnaire. The result indicates that white yam (Dioscorea rotundata) is the dominant variety among consuming households. The majority of the respondents prefer selling of white yam (76%) followed by water yam (13%) and yellow yam (l1%) in response to consumers’ preferences. The mean value of yam supplied was 505.34kg, while the mean quantity consumed was 14.56kg. The finding shows that the statistical relationship between the varieties consumed and supplied is strong and positive. It was concluded that as the demand-end is willing to purchase more quantity of white yam supplied, yam farmers and marketers are advised to scale-up production and supply respectively to take advantage of the increasing market demand for white yam in Nigeria. Also, more research works on yam varieties should be conducted by researchers to expand the value chain / industrial uses of other yam varieties to prevent their extinction.