The Ohio COVID-19 Survey: Preliminary Findings and Their Use During the Pandemic

Background: The coronavirus disease 2019 (COVID-19) pandemic has created exceptional health and economic uncertainty for Ohioans in 2020. In the spring of 2020, the state commissioned the Ohio COVID-19 Survey (OCS) to ask residential Ohio adults about how the pandemic was affecting them. The purpose of this research is to provide state leadership with real-time information about the effects of the pandemic and concurrent recession on Ohio households.Methods: The OCS is a special supplement to the Ohio Medicaid Assessment Survey (OMAS), a stratified random digit dial, cell phone and landline telephone survey. This study includes data collected weekly between April 20, 2020, and August 24, 2020. We conducted descriptive time-series analysis of the survey data and provided updates to the state's COVID-19 Response Team throughout the survey period.Results: Preliminary findings from the OCS reflect 3 themes among respondents: 1) elevated levels of concern over health and household economics; 2) disproportionate effects that exacerbate existing inequities; and 3) majority adjustment to "new normal" and acceptance of public health guidelines .Conclusion: Preliminary findings indicate that groups that were struggling before the pandemic have faced the biggest challenges with regard to health and household economics since it began. Data from the OCS enabled us to provide real-time analysis to state leadership regarding Ohioans' experience during the first 6 months of the COVID-19 pandemic. Further analysis and integration of additional data will allow us to provide deeper insights as Ohio seeks to move into recovery

Urogenital infection symptoms and occupational stress among women working in export production factories in Tianjin, China

Objective: To assess the prevalence of urogenital infection symptoms and their association with occupational stress among women working in export production factories in China. Methods: Six hundred and thirty-eight women workers in three factories in Tianjin, China were surveyed. Information was collected on women's demographic characteristics, levels of occupational stress, and urogenital infection symptoms. Data were analyzed using multiple logistic regression. Results: Among the 638 women who provided information on urogenital symptoms, 30.9% reported at least one symptom: 27.9% reported abnormal discharge, 2.4% reported genital sores, and 6.3% reported pain with urination. Feeling exhausted was associated with an increased risk for reporting genital sores [OR=1.35 (1.05, 1.73)] and pain with urination [OR=1.21 (1.06, 1.39)], while reporting low job security was significantly associated with reporting at least one symptom of urogenital infection [OR=1.51 (1.03, 2.20)]. Conclusions: Many women working in China's export factories report symptoms of urogenital infection. Occupational stress may be linked to an increased risk for urogenital infection. Focused efforts are needed to improve accessibility to reproductive health services for women working in China's export production factories

Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection

Sex workers have long been considered a high-risk group for HIV infection, but to date little quantitative research has explored the association between HIV risk and exchange of sex for material gain by women in the general population. The objective of this study was to estimate the prevalence of such transactional sex among women attending antenatal clinics in Soweto, South Africa, to identify demographic and social variables associated with reporting transactional sex, and to determine the association between transactional sex and HIV serostatus. We conducted a cross-sectional study of women seeking antenatal care in four Soweto health centres who accepted routine antenatal HIV testing. Private face-to-face interviews covered socio-demographics, sexual history and experience of gender-based violence. 21.1% of participants reported having ever had sex with a non-primary male partner in exchange for material goods or money. Women who reported past experience of violence by male intimate partners, problematic substance use, urban residence, ever earning money, or living in substandard housing were more likely to report transactional sex, while women who reported delayed first coitus, were married, or had a post-secondary education were less likely to report transactional sex. Transactional sex was associated with HIV seropositivity after controlling for lifetime number of male sex partners and length of time a woman had been sexually active (OR=1.54, 95% CI: 1.07, 2.21). Women who reported non-primary partners without transactional sex did not have increased odds of being HIV seropositive (OR=1.04, 95% CI: 0.75, 1.43). We conclude that transactional sex may place women at increased risk for HIV, and is associated with gender-based violence, substance use and socio-economic disadvantage. Research, policy and programmatic initiatives should consider the role of transactional sex in women's HIV risk, with attention to the intersecting roles of violence, poverty, and substance use in shaping women's sexual behaviour.Transactional sex HIV Women Africa Risk behaviour Intimate partner violence

Linoleic Acid-Rich Oil Supplementation Increases Total and High-Molecular-Weight Adiponectin and Alters Plasma Oxylipins in Postmenopausal Women with Metabolic Syndrome.

BackgroundThe onset of menopause increases the risk of metabolic syndrome (MetS). Adiponectin is an adipokine associated with insulin sensitivity that is lower in people with MetS. Supplementing diets with linoleic acid (LA)-rich oil increased adiponectin concentrations and improved glucose control in women with type 2 diabetes. The effect of LA on adipokines, especially total and the bioactive form of adiponectin, high-molecular-weight (HMW) adiponectin, in women with MetS is unknown.ObjectivesThe aim of this study was to explore the effect of supplementation of the diet with an oil rich in LA on adipokines in women with MetS. The effect of the LA-rich oil (LA-oil) on oxylipins, key metabolites that may influence inflammation and metabolism, was also explored.MethodsIn this open-label single-arm pilot study, 18 postmenopausal nondiabetic women with MetS enrolled in a 2-phase study were instructed to consume LA-rich vegetable oil (10 mL/d) as part of their habitual diets. Women consumed an oleic acid-rich oil (OA-oil) for 4 wk followed by an LA-oil for 16 wk. Fasting concentrations of adipokines, fatty acids, oxylipins, and markers of glycemia and inflammation were measured.ResultsAfter 4 wk of OA-oil consumption, fasting glucose and total adiponectin concentrations decreased whereas fasting C-reactive protein increased. After 16 wk of LA-oil supplementation total and HMW adiponectin and plasma oxylipins increased. Markers of inflammation and glycemia were unchanged after LA-oil consumption.ConclusionsSupplementation with LA-oil increased total and HMW adiponectin concentrations and altered plasma oxylipin profiles. Larger studies are needed to elucidate the links between these changes and MetS.This trial was registered at clinicaltrials.gov as NCT02063165

Linoleic Acid-Rich Oil Supplementation Increases Total and High-Molecular-Weight Adiponectin and Alters Plasma Oxylipins in Postmenopausal Women with Metabolic Syndrome.

BackgroundThe onset of menopause increases the risk of metabolic syndrome (MetS). Adiponectin is an adipokine associated with insulin sensitivity that is lower in people with MetS. Supplementing diets with linoleic acid (LA)-rich oil increased adiponectin concentrations and improved glucose control in women with type 2 diabetes. The effect of LA on adipokines, especially total and the bioactive form of adiponectin, high-molecular-weight (HMW) adiponectin, in women with MetS is unknown.ObjectivesThe aim of this study was to explore the effect of supplementation of the diet with an oil rich in LA on adipokines in women with MetS. The effect of the LA-rich oil (LA-oil) on oxylipins, key metabolites that may influence inflammation and metabolism, was also explored.MethodsIn this open-label single-arm pilot study, 18 postmenopausal nondiabetic women with MetS enrolled in a 2-phase study were instructed to consume LA-rich vegetable oil (10 mL/d) as part of their habitual diets. Women consumed an oleic acid-rich oil (OA-oil) for 4 wk followed by an LA-oil for 16 wk. Fasting concentrations of adipokines, fatty acids, oxylipins, and markers of glycemia and inflammation were measured.ResultsAfter 4 wk of OA-oil consumption, fasting glucose and total adiponectin concentrations decreased whereas fasting C-reactive protein increased. After 16 wk of LA-oil supplementation total and HMW adiponectin and plasma oxylipins increased. Markers of inflammation and glycemia were unchanged after LA-oil consumption.ConclusionsSupplementation with LA-oil increased total and HMW adiponectin concentrations and altered plasma oxylipin profiles. Larger studies are needed to elucidate the links between these changes and MetS.This trial was registered at clinicaltrials.gov as NCT02063165

Health economic design for cost, cost-effectiveness and simulation analyses in the HEALing Communities Study

•The HEALing Communities Study is designed to implement and evaluate the Communities That HEAL intervention to reduce opioid overdose deaths.•The HCS includes a health economics study.•Costs of CTH will be estimated for multiple perspectives.•The health economics study includes cost-effectiveness analyses and simulation modeling. The HEALing Communities Study (HCS) is designed to implement and evaluate the Communities That HEAL (CTH) intervention, a conceptually driven framework to assist communities in selecting and adopting evidence-based practices to reduce opioid overdose deaths. The goal of the HCS is to produce generalizable information for policy makers and community stakeholders seeking to implement CTH or a similar community intervention. To support this objective, one aim of the HCS is a health economics study (HES), the results of which will inform decisions around fiscal feasibility and sustainability relevant to other community settings. The HES is integrated into the HCS design: an unblinded, multisite, parallel arm, cluster randomized, wait list–controlled trial of the CTH intervention implemented in 67 communities in four U.S. states: Kentucky, Massachusetts, New York, and Ohio. The objectives of the HES are to estimate the economic costs to communities of implementing and sustaining CTH; estimate broader societal costs associated with CTH; estimate the cost-effectiveness of CTH for overdose deaths avoided; and use simulation modeling to evaluate the short- and long-term health and economic impact of CTH, including future overdose deaths avoided and quality-adjusted life years saved, and to develop a simulation policy tool for communities that seek to implement CTH or a similar community intervention. The HCS offers an unprecedented opportunity to conduct health economics research on solutions to the opioid crisis and to increase understanding of the impact and value of complex, community-level interventions