Health behaviours the month prior to COVID-19 infection and the development of self-reported long COVID and specific long COVID symptoms: a longitudinal analysis of 1581 UK adults

BACKGROUND: Demographic and infection-related characteristics have been identified as risk factors for long COVID, but research on the influence of health behaviours (e.g., exercise, smoking) immediately preceding the index infection is lacking. The aim of this study was to examine whether specific health behaviours in the month preceding infection with COVID-19 act as upstream risk factors for long COVID as well as well as three specific long COVID symptoms. METHODS: One thousand five hundred eighty-one UK adults from the UCL COVID-19 Social Study and who had previously been infected with COVID-19 were analysed. Health behaviours in the month before infection were weekly exercise frequency, days of fresh air per week, sleep quality, smoking, consuming more than the number of recommended alcoholic drinks per week (> 14), and the number of mental health care behaviours (e.g., online mental health programme). Logistic regressions controlling for covariates (e.g., COVID-19 infection severity, socio-demographics, and pre-existing health conditions) examined the impact of health behaviours on long COVID and three long COVID symptoms (difficulty with mobility, cognition, and self-care). RESULTS: In the month before infection with COVID-19, poor quality sleep increased the odds of long COVID (odds ratio [OR]: 3.53; (95% confidence interval [CI]: 2.01 to 6.21), as did average quality sleep (OR: 2.44; 95% CI: 1.44 to 4.12). Having smoked (OR: 8.39; 95% CI: 1.86 to 37.91) increased and meeting recommended weekly physical activity guidelines (3h hours) (OR: 0.05; 95% CI: 0.01 to 0.39) reduced the likelihood of difficulty with self-care (e.g., washing all over or dressing) amongst those with long COVID. CONCLUSIONS: Results point to the importance of sleep quality for long COVID, potentially helping to explain previously demonstrated links between stress and long COVID. Results also suggest that exercise and smoking may be modifiable risk factors for preventing the development of difficulty with self-care

A DISTRIBUTIONAL ANALYSIS OF THE COSTS OF FOODBORNE ILLNESS: WHO ULTIMATELY PAYS?

This paper traces the economic impact of the costs of foodborne illness on the U.S. economy using a Social Accounting Matrix (SAM) framework. Previous estimates of the costs of seven foodborne pathogens are disaggregated by type, and distributed across the population using data from the National Health Interview Survey. Initial income losses resulting from premature death cause a decrease in economic activity. Medical costs, in contrast, result in economic growth, though this growth does not outweigh the total costs of premature death. A SAM accounting of how the costs of illness are diffused through the economy provides useful information for policy makers.Cost of illness, Foodborne illness, Social Accounting Matrix, Food Consumption/Nutrition/Food Safety,

How to take into account general and contextual knowledge for interactive aiding design: Towards the coupling of CSP and CBR approaches

The goal of this paper is to show how it is possible to support design decisions with two different tools relying on two kinds of knowledge: case-based reasoning operating with contextual knowledge embodied in past cases and constraint filtering that operates with general knowledge formalized using constraints. Our goals are, firstly to make an overview of existing works that analyses the various ways to associate these two kinds of aiding tools essentially in a sequential way. Secondly, we propose an approach that allows us to use them simultaneously in order to assist design decisions with these two kinds of knowledge. The paper is organized as follows. In the first section, we define the goal of the paper and recall the background of case-based reasoning and constraint filtering. In the second section, the industrial problem which led us to consider these two kinds of knowledge is presented. In the third section, an overview of the various possibilities of using these two aiding decision tools in a sequential way is drawn up. In the fourth section, we propose an approach that allows us to use both aiding decision tools in a simultaneous and iterative way according to the availability of knowledge. An example dealing with helicopter maintenance illustrates our proposals

Racial discrimination, low trust in the health system and COVID-19 vaccine uptake: a longitudinal observational study of 633 UK adults from ethnic minority groups

OBJECTIVES: To examine whether racial/ethnic discrimination predicts future COVID-19 vaccine refusal, and whether this association is explained by trust in government and the health system. DESIGN: Longitudinal observational study of racial/ethnic discrimination occurring since the start of the first lockdown (measured in July 2020) and later COVID-19 vaccine status. SETTING: UK (England, Scotland, Wales and Northern Ireland). PARTICIPANTS: A total of 633 adults belonging to ethnic minority groups who took part in the UCL COVID-19 Social Study. MAIN OUTCOME MEASURES: COVID-19 vaccine refusal (vs. accepted/waiting/had at least one dose) between 23 December 2020 and 14 June 2021. RESULTS: Nearly 1 in 10 (6.69%) who had refused a COVID-19 vaccine had experienced racial/ethnic discrimination in a medical setting since the start of the pandemic and had experienced twice as many incidents of racial/ethnic discrimination than those who had accepted the vaccine. Structural equation modelling results indicated a nearly four fold (odds ratio = 3.91, 95% confidence interval = 1.40 to 10.92) total effect of racial/ethnic discrimination on refusing the vaccine which was mediated by low trust in the health system to handle the pandemic (odds ratio = 2.49, 95% confidence interval = 1.12 to 5.39). Analyses adjusted for a range of demographic and COVID-19 related factors. CONCLUSIONS: Findings underscore the importance of addressing racial/ethnic discrimination and the role the National Health Service in regaining trust from ethnic minority groups to increase COVID-19 vaccine uptake among ethnic minority adults

The quality of life of single mothers making the transition from welfare to work

This study examined the quality of life of single mothers making the mandatory transition from welfare to work. The Australian government purported that the benefits of making this transition would include higher incomes, better social participation, and improved wellbeing. It is currently unknown, however, how single mothers currently engaged in welfare to work programs evaluate their quality of life. Quality of life scores for 334 single mothers engaged in welfare to work in Australia were compared with normative data. Participants reported significantly lower quality of life scores than the general population for all quality of life domains, highlighting the need to carefully examine welfare to work policies to ensure they promote participants\u27 quality of life. <br /

Childhood Psychological Maltreatment And Adolescent Depressive And Conduct Disorder Symptoms: A Prospective Longitudinal Analysis

The relationship between childhood psychological maltreatment (CPM) and later maladjustment has been observed in numerous cross-sectional studies, but prospective longitudinal evidence is limited. The current analysis employed a prospective longitudinal design to investigate the contribution of CPM to adolescent depression, anxiety, and conduct disorder symptoms. The sample includes 696 youth age 14 years from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Youth self-report of CPM was assessed at age 12, and via official Child Protective Service (CPS) allegations from birth to age 12. Anxiety, depression, and conduct disorder symptoms were assessed via youth self-report at age 14 and conduct disorder using parent report. Zero-inflated binomial regression models controlled for youth age, caregiver education, household income, minority status, study site, and age 12 symptoms. Youth reports of CPM were significantly related to adolescent depressive and conduct disorder symptoms, but CPS reports were not

A systematic review of cost-effectiveness analyses of complex wound interventions reveals optimal treatments for specific wound types.

BackgroundComplex wounds present a substantial economic burden on healthcare systems, costing billions of dollars annually in North America alone. The prevalence of complex wounds is a significant patient and societal healthcare concern and cost-effective wound care management remains unclear. This article summarizes the cost-effectiveness of interventions for complex wound care through a systematic review of the evidence base.MethodsWe searched multiple databases (MEDLINE, EMBASE, Cochrane Library) for cost-effectiveness studies that examined adults treated for complex wounds. Two reviewers independently screened the literature, abstracted data from full-text articles, and assessed methodological quality using the Drummond 10-item methodological quality tool. Incremental cost-effectiveness ratios were reported, or, if not reported, calculated and converted to United States Dollars for the year 2013.ResultsOverall, 59 cost-effectiveness analyses were included; 71% (42 out of 59) of the included studies scored 8 or more points on the Drummond 10-item checklist tool. Based on these, 22 interventions were found to be more effective and less costly (i.e., dominant) compared to the study comparators: 9 for diabetic ulcers, 8 for venous ulcers, 3 for pressure ulcers, 1 for mixed venous and venous/arterial ulcers, and 1 for mixed complex wound types.ConclusionsOur results can be used by decision-makers in maximizing the deployment of clinically effective and resource efficient wound care interventions. Our analysis also highlights specific treatments that are not cost-effective, thereby indicating areas of resource savings. Please see related article: http://dx.doi.org/10.1186/s12916-015-0288-5