This internet survey study describes trends in respondents saying they were likely to accept vaccination for COVID-19 overall and by age, sex, race, and education between April and December 2020.
Assess the degree to which US parents are likely to have their children get coronavirus disease 2019 (COVID-19) vaccines and identify parental concerns about the vaccines.
In February 2021 to March ...2021, we surveyed parent members of a nationally representative probability-based Internet panel of ∼9000 adults regarding their intent to have their children receive a COVID-19 vaccination, perceptions of COVID-19 vaccines for children, and trust in sources of information about COVID-19 vaccines for children. We used descriptive and multivariate analyses to evaluate parent-stated likelihood of having their children get a COVID-19 vaccine and to assess the association between likelihood of child COVID-19 vaccination and child age, parent demographics, and parental perceptions about COVID-19 vaccines.
Altogether, 1745 parents responded (87% of eligible parents, 3759 children). Likelihood of child COVID-19 vaccination was as follows: very likely (28%), somewhat likely (18%), somewhat unlikely (9%), very unlikely (33%), and unsure (12%). The stated likelihood of child vaccination was greater among parents of older children (
< .001) as well as among parents who had a bachelor's degree or higher education (
< .001), had already received or were likely to receive a COVID-19 vaccine (
< .001), or had Democratic affiliation (
< .001); variations existed by race and ethnicity (
= .04). Parental concerns centered around vaccine safety and side effects. A key trusted source of information about COVID-19 vaccines for children was the child's doctor.
Less than one-half of US participants report that they are likely to have their child receive a COVID-19 vaccine. Pediatric health care providers have a major role in promoting and giving COVID-19 vaccination for children.
Background and Purpose: South Asians are a fast-growing ethnic minority in the Atlanta metro area and are at high risk for developing diabetes. In order to create culturally competent practices and ...interventions, it is critical to understand the nuances in health beliefs, attitudes towards diabetes, and cultural and religious practices.
Methods: Design: Key informant interviews were conducted with participants as part of a mixed-methods study. After 5 interviews, a codebook was created with themes through inductive analysis, and interview questions were adjusted for clarity. Analyses were done using MAXQDA. Transcripts were reviewed and coded; any discrepancies in coding were discussed and resolved in weekly meetings. Semi-structured 60 minute interviews (n=8) were conducted online or in-person and recorded.
Results: Of 2,460 participants enrolled in the parent study, 71 were selected for interviews based on age (18-79), gender, and religious backgrounds. Stratifying by generational cohort and nativity revealed differences in beliefs about healthy behavior (including physical activity and nutritional preferences) and interactions with various healthcare systems. Participants’ beliefs on mindfulness, meditation, and cultural foods affected their health and lifestyle choices. Most immigrants had different perceptions of western medicine and experiences with the U.S. healthcare system compared to ayurvedic medicine. Common areas of confusion included prescriptions and obtaining medications, insurance status, and distrust in medical practitioners. Conversely, first generation participants reported greater health knowledge and engagement in healthy practices to prevent diabetes.
Discussion: Health beliefs and practices among South Asians vary by nativity, education, age, generational cohort, and sociocultural customs. Future studies should address how nativity and age might affect engagement in lifestyle change for South Asians.
Disclosure
D.Arora: None. I.Rajwani: None. M.K.Shah: None.
This study compares age-adjusted mortality rates before and during the COVID-19 pandemic (2011-2020) among Latino and White individuals living in Los Angeles County.
Clinician burnout is a major risk to the health of the US. Nurses make up most of the health care workforce, and estimating nursing burnout and associated factors is vital for addressing the causes ...of burnout.
To measure rates of nurse burnout and examine factors associated with leaving or considering leaving employment owing to burnout.
This secondary analysis used cross-sectional survey data collected from April 30 to October 12, 2018, in the National Sample Survey of Registered Nurses in the US. All nurses who responded were included (N = 50 273). Data were analyzed from June 5 to October 1, 2020.
Age, sex, race and ethnicity categorized by self-reported survey question, household income, and geographic region. Data were stratified by workplace setting, hours worked, and dominant function (direct patient care, other function, no dominant function) at work.
The primary outcomes were the likelihood of leaving employment in the last year owing to burnout or considering leaving employment owing to burnout.
The weighted sample of 50 273 respondents (representing 3 957 661 nurses nationally) was predominantly female (90.4%) and White (80.7%); the mean (SD) age was 48.7 (0.04) years. Among nurses who reported leaving their job in 2017 (n = 418 769), 31.5% reported burnout as a reason, with lower proportions of nurses reporting burnout in the West (16.6%) and higher proportions in the Southeast (30.0%). Compared with working less than 20 h/wk, nurses who worked more than 40 h/wk had a higher likelihood identifying burnout as a reason they left their job (odds ratio, 3.28; 95% CI, 1.61-6.67). Respondents who reported leaving or considering leaving their job owing to burnout reported a stressful work environment (68.6% and 59.5%, respectively) and inadequate staffing (63.0% and 60.9%, respectively).
These findings suggest that burnout is a significant problem among US nurses who leave their job or consider leaving their job. Health systems should focus on implementing known strategies to alleviate burnout, including adequate nurse staffing and limiting the number of hours worked per shift.
The success of personal non-pharmaceutical interventions as a public health strategy requires a high level of compliance from individuals in private social settings. Strategies to increase compliance ...in these hard-to-reach settings depend upon a comprehensive understanding of the patterns and predictors of protective social behavior. Social cognitive models of protective behavior emphasize the contribution of individual-level factors while social-ecological models emphasize the contribution of environmental factors. This study draws on 28 waves of survey data from the Understanding Coronavirus in America survey to measure patterns of adherence to two protective social behaviors-private social-distancing behavior and private masking behavior-during the COVID-19 pandemic and to assess the role individual and environmental factors play in predicting adherence. Results show that patterns of adherence fall into three categories marked by high, moderate, and low levels of adherence, with just under half of respondents exhibiting a high level of adherence. Health beliefs emerge as the single strongest predictor of adherence. All other environmental and individual-level predictors have relatively poor predictive power or primarily indirect effects.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
CRISPR-Cas9 technology would be enhanced by the ability to inhibit Cas9 function spatially, temporally, or conditionally. Previously, we discovered small proteins encoded by bacteriophages that ...inhibit the CRISPR-Cas systems of their host bacteria. These “anti-CRISPRs” were specific to type I CRISPR-Cas systems that do not employ the Cas9 protein. We posited that nature would also yield Cas9 inhibitors in response to the evolutionary arms race between bacteriophages and their hosts. Here, we report the discovery of three distinct families of anti-CRISPRs that specifically inhibit the CRISPR-Cas9 system of Neisseria meningitidis. We show that these proteins bind directly to N. meningitidis Cas9 (NmeCas9) and can be used as potent inhibitors of genome editing by this system in human cells. These anti-CRISPR proteins now enable “off-switches” for CRISPR-Cas9 activity and provide a genetically encodable means to inhibit CRISPR-Cas9 genome editing in eukaryotes.
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•Some mobile elements in bacteria encode protein inhibitors of Cas9•Three families of anti-CRISPRs inhibit N. meningitidis Cas9 in vivo and in vitro•Anti-CRISPRs bind directly to NmeCas9•These proteins are potent “off-switches” for NmeCas9 genome editing in human cells
Naturally occurring inhibitors of CRISPR-Cas9 can block genome editing in cultured human cells, providing a means to spatially, temporally, and conditionally control Cas9 activity.
Background: Understanding trends in health habits of people with diabetes can inform interventions to improve lifestyle management. Design: We used data from non-pregnant adults aged 18 and older ...with self-reported diabetes participating in cross-sectional National Health and Nutrition Examination Survey 2007-2010, 2011-2014, and 2015-2018. Self-reported lifestyle goals included: healthy eating (consumption of added sugar, fruits, vegetables, and whole grains), physical activity, weight management, sleep, alcohol consumption, and tobacco use.
Methods: For each period, proportions of adults with diabetes who met each recommended lifestyle goal were estimated overall and by sociodemographic characteristics.
Results: During 2007-2010, in adjusted analyses, 63.4% of adults with diabetes met added sugar recommendations, 68.8% did not smoke, 66.5% met alcohol consumption goals, 32.8% reported adequate sleep, 67.1% reported engaging in weight management, and 26.5% met physical activity goals. From 2007-2010 to 2015-2018, proportions of adults with diabetes meeting sleep (difference: +16.7; 95% CI: 10.6, 22.8) and physical activity (difference: +8.31; 95%CI: 3.8, 12.8) goals increased. Proportions meeting the added sugar goal (difference: -8.8; 95% CI -14.7,-2.9) decreased, while no significant changes in tobacco use, alcohol consumption, and weight management were seen. There were significant variations in added sugar consumption, physical activity, and weight management by older age, lower education level, and tighter glycemic control.
Discussion: There has been little improvement in health habits among most adults with diabetes, although adults aged 65 years and older or had lower educational attainment significantly increased sleep and physical activity.
Disclosure
M.K.Shah: None. N.Gandrakota: None. K.R.Siegel: None. M.K.Ali: Advisory Panel; Bayer Inc., Eli Lilly and Company, Research Support; Merck & Co., Inc.
Funding
National Institute on Minority Health and Health Disparities (5K23MD015088-03); Emory University School of Medicine; Doris Duke Charitable Foundation; COVID-19 Fund to Retain Clinical Scientists; National Institutes of Health (UL1TR002378)
Since May 2021, the US has offered COVID-19 vaccines to all adults, yet only 66% of adults were fully vaccinated by Sep 25, 2021. The Delta variant surge heightens the importance of vaccination. To ...optimize outreach and education, understanding the degree to which an individual's intent to vaccinate changes over time and assessing factors that relate to rising vaccine likelihood are critical. For example, whether individuals who are initially "unsure" or "unlikely" will eventually be vaccinated is unknown. Most studies of vaccine intent are cross-sectional and cannot assess these changes. Using data from a nationally representative longitudinal study of adults in the US, Shah et al assessed individual-level change in vaccine intent and uptake between Apr 2021 and July 2021 and characteristics of individuals who reported an increase in vaccine likelihood or uptake.
Background
South Asians face a high prevalence of type II diabetes (DMII) and comorbid hypertension (HTN). Community health worker (CHW) interventions have the potential to improve chronic disease ...outcomes, yet few have been tailored to South Asian populations in the United States.
Objective
To test the effectiveness of an evidence-based CHW-led and culturally-tailored HTN and DMII management program for South Asian adults with diabetes and comorbid uncontrolled HTN (systolic blood pressure (SBP) > 130 mmHg or diastolic blood pressure (DBP) > 80 mmHg).
Design
Randomized-controlled Trial.
Participants
South Asian adults with DMII and comorbid HTN.
Intervention
The Diabetes Research, Education, and Action for Minorities (DREAM) Atlanta intervention was a CHW telehealth intervention designed to improve blood pressure (BP). The treatment group received five virtual group-based health education sessions, an action plan, and follow-up calls to assess goal setting activities. The control group received only the first session. Main Measures included: feasibility, improvement in BP control, and decreases in SBP, DBP, weight, and hemoglobin A1c (HbA1c).
Key Results
A total of 190 South Asian adults were randomized (97 to the treatment group and 93 to the control group); 94% of treatment group participants completed all 5 telehealth sessions. At endpoint, BP control increased 33.7% (95% CI: 22.5, 44.9, p < 0.001) in the treatment group and 16.5% (95%: 6.2, 26.8, p = 0.003) in the control group; the adjusted intervention effect was 1.8 (95% CI: 1.0, 3.2, p = 0.055). Mean weight decreased by 4.8 pounds (95% CI: -8.2, -1.4, p = 0.006) in the treatment group, and the adjusted intervention effect was -5.2 (95% CI: -9.0, -1.4, p = 0.007. The intervention had an overall retention of 95%.
Conclusions
A culturally-tailored, CHW-led telehealth intervention is feasible and can improve BP control among South Asian Americans with DMII.
Clinicaltrials.gov Registration
NCT04263311.
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