Understanding Physical Distancing and Face Mask Use Across High-Risk African American Subgroups During the COVID-19 Pandemic: Application of Health Belief Model.

Physical distancing and face masks remain frontline prevention strategies due to suboptimal vaccine uptake and the highly infectious COVID-19 variants. Communities of color are disproportionately impacted by a chronic disease burden that places them at higher risk of severe COVID-19 disease. Therefore, they can greatly benefit from face mask use and physical distancing, especially if the individual(s) have not received the vaccine. We applied the Health Belief Model to explore barriers and motivators influencing physical distancing and face mask use among high-risk, Black American subgroups during the early COVID-19 pandemic stages. We conducted 62 semi-structured interviews among four Black American subgroups: young adults, individuals with underlying medical conditions, essential workers, and parents. Thematic analysis, guided by the Health Belief Model, yielded six themes: (1) Knowledge on Face Mask Use and Physical Distancing, (2) Perceived Susceptibility and Severity Varies by Subgroup, (3) Experience with and Perceived Self-Efficacy to Engage in Preventive Behavior, (4) Perceived Benefits to engaging in preventive behaviors, (5) Perceived Barriers to engage in preventive behaviors, and (6) Cues to action to increase participation. Each subgroup's unique experience informed multilevel, tailored approaches that can be used by health promotion practitioners to improve face mask use and physical distancing among uniquely vulnerable Black American subgroups in the current and future pandemic.

Ai based motion analysis software for sport and physical therapy assessment / Software de análisis de movimiento basado en ia para la evaluación del deporte y la fisioterapia / Software de análise de movimento baseado em ia para avaliação de esporte e fisioterapia

ABSTRACT Introduction: As the World Health Organization declared the novel coronavirus as a pandemic in March 2020, physical therapy is more difficult to execute, and social distancing is mandatory in the healthcare sector. Objective: In physical therapy, an online video analysis software that provides real-time graphic and numerical information about the patient's movement executions without direct personal contact would mean a significant improvement in eHealth treatment. Methods: We have developed a software layer on top of OpenPose human body position estimation software that can extract the time series of angles of arbitrary body parts using the output coordinates from OpenPose processing the data recorded by two cameras simultaneously. To validate the procedure of determining the joint angles using the Openpose software we have used the Kinovea software. Results: The comparison of the determined maximal knee angle in our and the Kinovea software, which is widely used in biomechanical measurements, was not significantly different (2.03±1.06°, p<0.05) Conclusion: This indicates, that the developed software can calculate the appropriate joint angles with the accuracy that physiotherapy treatments require. As, to our knowledge no such software yet exists, with the help of this software development, therapists could control and correct the exercises in real-time, and also from a distance, and physical therapy effectiveness could be increased. Level of Evidence II; Experimental, comparative.

RESUMEN Introducción: Como la Organización Mundial de la Salud declaró el nuevo coronavirus como una pandemia en marzo de 2020, la fisioterapia es más difícil de ejecutar, el distanciamiento social es obligatorio en el sector de la salud. Objetivo: En la práctica de fisioterapia un software de análisis de vídeo online que proporcione información gráfica y numérica en tiempo real sobre las ejecuciones de movimiento del paciente sin contacto personal directo supondría una mejora significativa en el tratamiento de la eSalud. Métodos: Fue desarrollado una capa de software sobre el software de estimación de posición del cuerpo humano OpenPose que puede extraer la serie temporal de ángulos de partes arbitrarias del cuerpo utilizando las coordenadas de salida de OpenPose procesando los datos registrados por dos cámaras simultáneamente. Para validar el procedimiento de determinación de los ángulos articulares mediante el software Openpose fue utilizado el software Kinovea. Resultados: La comparación del ángulo máximo de rodilla determinado en nuestro software y Kinovea, que es ampliamente utilizado en mediciones biomecánicas, no fue significativamente diferente (2,03±1,06°, p<0,05). Conclusión: Esto indica que el software desarrollado puede calcular los ángulos articulares adecuados con la precisión que requieren los tratamientos de fisioterapia. Dado que aún no existe dicho software, con la ayuda de este desarrollo de software, los terapeutas podrían controlar y corregir los ejercicios en tiempo real, y también a distancia, y se podría aumentar la eficacia de la fisioterapia. Nivel de Evidencia II; Experimental, comparativo.

RESUMO Introdução: Como a Organização Mundial da Saúde declarou o novo coronavírus como pandemia em março de 2020, a fisioterapia é mais difícil de executar, o distanciamento social é obrigatório no setor de saúde. Objetivo: Na prática da fisioterapia, um software de análise de vídeo online que fornece informações gráficas e numéricas em tempo real sobre as execuções de movimento do paciente sem contato pessoal direto significaria uma melhora significativa no tratamento eHealth. Métodos: Desenvolveu-se uma camada de software em cima do software de estimativa de posição do corpo humano OpenPose que pode extrair as séries temporais de ângulos de partes do corpo arbitrárias usando as coordenadas de saída do OpenPose processando os dados gravados por duas câmeras simultaneamente. Para validar o procedimento de determinação dos ângulos articulares utilizando o software Openpose utilizou-se o software Kinovea. Resultados: A comparação do ângulo máximo do joelho determinado em nosso e no software Kinovea, amplamente utilizado em medidas biomecânicas, não foi significativamente diferente (2,03±1,06°, p<0,05) Conclusão: Isso indica que o software desenvolvido pode calcular os ângulos articulares adequados com a precisão que os tratamentos de fisioterapia exigem. Como esse software ainda não existe, com a ajuda do desenvolvimento desse software, os terapeutas puderam controlar e corrigir os exercícios em tempo real, e também à distância, aumentando a eficácia da fisioterapia. Nível de Evidência II; Experimental, comparativo.

Differential COVID-19 preventive behaviors among Asian subgroups in the United States.

BACKGROUND: Given the observed within-Asian disparity in COVID-19 incidence, we aimed to explore the differential preventive behaviors among Asian subgroups in the United States. METHODS: Based on data from the Asian subsample (N = 982) of the 2020 Health, Ethnicity, and Pandemic survey, we estimated the weighted proportion of noncompliance with Centers for Disease Control and Prevention (CDC) guidelines on preventive behaviors and COVID-19 testing by Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Other Asian). We examined these subgroup differences after adjusting for demographic factors and state-level clustering. RESULTS: Filipinos demonstrated the lowest rate of noncompliance for mask-wearing, social distancing, and handwashing. As compared with the Filipinos, our logistic models showed that the Chinese and the 'other Asians' subgroup had significantly higher risk of noncompliance with mask-wearing, while the Japanese, the Vietnamese, and other Asians were significantly more likely to report noncompliance with social distancing. CONCLUSIONS: The significant variation of preventive behavior across Asian subgroups signals the necessity of data disaggregation when it comes to understanding the health behavior of Asian Americans, which is critical for future pandemic preparedness. The excess behavioral risk among certain Asian subgroups (especially those 'other Asians') warrants further investigation and interventions about the driving forces behind these disparities.

Pandemia da Covid-19: Prática de Lazer entre Professores Brasileiros / Covid-19 pandemic: leisure practice among teachers brazilian

Neste estudo, examinamos as atividades de lazer entre os professores durante a COVID-19, avaliando questões relacionadas ao perfil sociodemográfico e às condições de trabalho. Trata-se de um websurvey transversal, realizado com professores da educação básica pública de Minas Gerais. Foi utilizado um formulário digital para a coleta de dados em 2020. A prática de lazer na pandemia foi a variável dependente. Na análise múltipla, foi utilizada a regressão de Poisson. Participaram do estudo 15.641 professores, dos quais 43% não estavam tendo práticas de lazer na pandemia. Houve maior prevalência de ausência da prática de lazer entre as mulheres, entre os idosos, professores pardos e pretos, contratados/designados e insatisfeitos com o trabalho docente na pandemia. Assim, esta pesquisa buscou discutir temas socioculturais, destacando que o acesso às práticas de lazer carece de uma visão social, humana e voltada para a desigualdade.

In this study, we examined leisure activities among teachers during the COVID-19, assessing issues related to sociodemographic profile and working conditions. This is a cross-sectional websurvey, performed with teachers of public basic education of Minas Gerais. A digital form was used to collect data in 2020. Leisure practice in pandemic was the dependent variable. In the multiple analysis, Poisson regression was used. A total of 15,641 teachers participated in the study, of which 43% were not having leisure practices in pandemic. There was a higher prevalence of absence of leisure practice among women, among the elderly, brown and black-skinned teachers, contracted/designated teachers and those not satisfied with teaching work in pandemic. Thus, this research sought to discuss sociocultural topics, highlighting, that access to leisure practices lacks a social, human vision focused on the inequality.

Impact of the government's restrictions and guidance in relation to "social distancing" on the lives of ethnic minority populations: A mixed methods study.

Background and Aims: The impacts of the COVID-19 pandemic have not been equal, with a disproportionate impact among ethnic minority communities. Structural inequalities in social determinants of health such as housing and employment have contributed to COVID-19's impact on deprived communities, including many ethnic minority communities. To compare (1) how the UK government's "social distancing" restrictions and guidance were perceived and implemented by ethnic minority populations compared to white populations, (2) the impact of restrictions and guidance upon these groups. Methods: An explanatory sequential mixed methods study incorporated a quantitative survey and qualitative semi-structured interviews to explore individual perceptions and experiences of COVID-19 and the national restrictions. Survey participants (n = 1587) were recruited from North West England; 60 (4%) participants were from ethnic minority communities. Forty-nine interviews were conducted; 19 (39%) participants were from ethnic minority communities. Interviews were transcribed verbatim and analysed using a thematic approach. Data collection was between April and August 2020. Results: Significant differences in demographics and household overcrowding were observed between white vs ethnic minority survey respondents, who were also significantly less confident in their knowledge of COVID-19, less likely to be high-risk drinkers, and marginally more likely to have experienced job loss and/or reduced household income. There were no group differences in wellbeing, perceptions, or nonfinancial impacts. Two inter-related themes included: (1) government guidance, incorporating people's knowledge and understanding of the guidance and their confusion/frustration over messaging; (2) the impacts of restrictions on keyworkers, home-schooling, working from home and changes in lifestyle/wellbeing. Conclusions: Further research is needed on the long-term impacts of COVID-19 on ethnic minority communities. If policy responses to COVID-19 are to benefit ethnic minority communities, there is a need for future studies to consider fundamental societal issues, such as the role of housing and economic disadvantage.

COVID-19, the COVID-19 response, and racial injustice: Associations with depressive and anxiety symptoms among US adults from April 2020 to March 2021.

Background: People in the United States have faced numerous large and intersecting threats to their mental health since the onset of the coronavirus disease pandemic. This study aimed to understand the unique relationships between these co-occurring threats - including the police killings of unarmed Black people and the fight for racial justice - and how they affect mental health symptoms among various demographic groups. Methods: Data on population mental health, state-level COVID-19 incidence rates, cases of police-involved killings, and occurrences of racial justice protests were analyzed. The primary outcome was depression or anxiety symptoms. Regression models were used to estimate prospective associations between individual-, household-, and state-level exposures to hypothesized mental health threats and subsequent depression or anxiety symptoms. Results: Data from 2,085,041 individual participants were included. Most were women (51.2%), and most were white, non-Hispanic (61.2%), with almost half (47.7%) reporting some loss of household income since March 13, 2020. Neither the killing of unarmed Black people by police, nor the above-average occurrence of Black Lives Matter (BLM) protests, were observed to be associated with anxiety or depressive symptoms in the overall population, though the BLM protests were associated with reduced depressive and anxiety symptoms among younger participants. State-level COVID-19 incidence risk was more strongly associated with depressive and anxiety symptoms among women, Black people, older people, and higher income people, compared to men, white people, younger people, and lower income people. Conclusion: Our findings are relevant for anticipating and addressing the mental health consequences of social injustice and protest movements in the context of COVID-19 pandemic, as well as future pandemics. Promoting population mental health requires addressing underlying social and structural inequities and prioritizing the pursuit of social justice and health equity as a primary mental health intervention.

Social Disparities and Social Distancing During the Covid Pandemic.

According to Putnam (2000) and Bourdieu (1986), social disparities may result in the formation of narrow social bonds that exacerbate existing social cleavages and impede collective action. Motivated by this insight, we examine the relationship between social disparities and social distancing during the pre-vaccine Covid pandemic in the US. Using a panel of weekly, county-level observations, we find that income, educational and racial disparities are associated with a statistically significant decrease in the social distancing. This result is robust to controls for a wide variety of socioeconomic variables, the Covid infection rate, and a measure of social capital.

Strict Lockdown versus Flexible Social Distance Strategy for COVID-19 Disease: a Cost-Effectiveness Analysis.

Objectives: To balance the costs and effects comparing a strict lockdown versus a flexible social distancing strategy for societies affected by Coronavirus-19 Disease (COVID-19). Design: Cost-effectiveness analysis. Participants: We used societal data and COVID-19 mortality rates from the public domain. Interventions: The intervention was a strict lockdown strategy that has been followed by Denmark. Reference strategy was flexible social distancing policy as was applied by Sweden. We derived mortality rates from COVID-19 national statistics, assumed the expected life years lost from each COVID-19 death to be 11 years and calculated lost life years until 31st August 2020. Expected economic costs were derived from gross domestic productivity (GDP) statistics from each country's official statistics bureau and forecasted GDP. The incremental financial costs of the strict lockdown were calculated by comparing Sweden with Denmark using externally available market information. Calculations were projected per one million inhabitants. In sensitivity analyses we varied the total cost of the lockdown (range -50% to +100%). Main Outcome Measure: Financial costs per life years saved. Results: In Sweden, the number of people who died with COVID-19 was 577 per million inhabitants, resulting in an estimated 6,350 life years lost per million inhabitants. In Denmark, where a strict lockdown strategy was installed for months, the number of people dying with COVID-19 was on average 111 per million, resulting in an estimated 1,216 life years per million inhabitants lost. The incremental costs of strict lockdown to save one life year was US$ 137,285, and higher in most of the sensitivity analyses. Conclusions: Comparisons of public health interventions for COVID-19 should take into account life years saved and not only lost lives. Strict lockdown costs more than US$ 130,000 per life year saved. As our all our assumptions were in favour of strict lockdown, a flexible social distancing policy in response to COVID19 is defendable.

Coefficient identification in a SIS fractional-order modelling of economic losses in the propagation of COVID-19.

A fractional-order SIS (Susceptible-Infectious-Susceptible) model with time-dependent coefficients is used to analyse some effects of the novel coronavirus 2019 (COVID-19). This generalized model is suitable for describing the COVID dynamics since it does not presume permanent immunity after contagion. The fractional derivative activates the memory property of the dynamics of the susceptible and infectious population time series. A coefficient identification inverse problem is posed, which consists of reconstructing the time-varying transmission and recovery rates, which are of paramount importance in practice for both medics and politicians. The inverse problem is reduced to a minimization problem, which is solved in a least squares sense. The iterative predictor-corrector algorithm reconstructs the time-dependent parameters in a piecewise-linear fashion. The economic losses emerging from social distancing using the calibrated model are also discussed. A comparison between the results obtained by the classical model and the fractional-order model is included, which is validated by ample tests with synthetic and real data.

The challenge of estimating the direct and indirect effects of COVID-19 interventions - Toward an integrated economic and epidemiological approach.

Decisions on public health measures to contain a pandemic are often based on parameters such as expected disease burden and additional mortality due to the pandemic. Both pandemics and non-pharmaceutical interventions to fight pandemics, however, produce economic, social, and medical costs. The costs are, for example, caused by changes in access to healthcare, social distancing, and restrictions on economic activity. These factors indirectly influence health outcomes in the short- and long-term perspective. In a narrative review based on targeted literature searches, we develop a comprehensive perspective on the concepts available as well as the challenges of estimating the overall disease burden and the direct and indirect effects of COVID-19 interventions from both epidemiological and economic perspectives, particularly during the early part of a pandemic. We review the literature and discuss relevant components that need to be included when estimating the direct and indirect effects of the COVID-19 pandemic. The review presents data sources and different forms of death counts, and discusses empirical findings on direct and indirect effects of the pandemic and interventions on disease burden as well as the distribution of health risks.

Optimal strategies for coordinating infection control and socio-economic activities.

It becomes challenging to identify feasible control strategies for simultaneously relaxing the countermeasures and containing the Covid-19 pandemic, given China's huge population size, high susceptibility, persist vaccination waning, and relatively weak strength of health systems. We propose a novel mathematical model with waning of immunity and solve the optimal control problem, in order to provide an insight on how much detecting and social distancing are required to coordinate socio-economic activities and epidemic control. We obtain the optimal intensity of countermeasures, i.e., the dynamic nucleic acid screening and social distancing, under which the health system is functioning normally and people can engage in a certain level of socio-economic activities. We find that it is the isolation capacity or the restriction of the case fatality rate (CFR) rather than the hospital capacity that mainly determines the optimal strategies. And the solved optimal controls under quarterly CFR restrictions exhibit oscillations. It is worth noticing that, if without considering booster or very low booster rate, the optimal strategy is a "on-off" mode, alternating between lock down and opening with certain social distancing, which reflects the importance and necessity of China's static management on a certain area during Covid-19 outbreak. The findings suggest some feasible paths to smoothly transit from the Covid-19 pandemic to an endemic phase.

Financial Fraud of Older Adults During the Early Months of the COVID-19 Pandemic.

BACKGROUND AND OBJECTIVES: Coronavirus disease 2019 (COVID-19) created a "perfect storm" for financial fraud targeting older adults. Guided by the Contextual Theory of Elder Abuse, we focused on individual and systemic contexts to examine how older adults became prey to financial fraud. RESEARCH DESIGN AND METHODS: In July 2020, 998 adults who were 60-98 years of age (93% White; 64% female) completed an online survey about experiences with financial fraud. Participants were recruited from gerontology research registries at Florida State University, University of Pittsburg, Virginia Tech, and Wayne State University. RESULTS: Over half (65.9%) of the respondents experienced a COVID-19-related scam attempt, with charity contributions (49%) and COVID-19 treatments (42%) being the most common. Perpetrators commonly contacted older adults electronically (47%) two or more times (64%). Although most respondents ignored the request (i.e., hung up the phone and deleted text/e-mail), 11.3% sent a requested payment, and 5.3% provided personal information. Predictors of vulnerability included contentment with financial situation, concern about finances in the aftermath of the pandemic, and wishing to talk to someone about financial decisions. Respondents targeted for a non-COVID-19 scam attempt were less likely to be targets of a COVID-19-related scam. DISCUSSION AND IMPLICATIONS: Older adults who were financially secure, worried about their financial situation, or wished they could speak with someone about their financial decisions appeared susceptible to falling victim to a fraud attempt. The high number of attempts indicates a need for a measurable and concerted effort to prevent the financial fraud of older adults.

Epidemiological modelling of the health and economic effects of COVID-19 control in Australia's second wave.

Background: We investigated the public health and economy outcomes of different levels of social distancing to control a 'second wave' outbreak in Australia and identify implications for public health management of COVID-19. Methods: Individual-based and compartment models were used to simulate the effects of different social distancing and detection strategies on Australian COVID-19 infections and the economy from March to July 2020. These models were used to evaluate the effects of different social distancing levels and the early relaxation of suppression measures, in terms of public health and economy outcomes. Results: The models, fitted to observations up to July 2020, yielded projections consistent with subsequent cases and showed that better public health outcomes and lower economy costs occur when social distancing measures are more stringent, implemented earlier and implemented for a sufficiently long duration. Early relaxation of suppression results in worse public health outcomes and higher economy costs. Conclusions: Better public health outcomes (reduced COVID-19 fatalities) are positively associated with lower economy costs and higher levels of social distancing; achieving zero community transmission lowers both public health and economy costs compared to allowing community transmission to continue; and early relaxation of social distancing increases both public health and economy costs.

Health insurance system and resilience to epidemics.

We theoretically analyze the resilience (efficiency) of health insurance systems and diverse factors including trace and test technology, infection and contagion rates, and social distancing/lockdown policy, in coping with contagious diseases like COVID-19. Our findings can be summarized as follows. First, public insurance is more resilient than market insurance, as the former's investment in test technology is made at the social optimum, whereas the latter's investment is less. The decentralized behavior of competing insurers leads to a less resilient outcome. Second, resilience decreases as the market becomes more competitive because the externality effect becomes more severe. Third, a higher contagion rate, a more cost-efficient test technology or a higher initial infection rate unless it is not too high, leads to a higher test accuracy level. Fourth, the socially optimal social distancing/lockdown policy is determined by comparison between its relative costs and the benefit from contagion reduction.

Trajectories of parent and child well-being across the pandemic year: Role of financial strain, social distancing, and COVID-19 prevalence.

Existing research demonstrated large deteriorations in parent, child, and family well-being within 2 months after the onset of the COVID-19 pandemic. Yet, little is known about the trajectories of families' adjustment in the following months, including what risk factors are associated with changes in families' adjustment. The current study examined (1) change in the parent, child, and family well-being over time; (2) associations of pandemic-related stressors, financial and social distancing-associated stress, with well-being between and within families; and (3) the role of local COVID-19 prevalence, prior participation in family-focused prevention, and parent gender. From April 2020 to January 2021, 393 parents from 235 families reported five times on parent mental health, child behavior problems, family relationships, and pandemic-related stressors. Findings indicate that, across all domains of well-being, there was either little change across the 8 months or a small degree of recovery followed by a shift to further deterioration. On average, parents experiencing greater pandemic-related stressors also reported poorer functioning in all domains; monthly fluctuations in pandemic-related stressors were also associated with fluctuations in parent mental health and child behavior problems. In some domains, the links between pandemic-related stressors and parent and child well-being were stronger among families living in areas with overall higher COVID-19 prevalence rates. Parents' experiences during the pandemic did not differ systematically across prior intervention participation or parent gender. Taken together, findings suggest a need for supportive interventions to help families navigate extended periods of crisis.

Camadas do sofrimento: impactos psicossociais das medidas de isolamento social em favelas da região metropolitana do Rio de Janeiro / Layers of suffering: psychosocial impacts from social isolation measures in slums of the Rio de Janeiro metropolitan region

Com a pandemia de COVID-19, medidas de isolamento social foram adotadas em escala global. Até 2019, pouco se sabia sobre os impactos desse tipo de estratégia na saúde mental das populações afetadas. Estudos realizados em outras epidemias apontam que indivíduos submetidos a períodos de quarentena tendem a apresentar sintomas de Transtorno de Estresse Pós-traumático (TEPT) e/ou Transtorno Depressivo Maior (TDM). No entanto, para além desta perspectiva psiquiátrica, autores vêm apontando para a necessidade de levar em consideração aspectos socioeconômicos e ambientais na investigação relacionados aos impactos da pandemia, sobretudo em populações que se encontram em situação de vulnerabilidade estrutural. No Brasil, favelas são territórios populacionalmente densos, permeados de pobreza e violência, que possuem muitas vezes habitações precárias, com pouca ventilação, falta de saneamento básico e água potável, fatores que, em si, são dificultantes para o atravessamento do período de isolamento. Nesse sentido, o presente trabalho tem como objetivo investigar os impactos psicossociais advindos de medidas de isolamento social em moradores de favelas da região metropolitana do Rio de Janeiro. Para tal, foram realizadas com 10 participantes moradores de favelas, maiores de 18 anos, entrevistas via Whatsapp de base qualitativa e roteiro semiestruturado. A partir dos resultados encontrados, foi possível inferir que o sofrimento, angústias e aflição dos participantes nesse momento não foram oriunda da pandemia ou de medidas de isolamento per se. Mas sim que a crise de COVID-19 se estabeleceu como um evento crítico que, em concomitância com outros atravessamentos e especificidades, tanto individuais como territoriais, compuseram o quadro de sofrimento dos participantes.

COVID-19 pandemis was responsible for the adpotion of social isolation measures on a global scale. Until 2019, little was known about the impacts of this type of strategy on the mental health of those which were subjected to those measueres. Studies conducted in other epidemics, indicates that individuals that undergone quarantine periods tend to exhibit symptoms of Post Traumatic Stress Disorder (PTSD) and/or Major Depressive Disorder (MDD). However, autores have been poiting to the need of going beyond this psychiatric perspective, and take into account socioeconomic and environmental aspects on investigations related to the impacts of the pandemic, especially of those in situation of structural vulnerability. In Brazil, slums are densely populated territories, permeated by poverty and violence, that often have precarious housing, with little ventilation, lack of basic sanitation and safe drinking-water, factors that are challenges during the period of social distancing. In this sense, this work aims to investigate psychosocial impacts from social isolation measures, on slum dwellers of the metropolitan region of Rio de Janeiro State. For this purpose were conducted via Whatsapp virtual, qualitative interviews with 10 participants who were over 18 years old, and lived on those regions. From the results it was possible to infer that the suffering, anguish and affliction of the participants at this moment did not originate from the pandemic or from isolation measures per se. Rather, the crisis of covid-19 was established as a Critical Event that, together with other smaller events, territorial and invidividual specificities, made up a web of suffering on the subjects of this research.

Mental health, economic well-being and health care access amid the COVID-19 pandemic: a mixed methods study among urban men who have sex with men in India.

Scant empirical research from Asia has addressed the impact of COVID-19 on sexual minority health. We aimed to explore and understand the impact of COVID-19 on income security, mental health, HIV risk and access to health services among men who have sex with men (MSM) in India. We conducted a concurrent mixed methods study from April to June 2020, including a cross-sectional survey and in-depth semi-structured interviews with MSM recruited from three non-governmental organisations providing HIV prevention services in Chandigarh, India. We examined the associations of sexual minority stressors (sexual stigma, internalised homonegativity), economic stressors, and stress due to social distancing, with depression and anxiety, HIV risk, and access to health services. Survey findings (n = 132) indicated that internalised homonegativity and stress related to social distancing were significantly associated with depressive and anxiety symptoms. Results also showed reduced access to condoms, HIV testing and counselling services. Qualitative findings (n = 10) highlighted adverse economic impacts of COVID-19, including loss of employment/wages and engaging in survival sex work, which contributed to psychological distress and HIV risk. The COVID-19 pandemic has resulted in considerable psychological and financial distress among low socioeconomic status MSM in India, including those involved in sex work - communities already marginalised in economic, family and healthcare sectors. Structural interventions to improve access to mental health and HIV services and decrease financial burden are critical to mitigate the impact of COVID-19.

Social distancing as a public-good dilemma for socio-economic cost: An evolutionary game approach.

Partaking in social distancing can contribute to a public good affected by the perceived risk of infection and socioeconomic cost. Although social distancing can save lives by slowing down the disease transmission before introducing any effective medical intervention, the economic fallout of social distancing can be brutal for the poorest, vulnerable, and marginalized members of society. We combined the epidemiological and evolutionary game theoretical (EGT) framework through the consolidations of the SEIR (Susceptible-Exposed-Infected-Removed) disease model to analyze behavior enticements in a social distancing dilemma situation with the complex behavioral decision-making aspect. Extensive theoretical and numerical analyses reveal that socioeconomic cost and infected individuals' compliance behavior are critical factors in reining disease spread in the community. Lower cost for maintaining relative safety distance encourages maximum avoidance of public interactions by a detected infected individual. The benefitted fraction due to compliance is parted from the naturally immunized population. People get insignificant benefits from social distancing when the disease transmission rate is too low or crosses critical higher values. Average Social Payoff (ASP) analysis suggests the correspondence of significant safety distance with lowest cost setting as the best strategy to derive the maximum goods. But mounting inherent cost converts social distancing obedience to a public good dilemma.

Education-related inequalities in beliefs and behaviors pertaining to COVID-19 non-pharmaceutical interventions.

BACKGROUND: The coronavirus pandemic has exposed existing social inequalities in relation to disease preventive behaviors, risk of exposure, testing and healthcare access, and consequences as a result of illness and containment measures across different population groups. However, due to a lack of data, to date there has been limited evidence of the extent of such within-country inequalities globally. METHODS: We examined education-related inequalities in four COVID-19 prevention and testing indicators within 90 countries, using data from the University of Maryland Social Data Science Center Global COVID-19 Trends and Impact Survey, in partnership with Facebook, over the period 1 June 2021 to 31 December 2021. The overall level of education-related inequalities, as well as how they differ across country income groups and how they have changed over time were analyzed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). We also assessed whether these education-related inequalities were associated with government policies and responses. RESULTS: Education-related inequalities in beliefs, mask wearing, social distancing and testing varied across the study countries. Mask wearing and beliefs in the effectiveness of social distancing and mask wearing were overall more common among people with a higher level of education. Even after controlling for other sociodemographic and health-related factors, social distancing practice was higher among the most educated in low/lower middle income countries, but was higher overall among the least educated in high income countries. Overall there were low education-related inequalities in COVID-19 testing, though there was variation across countries. CONCLUSIONS: The study highlights important within-country education-related differences in COVID-19 beliefs, preventive behaviors and testing, as well as differing trends across country income groups. This has implications for considering and targeting specific population groups when designing public health interventions and messaging during the COVID-19 pandemic and future health emergencies.

Impact of COVID social distancing measures on eating and exercise behaviors among a sample of Hispanic parents of young children in the United States.

Background: In the United States, healthy behaviors, such as eating fruits/vegetables and exercise, are well below recommended levels, particularly for Hispanics. The COVID pandemic may have exacerbated existing health behavior disparities. The current study examines the impact of COVID social distancing measures on Hispanic parents' eating and exercise behaviors, and how the impact may differ by socioeconomic status (SES) and distress levels. Design and methods: This cross-sectional logistic regression study utilized data from a sample of Hispanic parents in Texas (n = 237). COVID-related questions were collected in Summer 2020. Dependent variables included self-reported changes in exercise and eating behaviors due to the pandemic (i.e. got better or got worse). Primary independent variables included family-SES, neighborhood-SES, and distress due to COVID. Results: More than half (60%) of parents reported that their eating and exercise behaviors worsened. Results showed a significant relationship between distress due to COVID and both dependent variables; changes in eating (OR = 1.38, 95% CI [1.20, 1.58]) and changes in exercise (OR = 1.28, 95% CI [1.11, 1.48]). There were no observed differences by SES. Conclusions: Results suggest distress due to COVID was associated with worsening of eating and exercise behaviors, regardless of SES. The direction of the relationship between distress and healthy eating and exercise behaviors requires further attention.