Mask Mandate's Effect on Job Loss Expectation and Mental Health in the United States during the COVID-19 Pandemic.

BACKGROUND: Uncertainty around economic recovery from a pandemic, in addition to restrictions on mobility and socializing, can be isolating and stressful. While preventive measures, such as mask mandates, are expected to mitigate spread of the disease and lower concerns of future job loss, state- and local-level mandates could signal that infection rates are worse in the mandated areas and decrease consumer confidence and mobility. Thus, the association between mask mandates and psychological well-being is unclear. AIMS OF THE STUDY: Twenty-five states in the United States implemented statewide mask mandates early in the pandemic. This study seeks to examine the effect of mask mandates on self-reported job loss expectation and mental health. METHODS: This study analyzes U.S. Census Bureau's Household Pulse Survey data, collected between April 23rd and July 21st, 2020. Using a panel subset of the data, fixed effects models are estimated to understand statewide mask mandate's effect on psychological well-being over a twelve-week period while controlling for individual-level unobserved heterogeneity. All data are then state-aggregated, and fixed effects models are estimated to examine average differences in job loss expectation and mental health between mandate and non-mandate states. RESULTS: In the individual-level panel data, job loss expectation was lower by 1.1 percentage point by the second week of a statewide mask mandate and by 1.6 percentage point by the third week, compared to average job loss expectation in states without a mask mandate and to the mandate states before the policy implementation. Average job loss expectation was 6.5 percentage point lower by the twelfth week in the five states that were the first to implement statewide mask mandates. Mental health status improved steadily from the fourth week on in states with a mask mandate. Analysis of state-aggregated data indicates considerable variability and lack of uniformity in mask mandates' impact on job loss expectation and mental health status. DISCUSSION: Local-level mandates, such as those at the county-level, could not be identified in these data. The impact of a mask mandate could be underestimated when only state-level mandates are considered, and local regulations are excluded. This is a limitation of this study. IMPLICATIONS FOR HEALTH CARE PROVISION: The staggered state-by-state approach to implementing mask mandates and the considerable variability in enforcement of mask rules has possibly contributed to lack of uniformity and consistency in how mask mandates impact subjective psychological well-being. IMPLICATIONS FOR HEALTH POLICIES: The lack of statistically significant impact of statewide mask mandates on the two outcome variables in the state-aggregated data, and on long-run job loss expectation in the individual-level panel data, could be indicative of the complexities of effective science communication regarding behavioral recommendations to promote overall well-being. IMPLICATIONS FOR FURTHER RESEARCH: Multiple variants of SARS-CoV-2, the virus that causes COVID-19, has emerged around the world. Further research could more clearly assess the degree to which communicating public health implications of these variants has evolved, and whether it has elicited behavior change and affected psychological well-being.

Health insurance coverage during the COVID-19 pandemic: The role of Medicaid expansion.

Using data from the US Census Bureau's Household Pulse Survey, we analyzed the likelihood of loss of health insurance and enrollment into new health coverage during the early months of the COVID-19 pandemic. Loss of employment was associated with a significant increase in the likelihood of loss of health insurance and, specifically, an increase in the likelihood of employer-sponsored health insurance. However, individuals in Medicaid expansion states experienced a lower likelihood of loss of health insurance compared with individuals in nonexpansion states. At the same time, there was a statistically significant increase in Medicaid enrollment in expansion states, by 3.2 percentage points. Reemployment or acquiring employment was associated with a gain in health insurance coverage. During an economic downturn, eligibility, and coverage gaps leave many without affordable coverage options, and the pandemic will likely bring renewed attention to gaps in Medicaid coverage in nonexpansion states.

Anticancer potential of docetaxel-loaded cobalt ferrite nanocarrier: an in vitro study on MCF-7 and MDA-MB-231 cell lines.

AIM: To develop a biocompatible cobalt ferrite (CF-NP) nanodrug formulation using oleic acid and poly (d,l-lactide-co-glycolic) acid (PLGA) for the delivery of docetaxel (DTX) specifically to breast cancer cells. METHODS: The CF-NP were synthesised by hydrothermal method and conjugated with DTX in a PLGA matrix and were systematically characterised using XRD, FE-SEM, TEM, DLS, FTIR, TGA, SQUID etc. The drug loading, in vitro drug release, cellular uptake, cytotoxicity were evaluated and haemolytic effect was studied. RESULTS: The CF-NP showed good crystallinity with an average particle size of 21 nm and ferromagnetic nature. The DTX-loaded CF-NP (DCF-NP) showed 8.4% (w/w) drug loading with 81.8% loading efficiency with a sustained DTX release over time. An effective internalisation and anti-proliferative efficiency was observed in MCF-7 and MDA-MB-231 breast cancer cells and negligible haemolytic effect. CONCLUSION: The DCF-NP can have the potential for the effective delivery of DTX for breast cancer treatment.

Do gender gaps in education and health affect economic growth? A cross-country study from 1975 to 2010.

We use system-generalized method-of-moments to estimate the effect of gender-specific human capital on economic growth in a cross-country panel of 127 countries between 1975 and 2010. There are several benefits of using this methodology. First, a dynamic lagged dependent econometric model is suitable to address persistence in per capita output. Second, the generalized method-of-moments estimator uses dynamic properties of the data to generate appropriate instrumental variables to address joint endogeneity of the explanatory variables. Third, we allow the measurement error to include unobserved country-specific effect and random noise. We include two gender-disaggregated measures of human capital-education and health. We find that gender gap in health plays a critical role in explaining economic growth in developing countries. Our results provide aggregate evidence that returns to investments in health systematically differ across gender and between low-income and high-income countries.

The Effect of Paid Leave on Maternal Mental Health.

Objectives I examined the relationship between paid maternity leave and maternal mental health among women returning to work within 12 weeks of childbirth, after 12 weeks, and those returning specifically to full-time work within 12 weeks of giving birth. Methods I used data from 3850 women who worked full-time before childbirth from the Early Childhood Longitudinal Study-Birth Cohort. I utilized propensity score matching techniques to address selection bias. Mental health was measured using the Center for Epidemiologic Studies Depression (CESD) scale, with high scores indicating greater depressive symptoms. Results Returning to work after giving birth provided psychological benefits to women who used to work full-time before childbirth. The average CESD score of women who returned to work was 0.15 standard deviation (p < 0.01) lower than the average CESD score of all women who worked full-time before giving birth. Shorter leave, on the other hand, was associated with adverse effects on mental health. The average CESD score of women who returned within 12 weeks of giving birth was 0.13 standard deviation higher (p < 0.05) than the average CESD score of all women who rejoined labor market within 9 months of giving birth. However, receipt of paid leave was associated with an improved mental health outcome. Among all women who returned to work within 12 weeks of childbirth, those women who received some paid leave had a 0.17 standard deviation (p < 0.05) lower CESD score than the average CESD score. The result was stronger for women who returned to full-time work within 12 weeks of giving birth, with a 0.32 standard deviation (p < 0.01) lower CESD score than the average CESD score. Conclusions The study revealed that the negative psychological effect of early return to work after giving birth was alleviated when women received paid leave.

Expanding Access to Patient Care in Community Pharmacies for Minor Illnesses in Washington State.

Introduction: As the shortage of primary care providers widens nationwide, access to care utilizing non-physician providers is one strategy to ensure equitable access to care. This study aimed to compare community pharmacist-provided care for minor ailments to care provided at three traditional sites of care: primary care, urgent care, and emergency department, to determine if care provided by pharmacists improved access with comparable quality and reduced financial strain on the healthcare system. Methods: Pharmacy data was provided from 46 pharmacies and 175 pharmacists who participated across five pharmacy corporations over a 3-year period (2016-2019). Data for non-pharmacy sites of care was provided by a large health plan, matching episodes of care for conditions seen in the community pharmacy. Cost-of-care analysis was conducted using superiority study design and revisit data analysis was conducted using noninferiority study design. Results: Median cost-of-care across traditional sites of care was $277.78 higher than care provided at the pharmacies, showing superiority. Noninferiority was demonstrated for revisit care when the initial visit was conducted by a pharmacist compared to traditional sites. Discussion: The authors conclude community pharmacist-provided care for minor ailments improved cost-effective access for patients with comparable quality and reduced financial strains on the healthcare system.

Selection effects and prevention program outcomes.

A primary goal of the paper is to provide an example of an evaluation design and analytic method that can be used to strengthen causal inference in nonexperimental prevention research. We used this method in a nonexperimental multisite study to evaluate short-term outcomes of a preventive intervention, and we accounted for effects of two types of selection bias: self-selection into the program and differential dropout. To provide context for our analytic approach, we present an overview of the counterfactual model (also known as Rubin's causal model or the potential outcomes model) and several methods derived from that model, including propensity score matching, the Heckman two-step approach, and full information maximum likelihood based on a bivariate probit model and its trivariate generalization. We provide an example using evaluation data from a community-based family intervention and a nonexperimental control group constructed from the Washington State biennial Healthy Youth Survey (HYS) risk behavior data (HYS n = 68,846; intervention n = 1,502). We identified significant effects of participant, program, and community attributes in self-selection into the program and program completion. Identification of specific selection effects is useful for developing recruitment and retention strategies, and failure to identify selection may lead to inaccurate estimation of outcomes and their public health impact. Counterfactual models allow us to evaluate interventions in uncontrolled settings and still maintain some confidence in the internal validity of our inferences; their application holds great promise for the field of prevention science as we scale up to community dissemination of preventive interventions.

The Differential Effects of Childhood and Chronic Bullying Victimization on Health and Risky Health Behaviors.

We examine the heterogeneous effects of childhood bullying victimization and chronic bullying victimization on a wide range of outcomes using data from the National Longitudinal Survey of Youth in the United States. Bullying victimization is categorized as childhood or chronic depending on the duration of victimization. We find that bullying victimization negatively affects the physical and mental health of youths, and increases the likelihood of engaging in risky behaviors, such as, smoking and marijuana use. The adverse effects tend to increase in magnitude with chronic bullying victimization. In addition, chronic bullying victimization increases the likelihood of utilizing mental health services and experiencing life-disrupting emotional problems in adulthood. Supplementary Information: The online version contains supplementary material available at 10.1007/s40653-023-00542-0.

Methods for binding analysis of small GTP-binding proteins with their effectors.

Proteins often do not function as a single biomolecular entity; instead, they frequently interact with other proteins and biomolecules forming complexes. There is increasing evidence depicting the essentiality of protein-protein interactions (PPIs) governing a wide array of cellular processes. Thus, it is crucial to understand PPIs. Commonly used approaches like genetic (e.g., Yeast Two-Hybrid, Y2H), optical (e.g., Surface Plasmon Resonance, SPR; Fluorescence Resonance Energy Transfer, FRET), and biochemical have rendered ease in developing interactive protein maps as freely available information in protein databases on the web. The underlying basis of traditional protein interaction analysis is the core of biochemical methodologies providing direct evidence of interactions. Co-Immunoprecipitation (Co-IP) is a powerful biochemical technique that facilitates identifying novel interacting partners of a protein of interest in vivo, allowing specific capture of their complexes on an immunoglobulin. Here, using Arf-like (Arl) GTPase-8b (Arl8b) and Pleckstrin Homology Domain-Containing Family M Member 1 (PLEKHM1) as an example of small GTPase-effector pair, we provide a detailed protocol for performing Y2H and Co-IP assays to confirm the interaction between a small GTPase and its effector protein.

Potential Adverse Drug Events and Associated Costs During Transition from Hospital to Home.

OBJECTIVE: The purpose of this study was to evaluate differences in medication discrepancy identification between pharmacists and nurses for patients 50 years of age and older receiving home health services following discharge from an inpatient hospital. It also evaluates the potential cost savings to the health care system as a result of avoiding adverse drug events (ADEs). Medication discrepancies were documented within seven days following hospital discharge.
DESIGN: The study was a secondary analysis of existing data from a completed randomized clinical trial.
SETTING: Home health care following transition from inpatient hospital care.
PARTICIPANTS: Hospitalized patients (N = 101) 50 years of age or older referred for home care services following discharge.
INTERVENTION: Existing data on medication discrepancy identification by pharmacists and nurses and potential costs of ADEs that could result were evaluated. Anticipated costs of ADEs unrecognized by nurses were estimated using Centers for Medicare & Medicaid Services claims data.
MAIN OUTCOME MEASURES: Number and severity of medication discrepancies identified by pharmacists and nurses, potential consequences for patient health and health care utilization, and anticipated costs to the health care system.
RESULTS: Pharmacists identified 677 medication discrepancies, of which 271 (40%) were considered likely to result in an ADE. Nurses identified 202 (30%) of the 677 medication discrepancies identified by pharmacists. It was estimated that approximately $9,670 in additional health care expenses could have been prevented within the cohort by pharmacist intervention.
CONCLUSION: Pharmacists identified more medication discrepancies during transition from hospital to home when compared with nurses, with the potential benefit of preventing more ADEs and saving associated health care costs during such care transitions.

Job loss, retirement and the mental health of older Americans.

BACKGROUND: Millions of older individuals cope with physical limitations, cognitive changes, and various losses such as bereavement that are commonly associated with aging. Given increased vulnerability to various health problems during aging, work displacement might exacerbate these due to additional distress and to possible changes in medical coverage. Older Americans are of increasing interest to researchers and policymakers due to the sheer size of the Baby Boom cohort, which is approaching retirement age, and due to the general decline in job security in the U.S. labor market. AIMS OF THE STUDY: This research compares and contrasts the effect of involuntary job loss and retirement on the mental health of older Americans. Furthermore, it examines the impact of re-employment on the depressive symptoms. METHODS: There are two fundamental empirical challenges in isolating the effect of employment status on mental health. The first is to control for unobserved heterogeneity--all latent factors that could impact mental health so as to establish the correct magnitude of the effect of employment status. The second challenge is to verify the direction of causality. First difference models are used to control for latent effects and a two-stage least squares regression is used to account for reverse causality. RESULTS: We find that involuntary job loss worsens mental health, and re-employment recaptures the past mental health status. Retirement is found to improve mental health of older Americans. DISCUSSION: With the use of longitudinal data from the Health and Retirement Study surveys and the adoption of proper measures to control for the possibility of reverse causality, this study provides strong evidence of elevating depressive symptoms with involuntary job displacement even after controlling for other late-life events. Women suffer from greater distress levels than men after job loss due to business closure or lay-off. However, women also exhibit better psychological well-being than men following retirement. The present study is the first to report that the re-employment of involuntary job-loss sufferers leads to a recapturing of past mental health status. Additionally, we find that re-entering the labor force is psychologically beneficial to retirees as well. IMPLICATIONS FOR HEALTH CARE PROVISION: It is well established that out-of-pocket expenditures on all forms of health care for seniors with self-diagnosed depression significantly exceeds expenditures for seniors with other common ailments such as hypertension and arthritis in the U.S. Thus, our research suggests that re-employment of older Americans displaced from the labor force will be cost-effective with regard to personal mental health outcomes. IMPLICATIONS FOR HEALTH POLICIES: That re-employment of involuntary job loss sufferers leads to a recapturing of past mental health status illuminates one potential policy trade off - increased resources dedicated to job training and placement for older U.S. workers could reap benefits with regard to reduced private and public mental health expenditures. IMPLICATIONS FOR FURTHER RESEARCH: Further research could more clearly assess the degree to which the mental health benefits of employment among older Americans would warrant the expansion of job training and employment programs aimed at this group.

Child care choices, food intake, and children's obesity status in the United States.

This article studies two pathways in which selection into different types of child care settings may affect likelihood of childhood obesity. Frequency of intake of high energy-dense and low energy-dense food items may vary across care settings, affecting weight outcomes. We find that increased use of paid and regulated care settings, such as center care and Head Start, is associated with higher consumption of fruits and vegetables. Among children from single-mother households, the probability of obesity increases by 15 percentage point with an increase in intake of soft drinks from four to six times a week to daily consumption and by 25 percentage point with an increase in intake of fast food from one to three times a week to four to six times a week. Among children from two-parent households, eating vegetables one additional time a day is associated with 10 percentage point decreased probability of obesity, while one additional drink of juice a day is associated with 10 percentage point increased probability of obesity. Second, variation across care types could be manifested through differences in the structure of the physical environment not captured by differences in food intake alone. This type of effect is found to be marginal and is statistically significant among children from two-parent households only. Data are used from the Early Childhood Longitudinal Study - Birth Cohort surveys (N=10,700; years=2001-2008). Children's age ranged from four to six years in the sample.

Changes in a middle school food environment affect food behavior and food choices.

Increasing rates of obesity among children ages 12 to 19 years have led to recommendations to alter the school food environment. The purpose of this study was to determine whether there are associations between an altered school food environment and food choices of middle school students both in and outside of school. In a midsized western city, two of six middle schools allowed only bottled water in vending machines, only milk and fruit on à la carte menus, and offered a seasonal fruit and vegetable bar. Three years after the intervention was initiated, seventh- and eighth-grade students attending the two intervention schools and four control middle schools were surveyed about their food choices. A total of 2,292 surveys were completed. Self-reported frequency of consumption for nine food groups in the survey was low; consumption was higher outside than in school. Boys consumed more milk than girls although girls consumed more fruits and vegetables. Significant socioeconomic differences existed. Compared with students who paid the full lunch fee, students qualifying for free and reduced-price meals consumed more milk and juice in schools but less outside school; more candy and energy drinks in school; and more sweet drinks, candy, pastries, and energy drinks outside school. Students in intervention schools were 24% more likely to consume milk outside school, 27% less likely to consume juice in school, and 56% less likely to consume sweet pastries in school. There were no differences in fruit and vegetable consumption reported by children in control and intervention schools. Overall, there was a positive association between a modified school food environment and student food behavior in and outside school. Policies related to the school food environment are an important strategy to address the obesity epidemic in our country.

Job loss and depression: the role of subjective expectations.

Although the importance of expectations is well documented in the decision-making literature, a key shortcoming of the empirical research into effects of involuntary job loss on depression is perhaps its neglect of the subjective expectations of job loss. Using data from the US Health and Retirement Study surveys we examine whether the impact of job loss on mental health is influenced by an individual's subjective expectations regarding future displacement. Our results imply that, among older workers in the age range of 55-65 year, subjective expectations are as significant predictors of depression as job loss itself, and ignoring them can bias the estimate of the impact of job loss on mental health.

The differential effects of full-time and part-time work status on breastfeeding.

OBJECTIVES: Return to work is associated with diminished breastfeeding. Although more mothers breastfeed after returning to work compared to a decade ago, research has not documented the variations in breastfeeding initiation and duration based on full-time and part-time (less than 35h/week) work status. In this study, we clarify these differences. METHODS: Longitudinal data from the Infant Feeding Practices Study II, collected between 2005 and 2007, for over 1400 mothers are used. In analyzing initiation, mother's work status was categorized by the expected number of hours she planned to work postpartum. In the duration model, work status was categorized based on the actual number of hours worked upon mother's return to employment after controlling for baby's age when she returned to work. Covariates in logistic and censored regressions included demographics, maternity leave, parity, past breastfeeding experience, hospital experience, and social support. RESULTS: Compared with expecting not to work, expecting to work <35h/week was not associated with breastfeeding initiation while expecting to work full-time decreased breastfeeding initiation. Compared with breastfeeding mothers who did not work, returning to work within 12 weeks regardless of work status and returning to work after 12 weeks while working more than 34h/week were associated with significantly shorter breastfeeding duration. CONCLUSION: Part-time work and increased amount of leave taken promote breastfeeding initiation and duration.

Success of strategies for combining employment and breastfeeding.

OBJECTIVE: Return to work is associated with diminished breastfeeding intensity and duration. Although more mothers breastfeed after returning to work now than earlier, research has not documented the strategies that mothers use for combining paid work and breastfeeding or their effect on breastfeeding outcomes. This study examined which strategies are associated with smaller decrements in breastfeeding intensity and longer durations. PARTICIPANTS AND METHODS: We analyzed 810 mothers from the Infant Feeding Practices Study II who worked and breastfed. We used regression and censored regression models to analyze 4 strategies that mothers used to combine these 2 activities: (1) feed directly from the breast only; (2) both pump and feed directly; (3) pump only; and (4) neither pump nor breastfeed during the work day. Outcomes were the difference in percentage of milk feeds that were breast milk between the month before and after return to work and duration of breastfeeding after return to work. RESULTS: Forty-three percent of mothers pumped milk at work only; 32% fed the infant directly from the breast only. These 2 strategies, along with pumping and feeding directly, were statistically similar and superior to neither pumping nor breastfeeding during the work day for the outcome of change in breastfeeding intensity. For the outcome of breastfeeding duration, the 2 strategies that included directly feeding from the breast were associated with longer duration than pumping only, whereas the strategy of neither pumping nor breastfeeding during the work day was associated with the shortest duration. CONCLUSIONS: Feeding the infant from the breast during the work day is the most effective strategy for combining breastfeeding and work. Ways to enable direct feeding include on-site child care, telecommuting, keeping the infant at work, allowing the mother to leave work to go to the infant, and having the infant brought to the work site. Establishing ways for mothers to feed from the breast after return to work is important to meet US breastfeeding goals.