Do predictors of adherence to pandemic guidelines change over time? A panel study of 22,000 UK adults during the COVID-19 pandemic.
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ABSTRACT:
SUBMITTER: Wright L
PROVIDER: S-EPMC8259055 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundIn the absence of a vaccine, governments have focused on social distancing, self-isolation, and increased hygiene procedures to reduce the transmission of SARS-CoV-2 (COVID-19). Compliance with these measures requires voluntary cooperation from citizens. Yet, compliance is not complete. Existing research on the predictors of compliance is almost exclusively based on cross-sectional data, raising the possibility of reverse causality and confounding.MethodsUsing data from the UCL COVID-19 Social Study, a large weekly online panel of UK adults from first three months of lockdown in the UK (n = 51,600), we tested whether within-person changes in confidence in government, mental wellbeing, social experiences and awareness of COVID-19 were longitudinally related to self-reported compliance levels with guidelines from authorities using random intercept cross-lagged panel models.FindingsWe found evidence of a small longitudinal association between increased confidence in government to tackle the pandemic and higher self-reported compliance, but little evidence that factors such as mental health and wellbeing, worries about future adversities, and social isolation and loneliness were related to later compliance. We found higher self-reported compliance was longitudinally related to higher depressive symptoms. We found that low compliance was related to lower leisure engagement, providing care, and working outside the home.InterpretationOur results suggest that to effectively manage the pandemic, governments should ensure that confidence is maintained.FundingNuffield Foundation, Wellcome Trust and the MARCH Mental Health Network. MARCH is funded by the Cross-Disciplinary Mental Health Network Plus initiative supported by UK Research and Innovation.
| S-EPMC7907734 | biostudies-literature
Project description:The early years of marriage are a time of significant personal and relational changes as partners adjust to their new roles, but the specific ways that spouses' personalities may change in early marriage and how these changes are associated with spouses' marital satisfaction trajectories have been overlooked. Using 3 waves of data collected over the first 18 months of marriage (N = 338 spouses, or 169 heterosexual newlywed marriages), we examined changes in spouses' self-reported Big 5 personality traits over time and the association between initial levels and changes in personality and spouses' concurrent marital satisfaction trajectories. Results indicated significant changes in personality over time, including declines in agreeableness for husbands and for wives, declines in extraversion for husbands, declines in openness and neuroticism for wives, and increases in conscientiousness for husbands. These results did not differ by spouses' age, demographics, relationship length prior to marriage, cohabitation prior to marriage, initial marital satisfaction, or parenthood status. Initial levels of personality as well as changes in personality over time were associated with spouses' marital satisfaction trajectories. Taken together, these findings indicate that newlywed spouses' personalities undergo meaningful changes during the newlywed years and these changes are associated with changes in spouses' marital satisfaction. Further research is needed to understand the processes underlying changes in personality early in marriage and to examine the mechanisms linking changes in personality and changes in marital satisfaction. (PsycINFO Database Record
| S-EPMC5962362 | biostudies-literature
Project description:Changes in well child care (WCC) adherence over time have not previously been examined. Our objective is to describe adherence rates to WCC over time in a low-income urban population of infants 0-24 months of age, and to identify predictors of WCC adherence in this population.This is a secondary analysis of a cohort of Medicaid-eligible children followed from birth to 2 years between 2005 and 2008 with structured telephone surveys to assess maternal well-being, social support, and household and demographic information. For the 260 children attending 4 urban pediatric practices, WCC adherence was assessed based on visit data abstracted from electronic medical records. A random-intercept mixed effects logit model clustered on subject was used.92% of the mothers were African-American, 27% had not finished high school, 87% were single, and 43% earned<$500/month; mean age was 23. WCC adherence decreased from 88% at 6 months to 47% (12 mo), 44% (18 mo), and 67% (24 mo). The difference across time periods was statistically significant (p<0.001). Married (OR 1.71, p=0.02) and primiparous (OR 1.89, p<0.001) mothers had significantly greater odds of adherence, along with women who reported having been adherent to prenatal care visits (OR 1.49, p=0.03) and those with the lowest household income (OR 1.40, p=0.03).Maternal education efforts should emphasize the importance of establishing WCC, especially for mothers of more than one child. Further studies using larger, more broadly defined populations are needed to confirm our findings that efforts to increase WCC adherence should be intensified after 6 months of age, particularly for children at higher risk.
| S-EPMC3118120 | biostudies-literature
Project description:Background/aimsWe investigated changes in recurrence rates and significant recurrence predictors over time after complete cure of hepatocellular carcinoma (HCC).MethodsA total of 1,491 patients with first-time diagnosis of Barcelona Clinic Liver Cancer stage A HCC, completely cured by treatment between 2007 and 2016, were recruited from two Korean tertiary institutes.ResultsThe mean age of the population (1,144 men and 347 women) was 58.6 years. Of the total population, 914 patients (61.3%) had liver cirrhosis. Nine-hundred and forty-one (63.1%) and 550 (36.9%) patients were treated with surgical resection and radiofrequency ablation (RFA), respectively. One-year cumulative incidences of HCC recurrence were 14.3%, 9.9%, and 5.1% from the time of treatment, 3 years after treatment, and 5 years after treatment, respectively. Upon multivariate analysis, multiple tumors, maximal tumor size ≥3 cm, and high Model for End-Stage Liver Disease scores were independently associated with increased HCC recurrence risk from the time of treatment and 1 and 2 years after curative treatment (all p<0.05, except for maximal tumor size ≥3 cm for recurrence 2 years after treatment). Meanwhile, liver cirrhosis and RFA were independently associated with the increased HCC recurrence risk for almost all time points (liver cirrhosis: all p<0.05; RFA: all p<0.005 except for recurrence from 5 years after treatment).ConclusionsThe recurrence rate of HCC after curative treatment gradually decreased over time. Two years after treatment, when tumor-related factors lose their prognostic implications, may be used as a cutoff to define the boundary between early and late recurrence of HCC.
| S-EPMC8129665 | biostudies-literature
Project description:People with dementia are at risk of mobility decline. In this study, we measured changes in quantitative gait measures over a maximum 10-week period during the course of a psychogeriatric admission in older adults with dementia, with the aims to describe mobility changes over the duration of the admission, and to determine which factors were associated with this change. Fifty-four individuals admitted to a specialized dementia inpatient unit participated in this study. A vision-based markerless motion capture system was used to record participants' natural gait. Mixed effect models were developed with gait measures as the dependent variables and clinical and demographic variables as predictors. We found that gait stability, step time, and step length decreased, and step time variability and step length variability increased over 10 weeks. Gait stability of men decreased more than that of women, associated with an increased sacrum mediolateral range of motion over time. In addition, the sacrum mediolateral range of motion decreased in those with mild neuropsychiatric symptoms over 10 weeks, but increased in those with more severe neuropsychiatric symptoms. Our study provides evidence of worsening of gait mechanics and control over the course of a hospitalization in older adults with dementia. Quantitative gait monitoring in hospital environments may provide opportunities to intervene to prevent adverse events, decelerate mobility decline, and monitor rehabilitation outcomes.
| S-EPMC8598066 | biostudies-literature
Project description:There is a lack of research examining changes in women's fertility attitudes over relatively short periods of time. The aim of this study was to determine whether and how women's attempts to get pregnant and their desire to avoid pregnancy changed over six months' time as well as which characteristics and circumstances were associated with these changes. Using multinomial regression, we analyzed two panels of data from a sample of approximately 3,000 U.S. adult women gathered within six months apart. Only 4% of the women were trying to get pregnant at both time points, but six percent went from trying to not or vice versa. Two-thirds reported a strong desire to avoid pregnancy at both points, but 9% transitioned from strong to not strong and an additional 7% transitioned from not strong to strong. Women who transitioned to a more serious romantic relationship were at increased risk of transitioning to trying to become pregnant and, not surprisingly, to a weaker pregnancy avoidance. Some of the variables we tested, including changes in employment status and race/ethnicity, were associated with one outcome but not the other. The results highlight the importance of taking a holistic perspective of women's lives when studying pregnancy intentions and in reproductive health care services such as contraceptive counseling. Context matters and it may change rapidly.
| S-EPMC4994192 | biostudies-literature
Project description:PurposeIntensive care interventions that prolong life without achieving meaningful benefit are considered clinically "inappropriate". In 2012, the frequency of perceived-inappropriate critical care was 10.8% at one academic health system; and we aimed to re-evaluate this frequency.MethodsFor 4 months in 2017, we surveyed critical care physicians daily and asked whether each patient was receiving appropriate, probably inappropriate, or inappropriate critical care. Patients were categorized into three groups: 1) patients for whom treatment was never inappropriate, 2) patients with at least one assessment that treatment was probably inappropriate, but no inappropriate treatment assessments, and 3) patients who had at least one assessment of inappropriate treatment.ResultsFifty-five physicians made 10,105 assessments on 1424 patients. Of these, 94 (6.6%) patients received at least one assessment of inappropriate critical care, which is lower than 2012 (10.8% (p < 0.01)). Comparing 2017 and 2012, patient age, MS-DRG, length of stay, and hospital mortality were not significantly different (p > 0.05). Inpatient mortality in 2017 was 73% for patients receiving inappropriate critical care.ConclusionsOver five years the proportion of patients perceived to be receiving inappropriate critical care dropped by 40%. Understanding the reasons for such change might elucidate how to continue to reduce inappropriate critical care.
| S-EPMC7736139 | biostudies-literature
Project description:The effort to limit the spread of the coronavirus (COVID-19) has relied heavily on the general public's compliance with health guidelines limiting social contact and mitigating risk when contact occurs. The aim of this study was to identify latent variables underlying adherence to COVID-19 guidelines and to examine demographic and psychological predictors of adherence. A sample of US adults (N = 1,200) were surveyed in late April to mid-May 2020. The factor structure of adherence was examined using exploratory factor analysis. Machine learning regression models using elastic net regularization were used to examine predictors of adherence. Two factors characterized adherence: avoidance and cleaning. Elastic net models identified differential demographic and psychological predictors of these two forms of adherence. Religious affiliation, denial coping, full-time employment, substance use coping, and being 60 or older predicted lower avoidance adherence. Behavioral and mindfulness emotion regulation skills, agreeableness, and Democrat political affiliation predicted greater avoidance adherence. For cleaning adherence, interpersonal and behavioral emotion regulation skills and conscientiousness emerged as strong predictors of greater cleaning. Efforts to promote compliance with COVID-19 health guidelines may benefit from distinguishing avoidance and cleaning adherence and considering predictors of each of these aspects of adherence.
| S-EPMC8239601 | biostudies-literature
Project description:The Earth's climate has experienced dramatic changes over the past 22,000 years; however, the total meridional heat transport (MHT) of the climate system remains stable. A 22,000-year-long simulation using an ocean-atmosphere coupled model shows that the changes in atmosphere and ocean MHT are significant but tend to be out of phase in most regions, mitigating the total MHT change, which helps to maintain the stability of the Earth's overall climate. A simple conceptual model is used to understand the compensation mechanism. The simple model can reproduce qualitatively the evolution and compensation features of the MHT over the past 22,000 years. We find that the global energy conservation requires the compensation changes in the atmosphere and ocean heat transports. The degree of compensation is mainly determined by the local climate feedback between surface temperature and net radiation flux at the top of the atmosphere. This study suggests that an internal mechanism may exist in the climate system, which might have played a role in constraining the global climate change over the past 22,000 years.
| S-EPMC4645171 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic is putting health professionals under increasing pressure. This population is already acknowledged to be at risk of burnout.AimWe aim to provide a 'snapshot' of the levels of burnout, anxiety, depression and distress among healthcare workers during the COVID-19 pandemic.MethodsWe distributed an online survey via social media in June 2020 open to any UK healthcare worker. The primary outcome measure was symptoms of burnout measured using the Copenhagen Burnout Inventory. Secondary outcomes of depression, anxiety, distress and subjective measures of stress were also recorded. Multivariate logistic regression analysis was performed to identify factors associated with burnout, depression, anxiety and distress.ResultsA total of 539 persons responded to the survey; 90% female and 53% nurses. Participants with moderate-to-severe burnout were younger (49% vs. 33% under 40 years, P = 0.004), more likely to have pre-existing comorbidities (21% vs. 12%, P = 0.031), twice as likely to have been redeployed from their usual role (22% vs. 11%; P = 0.042), or to work in an area dedicated to COVID-19 patients (50% vs. 32%, P < 0.001) and were almost 4 times more likely to have previous depression (24% vs. 7%; P = 0.012).ConclusionIndependent predictors of burnout were being younger, redeployment, exposure to patients with COVID-19, being female and a history of depression. Evaluation of existing psychological support interventions is required with targeted approaches to ensure support is available to those most at risk.
| S-EPMC8083639 | biostudies-literature