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1. Misinformation, Trust, and Use of Ivermectin and Hydroxychloroquine for COVID-19

   https://doi.org/10.1001/jamahealthforum.2023.3257  

   Perlis, Roy H.; Lunz Trujillo, Kristin; Green, Jon; Safarpour, Alauna; Druckman, James N.; Santillana, Mauricio; Ognyanova, Katherine; Lazer, David (September 2023, JAMA Health Forum)

   ImportanceThe COVID-19 pandemic has been notable for the widespread dissemination of misinformation regarding the virus and appropriate treatment. ObjectiveTo quantify the prevalence of non–evidence-based treatment for COVID-19 in the US and the association between such treatment and endorsement of misinformation as well as lack of trust in physicians and scientists. Design, Setting, and ParticipantsThis single-wave, population-based, nonprobability internet survey study was conducted between December 22, 2022, and January 16, 2023, in US residents 18 years or older who reported prior COVID-19 infection. Main Outcome and MeasureSelf-reported use of ivermectin or hydroxychloroquine, endorsing false statements related to COVID-19 vaccination, self-reported trust in various institutions, conspiratorial thinking measured by the American Conspiracy Thinking Scale, and news sources. ResultsA total of 13 438 individuals (mean [SD] age, 42.7 [16.1] years; 9150 [68.1%] female and 4288 [31.9%] male) who reported prior COVID-19 infection were included in this study. In this cohort, 799 (5.9%) reported prior use of hydroxychloroquine (527 [3.9%]) or ivermectin (440 [3.3%]). In regression models including sociodemographic features as well as political affiliation, those who endorsed at least 1 item of COVID-19 vaccine misinformation were more likely to receive non–evidence-based medication (adjusted odds ratio [OR], 2.86; 95% CI, 2.28-3.58). Those reporting trust in physicians and hospitals (adjusted OR, 0.74; 95% CI, 0.56-0.98) and in scientists (adjusted OR, 0.63; 95% CI, 0.51-0.79) were less likely to receive non–evidence-based medication. Respondents reporting trust in social media (adjusted OR, 2.39; 95% CI, 2.00-2.87) and in Donald Trump (adjusted OR, 2.97; 95% CI, 2.34-3.78) were more likely to have taken non–evidence-based medication. Individuals with greater scores on the American Conspiracy Thinking Scale were more likely to have received non–evidence-based medications (unadjusted OR, 1.09; 95% CI, 1.06-1.11; adjusted OR, 1.10; 95% CI, 1.07-1.13). Conclusions and RelevanceIn this survey study of US adults, endorsement of misinformation about the COVID-19 pandemic, lack of trust in physicians or scientists, conspiracy-mindedness, and the nature of news sources were associated with receiving non–evidence-based treatment for COVID-19. These results suggest that the potential harms of misinformation may extend to the use of ineffective and potentially toxic treatments in addition to avoidance of health-promoting behaviors. 

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2. Chronic Stress and Severe Water Insecurity During the Historic 2022 Drought in Northern Kenya Were Associated With Inflammation Among Daasanach Seminomadic Pastoralists

   https://doi.org/10.1002/ajhb.70009  

   Roba, Kedir Teji; Jacobson, Hannah; McGrosky, Amanda; Sadhir, Srishti; Ford, Leslie B; Pfaff, Marcela; Kim, Elizabeth Y; Nzunza, Rosemary; Douglass, Matthew; Braun, David R; et al (February 2025, American Journal of Human Biology)

   ABSTRACT ObjectiveExtreme climatic events, like droughts, are increasing in frequency and severity. Droughts disrupt community livelihoods and resources with serious implications for human biology. This study investigated how chronic stress, measured by fingernail cortisol concentration (FCC), and water insecurity status were predictive of C‐reactive protein (CRP), a biomarker of inflammation, during a historic drought among Daasanach seminomadic pastoralists. MethodsData were collected at the height of the 2022 drought from 128 Daasanach household heads aged 16–80 years in northern Kenya using household surveys, anthropometric measurements, and dried blood spots to assess CRP levels and fingernails to assess FCC. We employed mixed‐effects linear and logistic regression models to examine the relationships between log‐transformed FCC, high water insecurity status measured via the Household Water Insecurity Experiences (HWISE ≥ 24) scale, and serum‐equivalent CRP (log‐transformed and dichotomized at mild, low‐grade inflammation ≥ 1 mg/L) adjusted for covariates. ResultsThe mean serum‐equivalent CRP was 4.1 mg/L and 56.3% of Daasanach adults had at least mild, low‐grade inflammation. Linear models indicated that ln(FCC) was positively associated with ln(CRP) (β = 0.56, SE = 0.12;p < 0.001). Further, logistic models demonstrated that ln(FCC) (OR = 2.69, 95% CI: 1.84–3.95;p < 0.001) and high water insecurity (OR = 2.23, 95% CI: 1.34–3.72;p = 0.002) were both associated with greater odds of low‐grade inflammation. ConclusionThis study provides evidence for how chronic stress and severe water insecurity may impact inflammation levels among pastoralists during drought. Since inflammation is central to cardiometabolic disease etiology, this is an additional reason to mitigate the negative health impacts of droughts and water insecurity exacerbated by climate change. 

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3. The effect of food insecurity during college on graduation and type of degree attained: evidence from a nationally representative longitudinal survey

   https://doi.org/10.1017/S1368980021003104  

   Wolfson, Julia A; Insolera, Noura; Cohen, Alicia J; Leung, Cindy W (July 2021, Public Health Nutrition)

   Abstract Objective: To examine the effect of food insecurity during college on graduation and degree attainment. Design: Secondary analysis of longitudinal panel data. We measured food insecurity concurrent with college enrollment using the 18-question USDA Household Food Security Survey Module. Educational attainment was measured in 2015-2017 via two questions about college completion and highest degree attained. Logistic and multinomial-logit models adjusted for sociodemographic characteristics were estimated. Setting: United States (US) Participants: A nationally representative, balanced panel of 1,574 college students in the US in 1999-2003 with follow-up through 2015-2017 from the Panel Study of Income Dynamics. Results: In 1999-2003, 14.5% of college students were food insecure and were more likely to be older, non-White, and first-generation students. In adjusted models, food insecurity was associated with lower odds of college graduation (OR 0.57, 95% CI: 0.37, 0.88, p=0.01) and lower likelihood of obtaining a Bachelor’s degree (RRR 0.57 95% CI: 0.35, 0.92, p=0.02) or graduate/professional degree (RRR 0.39, 95% CI: 0.17, 0.86, p=0.022). These associations were more pronounced among first-generation students. 47.2% of first-generation students who experienced food insecurity graduated from college; food insecure first-generation students were less likely to graduate compared to first-generation students who were food secure (47.2% vs. 59.3%, p=0.020) and non-first-generation students who were food insecure (47.2% vs. 65.2%, p=0.037). Conclusions: Food insecurity during college is a barrier to graduation and higher degree attainment, particularly for first-generation students. Existing policies and programs that help mitigate food insecurity should be expanded and more accessible to the college student population. 

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4. Prevalence and Correlates of Long COVID Symptoms Among US Adults

   https://doi.org/10.1001/jamanetworkopen.2022.38804  

   Perlis, Roy H.; Santillana, Mauricio; Ognyanova, Katherine; Safarpour, Alauna; Lunz Trujillo, Kristin; Simonson, Matthew D.; Green, Jon; Quintana, Alexi; Druckman, James; Baum, Matthew A.; et al (October 2022, JAMA Network Open)

   ImportancePersistence of COVID-19 symptoms beyond 2 months, or long COVID, is increasingly recognized as a common sequela of acute infection. ObjectivesTo estimate the prevalence of and sociodemographic factors associated with long COVID and to identify whether the predominant variant at the time of infection and prior vaccination status are associated with differential risk. Design, Setting, and ParticipantsThis cross-sectional study comprised 8 waves of a nonprobability internet survey conducted between February 5, 2021, and July 6, 2022, among individuals aged 18 years or older, inclusive of all 50 states and the District of Columbia. Main Outcomes and MeasuresLong COVID, defined as reporting continued COVID-19 symptoms beyond 2 months after the initial month of symptoms, among individuals with self-reported positive results of a polymerase chain reaction test or antigen test. ResultsThe 16 091 survey respondents reporting test-confirmed COVID-19 illness at least 2 months prior had a mean age of 40.5 (15.2) years; 10 075 (62.6%) were women, and 6016 (37.4%) were men; 817 (5.1%) were Asian, 1826 (11.3%) were Black, 1546 (9.6%) were Hispanic, and 11 425 (71.0%) were White. From this cohort, 2359 individuals (14.7%) reported continued COVID-19 symptoms more than 2 months after acute illness. Reweighted to reflect national sociodemographic distributions, these individuals represented 13.9% of those who had tested positive for COVID-19, or 1.7% of US adults. In logistic regression models, older age per decade above 40 years (adjusted odds ratio [OR], 1.15; 95% CI, 1.12-1.19) and female gender (adjusted OR, 1.91; 95% CI, 1.73-2.13) were associated with greater risk of persistence of long COVID; individuals with a graduate education vs high school or less (adjusted OR, 0.67; 95% CI, 0.56-0.79) and urban vs rural residence (adjusted OR, 0.74; 95% CI, 0.64-0.86) were less likely to report persistence of long COVID. Compared with ancestral COVID-19, infection during periods when the Epsilon variant (OR, 0.81; 95% CI, 0.69-0.95) or the Omicron variant (OR, 0.77; 95% CI, 0.64-0.92) predominated in the US was associated with diminished likelihood of long COVID. Completion of the primary vaccine series prior to acute illness was associated with diminished risk for long COVID (OR, 0.72; 95% CI, 0.60-0.86). Conclusions and RelevanceThis study suggests that long COVID is prevalent and associated with female gender and older age, while risk may be diminished by completion of primary vaccination series prior to infection. 

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5. Reports of Burnout Among Historically Marginalized and Female Graduating Medical Students During the COVID-19 Pandemic

   https://doi.org/10.1097/ACM.0000000000005854  

   Dyrbye, Liselotte N; Brushaber, Danielle E; West, Colin P (January 2024, Academic Medicine)

   Abstract PurposeTo examine graduating medical student reports of burnout by sex, race and ethnicity, and sexual orientation and explore trends within intersectional demographic groups from 2019–2021 in a national sample. MethodThe authors obtained medical student responses to the 2019–2021 Association of American Medical Colleges (AAMC) Graduation Questionnaires (GQs) linked to data from other AAMC sources. The dataset included year of GQ completion, responses to a modified Oldenburg Burnout Inventory (exhaustion subscale range: 0–24; disengagement subscale range: 0–15), and demographics previously shown to relate to the risk of burnout in medical students, residents, or physicians. Multivariable linear regression analysis was performed to evaluate independent associations between demographics and burnout. ResultsOverall response rate was 80.7%. After controlling for other factors, mean exhaustion scores were higher among Asian (parameter estimate [PE] 0.38, 95% confidence interval [CI] 0.21, 0.54), bisexual (PE 0.97, 95% CI 0.76, 1.17), and gay or lesbian (PE 0.55, 95% CI 0.35, 0.75) students than those who did not identify with each of those respective groups. Mean disengagement scores were lower among female (PE −0.47, 95% CI −0.52, −0.42), Hispanic (PE −0.11, 95% CI −0.22, −0.01), and White (PE −0.10, 95% CI −0.19, 0.00) students and higher among Asian (PE 0.17, 95% CI 0.07, 0.27), Black or African American (PE 0.31, 95% CI 0.18, 0.44), bisexual (PE 0.54, 95% CI 0.41, 0.66), and gay or lesbian (PE 0.23, 95% CI 0.11, 0.35) students than those who did not identify with each of those respective groups. From 2019–2021, mean exhaustion and disengagement scores were relatively stable or improved across nearly all intersectional groups. ConclusionsMale, Asian, Black or African American, and sexual minority students had a higher risk of burnout, while female, Hispanic, White, and heterosexual or straight students had a lower risk of burnout. 

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