Daily Step Counts Before and After the COVID-19 Pandemic Among All of Us Research Participants

Wearable activity data can predict functional recovery after musculoskeletal injury: Feasibility of a machine learning approach

Delayed functional recovery after injury is associated with significant personal and socioeconomic burden. Identification of patients at risk for a prolonged recovery after a musculoskeletal injury is thus of high relevance. The aim of the current study was to show the feasibility of using a machine learning assisted model to predict functional recovery based on the pre- and immediate post injury patient activity as measured with wearable systems in trauma patients. Patients with a pre-existing wearable (smartphone and/or body-worn sensor), data availability of at least 7 days prior to their injury, and any musculoskeletal injury of the upper or lower extremity were included in this study. Patient age, sex, injured extremity, time off work and step count as activity data were recorded continuously both pre- and post-injury. Descriptive statistics were performed and a logistic regression machine learning model was used to predict the patient's functional recovery status after 6 weeks based on their pre- and post-injury activity characteristics. Overall 38 patients (7 upper extremity, 24 lower extremity, 5 pelvis, 2 combined) were included in this proof-of-concept study. The average follow-up with available wearable data was 85.4 days. Based on the activity data, a predictive model was constructed to determine the likelihood of having a recovery of at least 50 % of the pre-injury activity state by post injury week 6. Based on the individual activity by week 3 a predictive accuracy of over 80 % was achieved on an independent test set (F1=0,82; AUC=0,86; ACC=8,83). The employed model is feasible to assess the principal risk for a slower recovery based on readily available personal wearable activity data. The model has the potential to identify patients requiring additional aftercare attention early during the treatment course, thus optimizing return to the pre-injury status through focused interventions. Additional patient data is needed to adapt the model to more specifically focus on different fracture entities and patient groups.

An Observational Study Quantifying the Disproportionate Impact of COVID-19 Among Immigrant Adults, 2021 California Health Interview Survey

OBJECTIVE

Substantial data on COVID-19-related morbidity and mortality among medically underserved populations are available, yet data on the social impact of the COVID-19 pandemic among immigrants in the United States are limited. We identified COVID-19-related health and social disparities among US immigrants.

METHODS

We analyzed predictors of COVID-19-related health and social outcomes (including ever had or thought had COVID-19, vaccine uptake, risk-reduction behaviors, job loss, childcare difficulties, and difficulty paying rent) during the pandemic by citizenship status, using data from the 2021 California Health Interview Survey. The overall sample size included 24 453 US-born citizens, naturalized citizens, and noncitizens aged ≥18 years. We examined relationships between sociodemographic variables, including immigration-related factors, and COVID-19-related health and social outcomes using descriptive, bivariate, and multivariate logistic regression analysis.

RESULTS

When accounting for sociodemographic characteristics, noncitizens had higher odds than naturalized and US-born citizens of experiencing challenges during the COVID-19 pandemic, including difficulty paying rent (adjusted odds ratio [aOR] = 1.54; 95% CI, 1.47-2.42) and job loss (aOR = 1.43; 95%, CI, 1.14-1.79). At the bivariate level, noncitizens had the highest rate of ever had or thought had COVID-19 (24.7%) compared with US-born citizens (20.8%) and naturalized citizens (16.8%; all P < .001). Noncitizens also had a significantly higher likelihood of risk-reduction behaviors (eg, always wearing a face covering, getting vaccinated if available) than US-born citizens (P < .001).

CONCLUSION

These findings reveal the disproportionate impact of the COVID-19 pandemic among noncitizens and reflect limited socioeconomic resources, limited access to health care, and precarious employment among noncitizens in California during the pandemic. Citizenship status should be considered a critical immigration-related factor when examining disparities among immigrant populations.

Assessing Workplace Factors That Influence Burnout and Identifying Recommendations to Support Well-being in Pharmacy Faculty

OBJECTIVE

Creating environments that promote well-being is critical as studies have shown that burnout, and thus poor well-being, results in poor health outcomes and declining workplace retention. While studies have measured the prevalence of burnout in pharmacy faculty, a gap exists regarding workplace factors that impact faculty well-being. The purpose of this study was to assess factors influencing pharmacy faculty burnout and identify recommendations to improve faculty well-being.

METHODS

Full-time pharmacy faculty were invited to participate in this exploratory study. Focus groups were divided by faculty rank (ie, assistant, associate, full professor). A semistructured interview format was used to identify factors contributing to faculty burnout and fulfillment as well as solicit suggestions for strategies to improve well-being. Inductive coding was used to identify themes.

RESULTS

Eleven faculty participated in 4 focus groups: 6 assistant professors in 2 focus groups (n = 3 faculty/focus group), 3 associate professors in 1 focus group, and 2 full professors in 1 focus group. Common factors influencing faculty burnout included overwhelming workload, workplace inefficiencies, and unexpected factors. Factors contributing to faculty fulfillment included impact, having a passion for work, and connecting with others. Recommendations for improving well-being included school-level well-being initiatives from leadership, encouraging work-life balance, and implementing intentional well-being initiatives and resources.

CONCLUSION

Participants identified several workplace factors that contribute to burnout and faculty fulfillment. This study fills a critical gap in the literature regarding factors that influence pharmacy faculty well-being and burnout and can inform strategies for fostering faculty well-being in pharmacy education.

Daily step counts before, during, and after COVID-19 pandemic: a smartphone-tracking study of university students in Egypt and Saudi Arabia

BACKGROUND

COVID-19 pandemic has drastically changed people's lifestyles and daily routines around the world. This study aimed to investigate changes in daily step counts - as an indicator of physical activity - before, during, and after the pandemic among university students in Egypt and Saudi Arabia and to identify regional and gender factors that may have influenced physical activity during these periods.

METHODS

A total of 1273 university students from Egypt (Assiut University and Zagazig University) and Saudi Arabia (Taif University, King Faisal University, and Imam AbdulRahman Bin Faisal University) provided valid data on their daily step counts recorded by a smartphone application (iPhone Health App) from January 2019 to December 2021. The data was divided and averaged based on three periods: the pre-pandemic year (January to December 2019), the first pandemic year (January to December 2020), and the second pandemic year (January to December 2021).

RESULTS

The results showed a significant decrease in daily steps from pre-pandemic to the first pandemic year, followed by an increase in the second pandemic year. However, daily step counts did not fully recover to pre-pandemic levels in male Egyptian and marginally in male Saudi participants. In both nationalities, female participants did not show a significant difference in daily steps between the pre-pandemic and second-pandemic years. Female Egyptian participants had significantly lower daily step counts than male Egyptian participants, and a gender difference in daily steps was also observed in Saudi female participants in the pre-pandemic and the second pandemic year but not during the first pandemic year.

CONCLUSION

These findings outline the need for strategies in Egypt and Saudi Arabia to promote physical activity and reduce sedentary behavior, especially among young women, to mitigate the negative consequences of COVID-19 and meet physical activity guidelines.

There's no time for no stress! Exploring the relationship between pharmacy student stress and time use

BACKGROUND

Health professions students experience significantly more stress than students 20 years ago. While prior studies have explored student time use and other studies have begun to explore factors influencing student stress, little is known about the relationship between student time use and stress. As more efforts are employed to promote student wellness and better understand student stress, it is imperative to recognize the implications of time as a finite resource. Thus, it is important to understand if and how time use relates to student stress so the two can be better managed.

METHODS

A mixed methods approach exploring the challenge-hindrance stressor framework was used to collect and analyze student stress and time use. First, second, and third year pharmacy students were invited to participate. Participants completed the Perceived Stress Scale (PSS10), a week-long daily time logging activity, and daily stress questionnaire. After the week-long daily time logging, students participated in a semi-structured focus group. Descriptive statistics were used to analyze quantitative data, and inductive coding along with creation of summary reports were created for the qualitative data.

RESULTS

Students reported moderate stress on the PSS10, and spending the majority of their time on activities of daily life and academic activities. Students shared that academics, co-curriculars, and working for pay increased their stress, whereas discretionary activities such as socializing and exercising alleviated stress. Finally, students reported feeling overwhelmed due to too little time to complete all necessary activities daily, including limited time to invest in discretionary activities to support their wellbeing.

CONCLUSIONS

Increased stress levels among students is a concerning trend that affects students' mental health and therefore limits their ability to perform to their greatest potential. Better understanding of the relationship between time use and stress is critical to improve the quality of life of students in the health professions. These findings provide critical insight into factors contributing towards student stress that can inform curricular strategies that support wellness within health professions education.