Background High rates of vaccination worldwide are required to establish a herd immunity and stop the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide. Methods A systematic literature search of PubMed and Web of Science was performed on July 5th, 2021, using developed keywords. Inclusion criteria required the study to (1) be conducted in English; (2) investigate attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; (3) utilize validated measurement techniques; (4) have the full text paper available and be peer-reviewed prior to final publication. Findings Following PRISMA guidelines, 209 studies were included. The Newcastle Ottawa (NOS) scale for cross-sectional studies was used to assess the quality of the studies. Overall, vaccine acceptance rates ranged considerably between countries and between different time points, with Arabian countries showing the highest hesitancy rates compared with other parts of the world. Interpretation A variety of different factors contributed to increased hesitancy, including having negative perception of vaccine efficacy, safety, convenience, and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, and people who were less educated, had lower income, had no insurance, living in a rural area, and self-identified as a racial/ethnic minority.

No abstract

Background Jordan, a Middle Eastern country, declared a state of national emergency due to COVID-19 and a strict nationwide lockdown on 17 March 2020, banning all travel and movement around the country, potentially impacting mental health. This study sought to investigate the association between mental health (eg, anxiety and depressive symptoms) and sleep health among a sample of Jordanians living through a state of COVID-19-induced nationwide lockdown. Methods Using Facebook, participants (n=1240) in Jordan in March 2020 were recruited and direct to a web-based survey measuring anxiety (items from General Anxiety Disorder 7-item (GAD-7) scale instrument), depressive symptoms (items from Center for Epidemiologic Studies Depression Scale), sleep health (items from the Pittsburgh Sleep Quality Index) and sociodemographic. A modified Poisson regression model with robust error variance. Adjusted prevalence ratios (aPRs) and 95% CIs were estimated to examine how anxiety and depressive symptoms may affect different dimensions of sleep health: (1) poor sleep quality, (2) short sleep duration, (3) encountering sleep problems. Results The majority of participants reported having experienced mild (33.8%), moderate (12.9%) or severe (6.3%) levels of anxiety during lockdown, and nearly half of respondents reported depressive symptoms during lockdown. Similarly, over 60% of participants reported having experienced at least one sleep problem in the last week, and nearly half reported having had short sleep duration. Importantly, anxiety was associated with poor sleep health outcomes. For example, corresponding to the dose–response relationship between anxiety and sleep health outcomes, those reporting severe anxiety were the most likely to experience poor sleep quality (aPR =8.95; 95% CI=6.12 to 13.08), short sleep duration (aPR =2.23; 95% CI=1.91 to 2.61) and at least one problem sleep problem (aPR=1.73; 95% CI=1.54 to 1.95). Moreover, depressive symptoms were also associated with poor sleep health outcomes. As compared with scoring in the first quartile, scoring fourth quartile was associated with poor sleep quality (aPR=11.82; 95% CI=6.64 to 21.04), short sleep duration (aPR=1.87; 95% CI=1.58 to 2.22), and experiencing at least one sleep problem (aPR=1.90; 95% CI=1.66 to 2.18). Conclusions Increased levels of anxiety and depressive symptoms can negatively influence sleep health among a sample of Jordanian adults living in a state of COVID-19-induced nationwide lockdown.

Purpose To examine if there was spatial misclassification in exposure to neighborhood noise complaints among a sample of low-income housing residents in New York City, comparing home-based spatial buffers and Global Positioning Systems (GPS) daily path buffers. Methods Data came from the community-based NYC Low-Income Housing, Neighborhoods and Health Study, where GPS tracking of the sample was conducted for a week (analytic n=102). We created a GPS daily path buffer (a buffering zone drawn around GPS tracks) of 200-meters and 400-meters. We also used home-based buffers of 200-meters and 400-meters. Using these “neighborhoods” (or exposure areas) we calculated neighborhood exposure to noisy events from 311 complaints data (analytic n=143,967). Friedman tests (to compare overall differences in neighborhood definitions) were applied. Results There were differences in neighborhood noise complaints according to the selected neighborhood definitions (p<0.05). For example, the mean neighborhood noise complaint count was 1196 per square kilometer for the 400-meter home-based and 812 per square kilometer for the 400-meter activity space buffer, illustrating how neighborhood definition influences the estimates of exposure to neighborhood noise complaints. Conclusions These analyses suggest that, whenever appropriate, GPS neighborhood definitions can be used in spatial epidemiology research in spatially mobile populations to understand people's lived experience.

Little is known about how neighborhood noise influences cardiovascular disease (CVD) risk among low-income populations. The aim of this study was to investigate associations between neighborhood noise complaints and body mass index (BMI) and blood pressure (BP) among low-income housing residents in New York City (NYC), including utilizing global positioning system (GPS) data. Data came from the NYC Low-Income Housing, Neighborhoods and Health Study in 2014, including objectively measured BMI and BP data (N=102, Black=69%), and one week of GPS data. Noise reports from “NYC 311” were used to create a noise complaints density (unit: 1,000 reports/km2) around participants' home and GPS-defined activity space neighborhoods. In fully-adjusted models, we examined associations of noise complaints density with BMI (kg/m2), and systolic and diastolic BP (mmHg), controlling for individual- and neighborhood-level socio-demographics. We found inverse relationships between home noise density and BMI (B=-2.7 [kg/m2], p=0.009), and systolic BP (B=-5.3 mmHg, P=0.008) in the fully-adjusted models, and diastolic BP (B=-3.9 mmHg, P=0.013) in age-adjusted models. Using GPS-defined activity space neighborhoods, we observed inverse associations between noise density and systolic BP (B=-10.3 mmHg, p=0.019) in fully-adjusted models and diastolic BP (B=-7.5 mmHg, p=0.016) in age-adjusted model, but not with BMI. The inverse associations between neighborhood noise and CVD risk factors were unexpected. Further investigation is needed to determine if these results are affected by unobserved confounding (e.g., variations in walkability). Examining how noise could be related to CVD risk could inform effective neighborhood intervention programs for CVD risk reduction.

Research has examined how the food environment affects the risk of cardiovascular disease (CVD). Many studies have focused on residential neighbourhoods, neglecting the activity spaces of individuals. The objective of this study was to investigate whether food environments in both residential and global positioning system (GPS)-defined activity space buffers are associated with body mass index (BMI) and blood pressure (BP) among low-income adults. Data came from the New York City Low Income Housing, Neighborhoods and Health Study, including BMI and BP data (n=102, age=39.3±14.1 years), and one week of GPS data. Five food environment variables around residential and GPS buffers included: fast-food restaurants, wait-service restaurants, corner stores, grocery stores, and supermarkets. We examined associations between food environments and BMI, systolic and diastolic BP, controlling for individual- and neighbourhood-level sociodemographics and population density. Within residential buffers, a higher grocery store density was associated with lower BMI (β=- 0.20 kg/m2, P<0.05), and systolic and diastolic BP (β =-1.16 mm Hg; and β=-1.02 mm Hg, P<0.01, respectively). In contrast, a higher supermarket density was associated with higher systolic and diastolic BP (β=1.74 mm Hg, P<0.05; and β=1.68, P<0.01, respectively) within residential buffers. In GPS neighbourhoods, no associations were documented. Examining how food environments are associated with CVD risk and how differences in relationships vary by buffer types have the potential to shed light on determinants of CVD risk. Further research is needed to investigate these relationships, including refined measures of spatial accessibility/exposure, considering individual’s mobility.

No abstract

Background Musculoskeletal (MSK) disorders are one of the main causes of disability among adults globally. The burden of MSK disorders varies greatly between different regions and is the highest in low- and middle income- countries. This study sought to investigate trends in the burden of MSK disorders across the MENA region, utilizing the GBD 2019 dataset. Methods This study utilized data from the Global Burden of Disease (GBD). Using age standardized rates of prevalence and disability-adjusted life-years (DALYs), we report trends in the burden of MSK disorders in The Middle East and North Africa (MENA) region between 1990 and 2019. Furthermore, we analyze trends in risk factors contributing to MSK disorders. Results In 2019, the age-standardized rate prevalence and DALYs for all MSK disorders among both genders was 17706 [95% UI = 16641, 18794] and 1782 [95% UI = 1278, 2366], respectively. Low back pain continued to be the most prevalent MSK condition in 2019. Afghanistan had the lowest age standardized DALYs rate attributed to MSK disorders (1408 per 100,000; 95% UI = 980–1899), while Iran had the highest burden of 2007 per 100,000 (95% UI = 1440–2655). In 2019, occupational risks, high body mass index, and tobacco smoking were the main risk factors for DALYs of MSK disorders. Conclusion MSK disorders carry a large burden of disease in the MENA region, and multiple risk factors contribute to this increased burden in the past decades. Interventions that address risk factors have the potential to improve health outcomes among the population. Future research should continue to explore the burden of MSK disorders and better understand how to intervene.