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Inequality on the frontline: A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic
- Diana Czepiel, Clare McCormack, Andréa T.C. da Silva, Dominika Seblova, Maria F. Moro, Alexandra Restrepo-Henao, Adriana M. Martínez, Oyeyemi Afolabi, Lubna Alnasser, Rubén Alvarado, Hiroki Asaoka, Olatunde Ayinde, Arin Balalian, Dinarte Ballester, Josleen A.l. Barathie, Armando Basagoitia, Djordje Basic, María S. Burrone, Mauro G. Carta, Sol Durand-Arias, Mehmet Eskin, Eduardo Fernández-Jiménez, Marcela I. F. Frey, Oye Gureje, Anna Isahakyan, Rodrigo Jaldo, Elie G. Karam, Dorra Khattech, Jutta Lindert, Gonzalo Martínez-Alés, Franco Mascayano, Roberto Mediavilla, Javier A. Narvaez Gonzalez, Aimee Nasser-Karam, Daisuke Nishi, Olusegun Olaopa, Uta Ouali, Victor Puac-Polanco, Dorian E. Ramírez, Jorge Ramírez, Eliut Rivera-Segarra, Bart P.F. Rutten, Julian Santaella-Tenorio, Jaime C. Sapag, Jana Šeblová, María T. S. Soto, Maria Tavares-Cavalcanti, Linda Valeri, Marit Sijbrandij, Ezra S. Susser, Hans W. Hoek, Els van der Ven
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- Journal:
- Cambridge Prisms: Global Mental Health / Volume 11 / 2024
- Published online by Cambridge University Press:
- 04 March 2024, e34
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Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women’s well-being and ensure healthcare system preparedness during future public health crises.
Developing a conceptual model of possible benefits of condensed tannins for ruminant production
- L. O. Tedeschi, C. A. Ramírez-Restrepo, J. P. Muir
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Enteric methane (CH4) emissions from ruminants have compelled a wide range of research initiatives to identify environmental abatement opportunities. However, although such mitigations can theoretically be attained with feed additives and feeding strategies, the limited empirical evidence on plant extracts used as feed additives does not support extensive or long-term reductions. Nevertheless, their strategic use (i.e. alone or combined in a simultaneous or consecutive use) may provide not only acceptable CH4 abatement levels, but also relevant effects on animal physiology and productivity. Condensed tannins (CT) represent a range of polyphenolic compounds of flavan-3-ol units present in some forage species that can also be added to prepared diets. Methods to determine CT, or their conjugated metabolites, are not simple. Although there are limitations and uncertainties about the methods to be applied, CT are thought to reduce CH4 production (1) indirectly by binding to the dietary fibre and/or reducing the rumen digestion and digestibility of the fibre and (2) directly by inhibiting the growth of rumen methanogens. On the basis of their role in livestock nutrition, CT influence the digestion of protein in the rumen because of their affinity for proteins (e.g. oxidative coupling and H bonding at neutral pH) that causes the CT-protein complex to be insoluble in the rumen; and dissociate in the abomasum at pH 2.5 to 3.0 for proteolysis and absorption in the small intestine. CT may also reduce gastro-intestinal parasite burdens and improve reproductive performance, foetal development, immune system response, hormone serum concentrations, wool production and lactation. The objectives of this paper are to discuss some of the beneficial and detrimental effects of CT on ruminant production systems and to develop a conceptual model to illustrate these metabolic relationships in terms of systemic physiology using earlier investigations with the CT-containing legume Lotus corniculatus. Our conceptual model indicated four complex and long-lasting relationships (digestive, toxicological, physiological and morphological) that can alter the normal biology of the animal. These relationships are interdependent, integrative, and sometimes, complementary to each other. This conceptual model can be used to develop mechanistic models to improve the understanding of the interaction between CT and the ruminants as well as to guide research initiatives of the impact of polyphenol-rich foods on human health.