ImportanceProstate cancer (PCa) is marked by disparities in clinical outcomes by race, ethnicity, and age. Equitable enrollment in clinical trials is fundamental to promoting health equity.ObjectiveTo evaluate disparities in the inclusion of racial and ethnic minority groups and older adults across PCa clinical trials.Data SourcesMEDLINE, Embase, and ClinicalTrials.gov were searched to identify primary trial reports from each database's inception through February 2021. Global incidence in age subgroups and US population-based incidence in racial and ethnic subgroups were acquired from the Global Burden of Disease and Surveillance, Epidemiology, and End Results 21 incidence databases respectively.Study SelectionAll phase 2/3 randomized PCa clinical trials were eligible for age disparity analyses. Trials recruiting exclusively from the US were eligible for primary racial and ethnic disparity analyses.Data Extraction and SynthesisThis study was reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Data were pooled using a random-effects model.Main Outcomes and MeasuresEnrollment incidence ratios (EIRs), trial proportions (TPs) of participants 65 years or older or members of a racial and ethnic subgroup divided by global incidence in the corresponding age group, or US population–based incidence in the corresponding racial and ethnic subgroup, were calculated. Meta-regression was used to explore associations between trial characteristics and EIRs and trends in EIRs during the past 3 decades.ResultsOf 9552 participants among trials reporting race, 954 (10.8%) were African American/Black, 80 (1.5%) were Asian/Pacific Islander, and 8518 (78.5) were White. Of 65 US trials, 45 (69.2%) reported race and only 9 (13.8%) reported data on all 5 US racial categories. Of 286 global trials, 75 (26.2%) reported the enrollment proportion of older adults. Outcomes by race and age were reported in 2 (3.1%) and 41 (15.0%) trials, respectively. Black (EIR, 0.70; 95% CI, 0.59-0.83) and Hispanic (EIR, 0.70; 95% CI, 0.59-0.83) patients were significantly underrepresented in US trials. There was no disparity in older adult representation (TP, 21 143 [71.1%]; EIR, 1.00; 95% CI, 0.95-1.05). The representation of Black patients was lower in larger trials (meta-regression coefficient, −0.06; 95% CI, −0.10 to −0.02; P = .002).Conclusions and RelevanceThe results of this meta-analysis suggest that Black and Hispanic men are underrepresented in trials compared with their share of PCa incidence. The representation of Black patients has consistently remained low during the past 2 decades.

Background: The Coronavirus Disease 2019 (COVID-19) was declared a pandemic by WHO as it is found to be excessively transmissible & to spread throughout the world. The disease has caused a worldwide impact because of the need to establish worldwide activity by extensive social distancing and quarantine due to the daily rising death toll. Through this study, we examined intend to examine the psychological effects, perceptual vulnerability, and perceived stress developed among the general population. Methodology: The study was conducted from 2nd March to 26th May 2020. A total of 2188 of subjects replied to our informal online survey internationally. The respondent's demographic details and data regarding precautionary measures, perceptual vulnerability, perceived stress, and level of susceptibility of COVID-19 was collected. The perceived stress scale (PSS-10) was used for assessment of perceived anxiety, stigmatization, and fear of developing COVID-19. Results: As per the study findings, moderate perceived stress was observed among 66.6% of the respondents. Among the protective measures, washing hands was most frequent 56.2%, but the use of face mask wasn't widespread, i.e. 48.9% rarely or never used face masks. 37.1% felt anxious around sick people, 58.5% were usually bothered by the people sneezing without covering their mouths. 32.3% occasionally felt agitated because of no control over the current situation & 18.6% frequently felt stressed and/or nervous. The contact history revealed that 11.2% had close contact, 20.9% had a non-close contact, and 12.9% were those who had suspected connection with a confirmed case. Conclusion: Evidently, COVID-19 has numerous psychological impacts, and the responses vary due to perceived vulnerability & stress. The social distancing, disease fear, and quarantine may have some negative effects which may have some lasting consequences on general population.

Background: The recent pandemic condition developed from the Coronavirus Disease 2019 (COVID-19) outbreak, have a profound effect on almost all the aspects of society. This outbreak has greatly compromised both the mental and physical health of the frontline healthcare workers and supporting hospital staff since they are responsible for the diagnosis and treatment of infected individuals with COVID-19. This study aimed to investigate the psychological impacts and factors causing stress among the healthcare workers & supporting hospital staff during the COVID-19 outbreak and also to identify the preferred coping strategies. Methodology: This cross-sectional survey-based study was conducted from 1st to 30th February 2020. The sample comprised of frontline healthcare workers & hospital staff providing supporting services like laboratory personnel & administrative workers. The data was collected using a structured self-administered online questionnaire focusing on the impacts of COVID-19, factors causing stress and the coping strategies used by frontline medical workers to deal with the psychological impacts of such pandemics. Results: A total of 127 frontline medical workers completed the survey. The findings from the present study suggested that frontline healthcare workers & hospital staff experience both psychological as well as emotional impacts due to COVID-19. The mean Impact of Event Scale (IES) score was 24.44±19.41 indicating partial PTSD or at least a few symptoms of PTSD. The major factor causing stress among these health workers was their fear of inflicting COVID-19 on family (33.1%). Among the coping strategies, emotion-focused coping techniques and positive thinking were found to be the most preferred strategies among the frontline medical workers and hospital staff in coping stress associated with the COVID-19 outbreak. Conclusion: The current study emphasizes the significance of the psychological impacts of COVID-19 among healthcare workers and the importance of psychiatric help for these long-term traumatic influences.

Background: In the aftermath of trauma, post-traumatic growth is demarcated as a positive change and traumatic stress as a negative change, which further leads to PTSD. Previous studies have also indicated that both constructs can co-exist. Detailed descriptions of post-traumatic stress reactions are available in the literature, but the psychophysiological phenomenon of post-traumatic growth is still unclear. Studies have shown that the restorative effects of nature-based therapy have been accounted for a reduction in stress and increase positive affect. The purpose of designing this randomized control trial is to observe nature-based walk on post-traumatic growth and Psychophysiological alterations associated with it. Methodology: This study is designed to examine recreational exposure to the natural environment for the promotion of post-traumatic growth among health care providers with traumatic stress. In addition, to assess whether post-traumatic growth is associated with psychophysiological alterations, i.e. Cortisol, C-Reactive Protein, Interleukin-6, Brain-Derived Neurotropic Factor and Heart Rate Variability. At baseline, the participant will be assessed with Trauma Symptom Checklist 40 to evaluate trauma intensity. Moreover, subjects who had developed PTG or did not have any trauma intensity will be excluded from the study. Blinded treatment will be provided to subjects meeting eligibility criteria and will be randomized into two groups sequentially as they agree to participate. The nature-based walk will be used as an intervention or experimental group vs the control (sit in nature). The study outcomes will be observed at baseline and 3-month follow-up. Discussion: This trial will provide information on the effectiveness of nature-based walk therapy. Moreover, one of the more promising findings of this research will be essential information about trauma-related psychophysiological effects. This study will also evaluate both (experimental and control) groups that influence whether negative changes accompany positive changes in the aftermath of trauma or not. Trial registration: The trial was registered with ClinicalTrials.gov (NCT04592770).

Background: Coronary artery bypass grafting (CABG) is referred to as the gold standard therapeutic modality for treating coronary artery disease (CAD) among both old or young patients. hypertension, diabetes, Increased BMI and obesity, etc. are among the major risk factors for the development of cardiovascular diseases. The aim of the current study was to highlight the increasing rate of CAD and associated CABG surgery among young adults and to identify the potential risk factors associated with it. Methodology: In this hospital based observational study, CAD patients ≤40 years of age admitted to the cardiac surgery department of a leading cardiac center for CABG surgery were included in the study. The study continued from 5th January 2018 to 21st August 2019 and the data of 184 patients who underwent CABG was collected during this time period. The details regarding patients' age, weight, height and body mass index (BMI) were obtained at the time of initial examination. Moreover, medical records, familial history and risk profile were also monitored. The collected data was analyzed using SPSS Version 22.0. Results: A total of 184 CAD patients who underwent CABG surgery were included in the study and 114(62%) of them were males and 70(38%) were females. The age range was 25 to 40 years with the mean age of 36.5±3.17 years. The risk profile displayed that increased BMI was the major contributor for cardiovascular disease i.e. 38% patients were overweight, 10.9% were in Obese I category and 5.97% were in obese II category. Following obesity, hypertension (49.5%), diabetes (29.9%) and dysfunctional lipids (14.7%) were common comorbid conditions. While smoking and positive familial history also contributed to the risk ratio. It was observed that hypertension, diabetic history was more among overweight and obese individuals (p=0.029 & 0.666). Conclusion: Young CAD patients ≤40 years of age display decreased risk and adverse outcomes as compared to the older counterparts but the clinical pattern of presentation is different and hence require different strategic attention.