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Ghazi M, Saleh A, Abdallah M, El Masri D, El Masri J, El Ayoubi LM, Hawi J, Jurjus A. Barriers toward xenotransplantation in Arab World. Xenotransplantation 2024; 31:e12852. [PMID: 38526015 DOI: 10.1111/xen.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/26/2024]
Abstract
Organ transplant is a crucial therapeutic strategy offering a life-saving and transformative medical intervention. It provides an opportunity to improve their quality of life and increase their lifespan. The shortage of organs remains a critical global challenge, leading to a prolonged waiting times for organ receivers, which contributes to an increase in morbidity and mortality rates. Hence, xenotransplantation offered a promising solution to the global shortage of organs through the use of animal organs, leading to an increase in donor availability, reducing waiting times, minimizing organ trafficking, improving genetic engineering advancements, and driving scientific innovation. Even though xenotransplantation has many benefits in the clinical setting, it has many barriers that are hindering its achievements and constraining its occurrence. Some barriers to xenotransplant are general, such as the immunological barrier, while others are specific to certain regions due to local causes. The Arab region exhibits disparities in clinical settings compared to the global context, marked by the huge economic crisis and a shortage of trained healthcare professionals. Considering the huge resources and advancements needed in the field of xenotransplantation, this review aims to explore the specific barriers toward xenotransplantation in the Arab countries, highlighting the challenges to overcome these barriers.
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Affiliation(s)
- Maya Ghazi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Aalaa Saleh
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Malak Abdallah
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Diala El Masri
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Faculty of Medicine, University of Balamand, Koura, Lebanon
| | - Jad El Masri
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | | | - Jihad Hawi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Abdo Jurjus
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Essien EA, Mahmood MY, Adiukwu F, Kareem YA, Hayatudeen N, Ojeahere MI, Salihu MO, Sanni KA, Omotoso AB, Pinto da Costa M. Workforce migration and brain drain - A nationwide cross-sectional survey of early career psychiatrists in Nigeria. Glob Ment Health (Camb) 2024; 11:e30. [PMID: 38572258 PMCID: PMC10988168 DOI: 10.1017/gmh.2024.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/07/2024] [Accepted: 02/14/2024] [Indexed: 04/05/2024] Open
Abstract
Background Nigeria's shortage of psychiatrists is exacerbated due to health worker migration. Aim This study explores migration experiences and tendencies among early-career psychiatrists in Nigeria. Methods We conducted a cross-sectional survey covering Nigeria's six geopolitical zones, using a 61-item online questionnaire assessing short-term mobility, long-term migration experiences and migration attitudes. Data was analysed using IBM SPSS version 29. Results Of 228 early-career psychiatrists surveyed, 9.7% had short-term mobility and 8.0% had long-term migration experiences. However, 85.8% had 'ever' considered migration, 69.2% were planning to leave 'now', and 52.9% had taken 'practical migration steps'. Over half (52.7%) said they would be working abroad in 5 years, with 25.2% indicating they would migrate within a year. The top reasons to leave were financial and academic, while personal and cultural factors were the key reasons to stay. Income dissatisfaction (OR = 2.27, 95%, CI = 1.05-4.88) predicted planning to leave 'now', while being in a relationship (OR = 3.46, 95%CI = 1.06-11.30) predicted taking 'practical migration steps'. Attractive job features were good welfare (85.4%) and high salaries (80.3%). Improvements in finances (90.8%) and work conditions (86.8%) were requested. Conclusions Systemic changes to address psychiatrists' migration from Nigeria are needed.
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Affiliation(s)
| | | | - Frances Adiukwu
- Department of Mental Health, University of Port Harcourt, Choba, Rivers State, Nigeria
| | | | - Nafisatu Hayatudeen
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria
| | | | - Mumeen Olaitan Salihu
- Department of Behavioural Sciences, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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Rukchart N, Hnuploy K, Eltaybani S, Sonlom K, Chutipattana N, Le CN, Patthanasak Khammaneechan, Jongjit W, Supaviboolas S. Prevalence and determinants of COVID-19 vaccine acceptance among vulnerable populations in Thailand: An application of the health belief model. Heliyon 2024; 10:e26043. [PMID: 38384553 PMCID: PMC10878938 DOI: 10.1016/j.heliyon.2024.e26043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
Background Assessing the acceptance of vaccinations among vulnerable populations is essential to ensure proper coronavirus disease 2019 (COVID-19) control. This study used the Health Belief Model to examine the intention to vaccinate against COVID-19 among vulnerable populations in Thailand. Methods This analytical cross-sectional study was conducted in Thailand between October and November 2021. Using multistage random sampling, 945 individuals from vulnerable populations (i.e., older adults, pregnant women, market or street vendors, and individuals with chronic diseases) were selected and invited to complete a self-reported questionnaire. The questionnaire assessed participants' socioeconomic characteristics, COVID-19 preventive measures, knowledge, preventative health beliefs, and vaccine intention. A generalized linear mixed model was used to identify factors associated with the intention to receive the vaccine. Results The prevalence of intent to accept the COVID-19 vaccine was 75.03% (95% confidence interval [CI]: 72.16-77.68). The Health Belief Model factors associated with vaccine acceptance were cue to action (adjusted odds ratio [AOR] = 3.13; 95% CI: 2.07-4.71), perceived benefits (AOR = 2.04; 95% CI: 1.38-3.01), and perceived severity (AOR = 1.77; 95% CI: 1.18-2.65). Significant other covariates were wearing a face mask in the previous month (AOR = 2.62; 95% CI: 1.59-4.31), being 1-2 m away from other people (AOR = 1.58; 95% CI: 1.11-2.24), trust in government (AOR = 1.44; 95% CI: 1.03-2.02). Additionally, women were more likely to accept the COVID-19 vaccine compared to men (AOR = 1.43; 95% CI: 1.02-2.01). Conclusions Approximately one quarter of vulnerable individuals do not intend to be vaccinated. Health Belief Models can explain vaccine acceptance, and aid the Ministry of Public Health in planning future efforts to increase vaccine uptake. Healthcare professionals' advice, village health volunteers' information, and partnership collaborations are critical. Facilitating mobile community units, launching educational campaigns, maintaining a distance of 1-2 m from others, and wearing masks may increase COVID-19 vaccine acceptability. This research can help prepare for future pandemics.
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Affiliation(s)
- Navarat Rukchart
- School of Nursing, Walailak University, Nakhon Si Thammarat, 80161, Thailand
| | - Kanit Hnuploy
- Suratthani Rajabhat University, Suratthani, 84100, Thailand
| | - Sameh Eltaybani
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
| | | | - Nirachon Chutipattana
- Department of Community Public Health, School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
- Excellent Centre for Dengue and Community Public Health (E.C. for DACH), School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
| | - Cua Ngoc Le
- Department of Community Public Health, School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
- Excellent Centre for Dengue and Community Public Health (E.C. for DACH), School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
| | - Patthanasak Khammaneechan
- Department of Community Public Health, School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
- Excellent Centre for Dengue and Community Public Health (E.C. for DACH), School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
| | - Wajinee Jongjit
- Department of Public Health Strategy Development, Nakhon Si Thammarat Provincial Public Health Office, Nakhon Si Thammarat, 80000, Thailand
| | - Suttakarn Supaviboolas
- Southern Border Regional Center for Primary Health Care Development, Nakhon Si Thammarat, 80000, Thailand
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Siette J, Ludlow K, Dodds L, Strutt P, Wuthrich V. "Provided a window on the world and lessened my feeling of isolation": older adults' perceived COVID-19 impact and technology use in Australia during recurrent lockdowns. BMC Geriatr 2024; 24:206. [PMID: 38419001 PMCID: PMC10900585 DOI: 10.1186/s12877-024-04807-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 02/13/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND An informed understanding of older adults' perceptions of the impact (positive or negative) of recurrent COVID-19 long lockdowns is important for the development of targeted interventions and resources for future restrictions. This study aimed to understand self-reported impacts of COVID-19 recurrent restrictions on older adults and how technology has been used to mitigate these. METHODS A cross-sectional national study of 257 community-dwelling older Australians based in Victoria (mean age = 67.6 years [SD = 7.2]; 20.6% male) completed an online or postal survey as part of a larger study examining the physical and mental health impacts of a second extended COVID-19 lockdown period. This secondary analysis reports on the findings from free-text responses to two open-ended questions included in that survey that asked participants to comment on the greatest impacts of the COVID-19 lockdowns (positive or negative) and the role of technology in supporting their wellbeing during this time. Responses were collected between July and September 2020. Data were analysed using content (COVID-19 impacts) and thematic (role of technology) analysis. RESULTS Respondents gave more negative responses (75.5%) than mixed (15.2%) and positive responses (6.2%) in reporting on the biggest impact of COVID-19 lockdowns. Inductive content analysis revealed two first-order main categories (Positive impacts and Negative impacts). Axial coding of main categories showed five second-order categories (Environmental, Physical Health, Social, Mental Health, and Personal) for both negative and positive main categories (totalling 10 second-order categories). Overall, respondents highlighted social loss as the key negative experience (70%), with acute feelings of social isolation contributing to negative impacts on mental wellbeing. The most commonly reported positive impact reported (11%) was having more time for relationships, relaxation, and new hobbies. Technology was primarily used to sustain socialisation and provide access to essential resources, services, and goods, which respondents perceived to contribute to maintaining their wellbeing. CONCLUSIONS Findings suggest a critical need for interventions that address the social loss experienced by older adults during COVID-19 recurrent lockdowns, particularly to alleviate the associated negative impact on mental wellbeing. Recognising the positive aspect of increased time for relationships and leisure activities indicates potential areas for resilience-building strategies. The pivotal role of technology in mitigating adverse effects highlights its significance in building social connections and supporting overall wellbeing during challenging times. These implications can guide future efforts to enhance older adults' resilience, mental health, and holistic wellbeing in future public health crises.
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Affiliation(s)
- Joyce Siette
- The MARCS Centre for Brain, Behaviour and Development, Western Sydney University, New South Wales, 2145, Australia.
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, New South Wales, 2109, Australia.
| | - Kristiana Ludlow
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, New South Wales, 2109, Australia
- Centre for Health Services Research, the University of Queensland, Queensland, 4102, Australia
| | - Laura Dodds
- The MARCS Centre for Brain, Behaviour and Development, Western Sydney University, New South Wales, 2145, Australia
| | - Paul Strutt
- The MARCS Centre for Brain, Behaviour and Development, Western Sydney University, New South Wales, 2145, Australia
- Lifespan Health Wellbeing Research Centre, Macquarie University, New South Wales, 2109, Australia
| | - Viviana Wuthrich
- Lifespan Health Wellbeing Research Centre, Macquarie University, New South Wales, 2109, Australia
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255
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Sayed AA. COVID-19 vaccine hesitancy and attitudes of subjects with disability and their carers in Saudi Arabia: a cross-sectional study. Front Public Health 2024; 12:1282581. [PMID: 38481833 PMCID: PMC10933131 DOI: 10.3389/fpubh.2024.1282581] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/19/2024] [Indexed: 05/01/2024] Open
Abstract
The COVID-19 pandemic has caused significant disruption to countries worldwide, including Saudi Arabia. The fast preventative measures and the mass vaccine enrollment were vital to contain the pandemic in the country. However, vaccine hesitancy was a significant obstacle to taking the vaccine but was not previously explored. One hundred eighty-six subjects with disabilities were enrolled in this study in an attempt to explore their hesitancy and attitudes toward COVID-19 vaccines. Most participants were previously diagnosed with COVID-19 and had a close family who was also diagnosed with it. Most of them were willing to be vaccinated but had not received previous vaccinations. Official sources of information, e.g., TV/radio, were an essential factor driving their intention to get vaccinated. Beliefs that drove participants' vaccine acceptance included vaccine safety, sufficient testing before its release, and its ability to protect from infection. The results of this seminal study provide insights to public health policymakers, which should be considered and taken together in light of other studies addressing the population's vaccine hesitancy.
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Affiliation(s)
- Anwar A. Sayed
- Department of Basic Medical Sciences, College of Medicine, Taibah University, Madinah, Saudi Arabia
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256
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Wang Y, Shi X, Hong H, Chang Q. How does multiscale greenspace exposure affect human health? Evidence from urban parks in the central city of Beijing. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 353:120253. [PMID: 38335596 DOI: 10.1016/j.jenvman.2024.120253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
While the health benefits of exposure to urban greenspace have been widely discussed at different spatial scales, the comprehensive health effects of multiscale greenspace exposure are far from understood. There is a lack of quantified evidence when conducting cost-effective greenspace management practices for promoting human health and well-being. This study proposed a conceptual model that links objective and subjective greenspace exposure metrics at different spatial scales with self-rated health of residents. The model attempted to deconstruct and explore the associations between multiscale greenspace exposure and human health, and a cross-sectional study was conducted to examine the model. Taking urban parks in the central city of Beijing as case study area, the objective greenspace exposure metrics at both the site and subdistrict scales were spatial explicitly assessed, and the subjective exposure metrics and self-rated health status of 1017 respondents were obtained through questionnaire survey and spatial positioning. The results of multiple regression analyses and path analyses suggested that greenspace exposure metrics at both site and subdistrict scales were significantly associated with the respondents' self-rated health status, with the exposure metrics at the site scale being more important than those at the subdistrict scale in affecting human health. The contribution of urban parks to self-rated physical and mental health of respondents varied across spatial scales. Specifically, the aesthetic value of urban parks at site scale contributed the most to mental health by promoting respondents' resting behaviors in urban parks, and the density of urban parks at subdistrict scale had the most significant effects on self-rated physical health by increasing the usage frequency of urban parks. Findings of this study can contribute to understanding the complex associations between urban greenspace and human health from a multiscale perspective, and are also expected to provide quantified information for health-oriented urban greenspace planning and management practices.
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Affiliation(s)
- Yanan Wang
- School of Architecture, Yantai University, Yantai, 264005, China; Department of Landscape Architecture, College of Horticulture, China Agricultural University, Beijing, 100193, China
| | - Xiaoxiao Shi
- Department of Landscape Architecture, College of Horticulture, China Agricultural University, Beijing, 100193, China
| | - Hailin Hong
- Department of Landscape Architecture, College of Horticulture, China Agricultural University, Beijing, 100193, China
| | - Qing Chang
- Department of Landscape Architecture, College of Horticulture, China Agricultural University, Beijing, 100193, China.
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Wondmeneh TG, Mohammed JA. COVID-19 mortality rate and its determinants in Ethiopia: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1327746. [PMID: 38476444 PMCID: PMC10928001 DOI: 10.3389/fmed.2024.1327746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/12/2024] [Indexed: 03/14/2024] Open
Abstract
Background The COVID-19 mortality rate continues to be high in low-income countries like Ethiopia as the new variant's transmission expands and the countries' limited capacity to combat the disease causes severe outcomes, including deaths. The aim of this study is to determine the magnitude of the COVID-19 mortality rate and its determinants in Ethiopia. Methods The main electronic databases searched were PubMed, CINAHL, Google Scholar, and African journals online. The included studies' qualities were assessed independently using the Newcastle-Ottawa scale. The data was extracted in Microsoft Excel spreadsheet format. The pooled effect size and odds ratios with 95% confidence intervals across studies were determined using the random-effects model. I2 is used to estimate the percentage of overall variation across studies due to heterogeneity. Egger's test and funnel plot were used to find the published bias. A subgroup analysis was conducted. The effect of a single study on the overall estimation was determined by sensitivity analysis. Results A total of 21 studies with 42,307 study participants were included in the final analysis. The pooled prevalence of COVID-19 mortality was 14.44% (95% CI: 10.35-19.08%), with high significant heterogeneity (I2 = 98.92%, p < 0.001). The risk of mortality from COVID-19 disease was higher for patients with comorbidity (AHR = 1.84, 95% CI: 1.13-2.54) and cardiovascular disease (AHR = 2, 95% CI: 1.09-2.99) than their counterparts without these conditions. Conclusion A significant number of COVID-19 patients died in Ethiopia. COVID-19 patients with comorbidities, particularly those with cardiovascular disease, should receive special attention to reduce COVID-19 mortality. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, registration identifier (ID) CRD42020165740.
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258
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Petakh P, Oksenych V, Kamyshna I, Boisak I, Lyubomirskaya K, Kamyshnyi O. Exploring the complex interplay: gut microbiome, stress, and leptospirosis. Front Microbiol 2024; 15:1345684. [PMID: 38476949 PMCID: PMC10927737 DOI: 10.3389/fmicb.2024.1345684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/30/2024] [Indexed: 03/14/2024] Open
Abstract
Leptospirosis, a re-emerging zoonotic disease, remains a significant global health concern, especially amid floods and disasters such as the Kakhovka Dam destruction. As is known, the stress that occurs in the conditions of military conflicts among civilian and military personnel significantly affects susceptibility to infectious diseases and possibly even influences their course. This review aims to explore how the gut microbiome and stress mediators (such as catecholamines and corticosteroids) might impact the leptospirosis disease course. The review opens new horizons for research by elucidating the connections between the gut microbiome, stress, and leptospirosis.
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Affiliation(s)
- Pavlo Petakh
- Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Valentyn Oksenych
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Iryna Kamyshna
- Department of Medical Rehabilitation, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Iryna Boisak
- Department of Childhood Diseases, Uzhhorod National University, Uzhhorod, Ukraine
| | - Katerina Lyubomirskaya
- Department of Obstetrics and Gynecology, Zaporizhzhia State Medical and Pharmaceuticals University, Zaporizhzhia, Ukraine
| | - Oleksandr Kamyshnyi
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
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Naved RT, Mahmud S, Al Mamun M, Parvin K, Kalra S, Laterra A, Sprinkel A. Effectiveness of combined interventions to empower girls and address social norms in reducing child marriage in a rural sub-district of Bangladesh: A Cluster Randomised Controlled Trial of the Tipping Point Initiative. J Glob Health 2024; 14:04020. [PMID: 38389481 PMCID: PMC10903545 DOI: 10.7189/jogh.14.04020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Background Elimination of girl child marriage (CM) globally at the current pace is projected to take about 300 years. Thus, innovative and effective solutions are urgently warranted. Bangladesh reports one of the highest rates of CM in the world. We present the impact of Tipping Point Initiative (TPI), a combined intervention to empower girls and to address social norms on CM in Bangladesh. Methods A three-arm non-blinded Cluster Randomised Controlled Trial was conducted in 51 villages/clusters in a sub-district of Bangladesh. Clusters were randomly assigned to the arms: Tipping Point Program (TPP), Tipping Point Program Plus (TPP+), and Pure Control. TPP conducted 40 weekly single-gender group sessions with never-married adolescent girls and boys recruited at 12 -<16 years; and 18-monthly gender-segregated group sessions with the parents. On top of TPP, TPP+ included cross-gender and -generation dialogues, girls' movement building and girl-led community sensitisation. Intention-to-treat analysis was performed to assess the impact of TPI on the hazard of CM, the primary outcome. The impact of girls' session attendance on CM was also assessed. At baseline 1275 girls (TPP = 412; TPP+ = 420; Control = 443) were interviewed between February-April 2019. At endline 1123 girls (TPP = 363; TPP + = 366; Control = 394) were interviewed and included in the analyses. Results No intervention impact was detected on the full sample (TPP vs. Control: adjusted hazard ratio (aHR) = 1.14; 95% CI = 0.79-1.63, P = 0.47), (TPP + vs. Control: aHR = 1.24; 95% CI = 0.89-1.71, P = 0.19, (TPP vs. TPP+: aHR = 1.03; 95% CI = 0.72-1.47, P = 0.87). However, in the TPP arm, the hazard of CM was reduced by 54% (aHR = 0.46; 95% CI = 0.23-0.92, P = 0.03) among the girls in the highest tertile of session attendance, compared to the lowest. In the TPP+ arm, this hazard was reduced by 49% (aHR = 0.51; 95% CI = 0.23-0.92, P = 0.03) among girls in the highest tertile, compared to the lowest tertile. Conclusions Although TPI did not show an effect on CM in any of the intervention arms, within each intervention arm, a positive effect was detected in reducing CM among girls in the highest tertile of session attendance despite implementation challenges due to COVID-19. Registration Clinicaltrials.gov: NCT03965273; Date: 29 May 2019.
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Affiliation(s)
- Ruchira Tabassum Naved
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sultan Mahmud
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mahfuz Al Mamun
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kausar Parvin
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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la Roi-Teeuw HM, Luijken K, Blom MT, Gussekloo J, Mooijaart SP, Polinder-Bos HA, van Smeden M, Geersing GJ, van den Dries CJ. Limited incremental predictive value of the frailty index and other vulnerability measures from routine care data for mortality risk prediction in older patients with COVID-19 in primary care. BMC PRIMARY CARE 2024; 25:70. [PMID: 38395766 PMCID: PMC10885372 DOI: 10.1186/s12875-024-02308-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, older patients in primary care were triaged based on their frailty or assumed vulnerability for poor outcomes, while evidence on the prognostic value of vulnerability measures in COVID-19 patients in primary care was lacking. Still, knowledge on the role of vulnerability is pivotal in understanding the resilience of older people during acute illness, and hence important for future pandemic preparedness. Therefore, we assessed the predictive value of different routine care-based vulnerability measures in addition to age and sex for 28-day mortality in an older primary care population of patients with COVID-19. METHODS From primary care medical records using three routinely collected Dutch primary care databases, we included all patients aged 70 years or older with a COVID-19 diagnosis registration in 2020 and 2021. All-cause mortality was predicted using logistic regression based on age and sex only (basic model), and separately adding six vulnerability measures: renal function, cognitive impairment, number of chronic drugs, Charlson Comorbidity Index, Chronic Comorbidity Score, and a Frailty Index. Predictive performance of the basic model and the six vulnerability models was compared in terms of area under the receiver operator characteristic curve (AUC), index of prediction accuracy and the distribution of predicted risks. RESULTS Of the 4,065 included patients, 9% died within 28 days after COVID-19 diagnosis. Predicted mortality risk ranged between 7-26% for the basic model including age and sex, changing to 4-41% by addition of comorbidity-based vulnerability measures (Charlson Comorbidity Index, Chronic Comorbidity Score), more reflecting impaired organ functioning. Similarly, the AUC of the basic model slightly increased from 0.69 (95%CI 0.66 - 0.72) to 0.74 (95%CI 0.71 - 0.76) by addition of either of these comorbidity scores. Addition of a Frailty Index, renal function, the number of chronic drugs or cognitive impairment yielded no substantial change in predictions. CONCLUSION In our dataset of older COVID-19 patients in primary care, the 28-day mortality fraction was substantial at 9%. Six different vulnerability measures had little incremental predictive value in addition to age and sex in predicting short-term mortality.
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Affiliation(s)
- Hannah M la Roi-Teeuw
- Department of General Practice and Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 6.131, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Kim Luijken
- Department of Epidemiology and Health Economics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marieke T Blom
- Department of General Practice, Amsterdam UMC Location Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jacobijn Gussekloo
- LUMC Center for Medicine for Older People, Department of Public Health and Primary Care, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Simon P Mooijaart
- LUMC Center for Medicine for Older People, Department of Public Health and Primary Care, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Harmke A Polinder-Bos
- Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maarten van Smeden
- Department of Epidemiology and Health Economics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Data Science and Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Geert-Jan Geersing
- Department of General Practice and Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 6.131, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Carline J van den Dries
- Department of General Practice and Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 6.131, PO Box 85500, 3508 GA, Utrecht, The Netherlands
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Johnson LF, Kassanjee R, Folb N, Bennett S, Boulle A, Levitt NS, Curran R, Bobrow K, Roomaney RA, Bachmann MO, Fairall LR. A model-based approach to estimating the prevalence of disease combinations in South Africa. BMJ Glob Health 2024; 9:e013376. [PMID: 38388163 PMCID: PMC10884267 DOI: 10.1136/bmjgh-2023-013376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/12/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The development of strategies to better detect and manage patients with multiple long-term conditions requires estimates of the most prevalent condition combinations. However, standard meta-analysis tools are not well suited to synthesising heterogeneous multimorbidity data. METHODS We developed a statistical model to synthesise data on associations between diseases and nationally representative prevalence estimates and applied the model to South Africa. Published and unpublished data were reviewed, and meta-regression analysis was conducted to assess pairwise associations between 10 conditions: arthritis, asthma, chronic obstructive pulmonary disease (COPD), depression, diabetes, HIV, hypertension, ischaemic heart disease (IHD), stroke and tuberculosis. The national prevalence of each condition in individuals aged 15 and older was then independently estimated, and these estimates were integrated with the ORs from the meta-regressions in a statistical model, to estimate the national prevalence of each condition combination. RESULTS The strongest disease associations in South Africa are between COPD and asthma (OR 14.6, 95% CI 10.3 to 19.9), COPD and IHD (OR 9.2, 95% CI 8.3 to 10.2) and IHD and stroke (OR 7.2, 95% CI 5.9 to 8.4). The most prevalent condition combinations in individuals aged 15+ are hypertension and arthritis (7.6%, 95% CI 5.8% to 9.5%), hypertension and diabetes (7.5%, 95% CI 6.4% to 8.6%) and hypertension and HIV (4.8%, 95% CI 3.3% to 6.6%). The average numbers of comorbidities are greatest in the case of COPD (2.3, 95% CI 2.1 to 2.6), stroke (2.1, 95% CI 1.8 to 2.4) and IHD (1.9, 95% CI 1.6 to 2.2). CONCLUSION South Africa has high levels of HIV, hypertension, diabetes and arthritis, by international standards, and these are reflected in the most prevalent condition combinations. However, less prevalent conditions such as COPD, stroke and IHD contribute disproportionately to the multimorbidity burden, with high rates of comorbidity. This modelling approach can be used in other settings to characterise the most important disease combinations and levels of comorbidity.
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Affiliation(s)
- Leigh F Johnson
- Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Cape Town, South Africa
| | - Reshma Kassanjee
- Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Cape Town, South Africa
| | | | | | - Andrew Boulle
- Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, Cape Town, South Africa
- Department of Health, Western Cape Provincial Government, Cape Town, South Africa
| | - Naomi S Levitt
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Robyn Curran
- Knowledge Translation Unit, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Kirsty Bobrow
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Rifqah A Roomaney
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa
| | - Max O Bachmann
- Norwich Medical School, University of East Anglia, Faculty of Medicine and Health Sciences, Norwich, UK
| | - Lara R Fairall
- Knowledge Translation Unit, University of Cape Town, Cape Town, Western Cape, South Africa
- King's Global Health Institute, King's College London, London, UK
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262
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Gu D, Wang Q, Chai Y, Yang X, Zhao W, Li M, Zolotarev O, Xu Z, Zhang G. Identifying the Risk Factors of Allergic Rhinitis Based on Zhihu Comment Data Using a Topic-Enhanced Word-Embedding Model: Mixed Method Study and Cluster Analysis. J Med Internet Res 2024; 26:e48324. [PMID: 38386404 PMCID: PMC10921335 DOI: 10.2196/48324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/30/2023] [Accepted: 01/03/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Allergic rhinitis (AR) is a chronic disease, and several risk factors predispose individuals to the condition in their daily lives, including exposure to allergens and inhalation irritants. Analyzing the potential risk factors that can trigger AR can provide reference material for individuals to use to reduce its occurrence in their daily lives. Nowadays, social media is a part of daily life, with an increasing number of people using at least 1 platform regularly. Social media enables users to share experiences among large groups of people who share the same interests and experience the same afflictions. Notably, these channels promote the ability to share health information. OBJECTIVE This study aims to construct an intelligent method (TopicS-ClusterREV) for identifying the risk factors of AR based on these social media comments. The main questions were as follows: How many comments contained AR risk factor information? How many categories can these risk factors be summarized into? How do these risk factors trigger AR? METHODS This study crawled all the data from May 2012 to May 2022 under the topic of allergic rhinitis on Zhihu, obtaining a total of 9628 posts and 33,747 comments. We improved the Skip-gram model to train topic-enhanced word vector representations (TopicS) and then vectorized annotated text items for training the risk factor classifier. Furthermore, cluster analysis enabled a closer look into the opinions expressed in the category, namely gaining insight into how risk factors trigger AR. RESULTS Our classifier identified more comments containing risk factors than the other classification models, with an accuracy rate of 96.1% and a recall rate of 96.3%. In general, we clustered texts containing risk factors into 28 categories, with season, region, and mites being the most common risk factors. We gained insight into the risk factors expressed in each category; for example, seasonal changes and increased temperature differences between day and night can disrupt the body's immune system and lead to the development of allergies. CONCLUSIONS Our approach can handle the amount of data and extract risk factors effectively. Moreover, the summary of risk factors can serve as a reference for individuals to reduce AR in their daily lives. The experimental data also provide a potential pathway that triggers AR. This finding can guide the development of management plans and interventions for AR.
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Affiliation(s)
- Dongxiao Gu
- School of Management, Hefei University of Technology, Hefei, China
| | - Qin Wang
- School of Management, Hefei University of Technology, Hefei, China
| | - Yidong Chai
- School of Management, Hefei University of Technology, Hefei, China
| | - Xuejie Yang
- School of Management, Hefei University of Technology, Hefei, China
| | - Wang Zhao
- School of Management, Hefei University of Technology, Hefei, China
| | - Min Li
- School of Management, Hefei University of Technology, Hefei, China
| | | | - Zhengfei Xu
- School of Management, Hefei University of Technology, Hefei, China
| | - Gongrang Zhang
- School of Management, Hefei University of Technology, Hefei, China
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263
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Mouro M, Duque V. Asymptomatic transmission of human mpox. BMJ Case Rep 2024; 17:e254305. [PMID: 38378593 PMCID: PMC10882404 DOI: 10.1136/bcr-2022-254305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024] Open
Abstract
Monkeypox virus belongs to the genus Orthopoxvirus There was a worldwide mpox outbreak in 2022, with many cases reported in Europe in gay, bisexual and other men who have sex with men. Here, we report a case of mpox diagnosed in a heterosexual woman in her twenties without any known history of exposure. This is a very rare event. Despite lesions remaining for more than 1 month, she recovered fully with no sequelae. We highlight the diagnosis of mpox in a heterosexual woman without a known or suspected history of exposure or any risk factor for acquiring the infection.
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Affiliation(s)
| | - Vitor Duque
- Doenças Infeciosas, HUC/ULS Coimbra, Coimbra, Portugal
- Clínica Universitária de Doenças Infeciosas, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
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264
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Sandlund J, Duriseti R, Ladhani SN, Stuart K, Noble J, Høeg TB. Child mask mandates for COVID-19: a systematic review. Arch Dis Child 2024; 109:e2. [PMID: 38050026 PMCID: PMC10894839 DOI: 10.1136/archdischild-2023-326215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/03/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Mask mandates for children during the COVID-19 pandemic varied in different locations. A risk-benefit analysis of this intervention has not yet been performed. In this study, we performed a systematic review to assess research on the effectiveness of mask wearing in children. METHODS We performed database searches up to February 2023. The studies were screened by title and abstract, and included studies were further screened as full-text references. A risk-of-bias analysis was performed by two independent reviewers and adjudicated by a third reviewer. RESULTS We screened 597 studies and included 22 in the final analysis. There were no randomised controlled trials in children assessing the benefits of mask wearing to reduce SARS-CoV-2 infection or transmission. The six observational studies reporting an association between child masking and lower infection rate or antibody seropositivity had critical (n=5) or serious (n=1) risk of bias; all six were potentially confounded by important differences between masked and unmasked groups and two were shown to have non-significant results when reanalysed. Sixteen other observational studies found no association between mask wearing and infection or transmission. CONCLUSIONS Real-world effectiveness of child mask mandates against SARS-CoV-2 transmission or infection has not been demonstrated with high-quality evidence. The current body of scientific data does not support masking children for protection against COVID-19.
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Affiliation(s)
- Johanna Sandlund
- Board-Certified Clinical Microbiologist and Independent Scholar, Alameda, California, USA
| | - Ram Duriseti
- Stanford University School of Medicine, Stanford, California, USA
| | - Shamez N Ladhani
- Immunisation Department, UK Health Security Agency, London, UK
- Centre for Neonatal and Paediatric Infection, St. George's University of London, London, UK
| | - Kelly Stuart
- SmallTalk Pediatric Therapy, San Diego, California, USA
| | - Jeanne Noble
- Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Tracy Beth Høeg
- Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- Clinical Research, University of Southern Denmark, Odense, Denmark
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Zambrano G, Tennhardt LM, Egger M, Ramírez K, Santos A, Moyano B, Curran M. Differing impacts of the COVID-19 pandemic on farmers and intermediaries: insights into the Ecuadorian cocoa value chain. AGRICULTURAL AND FOOD ECONOMICS 2024; 12:9. [PMID: 38371698 PMCID: PMC10866804 DOI: 10.1186/s40100-024-00302-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 01/24/2024] [Accepted: 02/06/2024] [Indexed: 02/20/2024]
Abstract
The COVID-19 pandemic generated diverse impacts and responses in agricultural value chains worldwide. Cocoa is a key crop for Ecuadorian exports, and the analysis of effects the pandemic had on value chain actors contributes to the understanding of their individual capacities to coping with a major shock. The purpose of this study was to assess the number and severity of impacts and responses implemented by two links in the cocoa value chain to the pandemic, based on a survey of 158 cocoa farmers and 52 cocoa intermediaries from the main cocoa-producing provinces of the northern coast of Ecuador in 2021. Surveyed farmers and part of the intermediaries form part of the sustainability program of a large Swiss chocolate manufacturer. The impacts and responses reported were grouped into seven resources according to the Activity System Approach. Then, a comparison between groups was applied using the Wilcoxon rank sum test for nonparametric data, determining the most severe impacts and effective resilience responses among the actors. The results reveal that farmers and intermediaries were similarly affected by the pandemic, reporting 21 and 16 negative impacts, respectively. Farmers experienced a higher number and severity of impacts on financial and social resources, while intermediaries on human and material resources. The strongest impact was the loss of sales, reported by 65% of farmers and 58% of intermediaries. Farmers implemented more social responses that they judged highly effective, while intermediaries implemented more human responses that they judged highly effective. Public policy should enhance the social resources of farmers by strengthening their associativity and the capacities of their members, as mechanisms to mitigate their vulnerability to future health and climate crises. The financial resources of both actors should be protected through public credit and agricultural insurance.
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Affiliation(s)
- Guillermo Zambrano
- Escuela Superior Politécnica del Litoral, ESPOL, Facultad de Ciencias de la Vida, Campus Gustavo Galindo Km 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
| | - Lina M. Tennhardt
- Research Institute of Organic Agriculture (FiBL), Frick, Switzerland
- Georges Lemaître Earth and Climate Research Centre, Earth, and Life Institute, University of Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - Moritz Egger
- Research Institute of Organic Agriculture (FiBL), Frick, Switzerland
| | - Karen Ramírez
- Escuela Superior Politécnica del Litoral, ESPOL, Facultad de Ciencias de la Vida, Campus Gustavo Galindo Km 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
| | - Adriana Santos
- Escuela Superior Politécnica del Litoral, ESPOL, Facultad de Ciencias de la Vida, Campus Gustavo Galindo Km 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
| | - Byron Moyano
- Escuela Superior Politécnica del Litoral, ESPOL, Facultad de Ciencias de la Vida, Campus Gustavo Galindo Km 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
| | - Michael Curran
- Research Institute of Organic Agriculture (FiBL), Frick, Switzerland
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Falguera CC, Tandinco FD, Labarda CE, Rosaldo AG, Firmo CN, Varona RN. A Mixed-Method Study on Rural Community's Response to Public Health Emergency in the Philippines: Lessons from the First Wave of the COVID-19 Pandemic. ACTA MEDICA PHILIPPINA 2024; 58:16-26. [PMID: 38966153 PMCID: PMC11219550 DOI: 10.47895/amp.vi0.6169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
Background People from rural communities are not spared from COVID-19. But implementing preventive measures and strategies can be made to control the spread. Objective This study was conducted to describe the epidemiologic situation and the healthcare capacity of the locality, determine the responses and strategies implemented in the control of COVID-19, and explain the activities performed in relation to the epidemiologic situation in Tarangnan, Samar - a low-income class municipality in the Philippines. Methods A mixed qualitative-quantitative design was employed in this study. Descriptive documentary research design through review of records from March to October 2020 was utilized. For the qualitative context, a case study design was employed whereby focus group discussions and key informant interviews using open-ended questions were performed. Results A total of 66 individuals were recorded as having COVID-19 in the municipality from March to October 2020. The first recorded confirmed cases of COVID-19 in Eastern Visayas were two adults in Tarangnan, Samar, in March 2020. Since then, additional confirmed cases have been recorded every month, but confirmed COVID-19 dramatically reduced from August to October 2020. Qualitative analysis revealed stringent COVID-19 preventive measures reflected in the confirmed case numbers. The tailwinds of the COVID-19 response include: the SARS pandemic precedent, coordination and communication, outpouring of support from other government and non-government partners, and innovative community-based approaches. The headwinds of COVID-19 response were challenges in imposing minimum health and safety precautions, stigmatization, and discrimination. Conclusion Even if challenges have arisen in implementing measures against the spread of the disease, good outcomes have been achieved through persistent good practice, positive modifications, and community-based innovations.
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Affiliation(s)
- Charlie C. Falguera
- Midwifery Department, School of Health Sciences, University of the Philippines Manila, Palo, Leyte, Philippines
| | - Filedito D. Tandinco
- Department of Medicine, School of Health Sciences, University of the Philippines Manila, Palo, Leyte, Philippines
| | - Charlie E. Labarda
- Department of Medicine, School of Health Sciences, University of the Philippines Manila, Palo, Leyte, Philippines
| | - Adelaida G. Rosaldo
- Department of Medicine, School of Health Sciences, University of the Philippines Manila, Palo, Leyte, Philippines
| | - Carmen N. Firmo
- Nursing Department, School of Health Sciences, University of the Philippines Manila, Palo, Leyte, Philippines
| | - Robelita N. Varona
- Extension Campus in South Cotabato, School of Health Sciences, University of the Philippines Manila, Koronadal City, South Cotabato, Philippines
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267
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Lupu D, Tiganasu R. Does education influence COVID-19 vaccination? A global view. Heliyon 2024; 10:e24709. [PMID: 38314273 PMCID: PMC10837567 DOI: 10.1016/j.heliyon.2024.e24709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/06/2024] Open
Abstract
After the recent hard attempts felt on a global scale, notably in the health sector, the steady efforts of scientists have been materialized in maybe one of the most expected findings of the last decades, i.e. the launching of the COVID-19 vaccines. Although it is not our goal to plead for vaccination, as the decision in this regard is a matter of individual choice, we believe it is necessary and enlightening to analyze how one's educational status interferes with COVID-19 vaccination. There are discrepancies between world states vis-à-vis their well-being and their feedback to crises, and from the collection of features that can segregate the states in handling vaccination, in this paper, the spotlight is on education. We are referring to this topic because, generally, researches converge rather on the linkage between economic issues and COVID-19 vaccination, while education levels are less tackled in relation to this. To notice the weight of each type of education (primary, secondary, tertiary) in this process, we employ an assortment of statistical methods, for three clusters: 45 low-income countries (LICs), 72 middle-income countries (MICs) and 53 high-income countries (HICs). The estimates suggest that education counts in the COVID-19 vaccination, the tertiary one having the greatest meaning in accepting it. It is also illustrated that the imprint of education on vaccination fluctuates across the country groups scrutinized, with HICs recording the upper rates. The heterogeneity of COVID-19 vaccination-related behaviors should determine health authorities to treat this subject differently. To expand the COVID-19 vaccines uptake, they should be in an ongoing dialogue with all population categories and, remarkably, with those belonging to vulnerable communities, originated mostly in LICs. Education is imperative for vaccination, and it would ought to be on the schedule of any state, for being assimilated into health strategies and policies.
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Affiliation(s)
- Dan Lupu
- "Alexandru Ioan Cuza" University of Iasi, Romania, Faculty of Economics and Business Administration, Romania
| | - Ramona Tiganasu
- "Alexandru Ioan Cuza" University of Iasi, Faculty of Law, Centre for European Studies, Romania
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268
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Macaluso M, Rothenberg ME, Ferkol T, Kuhnell P, Kaminski HJ, Kimberlin DW, Benatar M, Chehade M. Impact of the COVID-19 Pandemic on People Living With Rare Diseases and Their Families: Results of a National Survey. JMIR Public Health Surveill 2024; 10:e48430. [PMID: 38354030 PMCID: PMC10868638 DOI: 10.2196/48430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 09/20/2023] [Accepted: 12/15/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND With more than 103 million cases and 1.1 million deaths, the COVID-19 pandemic has had devastating consequences for the health system and the well-being of the entire US population. The Rare Diseases Clinical Research Network funded by the National Institutes of Health was strategically positioned to study the impact of the pandemic on the large, vulnerable population of people living with rare diseases (RDs). OBJECTIVE This study was designed to describe the characteristics of COVID-19 in the RD population, determine whether patient subgroups experienced increased occurrence or severity of infection and whether the pandemic changed RD symptoms and treatment, and understand the broader impact on respondents and their families. METHODS US residents who had an RD and were <90 years old completed a web-based survey investigating self-reported COVID-19 infection, pandemic-related changes in RD symptoms and medications, access to care, and psychological impact on self and family. We estimated the incidence of self-reported COVID-19 and compared it with that in the US population; evaluated the frequency of COVID-19 symptoms according to self-reported infection; assessed infection duration, complications and need for hospitalization; assessed the influence of the COVID-19 pandemic on RD symptoms and treatment, and whether the pandemic influenced access to care, special food and nutrition, or demand for professional psychological assistance. RESULTS Between May 2, 2020, and December 15, 2020, in total, 3413 individuals completed the survey. Most were female (2212/3413, 64.81%), White (3038/3413, 89.01%), and aged ≥25 years (2646/3413, 77.53%). Overall, 80.6% (2751/3413) did not acquire COVID-19, 2.08% (71/3413) acquired it, and 16.58% (566/3413) did not know. Self-reported cases represented an annual incidence rate of 2.2% (95% CI 1.7%-2.8%). COVID-19 cases were more than twice the expected (71 vs 30.3; P<.001). COVID-19 was associated with specific symptoms (loss of taste: odds ratio [OR] 38.9, 95% CI 22.4-67.6, loss of smell: OR 30.6, 95% CI 17.7-53.1) and multiple symptoms (>9 symptoms vs none: OR 82.5, 95% CI 29-234 and 5-9: OR 44.8, 95% CI 18.7-107). Median symptom duration was 16 (IQR 9-30) days. Hospitalization (7/71, 10%) and ventilator support (4/71, 6%) were uncommon. Respondents who acquired COVID-19 reported increased occurrence and severity of RD symptoms and use or dosage of select medications; those who did not acquire COVID-19 reported decreased occurrence and severity of RD symptoms and use of medications; those who did not know had an intermediate pattern. The pandemic made it difficult to access care, receive treatment, get hospitalized, and caused mood changes for respondents and their families. CONCLUSIONS Self-reported COVID-19 was more frequent than expected and was associated with increased prevalence and severity of RD symptoms and greater use of medications. The pandemic negatively affected access to care and caused mood changes in the respondents and family members. Continued surveillance is necessary.
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Affiliation(s)
- Maurizio Macaluso
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Marc E Rothenberg
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Thomas Ferkol
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Pierce Kuhnell
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Henry J Kaminski
- Department of Neurology and Rehabilitation Medicine, George Washington University, Washington, DC, United States
| | - David W Kimberlin
- Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michael Benatar
- Department of Neurology, University of Miami, Miami, FL, United States
| | - Mirna Chehade
- Mount Sinai Center for Eosinophilic Disorders, Departments of Pediatrics and Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Ambalavanan R, Snead RS, Marczika J, Malioukis A. Epidemiological contemplation for a currently pragmatic COVID-19 health passport: a perspective. Front Public Health 2024; 12:1347623. [PMID: 38414904 PMCID: PMC10896918 DOI: 10.3389/fpubh.2024.1347623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/23/2024] [Indexed: 02/29/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) has caused a global pandemic that has wreaked havoc on the lives of millions of people around the world. Confinement measures aim to reduce the epidemic's spread and minimize the burden of morbidity and mortality. In response to the challenges caused by the pandemic, digital health passports have been developed exponentially. We highlight the latent epidemiological barriers to health passports to achieve standardized digital care platforms. This review paper not only highlights the epidemiological barriers but also articulates the possible infrastructure required to make the International Standard for a multi-factor authenticated and validated health passport.
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Affiliation(s)
- Radha Ambalavanan
- Research Department, The Self Research Institute, Broken Arrow, OK, United States
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270
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Conradt E, Carter S, Crowell SE. What's next for the field of multigenerational mental health? The need for deep behavioral phenotyping via a prenatal mental health registry. Dev Psychopathol 2024:1-9. [PMID: 38347753 PMCID: PMC11323204 DOI: 10.1017/s0954579424000099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
From its inception, development and psychopathology theorists have sought to uncover the earliest forms of risk for mental health challenges in children, to prevent the development of more severe, intractable manifestations of psychopathology. Large familial risk registries have advanced our understanding of early, potentially modifiable factors that could prevent or mitigate the expression of challenging symptoms of neurodevelopmental conditions, and similar registries have been proposed to advance understanding of ADHD and related phenotypes. Data from single-site studies, largely focused on perinatal exposure to maternal mood disorders, reveal that a robust predictor of child psychopathology is parental psychopathology. However, early developmental trajectories of psychopathology risk may be better captured using transdiagnostic approaches in pregnancy, capturing the full range of mental health symptoms. We describe here the need for a parental mental health registry that begins prenatally that includes deep behavioral phenotyping across a range of transdiagnostic indicators of mental health risk to prevent psychopathology in children. This registry has the potential to uncover pathways to psychopathology risk in childhood and support the discovery of novel mechanisms to be targeted for prevention and intervention.
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Affiliation(s)
- Elisabeth Conradt
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Durham, NC
| | - Sierra Carter
- Georgia State University, Department of Psychology, Atlanta, GA
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271
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Poštuvan V, Krohne N, Lavrič M, Gomboc V, De Leo D, Rojs L. A Lonelier World after COVID-19: Longitudinal Population-Based Study of Well-Being, Emotional and Social Loneliness, and Suicidal Behaviour in Slovenia. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:312. [PMID: 38399599 PMCID: PMC10890292 DOI: 10.3390/medicina60020312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/26/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: The impact of coronavirus disease 2019 (COVID-19) goes beyond the consequences of the infectious disease, especially as the measures taken to prevent the spread of the virus have had a very profound impact on people's social relationships and everyday lives. Several studies have investigated these effects, but there is a lack of longitudinal studies in Central Europe. Objective: The aim of our study was to observe changes in well-being, loneliness, and suicidal behaviour before, during, and after the COVID-19 pandemic using the same population-based cohort. Materials and Methods: A representative sample of 440 participants completed online questionnaires at four time points: 2019 (wave 0), 2021 (wave 1), 2022 (wave 2), and 2023 (wave 3). Results: The results show significant changes in the levels of well-being and loneliness over these periods. In particular, both social and emotional loneliness increased during the pandemic, while emotional loneliness increased to a greater extent without further decreases. Well-being appeared to increase after pandemic-related restrictions diminished but decreased again one year later. No significant changes concerning suicidal ideation were observed. Conclusions: Our study suggests that the COVID-19 pandemic changed the way in which people perceive their well-being and especially their relationships with others. From the data, we can conclude that people's worldview is now lonelier than before the pandemic.
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Affiliation(s)
- Vita Poštuvan
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Nina Krohne
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Meta Lavrič
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Vanja Gomboc
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Diego De Leo
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Lucia Rojs
- Slovene Centre for Suicide Research, Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia; (N.K.); (M.L.); (V.G.); (D.D.L.); (L.R.)
- Department of Psychology, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
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272
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Petakh P, Oksenych V, Kamyshna I, Boisak I, Lyubomirskaya K, Kamyshnyi O. Exploring the interplay between posttraumatic stress disorder, gut microbiota, and inflammatory biomarkers: a comprehensive meta-analysis. Front Immunol 2024; 15:1349883. [PMID: 38410510 PMCID: PMC10895958 DOI: 10.3389/fimmu.2024.1349883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/29/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction Posttraumatic stress disorder (PTSD) is the most common mental health disorder to develop following exposure to trauma. Studies have reported conflicting results regarding changes in immune biomarkers and alterations in the abundance of bacterial taxa and microbial diversity in patients with PTSD. Aim The purpose of this meta-analysis is to summarize existing studies examining gut microbiota characteristics and changes in immune biomarkers in patients with PTSD. Methods Relevant studies were systematically searched in PubMed, Scopus, and Embase, published in English between January 1, 1960, and December 1, 2023. The outcomes included changes in abundance and diversity in gut microbiota (gut microbiota part) and changes in immune biomarkers (immune part). Results The meta-analysis included a total of 15 studies, with 9 focusing on changes in inflammatory biomarkers and 6 focusing on changes in gut microbiota composition in patients with PTSD. No differences were observed between groups for all inflammatory biomarkers (P≥0.05). Two of the six studies found that people with PTSD had less alpha diversity. However, the overall Standardized Mean Difference (SMD) for the Shannon Diversity Index was not significant (SMD 0.27, 95% CI -0.62-0.609, p = 0.110). Regarding changes in abundance, in two of the studies, a significant decrease in Lachnospiraceae bacteria was observed. Conclusion This meta-analysis provides a comprehensive overview of gut microbiota characteristics in PTSD, suggesting potential associations with immune dysregulation. Future research should address study limitations, explore causal relationships, and consider additional factors influencing immune function in individuals with PTSD. Systematic review registration https://www.crd.york.ac.uk, identifier CRD42023476590.
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Affiliation(s)
- Pavlo Petakh
- Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Valentyn Oksenych
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Iryna Kamyshna
- Department of Medical Rehabilitation, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Iryna Boisak
- Department of Childhood Diseases, Uzhhorod National University, Uzhhorod, Ukraine
| | - Katerina Lyubomirskaya
- Department of Obstetrics and Gynecology, Zaporizhzhia State Medical and Pharmaceuticals University, Zaporizhzhia, Ukraine
| | - Oleksandr Kamyshnyi
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
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273
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Macintyre AK, Shipton D, Sarica S, Scobie G, Craig N, McCartney G. Assessing the effects of population-level political, economic and social exposures, interventions and policies on inclusive economy outcomes for health equity in high-income countries: a systematic review of reviews. Syst Rev 2024; 13:58. [PMID: 38331910 PMCID: PMC10851517 DOI: 10.1186/s13643-023-02429-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/11/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND A fairer economy is increasingly recognised as crucial for tackling widening social, economic and health inequalities within society. However, which actions have been evaluated for their impact on inclusive economy outcomes is yet unknown. OBJECTIVE Identify the effects of political, economic and social exposures, interventions and policies on inclusive economy (IE) outcomes in high-income countries, by systematically reviewing the review-level evidence. METHODS We conducted a review of reviews; searching databases (May 2020) EconLit, Web of Science, Sociological Abstracts, ASSIA, International Bibliography of the Social Sciences, Public Health Database, Embase and MEDLINE; and registries PROSPERO, Campbell Collaboration and EPPI Centre (February 2021) and grey literature (August/September 2020). We aimed to identify reviews which examined social, political and/or economic exposures, interventions and policies in relation to two IE outcome domains: (i) equitable distribution of the benefits of the economy and (ii) equitable access to the resources needed to participate in the economy. Reviews had to include primary studies which compared IE outcomes within or between groups. Quality was assessed using a modified version of AMSTAR-2 and data synthesised informed by SWiM principles. RESULTS We identified 19 reviews for inclusion, most of which were low quality, as was the underlying primary evidence. Most reviews (n = 14) had outcomes relating to the benefits of the economy (rather than access to resources) and examined a limited set of interventions, primarily active labour market programmes and social security. There was limited high-quality review evidence to draw upon to identify effects on IE outcomes. Most reviews focused on disadvantaged groups and did not consider equity impacts. CONCLUSIONS Review-level evidence is sparse and focuses on 'corrective' approaches. Future reviews should examine a diverse set of 'upstream' actions intended to be inclusive 'by design' and consider a wider range of outcomes, with particular attention to socioeconomic inequalities.
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Affiliation(s)
- Anna K Macintyre
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK.
| | - Deborah Shipton
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Shifa Sarica
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Graeme Scobie
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Neil Craig
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Gerry McCartney
- School of Social & Political Sciences, University of Glasgow, Glasgow, UK
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Paglino E, Lundberg DJ, Wrigley-Field E, Zhou Z, Wasserman JA, Raquib R, Chen YH, Hempstead K, Preston SH, Elo IT, Glymour MM, Stokes AC. Excess natural-cause mortality in US counties and its association with reported COVID-19 deaths. Proc Natl Acad Sci U S A 2024; 121:e2313661121. [PMID: 38300867 PMCID: PMC10861891 DOI: 10.1073/pnas.2313661121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/06/2023] [Indexed: 02/03/2024] Open
Abstract
In the United States, estimates of excess deaths attributable to the COVID-19 pandemic have consistently surpassed reported COVID-19 death counts. Excess deaths reported to non-COVID-19 natural causes may represent unrecognized COVID-19 deaths, deaths caused by pandemic health care interruptions, and/or deaths from the pandemic's socioeconomic impacts. The geographic and temporal distribution of these deaths may help to evaluate which explanation is most plausible. We developed a Bayesian hierarchical model to produce monthly estimates of excess natural-cause mortality for US counties over the first 30 mo of the pandemic. From March 2020 through August 2022, 1,194,610 excess natural-cause deaths occurred nationally [90% PI (Posterior Interval): 1,046,000 to 1,340,204]. A total of 162,886 of these excess natural-cause deaths (90% PI: 14,276 to 308,480) were not reported to COVID-19. Overall, 15.8 excess deaths were reported to non-COVID-19 natural causes for every 100 reported COVID-19 deaths. This number was greater in nonmetropolitan counties (36.0 deaths), the West (Rocky Mountain states: 31.6 deaths; Pacific states: 25.5 deaths), and the South (East South Central states: 26.0 deaths; South Atlantic states: 25.0 deaths; West South Central states: 24.2 deaths). In contrast, reported COVID-19 death counts surpassed estimates of excess natural-cause deaths in metropolitan counties in the New England and Middle Atlantic states. Increases in reported COVID-19 deaths correlated temporally with increases in excess deaths reported to non-COVID-19 natural causes in the same and/or prior month. This suggests that many excess deaths reported to non-COVID-19 natural causes during the first 30 mo of the pandemic in the United States were unrecognized COVID-19 deaths.
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Affiliation(s)
- Eugenio Paglino
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA19104
| | - Dielle J. Lundberg
- Department of Global Health, Boston University School of Public Health, Boston, MA02118
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA98195
| | - Elizabeth Wrigley-Field
- Department of Sociology and Minnesota Population Center, University of Minnesota, Minneapolis, MN55455
| | - Zhenwei Zhou
- Department of Biostatistics, Boston University School of Public Health, Boston, MA02118
| | | | - Rafeya Raquib
- Department of Global Health, Boston University School of Public Health, Boston, MA02118
| | - Yea-Hung Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA94158
| | | | - Samuel H. Preston
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA19104
| | - Irma T. Elo
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA19104
| | - M. Maria Glymour
- Department of Epidemiology, Boston University School of Public Health, Boston, MA02118
| | - Andrew C. Stokes
- Department of Global Health, Boston University School of Public Health, Boston, MA02118
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275
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Du Q, Li X, Wang Z, Chen S, Zhang X, Liang J, Guo H, Chen N, Yu H, Zhu X, Zhou X, Sun K. Effects of 6-month customized home-based exercise on motor development, bone strength, and parental stress in children with simple congenital heart disease: a single-blinded randomized clinical trial. BMC Med 2024; 22:27. [PMID: 38317125 PMCID: PMC10845703 DOI: 10.1186/s12916-023-03242-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/22/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND New "noncardiac" problems in children with congenital heart disease (CHD), such as developmental delay or long-term neurodevelopmental impairments, have attracted considerable attention in recent years. It is hypothesized that exercise might attenuate CHD-associated neurodevelopmental impairments; however, this has not been thoroughly investigated. The objective of this prospective, single-blinded, randomized controlled experiment was to evaluate the impact of customized home-based exercise for children with CHD. METHODS Children aged 0-5 years with echocardiography-confirmed simple CHD subtypes who were scheduled to undergo cardiac catheterization were screened for enrolment. Among 420 screened CHD children, 192 were enrolled and randomly assigned at a 1:1 ratio to receive a 6-month intervention (30 min daily customized home-based exercise program with supervision for no less than 5 days per week, combined with home-based exercise education) or control treatment (home-based education). The primary outcome was motor development (gross motor quotient (GMQ), fine motor quotient (FMQ), and total motor quotient (TMQ)). The secondary outcomes were cardiac function and structure, bone quality, physical development, parental anxiety, caregiver burden, and quality of life. Children and their families were assessed before and 1, 3, and 6 months after catheterization; 183 (95.3%) children were included in the primary analysis. RESULTS After 6-month treatment, the intervention group significantly increased their motor quotient, which was consistently higher than that of the control group (GMQ p < 0.0001, FMQ p = 0.02, TMQ p < 0.001). The physical developments in height, weight, and circumferences of the upper-arm, chest, and head were also significantly improved by exercise (all p < 0.017). No significant improvements in the bone strength or the cardiac structure and function were found among patients in the intervention group (all p > 0.017). For parents, higher quality of life level (total score p = 0.016) was observed in the intervention group; while effects of exercise on the anxiety (rude score p = 0.159, standard score p = 0.159) or the Zarit caregiver burden scale score (p = 0.404) were non-significant. No adverse events occurred during the study period. CONCLUSIONS Customized home-based exercise improved motor development in children with CHD. While the long-term effects of parent training in home-based exercise are unknown, the study results suggest positive outcomes. TRIAL REGISTRATION A home-based exercise program in congenital heart disease children with cardiac catheterization: a randomized controlled trial. ( http://www.chictr.org.cn/ , ChiCTR-IOR-16007762, January 14, 2016).
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Affiliation(s)
- Qing Du
- Department of Rehabilitation Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xin Li
- Department of Rehabilitation Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Zhaoxi Wang
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sun Chen
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xi Zhang
- Clinical Research Unit, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Juping Liang
- Department of Rehabilitation Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Haibin Guo
- Department of Rehabilitation Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Nan Chen
- Department of Rehabilitation Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Yu
- Department of Rehabilitation Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoqing Zhu
- Department of Rehabilitation Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xuan Zhou
- Department of Rehabilitation Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Kun Sun
- Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Wu Y, Wang P, Huang Y, Chen J, Chang Y, Li J, Wang Y, Hao Y, Zhang W, Du Z. Assessing the effectiveness of the expanded hepatitis A vaccination program in China: an interrupted time series design. BMJ Glob Health 2024; 9:e013444. [PMID: 38320803 PMCID: PMC10859990 DOI: 10.1136/bmjgh-2023-013444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/06/2024] [Indexed: 02/15/2024] Open
Abstract
INTRODUCTION China initialised the expanded hepatitis A vaccination programme (EHAP) in 2008. However, the effectiveness of the programme remains unclear. We aimed to comprehensively evaluate the effectiveness of EHAP in the country. METHODS Based on the provincial data on the incidence of hepatitis A (HepA), the population and meteorological variables in China, we developed interrupted time series (ITS) models to estimate the effectiveness of EHAP with the autocorrelation, seasonality and the meteorological confounders being controlled. Results were also stratified by economic zones, age groups and provinces. RESULTS We found a 0.9% reduction (RR=0.991, 95% CI: 0.990 to 0.991) in monthly HepA incidence after EHAP, which was 0.3% greater than the reduction rate before EHAP in China. Across the three economic regions, we found a 1.1% reduction in HepA incidence in both central and western regions after EHAP, which were 0.3% and 1.2% greater than the reduction rates before EHAP, respectively. We found a decreased reduction rate for the eastern region. In addition, we found generally increased reduction rate after EHAP for age groups of 0-4, 5-14 and 15-24 years. However, we found decreased reduction rate among the 25-64 and ≥65 years groups. We found a slight increased rate after EHAP in Shanxi Province but not elsewhere. CONCLUSION Our finding provides comprehensive evidence on the effectiveness of EHAP in China, particularly in the central and western regions, and among the population aged 0-24 years old. This study has important implications for the adjustment of vaccination strategies for other regions and populations.
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Affiliation(s)
- Yueqian Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Pengyu Wang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Yong Huang
- Department of Immunization Programme Planning, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jinwei Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Yikun Chang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Junxi Li
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Yibing Wang
- School of Medicine & Warshel Institute for Computational Biology, The Chinese University of Hong Kong, Shenzhen, Shenzhen, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Peking University, Beijing, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
- Guangzhou Joint Research Center for Disease Surveillance and Risk Assessment, Sun Yat-sen University & Guangzhou Center for Disease Control and Prevention, Sun Yat-sen University, Guangzhou, China
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Shulman RM, Deng M, Handorf EA, Meyer JE, Lynch SM, Arora S. Factors Associated With Racial and Ethnic Disparities in Locally Advanced Rectal Cancer Outcomes. JAMA Netw Open 2024; 7:e240044. [PMID: 38421650 PMCID: PMC10905315 DOI: 10.1001/jamanetworkopen.2024.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/27/2023] [Indexed: 03/02/2024] Open
Abstract
Importance Hispanic and non-Hispanic Black patients receiving neoadjuvant therapy and surgery for locally advanced rectal cancer (LARC) achieve less favorable clinical outcomes than non-Hispanic White patients, but the source of this disparity is incompletely understood. Objective To assess whether racial and ethnic disparities in treatment outcomes among patients with LARC could be accounted for by social determinants of health and demographic, clinical, and pathologic factors known to be associated with treatment response. Design, Setting, and Participants The National Cancer Database was interrogated to identify patients with T3 to T4 or N1 to N2 LARC treated with neoadjuvant therapy and surgery. Patients were diagnosed between January 1, 2004, and December 31, 2017. Data were culled from the National Cancer Database from July 1, 2022, through December 31, 2023. Exposure Neoadjuvant therapy for rectal cancer followed by surgical resection. Main Outcomes and Measures The primary outcome was the rate of pathologic complete response (pCR) following neoadjuvant therapy. Secondary outcomes were rate of tumor downstaging and achievement of pN0 status. Results A total of 34 500 patient records were reviewed; 21 679 of the patients (62.8%) were men and 12 821 (37.2%) were women. The mean (SD) age at diagnosis was 59.7 (12.0) years. In terms of race and ethnicity, 2217 patients (6.4%) were Hispanic, 2843 (8.2%) were non-Hispanic Black, and 29 440 (85.3%) were non-Hispanic White. Hispanic patients achieved tumor downstaging (48.9% vs 51.8%; P = .01) and pN0 status (66.8% vs 68.8%; P = .02) less often than non-Hispanic White patients. Non-Hispanic Black race, but not Hispanic ethnicity, was associated with less tumor downstaging (odds ratio [OR], 0.86 [95% CI, 0.78-0.94]), less frequent pN0 status (OR, 0.91 [95% CI, 0.83-0.99]), and less frequent pCR (OR, 0.81 [95% CI, 0.72-0.92]). Other factors associated with reduced rate of pCR included rural location (OR, 0.80 [95% CI, 0.69-0.93]), lack of or inadequate insurance (OR for Medicaid, 0.86 [95% CI, 0.76-0.98]; OR for no insurance, 0.65 [95% CI, 0.54-0.78]), and treatment in a low-volume center (OR for first quartile, 0.73 [95% CI, 0.62-0.87]; OR for second quartile, 0.79 [95% CI, 0.70-0.90]; OR for third quartile, 0.86 [95% CI, 0.78-0.94]). Clinical and pathologic variables associated with a decreased pCR included higher tumor grade (OR, 0.58 [95% CI, 0.49-0.70]), advanced tumor stage (OR for T3, 0.56 [95% CI, 0.42-0.76]; OR for T4, 0.30 [95% CI, 0.22-0.42]), and lymph node-positive disease (OR for N1, 0.83 [95% CI, 0.77-0.89]; OR for N2, 0.73 [95% CI, 0.65-0.82]). Conclusions and Relevance The findings of this cohort study suggest that disparate treatment outcomes for Hispanic and non-Hispanic Black patients are likely multifactorial in origin. Future investigation into additional social determinants of health and biological variables is warranted.
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Affiliation(s)
- Rebecca M. Shulman
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Mengying Deng
- Biostatistics and Bioinformatics Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Elizabeth A. Handorf
- Biostatistics and Bioinformatics Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Joshua E. Meyer
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Shannon M. Lynch
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Sanjeevani Arora
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
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Frizell CA, Graham D, DuVentre A, Brown SD. Embracing Neuro-Inclusivity Within Physician Assistant/Associate Education: Challenging Organizational Cultural Norms and Navigating Communication Challenges. J Physician Assist Educ 2024:01367895-990000000-00128. [PMID: 38306305 DOI: 10.1097/jpa.0000000000000575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
ABSTRACT Effective communication in health care education is essential for creating an inclusive learning environment. This manuscript examines the crucial role of communication in physician assistant/associate (PA) education, particularly in the context of neurodiverse individuals, who constitute approximately 20% of the global population. A groundbreaking study by Nouri et al reveals a 3.1% overall disability prevalence among US practicing physicians, emphasizing the necessity for a comprehensive understanding of diversity in the health care profession. Considering the intersectionality of marginalized identities, this research sheds light on potential challenges health care providers face, underscoring the importance of promoting inclusivity and support for neurodiverse individuals in the PA profession. The increasing presence of neurodivergent students in postsecondary institutions, despite academic strengths, holds relevance for PA education. Recognizing the barriers and stigmas associated with neurodiversity is crucial for fostering inclusive environments within PA programs and sponsoring institutions. This manuscript explores the challenges faced by neurodiverse individuals in PA education and proposes strategies for cultivating a neuroinclusive culture through effective communication. With a focus on celebrating and using the strengths of all learners, regardless of neurodiversity, the overarching goal is to contribute to a paradigm shift in PA education, enriching the educational experience for students, educators, and support staff.
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Affiliation(s)
- Carl A Frizell
- Carl A. Frizell, DMSc, MSPAS, PA-C, is a graduate student at University of Central Arkansas, Conway, Arkansas
- Devin Graham, BA, is a graduate student at University of California, Irvine, Irvine, California
- Amber DuVentre, MS, CNP, is a member of Southern States Communication Association, Knoxville, Tennessee
- Sheena D. Brown, PhD, MSCR, is a volunteer with South College PA Program, Atlanta, Georgia
| | - Devin Graham
- Carl A. Frizell, DMSc, MSPAS, PA-C, is a graduate student at University of Central Arkansas, Conway, Arkansas
- Devin Graham, BA, is a graduate student at University of California, Irvine, Irvine, California
- Amber DuVentre, MS, CNP, is a member of Southern States Communication Association, Knoxville, Tennessee
- Sheena D. Brown, PhD, MSCR, is a volunteer with South College PA Program, Atlanta, Georgia
| | - Amber DuVentre
- Carl A. Frizell, DMSc, MSPAS, PA-C, is a graduate student at University of Central Arkansas, Conway, Arkansas
- Devin Graham, BA, is a graduate student at University of California, Irvine, Irvine, California
- Amber DuVentre, MS, CNP, is a member of Southern States Communication Association, Knoxville, Tennessee
- Sheena D. Brown, PhD, MSCR, is a volunteer with South College PA Program, Atlanta, Georgia
| | - Sheena D Brown
- Carl A. Frizell, DMSc, MSPAS, PA-C, is a graduate student at University of Central Arkansas, Conway, Arkansas
- Devin Graham, BA, is a graduate student at University of California, Irvine, Irvine, California
- Amber DuVentre, MS, CNP, is a member of Southern States Communication Association, Knoxville, Tennessee
- Sheena D. Brown, PhD, MSCR, is a volunteer with South College PA Program, Atlanta, Georgia
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279
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Omigbodun O, Ani C. A postgraduate training programme in child and adolescent mental health in a lower-middle-income country: a partnership model from Nigeria. BJPsych Int 2024; 21:8-11. [PMID: 38304406 PMCID: PMC10803771 DOI: 10.1192/bji.2023.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/07/2023] [Accepted: 08/18/2023] [Indexed: 02/03/2024] Open
Abstract
This paper describes a postgraduate training programme in child and adolescent mental health (CAMH) in Nigeria. It explains the background, curriculum development, teaching, evaluation and outcomes. By its 10th year the programme had trained 166 CAMH professionals from 14 African countries. Many of the graduates are running clinical CAMH services in their countries, mostly pioneered by them. They are also conducting CAMH training, including as faculty on the programme, and some are in international CAMH leadership roles. Key success elements of the programme that can be replicated in other low- and middle-income countries include international partnership, adopting a train-the-trainer approach, using a curriculum that covers clinical aspects of CAMH while also developing leadership and research skills, use of free-access training resources, and access to seed funding.
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Affiliation(s)
- Olayinka Omigbodun
- MPH, FWACP, MD Professor of Psychiatry and Founding Director, Centre for Child and Adolescent Mental Health, University of Ibadan, Ibadan, Nigeria.
| | - Cornelius Ani
- FRCPysch, MD, Consultant Child and Adolescent Psychiatrist and Honorary Clinical Senior Lecturer, Division of Psychiatry, Imperial College London, London, UK
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280
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Carr HR, Hall JE, Eisenbarth H, Brandt VC. The bidirectional relationship between head injuries and conduct problems: longitudinal modelling of a population-based birth cohort study. Eur Child Adolesc Psychiatry 2024; 33:411-420. [PMID: 36826528 PMCID: PMC10869410 DOI: 10.1007/s00787-023-02175-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/17/2023] [Indexed: 02/25/2023]
Abstract
Childhood head injuries and conduct problems increase the risk of aggression and criminality and are well-known correlates. However, the direction and timing of their association and the role of their demographic risk factors remain unclear. This study investigates the bidirectional links between both from 3 to 17 years while revealing common and unique demographic risks. A total of 8,603 participants (50.2% female; 83% White ethnicity) from the Millennium Cohort Study were analysed at 6 timepoints from age 3 to 17. Conduct problems were parent-reported for ages 3 to 17 using the Strengths and Difficulties Questionnaire (SDQ) and head injuries at ages 3 to 14. A cross-lagged path model estimated the longitudinal bidirectional effects between the two whilst salient demographic risks were modelled cumulatively at three ecological levels (child, mother, and household). Conduct problems at age 5 promoted head injuries between 5 and 7 (Z = 0.07; SE = 0.03; 95% CI, 0.02-0.13), and head injuries at ages 7 to 11 promoted conduct problems at age 14 (ß = .0.06; SE = .0.03; 95% CI, 0.01-0.12). Head injuries were associated with direct child-level risk at age 3, whereas conduct problems were associated with direct risks from all ecological levels until 17 years. The findings suggest a sensitive period at 5-11 years for the bidirectional relationship shared between head injuries and conduct problems. They suggest that demographic risks for increased head injuries play an earlier role than they do for conduct problems. Both findings have implications for intervention timing.
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Affiliation(s)
- Hannah R Carr
- School of Psychology, Centre for Innovation in Mental Health, University of Southampton, University Road, Highfield Campus, Building 44, Southampton, SO17 1PS, UK.
| | - James E Hall
- Southampton Education School, University of Southampton, Southampton, SO17 1BJ, UK
| | - Hedwig Eisenbarth
- School of Psychology, Victoria University of Wellington, Wellington, 6140, New Zealand
| | - Valerie C Brandt
- School of Psychology, Centre for Innovation in Mental Health, University of Southampton, University Road, Highfield Campus, Building 44, Southampton, SO17 1PS, UK
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281
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Lawal SA, Adedeji IA, Ogunniyi A, Henderson D. Social domains of poor mental health: A qualitative pilot study of community stakeholders' understanding and demarcation of mental illness and its interpretations in rural Nigeria. Health Sci Rep 2024; 7:e1922. [PMID: 38420202 PMCID: PMC10899201 DOI: 10.1002/hsr2.1922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/17/2024] [Accepted: 02/01/2024] [Indexed: 03/02/2024] Open
Abstract
Background and Aims Although previous studies on mental health/illness in Nigeria have explored knowledge and attitude of community members using quantitative approaches, few studies have engaged stakeholders within rural communities on the issue of mental illness using qualitative approaches. Community stakeholders play a critical role in influencing health behaviors. The objective of this pilot study was to explore community stakeholders' understanding and demarcation of mental illness, and its interpretations in a rural Nigerian town. This is with the aim of shaping stakeholders understanding of people when they experience mental distress within the community. Methods The study was conducted in Ijebu-Igbo town of Ogun State in south-west Nigeria. In-depth interviews were conducted among two religious' leaders: a Pastor and an Imam, a traditional healer, a medical doctor, and a registered nurse, and a focus group discussion was held in a church with members of its advisory committee. Results The findings showed that community stakeholders gave multiple interpretations of mental illness and many attribute mental illness to spiritual attack, ancestral curse, anger of the gods, and personal affliction (Ogun-Afowofa). This has been categorized as familial and individual attributes in this study which is part of the main themes derived. The study findings also show that the understanding of community members regarding the root causes of mental illness is somewhat vague based on their poor knowledge of mental illness. This is because of the various interpretations they gave to explain mental health is based on their cultural orientation, socialization, and belief system, and not based on any medical knowledge. Conclusion This pilot study was conducted to justify the main study. There is therefore a need for health education interventions to enlighten and educate community stakeholders with requisite knowledge for better understanding and interpretation of mental illness. Also, through mental health education interventions, community members will gain clarity on what mental health is and what it is not.
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Affiliation(s)
- Saheed A. Lawal
- Department of Public Health, School of Public and Allied HealthBabcock UniversityIlishan‐RemoOgun StateNigeria
| | - Isaac A. Adedeji
- Department of GerontologySimon Fraser UniversityBritish ColumbiaCanada
| | - Adesola Ogunniyi
- Department of Medicine, College of MedicineUniversity of IbadanIbadanNigeria
| | - David Henderson
- Department of Psychiatry, Boston University Medical CenterBoston UniversityBostonMassachusettsUSA
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282
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Abreu MADF, Lopes BC, Assemany PP, Souza ADR, Siniscalchi LAB. COVID-19 cases, vaccination, and SARS-CoV-2 in wastewater: insights from a Brazilian municipality. JOURNAL OF WATER AND HEALTH 2024; 22:268-277. [PMID: 38421621 PMCID: wh_2024_159 DOI: 10.2166/wh.2024.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Vaccines combatting COVID-19 demonstrate the ability to protect against disease and hospitalization, and reduce the likelihood of death caused by SARS-CoV-2. In addition, monitoring viral loads in sewage emerges as another crucial strategy in the epidemiological context, enabling early and collective detection of outbreaks. The study aimed to monitor the viral concentration of SARS-CoV-2 in untreated sewage in a Brazilian municipality. Also, it attempted to correlate these measurements with the number of clinical cases and deaths resulting from COVID-19 between July 2021 and July 2022. SARS-CoV-2 viral RNA was quantified by RT-qPCR. Pearson's correlation was performed to analyze the variables' relationship using the number of cases, deaths, vaccinated individuals, and viral concentration of SARS-CoV-2. The results revealed a significant negative correlation (p < 0.05) between the number of vaccinated individuals and the viral concentration of SARS-CoV-2, suggesting that after vaccination, the RNA viral load concentration was reduced in the sample population by the circulating concentration of wastewater. Consequently, wastewater monitoring, in addition to functioning as an early warning system for the circulation of SARS-CoV-2 and other pathogens, can offer a novel perspective that enhances decision-making, strengthens vaccination campaigns, and contributes to authorities establishing systematic networks for monitoring SARS-CoV-2.
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Affiliation(s)
- Mariana Aparecida de Freitas Abreu
- Department of Environmental Engineering (DAM), Federal University of Lavras (UFLA), Lavras, Brazil; Applied Microbiology Laboratory at the Environmental Engineering Department of UFLA, Federal University of Lavras (UFLA), Lavras, Brazil E-mail:
| | - Bruna Coelho Lopes
- Department of Sanitary and Environmental Engineering (DESA), Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Paula Peixoto Assemany
- Department of Environmental Engineering (DAM), Federal University of Lavras (UFLA), Lavras, Brazil; Applied Microbiology Laboratory at the Environmental Engineering Department of UFLA, Federal University of Lavras (UFLA), Lavras, Brazil
| | - Aline Dos Reis Souza
- Department of Environmental Engineering (DAM), Federal University of Lavras (UFLA), Lavras, Brazil
| | - Luciene Alves Batista Siniscalchi
- Department of Environmental Engineering (DAM), Federal University of Lavras (UFLA), Lavras, Brazil; Applied Microbiology Laboratory at the Environmental Engineering Department of UFLA, Federal University of Lavras (UFLA), Lavras, Brazil
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283
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Binmadi N. Oral Cancer and Twitter: An Analysis of Oral Cancer Awareness Month Tweets. Cureus 2024; 16:e54055. [PMID: 38348199 PMCID: PMC10860363 DOI: 10.7759/cureus.54055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE The objective of this research was to assess Twitter usage during Oral Cancer Awareness Month and explore the content and engagement related to oral cancer. METHODS A comprehensive search was performed using relevant hashtags and keywords related to oral cancer on Twitter throughout the oral cancer awareness month, April 2022. All extracted tweets that match the inclusion criteria were analyzed for content, users were classified, and their countries were identified. RESULT A total of 5551 English tweets were identified during Oral Cancer Awareness Month, and 5543 were included in the analysis covering a wide range of oral cancer-related topics. The analyzed tweets encompassed a diverse range of topics, from cancer and oral health to oncology, cancer research, cancer awareness, and even discussions related to alcohol. We found that the majority of users who post on Twitter were individuals. The most common tweets were posted from the USA. CONCLUSIONS This study provides an analysis of Twitter activity during Oral Cancer Awareness Month, highlighting the diverse range of content being shared, offering valuable insights. The findings demonstrate the importance of leveraging social media platforms to disseminate information and raise awareness. With a strategic approach to social media, organizations and individuals worldwide have the power to amplify their message, attract attention, and effectively advocate for oral cancer awareness.
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Affiliation(s)
- Nada Binmadi
- Department of Oral Diagnostic Sciences, King Abdulaziz University, Jeddah, SAU
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284
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Park J. Expertise as a Response to Limited Multilateralism: The Case of South Korea's Vaccine Procurement Task Force for COVID-19 Vaccines amid Unequal Access via the COVAX Facility. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2024; 49:99-132. [PMID: 37522333 DOI: 10.1215/03616878-10910224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
This study investigates South Korea's trials and errors in procuring COVID-19 vaccines from abroad, amid the limitations of a multilateral scheme for global provision through the COVID-19 Vaccines Global Access (COVAX) program via the World Health Organization (WHO) and the discussions on COVID-19 vaccine patent waivers at the World Trade Organization. Using the framework of "self-help" in the international system and country categorization to explicate country behaviors by state-business relations and expertise to explain South Korea's COVID-19 vaccine procurement process, this study argues that in the absence of a global mechanism that guarantees adequate and timely vaccine provision, countries are left to the sole option of depending on their own capabilities: expertise, budget, and policy planning by consolidating public and private capacities to acquire vaccines for the public. To support the argument, an in-depth case investigation of South Korea's Vaccine Procurement Task Force is presented. The case study focuses on the policy assessment of critical elements in South Korea's vaccine procurement and rollout on facing obstacles to sufficient procurement through COVAX: decision-making impacting the timing and dosage of procurement, diplomatic and business channels to sign bilateral contracts, setup of a smart-factory vaccination hub, and indigenous vaccine development for WHO approval.
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285
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Crawshaw AF, Kitoko LM, Nkembi SL, Lutumba LM, Hickey C, Deal A, Carter J, Knights F, Vandrevala T, Forster AS, Hargreaves S. Co-designing a theory-informed, multicomponent intervention to increase vaccine uptake with Congolese migrants: A qualitative, community-based participatory research study (LISOLO MALAMU). Health Expect 2024; 27:e13884. [PMID: 37831054 PMCID: PMC10726157 DOI: 10.1111/hex.13884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/11/2023] [Accepted: 09/22/2023] [Indexed: 10/14/2023] Open
Abstract
INTRODUCTION Disparities in the uptake of routine and COVID-19 vaccinations have been observed in migrant populations, and attributed to issues of mistrust, access and low vaccine confidence. Participatory research approaches and behaviour change theory hold the potential for developing tailored vaccination interventions that address these complex barriers in partnership with communities and should be explored further. METHODS This study used a theory-informed, community-based participatory research approach to co-design a culturally tailored behaviour change intervention aimed at increasing COVID-19 vaccine uptake among Congolese migrants in London, United Kingdom (2021-2022). It was designed and led by a community-academic partnership in response to unmet needs in the Congolese community as the COVID-19 pandemic started. Barriers and facilitators to COVID-19 vaccination, information and communication preferences, and intervention suggestions were explored through qualitative in-depth interviews with Congolese migrants, thematically analysed, and mapped to the theoretical domains framework (TDF) and the capability, opportunity, motivation, behaviour model to identify target behaviours and strategies to include in interventions. Interventions were co-designed and tailored in workshops involving Congolese migrants. RESULTS Thirty-two Congolese adult migrants (24 (75%) women, mean 14.3 (SD: 7.5) years in the United Kingdom, mean age 52.6 (SD: 11.0) years) took part in in-depth interviews and 16 (same sample) took part in co-design workshops. Fourteen barriers and 10 facilitators to COVID-19 vaccination were identified; most barrier data related to four TDF domains (beliefs about consequences; emotion; social influences and environmental context and resources), and the behavioural diagnosis concluded interventions should target improving psychological capability, reflective and automatic motivations and social opportunities. Strategies included culturally tailored behaviour change techniques based on education, persuasion, modelling, enablement and environmental restructuring, which resulted in a co-designed intervention comprising community-led workshops, plays and posters. Findings and interventions were disseminated through a community celebration event. CONCLUSIONS Our study demonstrates how behavioural theory can be applied to co-designing tailored interventions with underserved migrant communities through a participatory research paradigm to address a range of health issues and inequalities. Future research should build on this empowering approach, with the goal of developing more sensitive vaccination services and interventions which respond to migrant communities' unique cultural needs and realities. PATIENT OR PUBLIC CONTRIBUTION Patient and public involvement (PPI) were embedded in the participatory study design and approach, with community members co-producing all stages of the study and co-authoring this paper. An independent PPI board (St George's Migrant Health Research Group Patient and Public Involvement Advisory Board) comprising five adult migrants with lived experience of accessing healthcare in the United Kingdom were also consulted at significant points over the course of the study.
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Affiliation(s)
- Alison F. Crawshaw
- The Migrant Health Research Group, Institute for Infection and ImmunitySt George's University of LondonLondonUK
| | | | | | | | | | - Anna Deal
- The Migrant Health Research Group, Institute for Infection and ImmunitySt George's University of LondonLondonUK
- Faculty of Public Health and Policy, London School of Hygiene and Tropical MedicineLondonUK
| | - Jessica Carter
- The Migrant Health Research Group, Institute for Infection and ImmunitySt George's University of LondonLondonUK
| | - Felicity Knights
- The Migrant Health Research Group, Institute for Infection and ImmunitySt George's University of LondonLondonUK
| | - Tushna Vandrevala
- Centre for Applied Health and Social Care Research, Faculty of Health, Science, Social Care and EducationKingston University LondonLondonUK
| | | | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and ImmunitySt George's University of LondonLondonUK
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286
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Hurtado DA, Greenspan SA, Alley L, Hammer LB, Furnari M, Lenhart A. Safety Responsiveness and Psychological Distress Among Health Care Workers During COVID-19 (2020-2022) in the Pacific Northwest. Am J Public Health 2024; 114:204-212. [PMID: 38354349 PMCID: PMC10916732 DOI: 10.2105/ajph.2024.307582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 02/16/2024]
Abstract
Objectives. The COVID-19 pandemic imposed unprecedented safety challenges on health care facilities. This study examined whether health care workers who deemed a better safety response to the pandemic by their units or employers experienced lower psychological distress. Methods. Patient care workers at a health care system in the Pacific Northwest were surveyed every 6 to 8 months from May 2020 to May 2022 (n = 3468). Psychological distress was measured with the Well-being Index (range: -2 to 7 points). Safety response was scored on the basis of participants' ratings (on a 1-5 scale) of equipment sufficiency and responsiveness to safety concerns by their health care system and unit. Results. Adjusted multilevel regressions showed an inverse association between safety responsiveness and psychological distress at the individual level (b = -0.54; 95% confidence interval [CI] = -0.67, -0.41) and the unit level (b = -0.73; 95% CI = -1.46, -0.01). The cross-level interaction was also statistically significant (b = -0.46; 95% CI = -0.87, -0.05). Conclusions. Health care workers who deemed a better response to safety challenges reported lower psychological distress. This study highlights the need for continued efforts to ensure adequate safety resources. (Am J Public Health. 2024;114(S2):S204-S212. https://doi.org/10.2105/AJPH.2024.307582).
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Affiliation(s)
- David A Hurtado
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Samuel A Greenspan
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Lindsey Alley
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Leslie B Hammer
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Megan Furnari
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Abigail Lenhart
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
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287
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Purwandari R, Daniel D, Hafidz F. Analysis of water, sanitation, and hygiene facilities using the WASH-FIT approach and its relation to patient satisfaction and maternal mortality at hospitals in Indonesia. Front Public Health 2024; 12:1322470. [PMID: 38362217 PMCID: PMC10867246 DOI: 10.3389/fpubh.2024.1322470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction The provision of Water, Sanitation, and Hygiene (WASH) is critical to reducing infection and enhancing the quality of health care services. The study aims to assess WASH facilities in Indonesian hospitals using the Water, Sanitation, and Hygiene Facility Improvement Tool (WASH-FIT) approach and examine their association with customer satisfaction and maternal mortality owing to infection. Methods We utilized the national scale Health Facilities Research dataset in Indonesian hospitals in 2019. WASH status is determined using WASH-FIT indicators, i.e., water, sanitation, waste management, hand hygiene, environmental cleaning, and management services, and then divided into three levels: poor, adequate, and good categories. Results The majority of hospitals in Indonesia had a good category, i.e., the range of hospitals with a good category was 79-97% nationally, in 6 aspects: water, sanitation, hand hygiene, environmental cleaning, and management services, except for waste management services (13%). Good WASH service facilities are more frequently found in government hospitals than in private and specialized hospitals, while lower-level hospitals tend to have poor levels of all WASH-FIT indicators. There are significant relationships between adequate sanitation services (β = 0.724), adequate and good categories of hand hygiene services (β = 0.712 and 0.866, respectively), environmental cleaning (β = -0.501 and -0.503, respectively), and management (β = -0.645 and 0.446, respectively), with the proportion of maternal mortality owing to infection. Furthermore, there was no relationship between WASH-FIT indicators and patient satisfaction, except for good hand hygiene services (β = 0.453). Discussion Despite good conditions in almost all WASH-FIT indicators, the improvement of waste management is urgently needed to improve the WASH services in hospitals in Indonesia, as also found in other developing countries.
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Affiliation(s)
- Rina Purwandari
- Master of Public Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - D. Daniel
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Firdaus Hafidz
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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288
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Basta K, Ledwaba-Chapman L, Dodhia H, Ashworth M, Whitney D, Dalrymple K, Wang Y. Hypertension prevalence, coding and control in an urban primary care setting in the UK between 2014 and 2021. J Hypertens 2024; 42:350-359. [PMID: 37796225 DOI: 10.1097/hjh.0000000000003584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Hypertension is a leading preventable cause of mortality, yet high rates of undiagnosed and uncontrolled hypertension continue. The burden falls most heavily on some ethnic minorities and the socially deprived, with the COVID-19 pandemic having further widened inequalities. We sought to determine the prevalence and predictors of unmeasured blood pressure (BP), uncoded elevated BP and uncontrolled hypertension in primary care across 2014-2021. METHODS A population-based cohort study using data from all 41 general practices in a socioeconomically diverse inner-city borough. BP measurements, sociodemographic, lifestyle and clinical factors were extracted from anonymized primary care data. Hypertension and BP control were defined using NICE guidelines. Associations between patient characteristics and hypertension outcomes were identified using logistical regression modelling. RESULTS Of 549 082 patients, 39.5% had unmeasured BP; predictors included male sex [AOR 2.40, 95% confidence interval (95% CI) 2.26-2.43] and registration in the pandemic years. Of 71 970 adults with elevated BP, 36.0% were uncoded; predictors included obesity (AOR 2.51, 95% CI 2.42-2.60) and increasing age. Of 44 648 adults on the hypertension register, 46.8% had uncontrolled hypertension; predictors included black ethnicity compared to white (AOR 1.54, 95% CI 1.41-1.68) and cardiovascular co-morbidities (AOR 1.23, 95% CI 1.21-1.25). Social deprivation was only weakly or not significantly associated with hypertension outcomes. CONCLUSION The burden of uncoded elevated BP and uncontrolled hypertension is high. Obesity and male sex were associated with uncoded elevated BP and uncontrolled hypertension. Black ethnicity was associated with uncontrolled hypertension. Initiatives are needed to optimize hypertension coding and control, with an emphasis on specific population subgroups.
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Affiliation(s)
| | - Lesedi Ledwaba-Chapman
- Department of Population Health, School of Life Course and Population Sciences, King's College London, London, UK
| | | | - Mark Ashworth
- Department of Population Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - David Whitney
- Department of Population Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Kathryn Dalrymple
- Department of Population Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Yanzhong Wang
- Department of Population Health, School of Life Course and Population Sciences, King's College London, London, UK
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289
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Alhraiwil NJ, Alghaith L, Alharbi W, AlAjaji S, Alhumaid A, Aldossary MS. Mobilizing a Kingdom During a Pandemic: The Health Marketing Campaigns Applied by the Saudi Ministry of Health to Promote (COVID-19) Vaccine Confidence and Uptake. Cureus 2024; 16:e53734. [PMID: 38455787 PMCID: PMC10919942 DOI: 10.7759/cureus.53734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND COVID-19 vaccination hesitancy is threatening the global intended herd immunity. Social marketing integration rocketed in promoting public health through awareness campaigns. Saudi Arabia was one of the countries that used social marketing to promote COVID-19 vaccinations for all age groups through successive campaigns. This study aims to describe the content of the campaigns held by the Saudi Ministry of Health to promote COVID-19 vaccine uptake. METHODS A track's working strategy was created to contain COVID-19 spread in Saudi Arabia followed by a vaccination track. Six tracks were maintained over six months extended from June 2020 to December 2020. As a result, different campaigns were launched, and key performance indicators were identified and collected. Data from campaigns and key indicators were collected to determine outreach and impact. RESULTS Five campaigns were initiated receiving high interactions from governmental entities and the public. The individuals' percentage who received full vaccination doses and booster vaccinations increased. Moreover, the last campaign promoting vaccinations in children achieved a 60% willingness rate among adults to vaccinate their children. CONCLUSION COVID-19 awareness campaigns achieved successful outcomes in Saudi Arabia and currently the Kingdom sustained higher vaccination proportions than the average vaccination attainment worldwide.
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Affiliation(s)
| | - Lamay Alghaith
- Communication, Saudi Arabia Ministry of Health, Riyadh, SAU
| | - Walid Alharbi
- Communication, Saudi Arabia Ministry of Health, Riyadh, SAU
| | - Sarah AlAjaji
- Communication, Saudi Arabia Ministry of Health, Riyadh, SAU
| | - Anas Alhumaid
- Communication, Saudi Arabia Ministry of Health, Riyadh, SAU
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Hu Y, Huang J, Zhao D, Zhang C, Xia J, Lu XM. Effect of safety and security equipment on patient and visitor violence towards nurses in multiple public hospitals of China during the COVID-19 pandemic: a retrospective, difference-in-difference analysis. BMJ Open 2024; 14:e078598. [PMID: 38296297 PMCID: PMC10831433 DOI: 10.1136/bmjopen-2023-078598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVES This study aimed to analyse whether safety and security equipment decreased patient and visitor violence (PVV) towards nurses in the COVID-19 period and quantify to what extent safety and security equipment affects PVV. DESIGN Controlled before and after study and difference-in-difference (DID) analysis. SETTING A large hospital medical group, consisting of three public tertiary teaching hospitals, namely, Xinjiekou Branch, Huilongguan Branch and Xinlongze Branch of Beijing Jishuitan Hospital, located in the west and north parts of Beijing, China. PARTICIPANTS A panel of nine departments recruited using two-step sampling method, administered online surveys in 2021 and 2022. A total of 632 eligible nurses participated in the survey in 2021 and 725 eligible nurses in 2022. MEASURES We assessed impacts of the safety and security equipment on the PVV. The policy had been enacted in June 2020, and the corresponding measures were established after mid-December 2020, and therefore, we use a DID design to evaluate changes in nurses' PVV incidence. Departments are classified as either department installed or non installed, and nurses are classified based on their department. RESULTS Within the treatment group, the incidence of physical PVV significantly decreased from 13.8% in 2020 to 2.0% in 2021. In the control group, the incidence of physical PVV increased from 0.6% in 2020 to 2.7% in 2021. The application of the safety and security equipment decreased the incidence of physical PVV by 13.93% (95% CI: -23.52% to -4.34%). In contrast, no difference was observed between the treatment and control groups for the incidence of psychological PVV (6.23%, 95% CI: -11.56% to 24.02%) and overall PVV (0.88, 95% CI: -20.90% to 22.66%). CONCLUSION The safety and security equipment reduced the incidence of physical PVV towards nurses. For hospital managers in public hospitals, longer-term strategies roadmap for PVV prevention measures are needed to create a more supportive work environment in employees.
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Affiliation(s)
- Yanzhen Hu
- Department of Nursing, Beijing Jishuitan Hospital, Capital Medical University, Beijing, Beijing, China
| | - Ju Huang
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dan Zhao
- Department of Nursing, Beijing Jishuitan Hospital, Capital Medical University, Beijing, Beijing, China
| | - Cheng Zhang
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jinghua Xia
- Department of Nursing, Beijing Jishuitan Hospital, Capital Medical University, Beijing, Beijing, China
| | - Xue-Mei Lu
- Department of Nursing, Beijing Jishuitan Hospital, Capital Medical University, Beijing, Beijing, China
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291
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Prasad A, Wynands E, Roche SM, Romo-Bernal C, Allan N, Olson M, Levengood S, Andersen R, Loebel N, Sabino CP, Ross JA. Photodynamic Inactivation of Foodborne Bacteria: Screening of 32 Potential Photosensitizers. Foods 2024; 13:453. [PMID: 38338588 PMCID: PMC10855769 DOI: 10.3390/foods13030453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
The development of novel antimicrobial technologies for the food industry represents an important strategy to improve food safety. Antimicrobial photodynamic disinfection (aPDD) is a method that can inactivate microbes without the use of harsh chemicals. aPDD involves the administration of a non-toxic, light-sensitive substance, known as a photosensitizer, followed by exposure to visible light at a specific wavelength. The objective of this study was to screen the antimicrobial photodynamic efficacy of 32 food-safe pigments tested as candidate photosensitizers (PSs) against pathogenic and food-spoilage bacterial suspensions as well as biofilms grown on relevant food contact surfaces. This screening evaluated the minimum bactericidal concentration (MBC), minimum biofilm eradication concentration (MBEC), and colony forming unit (CFU) reduction against Salmonella enterica, methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas fragi, and Brochothrix thermosphacta. Based on multiple characteristics, including solubility and the ability to reduce the biofilms by at least 3 log10 CFU/sample, 4 out of the 32 PSs were selected for further optimization against S. enterica and MRSA, including sunset yellow, curcumin, riboflavin-5'-phosphate (R-5-P), and erythrosin B. Optimized factors included the PS concentration, irradiance, and time of light exposure. Finally, 0.1% w/v R-5-P, irradiated with a 445 nm LED at 55.5 J/cm2, yielded a "max kill" (upwards of 3 to 7 log10 CFU/sample) against S. enterica and MRSA biofilms grown on metallic food contact surfaces, proving its potential for industrial applications. Overall, the aPDD method shows substantial promise as an alternative to existing disinfection technologies used in the food processing industry.
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Affiliation(s)
- Amritha Prasad
- Chinook Contract Research Inc., Airdrie, AB T4A 0C3, Canada; (A.P.); (N.A.); (M.O.)
| | - Erin Wynands
- ACER Consulting, Guelph, ON N1G 5L3, Canada; (E.W.); (S.M.R.)
| | - Steven M. Roche
- ACER Consulting, Guelph, ON N1G 5L3, Canada; (E.W.); (S.M.R.)
| | - Cristina Romo-Bernal
- Ondine Biomedical Inc., Bothell, WA 98011, USA; (C.R.-B.); (S.L.); (R.A.); (N.L.); (C.P.S.)
| | - Nicholas Allan
- Chinook Contract Research Inc., Airdrie, AB T4A 0C3, Canada; (A.P.); (N.A.); (M.O.)
| | - Merle Olson
- Chinook Contract Research Inc., Airdrie, AB T4A 0C3, Canada; (A.P.); (N.A.); (M.O.)
| | - Sheeny Levengood
- Ondine Biomedical Inc., Bothell, WA 98011, USA; (C.R.-B.); (S.L.); (R.A.); (N.L.); (C.P.S.)
| | - Roger Andersen
- Ondine Biomedical Inc., Bothell, WA 98011, USA; (C.R.-B.); (S.L.); (R.A.); (N.L.); (C.P.S.)
| | - Nicolas Loebel
- Ondine Biomedical Inc., Bothell, WA 98011, USA; (C.R.-B.); (S.L.); (R.A.); (N.L.); (C.P.S.)
| | - Caetano P. Sabino
- Ondine Biomedical Inc., Bothell, WA 98011, USA; (C.R.-B.); (S.L.); (R.A.); (N.L.); (C.P.S.)
- Center for Lasers and Applications, Energy and Nuclear Research Institute, São Paulo 05508-000, SP, Brazil
| | - Joseph A. Ross
- Chinook Contract Research Inc., Airdrie, AB T4A 0C3, Canada; (A.P.); (N.A.); (M.O.)
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Ilesanmi OS, Faseru B, Afolabi AA, Odukoya O, Ayo-Yusuf O, Akinsolu F, Adebiyi AO, Evans WK. Physician-brief advice for promoting smoking cessation among cancer patients on treatment in low and middle-income countries: a scoping review. BMC Cancer 2024; 24:149. [PMID: 38291373 PMCID: PMC10826229 DOI: 10.1186/s12885-024-11872-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/12/2024] [Indexed: 02/01/2024] Open
Abstract
INTRODUCTION Physician-brief advice has been utilized in high-income countries to promote smoking cessation among cancer patients. Empirical evidence on its effectiveness among cancer patients in low and middle-income countries (LMICs) is lacking. The gap could be due to inadequate training, and competing healthcare priorities, leading to insufficient implementation of targeted smoking cessation interventions in oncology settings. We undertook this scoping review to determine if physician-brief advice is effective in promoting smoking cessation among cancer patients in LMICs. METHODS We conducted a literature search of all relevant articles across five databases: Cochrane Central Register of Controlled Trials, Cochrane Library (Tobacco Addiction Group trials), World Conference on Lung Cancer proceedings, PubMed, and Google Scholar up to November 2023, using pre-defined inclusion criteria and keywords. The study population was cancer survivors in LMICs, the intervention was smoking cessation advice by a physician in a clinic or oncology center during a consultation, and the outcome was the effect of smoking cessation programs in discontinuing smoking among cancer survivors in LMICs. RESULTS Overall, out of every 10 cancer patients in LMICs, about seven were smokers, and one-half had received physician-brief advice for smoking cessation. Physician-brief advice was more likely to be delivered to patients with smoking-related cancer (Cohen's d = 0.396). This means that there is a noticeable difference between patients with smoking-related cancer compared to those with cancer unrelated to smoking. Smoking cessation failure was due to the inability to cope with the symptoms of withdrawal, missed smoking cessation clinic visits, mental health disorders, limited time and resources, and minimal patient-physician contact. CONCLUSION There is very little literature on the frequency of use or the efficacy of physician-brief advice on smoking cessation in LMICs. The literature suggests that cancer patients in LMICs have low self-efficacy to quit smoking, and smoking cessation is rarely part of cancer care in LMICs. Physicians in LMICs should be trained to use motivational messages and good counseling techniques to improve smoking cessation among cancer patients. Policymakers should allocate the resources to implement physician-brief advice and design training programs for physicians focusing on physician-brief advice tailored to cancer patients.
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Affiliation(s)
| | - Babalola Faseru
- Department of Population Health, University of Kansas Medical Center, Kansas City, US
- Department of Family Medicine and Community Health, University of Kansas Medical Center, Kansas City, US
| | - Aanuoluwapo Adeyimika Afolabi
- Department of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
- Technical and Strategic Research Directorate, MSI Nigeria Reproductive Choices, Abuja, Nigeria
| | - Olukemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olalekan Ayo-Yusuf
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | | | | | - William K Evans
- Department of Oncology, McMaster University, Hamilton, ON, Canada
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293
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Zhao W, Gao Q, Cao Y, Meng Y, He J. Kinetics of sterilization of atomized slightly acidic electrolyzed water on tableware. Heliyon 2024; 10:e24721. [PMID: 38312634 PMCID: PMC10835237 DOI: 10.1016/j.heliyon.2024.e24721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/05/2023] [Accepted: 01/12/2024] [Indexed: 02/06/2024] Open
Abstract
The aim of this study was to elucidate the kinetics of atomization of slightly acidic electrolyzed water (SAEW) for use in sterilization of secondary contaminated tableware surfaces. The sterilization efficacy of SAEW was assessed on the basis of the change in the total number of colonies with different contamination levels (101 CFU/mL and 102 CFU/mL), atomization time (10, 20, 30, 40, and 50 s), atomizing distance (5, 10, 15, 20, 25, and 30 cm), and available chlorine concentration (ACC; 25.2, 30.2, 34.9, 40.5, 44.8, and 53.3 mg/L) as the main influencing factors. According to the relationship among flux, atomization area, and time, a kinetic model of SAEW atomization for the sterilization of tableware surfaces was established. The results indicated that the sterilization efficacy of SAEW gradually improved with decreased contamination levels (12.69 %-15.74 %), extended atomization time (13.68 %-46.58 %), and increased ACC (36.89 %-95.14 %). Based on the kinetics analysis, the change law of the kinetic model of SAEW atomization and sterilization of tableware surfaces with secondary pollution was found to be consistent with the change law of sterilization (r2 > 0.8). The results of this study provide a theoretical basis for SAEW atomization for sterilization of secondary contaminated tableware surfaces and also contributes to the improvement of technological theory of SAEW sterilization.
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Affiliation(s)
| | | | - Yu Cao
- College of Food Science and Technology, Yunnan Agricultural University, Kunming, 650201, China
| | - Yuanyan Meng
- College of Food Science and Technology, Yunnan Agricultural University, Kunming, 650201, China
| | - Jinsong He
- College of Food Science and Technology, Yunnan Agricultural University, Kunming, 650201, China
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Durairaj T, Aparnavi P, Narayanan S, Mahantshetti S, Dhandapani S, Shanmugam J, Rathinamoorthy R, Kumar M. Utilization of modern menstrual methods and related unmet needs among college going women in Coimbatore district: a descriptive cross-sectional study. BMC Womens Health 2024; 24:78. [PMID: 38291382 PMCID: PMC10826201 DOI: 10.1186/s12905-024-02915-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVES The primary objectives were to determine the proportion of modern menstrual method (MMM) users among college going women in Coimbatore district, Tamil Nadu; and to estimate the unmet needs associated with use of MMMs in comparison with other menstrual hygiene methods (MHMs). We also assessed the factors that determine MMM use among college going women. METHODS This was a descriptive cross-sectional study conducted among college going women in Coimbatore district, Tamil Nadu, India between October 2022 and January 2023 using a purpose predesigned, pretested, semi-structured proforma that included validated Menstrual Practice Needs Scale (MPNS-36). RESULTS Only 1.4% of the study participants used MMMs - menstrual cups (1.3%) and tampons (0.1%). Sanitary pads were the most common MHM of choice (96.3%); of which majority (98.6%) used disposable pads and more than half (50.4%) used non-biodegradable pads. Importantly, one in six (16.5%) were not aware of nature of sanitary pads (biodegradable or nonbiodegradable) used. The unmet needs associated with MMMs (menstrual cups and tampons) were significantly lower than that for other MHMs (including sanitary pads), in particular, the unmet material and home environment needs, unmet material reliability concerns, unmet reuse needs and unmet reuse insecurity. However, we found no significant difference between MMMs, sanitary pads and other MHMs in terms of unmet transport, college environment, change and disposal insecurity needs. The significant predictors of use of MMMs were age (more than 21 years of age), residence (urban), type of stay (off campus including home), socioeconomic status (upper), fathers' and mothers' education (high school and above), and presence of personal income. Discussions with friends (or peers) both before and after menarche regarding menstruation resulted in higher adoption of modern menstrual methods. CONCLUSION MMMs provided comparative advantage with lesser unmet needs for material reliability and reuse insecurity concerns, particularly in home environment. However, none of the MHMs fulfilled the user expectations for transport and disposal insecurity concerns, particularly outdoors.
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Affiliation(s)
- Thavansree Durairaj
- KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Periasamy Aparnavi
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Seetharaman Narayanan
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Sushmitha Mahantshetti
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Srihari Dhandapani
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Jeevithan Shanmugam
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Ramesh Rathinamoorthy
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Mohan Kumar
- Department of Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India.
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295
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Portela V, Hamwi S, Oliveira Martins MR. Exploring refugees' health care access in times of COVID-19: a quantitative study in the Lisbon region, Portugal. Front Public Health 2024; 12:1337299. [PMID: 38347925 PMCID: PMC10859453 DOI: 10.3389/fpubh.2024.1337299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/04/2024] [Indexed: 02/15/2024] Open
Abstract
Background To address the health needs of refugees, health services must be culturally competent and facilitate this population's access to health care, especially in a context prone to the amplification of social inequities, such as the COVID-19 pandemic. However, few quantitative studies exist in the European Union, and to the extent of our knowledge, there are no published quantitative studies exploring refugees' access to health care during the pandemic in Portugal. The objective of this study is to describe the demographic and socioeconomic characteristics of refugees living in Lisbon and to explore their healthcare access patterns during the COVID-19 pandemic. Methods We conducted a cross-sectional, descriptive, and quantitative study from May to November 2022. Using Levesque' s theory on health care access, we designed and applied a 38-item questionnaire through face-to-face interviews with refugees living in Lisbon for at least 12 months, and used descriptive statistics to characterize sociodemographic and healthcare access profiles during the pandemic. Results The mean age of the 36 recruited refugees was 35 years (SD = 10.24), the majority were male (56%), married (72%), had at least a secondary education (69%), were unemployed (77.8%), and had a median length of stay in Portugal of 17 months (IQR = 45). All were registered in a primary care center, and 94% used healthcare services during the pandemic. The majority never tested positive for the coronavirus (58%) and one out of the positive was admitted to hospital due to severe COVID-19. A total of 97% received COVID-19 vaccination, of which 69% had an incomplete schedule. A quarter of the participants did not have access to information about COVID-19 in a language they understood, and although 97% needed health care during the pandemic, more than half (63%) did not seek it because of structural and cultural barriers. Half of the respondents had difficulty getting medical advice by phone or email, and 39.4% could not afford a medical examination or treatment. Only 18.2% sought counseling services. A total of 58.8% of the participants felt like healthcare professionals did not always show respect towards their culture, and 64.7% reported that healthcare professionals did not always discuss treatment options with them. Conclusion This study's findings highlight the need to endow inclusive communication, cultural competency, and patient involvement in health care, alongside improving the socioeconomic condition of refugees. Identified population characteristics and barriers to health care access by refugees in this study may inform future research on the health care needs of refugees in Portugal and ultimately assist in the devising of strategies to reduce inequalities in health care access.
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Affiliation(s)
- Vanessa Portela
- Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Lisbon, Portugal
| | - Sousan Hamwi
- NOVA National School of Public Health, Public Health Research Centre, NOVA University of Lisbon, Lisbon, Portugal
| | - Maria R. Oliveira Martins
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Lisbon, Portugal
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Sakr CJ, Assaf SA, Fakih L, Dakroub S, Rahme D, Musharrafieh U, Khater B, Naous J, Romani M, Tannous J, Zahreddine N, Fakhreddine M, Itani M, Zalaquett N, Honein G. Hospitals' Collaborations Strengthen Pandemic Preparedness: Lessons Learnt from COVID-19. Healthcare (Basel) 2024; 12:321. [PMID: 38338207 PMCID: PMC10855495 DOI: 10.3390/healthcare12030321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/13/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic strained healthcare systems around the world. This study aims to understand the preparedness of private remote hospitals in Lebanon to respond to the pandemic and evaluate the impact of inter-hospital collaborations on the hospitals' readiness. METHODS A multi-centered study was conducted between August 2020 and June 2021 in ten Lebanese private remote hospitals based on a mixed-methods embedded approach where the quantitative supported the qualitative. Through the AUB-USAID (American University of Beirut-United States Agency for International Development) COVID-19 project, these hospitals received personal protective equipment and medical equipment in addition to COVID-19-related training using the Train-the-Trainer model. The quantitative part used knowledge and evaluation questionnaires and a pre-post-intervention hospital preparedness checklist. The qualitative approach adopted semi-structured interviews with a purposive sample from key hospital personnel. Quantitative data were analyzed using SPSS version 27, and a p-value of <0.05 was considered to be statistically significant. For the qualitative data, a thematic analysis was performed by adopting the six-phase process described by Braun and Clarke. RESULTS Of the 393 healthcare workers who attended the training and completed the evaluation questionnaire, 326 completed the pre- and post-training knowledge questionnaire. A significant improvement was observed in mean knowledge scores following training for infection control, nursing, and polymerase chain reaction sampling staff (p-value < 0.001, p-value < 0.001, and p-value = 0.006, respectively), but not for housekeeping staff. More than 93% of the participants showed high trainer and content evaluation scores. As for the hospitals' preparedness assessments, there was a clear improvement in the pre- and post-assessment scores for each hospital, and there was a significant difference in the mean of the total scores of partner hospitals pre- and post-USAID-AUB project (p-value = 0.005). These findings were supported by the qualitative analysis, where nine hospitals expressed the positive impact of the USAID-AUB intervention in improving their preparedness to respond to the COVID-19 pandemic at a critical time when it was highly needed. Despite the intervention, persistent challenges remained. CONCLUSIONS A timely and proactive collaborative program between academic/tertiary care centers and remote community hospitals that includes sharing supplies and expertise is feasible and highly effective during public health emergencies.
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Affiliation(s)
- Carine J. Sakr
- Employee Health Unit, Department of Family Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (C.J.S.); (L.F.); (S.D.); (D.R.)
| | - Sara A. Assaf
- Employee Health Unit, Department of Family Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (C.J.S.); (L.F.); (S.D.); (D.R.)
| | - Lina Fakih
- Employee Health Unit, Department of Family Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (C.J.S.); (L.F.); (S.D.); (D.R.)
| | - Saada Dakroub
- Employee Health Unit, Department of Family Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (C.J.S.); (L.F.); (S.D.); (D.R.)
| | - Diana Rahme
- Employee Health Unit, Department of Family Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (C.J.S.); (L.F.); (S.D.); (D.R.)
| | - Umayya Musharrafieh
- Department of Family Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon; (U.M.); (B.K.); (J.N.); (M.R.)
| | - Beatrice Khater
- Department of Family Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon; (U.M.); (B.K.); (J.N.); (M.R.)
| | - Jihane Naous
- Department of Family Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon; (U.M.); (B.K.); (J.N.); (M.R.)
| | - Maya Romani
- Department of Family Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon; (U.M.); (B.K.); (J.N.); (M.R.)
| | - Joseph Tannous
- Infection Prevention and Control Program, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon; (J.T.); (N.Z.)
| | - Nada Zahreddine
- Infection Prevention and Control Program, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon; (J.T.); (N.Z.)
| | - Mohammad Fakhreddine
- Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (M.F.); (M.I.); (N.Z.)
| | - Mira Itani
- Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (M.F.); (M.I.); (N.Z.)
| | - Nader Zalaquett
- Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; (M.F.); (M.I.); (N.Z.)
| | - Gladys Honein
- Hariri School of Nursing, American University of Beirut, Beirut 1107 2020, Lebanon;
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V Carvalho AS, Broekema B, Brito Fernandes Ó, Klazinga N, Kringos D. Acute care pathway assessed through performance indicators during the COVID-19 pandemic in OECD countries (2020-2021): a scoping review. BMC Emerg Med 2024; 24:19. [PMID: 38273229 PMCID: PMC10811879 DOI: 10.1186/s12873-024-00938-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic severely impacted care for non-COVID patients. Performance indicators to monitor acute care, timely reported and internationally accepted, lacked during the pandemic in OECD countries. This study aims to summarize the performance indicators available in the literature to monitor changes in the quality of acute care in OECD countries during the first year and a half of the pandemic (2020-July 2021) and to assess their trends. METHODS Scoping review. Search in Embase and MEDLINE (07-07-2022). Acute care performance indicators and indicators related to acute general surgery were collected and collated following a care pathway approach. Indicators assessing identical clinical measures were grouped under a common indicator title. The trends from each group of indicators were collated (increase/decrease/stable). RESULTS A total of 152 studies were included. 2354 indicators regarding general acute care and 301 indicators related to acute general surgery were included. Indicators focusing on pre-hospital services reported a decreasing trend in the volume of patients: from 225 indicators, 110 (49%) reported a decrease. An increasing trend in pre-hospital treatment times was reported by most of the indicators (n = 41;70%) and a decreasing trend in survival rates of out-of-hospital cardiac arrest (n = 61;75%). Concerning care provided in the emergency department, most of the indicators (n = 752;71%) showed a decreasing trend in admissions across all levels of urgency. Concerning the mortality rate after admission, most of the indicators (n = 23;53%) reported an increasing trend. The subset of indicators assessing acute general surgery showed a decreasing trend in the volume of patients (n = 50;49%), stability in clinical severity at admission (n = 36;53%), and in the volume of surgeries (n = 14;47%). Most of the indicators (n = 28;65%) reported no change in treatment approach and stable mortality rate (n = 11,69%). CONCLUSION This review signals relevant disruptions across the acute care pathway. A subset of general surgery performance indicators showed stability in most of the phases of the care pathway. These results highlight the relevance of assessing this care pathway more regularly and systematically across different clinical entities to monitor disruptions and to improve the resilience of emergency services during a crisis.
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Affiliation(s)
- Ana Sofia V Carvalho
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands.
| | - Bente Broekema
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Department of Pediatrics, Dijklander Hospital, Location Hoorn, Maelsonstraat 3, Hoorn, 1624 NP, The Netherlands
| | - Óscar Brito Fernandes
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Niek Klazinga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Dionne Kringos
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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Byabamazima C, Masvikeni B, Katsande R, Manyanga D. Monitoring the evolution of vaccine-derived poliovirus in East and Southern African countries, 2010 - 2021. Pan Afr Med J 2024; 47:31. [PMID: 38586072 PMCID: PMC10998255 DOI: 10.11604/pamj.2024.47.31.39945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 01/22/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction the Africa region was certified indigenous wild poliovirus-free in August 2020. Countries in East and Southern Africa have, during acute flaccid paralysis (AFP) and environmental surveillance (ES), detected equally concerning vaccine-derived polioviruses (VDPVs) that have not been systematically documented to guide programming in the sub-region. The study documents trends and salient observations of the VDPVs by country of detection, for 11 years from 2010 to 2021. Methods we conducted secondary data analysis, a descriptive study design, by deploying field and laboratory of AFP and environmental surveillance databases of the 20 East and Southern African countries from 2010 to 2021. Results a total of 318 VDPVs were reported over the study period. The majority were from AFP cases (58.8%) and the rest equally distributed between healthy community children and environmental surveillance sources. More polioviruses were detected after 2016 than during the period before. We observed that more boys were affected by VDPVs compared to girls. Children under 5 years were more affected than other age groups, with a mean age of 3.6 years. Delay of samples in the field seemed to increase the likelihood of not reporting VDPVs and not mounting timely public health detailed investigations and vaccination responses. Conclusion the study provides useful evolutional trends of VDPVs for surveillance and vaccination programming. We also noted that the VDPV2s have been increasing after the 2016 tOPV to oral polio vaccine (bOPV) switch. The COVID-19 pandemic emergence in 2020, led to a decline in AFP, ES surveillance, and immunization activities. Our findings point to the need to implement enhanced tailored childhood immunization recovery strategies and to speed up the use of inactivated polio vaccine (IPV) to boost population immunity.
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Affiliation(s)
- Charles Byabamazima
- World Health Organization, Inter-Country Support Team Office for East and Southern Africa, Belvedere, Harare, Zimbabwe
| | - Brine Masvikeni
- World Health Organization, Inter-Country Support Team Office for East and Southern Africa, Belvedere, Harare, Zimbabwe
| | - Reggis Katsande
- World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Daudi Manyanga
- World Health Organization, Inter-Country Support Team Office for East and Southern Africa, Belvedere, Harare, Zimbabwe
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299
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Enyinnaya JC, Anderson AA, Kelp NC, Long M, Duncan CG. The Social Ecology of Health Beliefs and Misinformation Framework: Examining the impact of misinformation on vaccine uptake through individual and sociological factors. Vaccine 2024; 42:455-463. [PMID: 38184392 DOI: 10.1016/j.vaccine.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 12/04/2023] [Accepted: 01/01/2024] [Indexed: 01/08/2024]
Abstract
BACKGROUND Misinformation presents a critical concern for academic and public health discourse, particularly around vaccine response. Before the COVID-19 pandemic, vaccine hesitancy was responsible for decreased immunization uptake for vaccine-preventable diseases. Misinformation connected to the novel COVID-19 vaccine has further fueled vaccine hesitancy in Colorado and the United States. Our study brings together three different perspectives - physicians, public health professionals, and parents - to understand the impact of misinformation on vaccine uptake in Colorado. Our study proposes a framework for combining the Health Belief Model with the Socio-Ecological model to account for societal factors in healthcare decision making. METHODS Semi-structured interviews and focus groups with public health professionals, physicians, and parents (n = 31) were conducted in late spring and summer 2022. Data were coded inductively using thematic analysis. Identified themes were deductively categorized according to the Socio-Ecological Model and Health Belief Model. RESULTS Using a theoretical framework that combined the Health Belief Model and the Socio-Ecological Model, we identified seven factors that influenced vaccine hesitancy in Colorado. Intrapersonal factors included routine vaccine hesitancy connected to perceptions of severity and susceptibility, efficacy, and benefits and barriers to vaccine uptake; interpersonal factors included social networks; institutional factors included mass mediated platforms, portrayals of uncertainty, distrust in institutional sources of information, and political influences in vaccine decision making; and structural factors included economic barriers behind vaccine hesitancy. CONCLUSIONS Our study provides a unique, triangulated, post-positivist perspective on the role of misinformation in vaccine hesitancy in Colorado. The findings provide evidence that misinformation is an important barrier to vaccination uptake and can permeate multiple socio-ecological determinants/characteristics to influence vaccination behaviors including intrapersonal, interpersonal, institutional, and structural levels. We introduce the Social Ecology of Health Beliefs and Misinformation Framework to account for how misinformation may interrupt vaccine uptake.
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Affiliation(s)
- Joy C Enyinnaya
- Department of Communication, University of the Fraser Valley, Abbotsford Campus, BC Canada
| | - Ashley A Anderson
- Department of Journalism and Media Communication, Colorado State University, United States.
| | - Nicole C Kelp
- Department of Microbiology, Immunology, and Pathology, Colorado State University, United States
| | - Marilee Long
- Department of Journalism and Media Communication, Colorado State University, United States
| | - Colleen G Duncan
- Department of Microbiology, Immunology, and Pathology, Colorado State University, United States
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300
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Halder CE, Hasan MA, Mohamud YM, Nyawara M, Okello JC, Mizan MN, Sayum MA, Hossain A, Willam A, Tassdik H. COVID-19 preventive measures in Rohingya refugee camps: An assessment of knowledge, attitude and practice. PLoS One 2024; 19:e0282558. [PMID: 38266022 PMCID: PMC10807836 DOI: 10.1371/journal.pone.0282558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 10/08/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Although many studies were conducted on COVID-19 knowledge, attitude, and practice (KAP) among the general population in many countries, very little is known about refugees, particularly Rohingya refugees in Cox's Bazar. A vast array of risk communication and community engagement (RCCE) interventions were implemented in Cox's Bazar with the intent of reducing disease transmission by empowering the community to adopt public health measures. OBJECTIVES The study aimed to assess the level of knowledge, attitude and practice (KAP) of COVID-19 preventive measures among the Rohingya refugees in Cox's Bazar, and to identify their socio-demographic determinants. MATERIALS AND METHODS A cross-sectional study was conducted with 500 Rohingya individuals. Participants in the study were Rohingya refugees residing in five randomly selected camps where International Organization for Migration (IOM) Health was operating. Using a structured questionnaire, skilled community health workers surveyed the Rohingya population. In addition to the survey on knowledge, attitude, and practice, the study gathered information on the perspectives and relevance of sociodemographic factors that influence KAP. RESULTS The study findings indicate that the mean scores for knowledge, attitude, and practice were 9.93, 7.55, and 2.71 respectively. Association was found between knowledge and practice level and age group-the elderly age group (>/ = 61 years) had less level of knowledge (AOR 0.42, P value = 0.058) and the late mid-age group (46-60 years) had better practice level (AOR 2.67, P value <0.001). CONCLUSIONS Our study found that the Rohingya refugee community in Cox's Bazar has improved knowledge and attitude toward COVID-19 preventive measures. However, the practice level of these measures remains low compared to the knowledge and positive attitude. The reason behind the poor practice of preventive measures needs to be identified and addressed engaging the community in similar future outbreaks.
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Affiliation(s)
- Charls Erik Halder
- Migration Health Division, International Organization for Migration (IOM), Cox’s Bazar, Bangladesh
| | - Md Abeed Hasan
- Migration Health Division, International Organization for Migration (IOM), Cox’s Bazar, Bangladesh
| | - Yussuf Mohamed Mohamud
- Migration Health Division, International Organization for Migration (IOM), Cox’s Bazar, Bangladesh
| | - Marsela Nyawara
- Migration Health Division, International Organization for Migration (IOM), Cox’s Bazar, Bangladesh
| | - James Charles Okello
- Migration Health Division, International Organization for Migration (IOM), Cox’s Bazar, Bangladesh
| | - Md Nahid Mizan
- Migration Health Division, International Organization for Migration (IOM), Cox’s Bazar, Bangladesh
| | - Md Abu Sayum
- Migration Health Division, International Organization for Migration (IOM), Cox’s Bazar, Bangladesh
| | - Ahmed Hossain
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Global Health Institute, North South University, Dhaka, Bangladesh
| | - Andrew Willam
- Migration Health Division, International Organization for Migration (IOM), Cox’s Bazar, Bangladesh
| | - Hamim Tassdik
- Migration Health Division, International Organization for Migration (IOM), Cox’s Bazar, Bangladesh
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