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Jouffroy R, Djossou F, Neviere R, Jaber S, Vivien B, Heming N, Gueye P. The chain of survival and rehabilitation for sepsis: concepts and proposals for healthcare trajectory optimization. Ann Intensive Care 2024; 14:58. [PMID: 38625453 PMCID: PMC11019190 DOI: 10.1186/s13613-024-01282-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
This article describes the structures and processes involved in healthcare delivery for sepsis, from the prehospital setting until rehabilitation. Quality improvement initiatives in sepsis may reduce both morbidity and mortality. Positive outcomes are more likely when the following steps are optimized: early recognition, severity assessment, prehospital emergency medical system activation when available, early therapy (antimicrobials and hemodynamic optimization), early orientation to an adequate facility (emergency room, operating theater or intensive care unit), in-hospital organ failure resuscitation associated with source control, and finally a comprehensive rehabilitation program. Such a trajectory of care dedicated to sepsis amounts to a chain of survival and rehabilitation for sepsis. Implementation of this chain of survival and rehabilitation for sepsis requires full interconnection between each link. To date, despite regular international recommendations updates, the adherence to sepsis guidelines remains low leading to a considerable burden of the disease. Developing and optimizing such an integrated network could significantly reduce sepsis related mortality and morbidity.
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Affiliation(s)
- Romain Jouffroy
- Intensive Care Unit, Ambroise Paré Hospital, Assistance Publique - Hôpitaux de Paris, Boulogne Billancourt, France.
- Centre de recherche en Epidémiologie et Santé des Populations - U1018 INSERM - Paris Saclay University, Paris, France.
- EA 7329 - Institut de Recherche Médicale et d'Épidémiologie du Sport - Institut National du Sport, de l'Expertise et de la Performance, Paris, France.
- Service de Médecine Intensive Réanimation, Hôpital Universitaire Ambroise Paré, Assistance Publique - Hôpitaux de Paris, and Paris Saclay University, Saclay, France.
| | - Félix Djossou
- Service des Maladies Infectieuses et Tropicales, Guyane and Laboratoire Ecosystèmes Amazoniens et Pathologie Tropicale EA 3593, Centre Hospitalier de Cayenne, Université de Guyane, Cayenne, France
| | - Rémi Neviere
- Service des Explorations Fonctionnelles Centre Hospitalier Universitaire de Martinique et UR5_3 PC2E Pathologie Cardiaque, toxicité Environnementale et Envenimations (ex EA7525, Université des Antilles, Antilles, France
| | - Samir Jaber
- Anesthesiology and Intensive Care; Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, University of Montpellier, INSERM U1046, Centre Hospitalier Universitaire Montpellier, Montpellier, 34295, France
| | - Benoît Vivien
- Service d'Anesthésie Réanimation, SAMU de Paris, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Nicholas Heming
- Department of Intensive Care, Raymond Poincaré Hospital, Laboratory of Infection & Inflammation - U1173, School of Medicine Simone Veil, FHU SEPSIS (Saclay and Paris Seine Nord Endeavour to PerSonalize Interventions for Sepsis), APHP University Versailles Saint Quentin - University Paris Saclay, University Versailles Saint Quentin - University Paris Saclay, INSERM, Garches, Garches, 92380, France
| | - Papa Gueye
- SAMU 972, Centre Hospitalier Universitaire de Martinique, Fort-de-France Martinique, University of the Antilles, French West Indies, Antilles, France
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2
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Alnofaiey Y, Alharthi SM, Alhulayfi RM, Alqurashi MM, Alsufyani RM, Alamri GM. Public Awareness and Knowledge of Sepsis: A Cross-Sectional Survey of Adults in the Western Region of Saudi Arabia. Cureus 2023; 15:e49102. [PMID: 38125215 PMCID: PMC10731998 DOI: 10.7759/cureus.49102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Sepsis is a condition in which the body responds improperly to harmful microorganisms and infections, which triggers a chain reaction throughout the body. It is a life-threatening medical emergency. Infections that lead to sepsis, in most cases, start in the lungs, urinary tract, skin, or gastrointestinal tract. Without timely treatment, sepsis rapidly leads to multi-organ failure and death. The risk factors for sepsis include a weakened immune system, being 65 years of age or older, and chronic medical conditions including diabetes, lung disease, and kidney disease. A thorough understanding of the warning signs and symptoms, as well as prompt medical attention, are required for successful sepsis management. Early detection, antimicrobial therapy, and intensive supportive care are the cornerstones of the best sepsis management. AIM This study aimed to assess the public awareness and knowledge of sepsis in the Western region of Saudi Arabia. METHODS This was a cross-sectional study conducted from the beginning of June till the end of August 2023, among 425 Saudi adults in the Western region above the age of 18 years. Data collection was carried out by administering a questionnaire through an online platform. The questionnaire included demographic information, risk factors, symptoms, protective factors, and the source of information about sepsis. The data collected were reviewed, coded, and then fed into IBM SPSS Statistics software for Windows, Version 21 (released 2012; IBM Corp., Armonk, NY). RESULTS The study found that almost half (47.8%) of participants were aware of bacterial septicemia, with the most common sources of awareness being the internet (48.3%) and healthcare professionals (47.8%). Low immunity (75.9%) and infection (39.4%) have been the most frequently reported risk factors. Fever (31.5%) was the most commonly reported symptom. Participants from Yanbu and Jeddah and those in the healthcare sector had significantly higher awareness levels. The majority of participants (93.1%) had poor knowledge about the risk factors and symptoms of septicemia, with only 3.4% having fair or good knowledge. Sociodemographic characteristics did not significantly affect knowledge about septicemia (P>0.05). CONCLUSION In summary, this study reveals that while awareness of bacterial septicemia is relatively high among the sample population, knowledge about the risk factors and symptoms of the condition is low. The internet, healthcare professionals, and social media play significant roles in raising awareness about bacterial septicemia. Participants from Yanbu and Jeddah, students, and healthcare sector workers had higher awareness levels compared to other groups. However, overall knowledge levels regarding bacterial septicemia were poor across various demographic characteristics. This highlights the need for targeted educational interventions to improve knowledge and understanding of septicemia and its risk factors and symptoms among the general population. Further research is needed to identify the reasons for low knowledge levels and develop effective strategies to improve awareness about bacterial septicemia.
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Affiliation(s)
- Yasser Alnofaiey
- Internal Medicine, College of Medicine, Taif University, Taif, SAU
| | | | | | | | | | - Ghadi M Alamri
- Medicine, College of Medicine, Taif University, Taif, SAU
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3
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van der Slikke EC, Beumeler LFE, Holmqvist M, Linder A, Mankowski RT, Bouma HR. Understanding Post-Sepsis Syndrome: How Can Clinicians Help? Infect Drug Resist 2023; 16:6493-6511. [PMID: 37795206 PMCID: PMC10546999 DOI: 10.2147/idr.s390947] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 09/21/2023] [Indexed: 10/06/2023] Open
Abstract
Sepsis is a global health challenge, with over 49 million cases annually. Recent medical advancements have increased in-hospital survival rates to approximately 80%, but the escalating incidence of sepsis, owing to an ageing population, rise in chronic diseases, and antibiotic resistance, have also increased the number of sepsis survivors. Subsequently, there is a growing prevalence of "post-sepsis syndrome" (PSS). This syndrome includes long-term physical, medical, cognitive, and psychological issues after recovering from sepsis. PSS puts survivors at risk for hospital readmission and is associated with a reduction in health- and life span, both at short and long term, after hospital discharge. Comprehensive understanding of PSS symptoms and causative factors is vital for developing optimal care for sepsis survivors, a task of prime importance for clinicians. This review aims to elucidate our current knowledge of PSS and its relevance in enhancing post-sepsis care provided by clinicians.
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Affiliation(s)
- Elisabeth C van der Slikke
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, 9713GZ, the Netherlands
| | - Lise F E Beumeler
- Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, 8934AD, the Netherlands
- Department of Sustainable Health, Campus Fryslân, University of Groningen, Groningen, 8911 CE, the Netherlands
| | - Madlene Holmqvist
- Department of Infection Medicine, Skåne University Hospital Lund, Lund, 221 84, Sweden
| | - Adam Linder
- Department of Infection Medicine, Skåne University Hospital Lund, Lund, 221 84, Sweden
| | - Robert T Mankowski
- Department of Physiology and Aging, University of Florida, Gainesville, FL, 32610, USA
| | - Hjalmar R Bouma
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, 9713GZ, the Netherlands
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9713GZ, the Netherlands
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4
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Kamiński M, Czarny J, Skrzypczak P, Sienicki K, Roszak M. The Characteristics, Uses, and Biases of Studies Related to Malignancies Using Google Trends: Systematic Review. J Med Internet Res 2023; 25:e47582. [PMID: 37540544 PMCID: PMC10439473 DOI: 10.2196/47582] [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: 03/25/2023] [Revised: 05/24/2023] [Accepted: 06/12/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND The internet is a primary source of health information for patients, supplementing physician care. Google Trends (GT), a popular tool, allows the exploration of public interest in health-related phenomena. Despite the growing volume of GT studies, none have focused explicitly on oncology, creating a need for a systematic review to bridge this gap. OBJECTIVE We aimed to systematically characterize studies related to oncology using GT to describe its utilities and biases. METHODS We included all studies that used GT to analyze Google searches related to malignancies. We excluded studies written in languages other than English. The search was performed using the PubMed engine on August 1, 2022. We used the following search input: "Google trends" AND ("oncology" OR "cancer" or "malignancy" OR "tumor" OR "lymphoma" OR "multiple myeloma" OR "leukemia"). We analyzed sources of bias that included using search terms instead of topics, lack of confrontation of GT statistics with real-world data, and absence of sensitivity analysis. We performed descriptive statistics. RESULTS A total of 85 articles were included. The first study using GT for oncology research was published in 2013, and since then, the number of publications has increased annually. The studies were categorized as follows: 22% (19/85) were related to prophylaxis, 20% (17/85) pertained to awareness events, 11% (9/85) were celebrity-related, 13% (11/85) were related to COVID-19, and 47% (40/85) fell into other categories. The most frequently analyzed cancers were breast (n=28), prostate (n=26), lung (n=18), and colorectal cancers (n=18). We discovered that of the 85 studies, 17 (20%) acknowledged using GT topics instead of search terms, 79 (93%) disclosed all search input details necessary for replicating their results, and 34 (40%) compared GT statistics with real-world data. The most prevalent methods for analyzing the GT data were correlation analysis (55/85, 65%) and peak analysis (43/85, 51%). The authors of only 11% (9/85) of the studies performed a sensitivity analysis. CONCLUSIONS The number of studies related to oncology using GT data has increased annually. The studies included in this systematic review demonstrate a variety of concerning topics, search strategies, and statistical methodologies. The most frequently analyzed cancers were breast, prostate, lung, colorectal, skin, and cervical cancers, potentially reflecting their prevalence in the population or public interest. Although most researchers provided reproducible search inputs, only one-fifth used GT topics instead of search terms, and many studies lacked a sensitivity analysis. Scientists using GT for medical research should ensure the quality of studies by providing a transparent search strategy to reproduce results, preferring to use topics over search terms, and performing robust statistical calculations coupled with sensitivity analysis.
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Affiliation(s)
- Mikołaj Kamiński
- Department of Rheumatology, District Hospital in Kościan, Kościan, Poland
- Department of the Treatment of Obesity, Metabolic Disorders, and of Clinical Dietetics, Poznań University of Medical Sciences, Poznań, Poland
| | - Jakub Czarny
- Faculty of Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Piotr Skrzypczak
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Krzysztof Sienicki
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznań, Poland
| | - Magdalena Roszak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznań, Poland
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Parsons Leigh J, Brundin-Mather R, Moss SJ, Nickel A, Parolini A, Walsh D, Bigham BL, Carter AJE, Fox-Robichaud A, Fiest KM. Public awareness and knowledge of sepsis: a cross-sectional survey of adults in Canada. Crit Care 2022; 26:337. [PMID: 36329489 PMCID: PMC9632573 DOI: 10.1186/s13054-022-04215-6] [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: 08/29/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022] Open
Abstract
Background Sepsis is a life-threatening complication of the body’s response to infection. The financial, medical, and psychological costs of sepsis to individuals and to the healthcare system are high. Most sepsis cases originate in the community, making public awareness of sepsis essential to early diagnosis and treatment. There has been no comprehensive examination of adult’s sepsis knowledge in Canada. Methods We administered an online structured survey to English- or French-literate adults in Canada. The questionnaire comprised 28 questions in three domains: awareness, knowledge, and information access. Sampling was stratified by age, sex, and geography and weighted to 2016 census data. We used descriptive statistics to summarize responses; demographic differences were tested using the Rao–Scott correction for weighted chi-squared tests and associations using multiple variable regression. Results Sixty-one percent of 3200 adults sampled had heard of sepsis. Awareness differed by respondent’s residential region, sex, education, and ethnic group (p < 0.001, all). The odds of having heard of sepsis were higher for females, older adults, respondents with some or completed college/university education, and respondents who self-identified as Black, White, or of mixed ethnicity (p < 0.01, all). Respondent’s knowledge of sepsis definitions, symptoms, risk factors, and prevention measures was generally low (53.0%, 31.5%, 16.5%, and 36.3%, respectively). Only 25% of respondents recognized vaccination as a preventive strategy. The strongest predictors of sepsis knowledge were previous exposure to sepsis, healthcare employment, female sex, and a college/university education (p < 0.001, all). Respondents most frequently reported hearing about sepsis through television (27.7%) and preferred to learn about sepsis from healthcare providers (53.1%). Conclusions Sepsis can quickly cause life-altering physical and psychological effects and 39% of adults sampled in Canada have not heard of it. Critically, a minority (32%) knew about signs, risk factors, and strategies to lower risk. Education initiatives should focus messaging on infection prevention, employ broad media strategies, and use primary healthcare providers to disseminate evidence-based information. Future work could explore whether efforts to raise public awareness of sepsis might be bolstered or hindered by current discourse around COVID-19, particularly those centered on vaccination. Supplementary Information The online version contains supplementary material available at 10.1186/s13054-022-04215-6.
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Affiliation(s)
- Jeanna Parsons Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada. .,Department of Critical Care Medicine, Dalhousie University, Halifax, NS, Canada.
| | | | - Stephana Julia Moss
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada.,Department of Critical Care, CRISMA Center, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Angie Nickel
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
| | - Ariana Parolini
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
| | - Deirdre Walsh
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
| | - Blair L Bigham
- Division of Critical Care, Department of Anesthesia, Stanford University, Stanford, CA, USA
| | - Alix J E Carter
- Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada.,Emergency Health Services Nova Scotia, Halifax, NS, Canada
| | - Alison Fox-Robichaud
- Division of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.,Hamilton Health Sciences, Hamilton, ON, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
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6
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Baker E. Improving sepsis recognition through use of the Sepsis Trust's community screening tool. Br J Community Nurs 2022; 27:69-75. [PMID: 35137616 DOI: 10.12968/bjcn.2022.27.2.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Sepsis is associated with high levels of morbidity and mortality. All healthcare professionals have a responsibility to ensure they have sufficient knowledge to effectively screen patients for signs and symptoms of sepsis. In the community setting, screening for sepsis can be challenging, due to the complexity within the patient population and difficulties associated with observation for changes in the patient's condition. The Sepsis Trust community nursing sepsis screening tool provides decision-making support to community healthcare professionals, enabling them to make a rapid assessment for risk factors for sepsis, ensuring a proportionate, consistent and appropriate response. Through implementation of a decision-support tool within the clinical setting, it is likely that patients at risk of sepsis will be identified earlier, and patients will be escalated in a more consistent manner. This process of improving consistency in practice can improve patient outcomes, including mortality, morbidity and overall patient experience.
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Affiliation(s)
- Edward Baker
- Lecturer in Applied Technology for Clinical Care, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Do SN, Luong CQ, Pham DT, Nguyen MH, Nguyen NT, Huynh DQ, Hoang QTA, Dao CX, Le TM, Bui HN, Nguyen HT, Hoang HB, Le TTP, Nguyen LTB, Duong PT, Nguyen TD, Vu YH, Pham GTT, Van Bui T, Pham TTN, Hoang HT, Van Bui C, Nguyen NM, Bui GTH, Vu TD, Le ND, Tran TH, Nguyen TQ, Le VH, Van Nguyen C, McNally BF, Phua J, Nguyen AD. Factors relating to mortality in septic patients in Vietnamese intensive care units from a subgroup analysis of MOSAICS II study. Sci Rep 2021; 11:18924. [PMID: 34556710 PMCID: PMC8460806 DOI: 10.1038/s41598-021-98165-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/06/2021] [Indexed: 12/29/2022] Open
Abstract
Sepsis is the most common cause of in-hospital deaths, especially from low-income and lower-middle-income countries (LMICs). This study aimed to investigate the mortality rate and associated factors from sepsis in intensive care units (ICUs) in an LMIC. We did a multicenter cross-sectional study of septic patients presenting to 15 adult ICUs throughout Vietnam on the 4 days representing the different seasons of 2019. Of 252 patients, 40.1% died in hospital and 33.3% died in ICU. ICUs with accredited training programs (odds ratio, OR: 0.309; 95% confidence interval, CI 0.122-0.783) and completion of the 3-h sepsis bundle (OR: 0.294; 95% CI 0.083-1.048) were associated with decreased hospital mortality. ICUs with intensivist-to-patient ratio of 1:6 to 8 (OR: 4.533; 95% CI 1.621-12.677), mechanical ventilation (OR: 3.890; 95% CI 1.445-10.474) and renal replacement therapy (OR: 2.816; 95% CI 1.318-6.016) were associated with increased ICU mortality, in contrast to non-surgical source control (OR: 0.292; 95% CI 0.126-0.678) which was associated with decreased ICU mortality. Improvements are needed in the management of sepsis in Vietnam such as increasing resources in critical care settings, making accredited training programs more available, improving compliance with sepsis bundles of care, and treating underlying illness and shock optimally in septic patients.
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Affiliation(s)
- Son Ngoc Do
- Center for Emergency Medicine, Bach Mai Hospital, 78 Giai Phong road, Phuong Mai ward, Dong Da district, Hanoi, 100000, Vietnam.,Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam.,Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, 100000, Vietnam
| | - Chinh Quoc Luong
- Center for Emergency Medicine, Bach Mai Hospital, 78 Giai Phong road, Phuong Mai ward, Dong Da district, Hanoi, 100000, Vietnam. .,Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam. .,Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, 100000, Vietnam.
| | - Dung Thi Pham
- Department of Nutrition and Food Safety, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam
| | - My Ha Nguyen
- Department of Health Organization and Management, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam
| | - Nga Thi Nguyen
- Department of Intensive Care and Poison Control, Vietnam-Czechoslovakia Friendship Hospital, Hai Phong, 180000, Vietnam
| | - Dai Quang Huynh
- Intensive Care Department, Cho Ray Hospital, Ho Chi Minh City, 700000, Vietnam.,Department of Critical Care, Emergency Medicine and Clinical Toxicology, Faculty of Medicine, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, 700000, Vietnam
| | - Quoc Trong Ai Hoang
- Emergency Department, Hue Central General Hospital, Hue City, Thua Thien Hue, 530000, Vietnam
| | - Co Xuan Dao
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam.,Department of Intensive Care, Bach Mai Hospital, Hanoi, 100000, Vietnam
| | - Trung Minh Le
- Intensive Care Unit, 115 People's Hospital, Ho Chi Minh City, 700000, Vietnam
| | - Ha Nhat Bui
- Intensive Care Unit, Bai Chay General Hospital, Quang Ninh, 200000, Vietnam
| | - Hung Tan Nguyen
- Intensive Care Unit, Da Nang Hospital, Da Nang, 550000, Vietnam
| | - Hai Bui Hoang
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam.,Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, 100000, Vietnam
| | | | | | - Phuoc Thien Duong
- Intensive Care Unit, Can Tho Central General Hospital, Can Tho, 900000, Vietnam
| | - Tuan Dang Nguyen
- Intensive Care Unit, Vinmec Times City International Hospital, Hanoi, 100000, Vietnam
| | - Yen Hai Vu
- Intensive Care Unit, Da Nang Hospital, Da Nang, 550000, Vietnam.,Intensive Care Unit, Thai Nguyen Central General Hospital, Thai Nguyen, 250000, Vietnam
| | - Giang Thi Tra Pham
- Emergency Department, Thanh Nhan General Hospital, Hanoi, 100000, Vietnam
| | - Tam Van Bui
- Department of Intensive Care and Poison Control, Vietnam-Czechoslovakia Friendship Hospital, Hai Phong, 180000, Vietnam
| | - Thao Thi Ngoc Pham
- Intensive Care Department, Cho Ray Hospital, Ho Chi Minh City, 700000, Vietnam.,Department of Critical Care, Emergency Medicine and Clinical Toxicology, Faculty of Medicine, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, 700000, Vietnam
| | - Hanh Trong Hoang
- Intensive Care Unit, Hue Central General Hospital, Hue City, Thua Thien Hue, 530000, Vietnam.,Department of Emergency and Critical Care Medicine, Faculty of Medicine, Hue University of Medicine and Pharmacy, Hue City, Thua Thien Hue, 530000, Vietnam
| | - Cuong Van Bui
- Department of Intensive Care, Bach Mai Hospital, Hanoi, 100000, Vietnam
| | - Nguyen Minh Nguyen
- Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, 100000, Vietnam
| | - Giang Thi Huong Bui
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam.,Department of Intensive Care, Bach Mai Hospital, Hanoi, 100000, Vietnam
| | - Thang Dinh Vu
- Intensive Care Unit, 115 People's Hospital, Ho Chi Minh City, 700000, Vietnam
| | - Nhan Duc Le
- Intensive Care Unit, Da Nang Hospital, Da Nang, 550000, Vietnam
| | - Trang Huyen Tran
- Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, 100000, Vietnam
| | - Thang Quang Nguyen
- Intensive Care Unit, Vinmec Times City International Hospital, Hanoi, 100000, Vietnam
| | - Vuong Hung Le
- Intensive Care Unit, Thai Nguyen Central General Hospital, Thai Nguyen, 250000, Vietnam
| | - Chi Van Nguyen
- Center for Emergency Medicine, Bach Mai Hospital, 78 Giai Phong road, Phuong Mai ward, Dong Da district, Hanoi, 100000, Vietnam.,Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam
| | - Bryan Francis McNally
- Emory University Rollins School of Public Health, Atlanta, GA, 30322, USA.,Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Jason Phua
- FAST and Chronic Programmes, Alexandra Hospital, National University Health System, Singapore, 159964, Singapore.,Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Health System, Singapore, 119228, Singapore
| | - Anh Dat Nguyen
- Center for Emergency Medicine, Bach Mai Hospital, 78 Giai Phong road, Phuong Mai ward, Dong Da district, Hanoi, 100000, Vietnam.,Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam
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Jindal HA, Jindal P, Jamir L, Faujdar DS, Datta H. Global Change in Interest toward Yoga for Mental Health Ailments during Coronavirus Disease-19 Pandemic: A Google Trend Analysis. Int J Yoga 2021; 14:109-118. [PMID: 34188382 PMCID: PMC8191227 DOI: 10.4103/ijoy.ijoy_82_20] [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: 07/15/2020] [Revised: 12/09/2020] [Accepted: 01/30/2021] [Indexed: 11/05/2022] Open
Abstract
Background: With coronavirus disease (COVID)-19 pandemic, society is gripped with uncertainty and fear, inclining them toward Yoga to prevent mental health issues. Google Trends (GT) depicts the public interest of the community which may vary due to evolving policy dynamics of the COVID-19 pandemic. Aim: The aim was to study global public interest in Yoga for mental health during the COVID-19 pandemic. Material and Methods: Global time trends were obtained for Yoga, Anxiety, and Depression from November 1, 2019 to May 31, 2020 using GT. The time series analysis was done in three different time periods – pre-COVID-19 phase, transition period, and COVID-19 pandemic phase. Cross-correlation, Spearman rho, Friedman ANOVA test, and forecasting were used for analysis. Results: GT found a global change in the search queries for Yoga, anxiety, and depression during the three time periods. High burden COVID-19 countries – Italy, Spain, Russia, and Brazil had an increasing search trend for Yoga. During the COVID-19 phase, there was a significant positive correlation between the search trends of Yoga with depression (r = 0.232; P < 0.05) and anxiety (r = 0.351; P < 0.05), but higher anxiety and depression searches lead to lower Yoga searches at lag +6. Forecast projected a continuous increase in Yoga searches and anxiety queries. Conclusion: Google Trends captured a significant rise in interest of Yoga among the global community but diminished with time. Hence, the need for interventions to promote Yoga to be part of routine life and for making sure that people adhere to the Yoga practices on a continuous basis.
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Affiliation(s)
- Har Ashish Jindal
- Senior Consultant, Ministry of Health and Family Welfare, New Delhi, India
| | - Parineeta Jindal
- Yoga Therapist, Government Rehabilitation Institute of Intellectual Disabilities, Chandigarh, India
| | - Limalemla Jamir
- Assistant Professor, All India Institute of Medical Sciences, Guwahati, India
| | - Dharamjeet Singh Faujdar
- Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India
| | - Himani Datta
- Schulich School of Business, 111 Ian MacDonald Blvd, North York, Ontario, Canada, M3J1P3
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9
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The Presentation, Pace, and Profile of Infection and Sepsis Patients Hospitalized Through the Emergency Department: An Exploratory Analysis. Crit Care Explor 2021; 3:e0344. [PMID: 33655214 PMCID: PMC7909460 DOI: 10.1097/cce.0000000000000344] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
To characterize the signs and symptoms of sepsis, compare them with those from simple infection and other emergent conditions and evaluate their association with hospital outcomes. Design Setting Participants and INTERVENTION A multicenter, retrospective cohort study of 408,377 patients hospitalized through the emergency department from 2012 to 2017 with sepsis, suspected infection, heart failure, or stroke. Infected patients were identified based on Sepsis-3 criteria, whereas noninfected patients were identified through diagnosis codes. MEASUREMENTS AND MAIN RESULTS Signs and symptoms were identified within physician clinical documentation in the first 24 hours of hospitalization using natural language processing. The time of sign and symptom onset prior to presentation was quantified, and sign and symptom prevalence was assessed. Using multivariable logistic regression, the association of each sign and symptom with four outcomes was evaluated: sepsis versus suspected infection diagnosis, hospital mortality, ICU admission, and time of first antibiotics (> 3 vs ≤ 3 hr from presentation). A total of 10,825 signs and symptoms were identified in 6,148,348 clinical documentation fragments. The most common symptoms overall were as follows: dyspnea (35.2%), weakness (27.2%), altered mental status (24.3%), pain (23.9%), cough (19.7%), edema (17.8%), nausea (16.9%), hypertension (15.6%), fever (13.9%), and chest pain (12.1%). Compared with predominant signs and symptoms in heart failure and stroke, those present in infection were heterogeneous. Signs and symptoms indicative of neurologic dysfunction, significant respiratory conditions, and hypotension were strongly associated with sepsis diagnosis, hospital mortality, and intensive care. Fever, present in only a minority of patients, was associated with improved mortality (odds ratio, 0.67, 95% CI, 0.64-0.70; p < 0.001). For common symptoms, the peak time of symptom onset before sepsis was 2 days, except for altered mental status, which peaked at 1 day prior to presentation. Conclusions The clinical presentation of sepsis was heterogeneous and occurred with rapid onset prior to hospital presentation. These findings have important implications for improving public education, clinical treatment, and quality measures of sepsis care.
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Sofi-Mahmudi A, Shamsoddin E, Ghasemi P, Mehrabi Bahar A, Shaban Azad M, Sadeghi G. Association of COVID-19-imposed lockdown and online searches for toothache in Iran. BMC Oral Health 2021; 21:69. [PMID: 33588832 PMCID: PMC7883957 DOI: 10.1186/s12903-021-01428-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 02/04/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Novel coronavirus disease-2019 (COVID-19) has impacted populations in many ways worldwide, including access to oral health services. This study aims to assess the association between lockdown due to COVID-19 and online searches for toothache in Iran using Google Trends (GT). METHODS We investigated GT online searches for toothache within the past five years. The time frame for data gathering was considered as the initiation and end dates of the national lockdown in Iran. We performed one-way ANOVA statistical test to compare relative search volumes (RSVs) between the year 2020 and 2016-2019 for the whole country. Then we investigated the possible association of RSVs in provinces with dentists' density, prevalence of current daily smokers, Human Development Index (HDI), Internet access, and fluoride concentration in water using linear regression. RESULTS When comparing 2020 with the previous four years, there was a rise of 2020 RSVs versus all previous years combined and each year (P < 0.001 for all of them). In the linear model for the year 2020, HDI (B = - 3.29, 95% CI: (- 5.80, - 0.78), P = 0.012) had a strong negative relationship with provincial RSVs. HDI mostly had strong positive relationship with provincial RSVs in prior years. Fluoride concentration (B = - 0.13, 95% CI: (- 0.24, - 0.03), P = 0.017) and dentists' density (B = - 0.04, 95% CI: (- 0.25, 0.17), P = 0.669) were also negatively associated with RSVs in 2020. These associations were mostly negative in the previous years as well. Internet access (B = 0.36, 95% CI: (- 0.38, 1.09), P = 0.325) and prevalence of daily smokers (B = 0.33, 95% CI: (0.13, 0.53), P = 0.002) were positively associated with RSVs. CONCLUSION The RSVs for toothache in 2020 have increased due to COVID-19-imposed lockdown compared with the same period in the past four years. This increase was related to socioeconomic factors.
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Affiliation(s)
- Ahmad Sofi-Mahmudi
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), West Fatemi St., 1419693111, Tehran, Iran
| | - Erfan Shamsoddin
- Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), West Fatemi St., 1419693111, Tehran, Iran.
| | - Peyman Ghasemi
- Department of Health Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mehrabi Bahar
- Department of Health Policy and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Shaban Azad
- Department of Cardiovascular Surgery, Shahid Chamran Heart Educational, Medical and Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ghasem Sadeghi
- Bureau of Dentistry, Vice Chancellery for Treatment, Ministry of Health and Medical Education, Tehran, Iran
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11
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Havelka EM, Mallen CD, Shepherd TA. Using Google Trends to assess the impact of global public health days on online health information seeking behaviour in Central and South America. J Glob Health 2020; 10:010403. [PMID: 32373327 PMCID: PMC7182390 DOI: 10.7189/jogh.10.010403] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Public health awareness can help prevent illness and result in earlier intervention when it does occur. For this reason, health promotion and disease awareness campaigns have great potential to alleviate the global burden of disease. Global Public Health Days (GPHD) are frequently implemented with this intent, but research evaluating their effectiveness, especially in the developing world setting, is scant. Objectives We aimed to evaluate the impact of four GPHDs (World Cancer Day, World Diabetes Day, World Mental Health Day, World AIDS Day) on online health information seeking behaviour (OHISB) in five Central and South American (CSA) countries which differ in their stage of economic development and epidemiological transition (Uruguay, Chile, Brazil, Colombia, Nicaragua). Methods Google Trends data was used as a ‘surrogate’ of OHISB. This was measured on the 28 days leading up to the GPHD, on the date of the GPHD, and on the seven days following it. The Joinpoint regression programme was used to perform a time trend analysis on the Google Trends data. This allowed us to identify statistically significant time points of a change in trend, which reflect significant ‘changes’ to OHISB. Results GPHDs were inconsistently effective at influencing internet search query activity in the studied countries. In situations where an effect was significant, this impact was consistently short-term, with Relative Search Volume level returning to precampaign levels within 7 days of the GPHD. Conclusions Our findings imply the need to revise GPHDs or create alternative health awareness campaigns, perhaps with a more long-term approach and tailored to the specific health needs of the CSA population. Developing effective preventive strategies is vital in helping combat the rising threat of NCDs in this region.
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Anderson JM, Stafford AL, Johnson AL, Hartwell M, Jellison S, Vassar M. Is World Malaria Day an effective awareness campaign? An evaluation of public interest in malaria during World Malaria Day. Trop Med Int Health 2020; 25:1416-1421. [DOI: 10.1111/tmi.13480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Micah Hartwell
- Oklahoma State University Center for Health Sciences Tulsa OK USA
| | - Samuel Jellison
- Oklahoma State University Center for Health Sciences Tulsa OK USA
| | - Matt Vassar
- Oklahoma State University Center for Health Sciences Tulsa OK USA
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13
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Lin RT, Cheng Y, Jiang YC. Exploring Public Awareness of Overwork Prevention With Big Data From Google Trends: Retrospective Analysis. J Med Internet Res 2020; 22:e18181. [PMID: 32589160 PMCID: PMC7394374 DOI: 10.2196/18181] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/03/2020] [Accepted: 05/14/2020] [Indexed: 12/26/2022] Open
Abstract
Background To improve working conditions and prevent illness and deaths related to overwork, the Taiwanese government in 2015, 2016, and 2018 amended regulations regarding working time, overtime, shifts, and rest days. Such policy changes may lead to a rising public awareness of overwork-related issues, which may in turn reinforce policy development. Objective This study aimed to investigate to what extent public awareness of overwork-related issues correlated with policy changes. Methods Policies, laws, and regulations promulgated or amended in Taiwan between January 2004 and November 2019 were identified. We defined 3 working conditions (overwork, long working hours, and high job stress) related to overwork prevention, generated a keyword for each condition, and extracted the search volumes for each keyword on the Google search engine as proxy indicators of public awareness. We then calculated the monthly percentage change in the search volumes using the Joinpoint Regression Program. Results Apparent peaks in search volumes were observed immediately after policy changes. Especially, policy changes in 2010 were followed by a remarkable peak in search volumes for both overwork and working hours, with the search volumes for overwork increased by 29% per month from June 2010 to March 2011. This increase was preceded by the implementation of new overwork recognition guidelines and media reports of several suspected overwork-related events. The search volumes for working hours also steadily increased, by 2% per month in September 2013 and afterward, reaching a peak in January 2017. The peak was likely due to the amendment to the Labor Standards Act, which called for “1 fixed and 1 flexible day off per week,” in 2016. The search volumes for job stress significantly increased (P=.026) but only by 0.4% per month since March 2013. Conclusions Over the past 15 years, Taiwanese authorities have revised and implemented several policies to prevent overwork-related health problems. Our study suggests a relationship between the implementation of policies that clearly defined the criteria for overwork and working hours and the rising public awareness of the importance of overwork prevention and shorter working hours.
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Affiliation(s)
- Ro-Ting Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Yawen Cheng
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yan-Cheng Jiang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
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14
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Brizuela V, Bonet M, Trigo Romero CL, Abalos E, Baguiya A, Fawole B, Knight M, Lumbiganon P, Minkauskienė M, Nabhan A, Bique Osman N, Qureshi ZP, Souza JP. Early evaluation of the 'STOP SEPSIS!' WHO Global Maternal Sepsis Awareness Campaign implemented for healthcare providers in 46 low, middle and high-income countries. BMJ Open 2020; 10:e036338. [PMID: 32444432 PMCID: PMC7247401 DOI: 10.1136/bmjopen-2019-036338] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To evaluate changes in awareness of maternal sepsis among healthcare providers resulting from the WHO Global Maternal Sepsis Study (GLOSS) awareness campaign. DESIGN Independent sample precampaign/postcampaign through online and paper-based surveys available for over 30 days before campaign roll-out (pre) and after study data collection (post). Descriptive statistics were used for campaign recognition and exposure, and odds ratio (OR) and percentage change were calculated for differences in awareness, adjusting for confounders using multivariate logistic regression. SETTING AND PARTICIPANTS Healthcare providers from 398 participating facilities in 46 low, middle and high-income countries. INTERVENTION An awareness campaign to accompany GLOSS launched 3 weeks prior to data collection and lasting the entire study period (28 November 2017 to 15 January 2018) and beyond. MAIN OUTCOME MEASURES Campaign recognition and exposure, and changes in awareness. RESULTS A total of 2188 surveys were analysed: 1155 at baseline and 1033 at postcampaign. Most survey respondents found the campaign materials helpful (94%), that they helped increase awareness (90%) and that they helped motivate to act differently (88%). There were significant changes with regard to: not having heard of maternal sepsis (-63.4% change, pre-OR/post-OR 0.35, 95% CI 0.18 to 0.68) and perception of confidence in making the right decisions with regard to maternal sepsis identification and management (7.3% change, pre-OR/post-OR 1.44, 95% CI 1.01 to 2.06). CONCLUSIONS Awareness raising campaigns can contribute to an increase in having heard of maternal sepsis and an increase in provider perception of confidence in making correct decisions. Offering the information to make accurate and timely decisions while promoting environments that enable self-confidence and support could improve maternal sepsis identification and management.
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Affiliation(s)
- Vanessa Brizuela
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Mercedes Bonet
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Edgardo Abalos
- Centro Rosarino de Estudios Perinatales (CREP), Rosario, Argentina
| | - Adama Baguiya
- Research Institute of Health Sciences, Ouagadougou, Burkina Faso
| | - Bukola Fawole
- Department of Obstetrics and Gynaecology, University of Ibadan College of Medicine, Ibadan, Oyo, Nigeria
| | - Marian Knight
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, Oxfordshire, UK
| | - Pisake Lumbiganon
- Obstetrics and Gynecology Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Meilė Minkauskienė
- Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ashraf Nabhan
- Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt
| | - Nafissa Bique Osman
- Department of Obstetrics/Gynaecology, Eduardo Mondlane University, Maputo, Mozambique
| | - Zahida P Qureshi
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
| | - João Paulo Souza
- Department of Social Medicine, Ribeirão Preto Medical School, Ribeirão Preto, Brazil
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15
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Otu A, Nsutebu EF, Hirst JE, Thompson K, Walker K, Yaya S. How to close the maternal and neonatal sepsis gap in sub-Saharan Africa. BMJ Glob Health 2020; 5:e002348. [PMID: 32399259 PMCID: PMC7204918 DOI: 10.1136/bmjgh-2020-002348] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/05/2020] [Accepted: 04/07/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Akaninyene Otu
- Department of Infection and Travel Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Emmanuel Fru Nsutebu
- Division of Infectious Diseases, Sheikh Shakbout Medical City, Abu Dhabi, United Arab Emirates
| | - Jane E Hirst
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, Oxfordshire, United Kingdom
| | - Kelly Thompson
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Karen Walker
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada.,The George Institute for Global Health, University of Oxford, Oxford, Oxfordshire, United Kingdom
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16
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Google Medical Update: Why Is the Search Engine Decreasing Visibility of Health and Medical Information Websites? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041160. [PMID: 32059576 PMCID: PMC7068473 DOI: 10.3390/ijerph17041160] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/29/2020] [Accepted: 02/11/2020] [Indexed: 12/21/2022]
Abstract
The Google search engine answers many health and medical information queries every day. People have become used to searching for this type of information. This paper presents a study which examined the visibility of health and medical information websites. The purpose of this study was to find out why Google is decreasing the visibility of such websites and how to measure this decrease. Since August 2018, Google has been more rigorously rating these websites, since they can potentially impact people’s health. The method of the study was to collect data about the visibility of health and medical information websites in sequential time snapshots. Visibility consists of combined data of unique keywords, positions, and URL results. The sample under study was made up of 21 websites selected from 10 European countries. The findings reveal that in sequential time snapshots, search visibility decreased. The decrease was not dependent on the country or the language. The main reason why Google is decreasing the visibility of such websites is that they do not meet high ranking criteria.
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17
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Rhee C, Klompas M. Sepsis trends: increasing incidence and decreasing mortality, or changing denominator? J Thorac Dis 2020; 12:S89-S100. [PMID: 32148931 DOI: 10.21037/jtd.2019.12.51] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Numerous studies suggest that the incidence of sepsis has been steadily increasing over the past several decades while mortality rates are falling. However, reliably assessing trends in sepsis epidemiology is challenging due to changing diagnosis and coding practices over time. Ongoing efforts by clinicians, administrators, policy makers, and patient advocates to increase sepsis awareness, screening, and recognition are leading to more patients being labeled with sepsis. Subjective clinical definitions and heterogeneous presentations also allow for wide discretion in diagnosing sepsis rather than specific infections alone or non-specific syndromes. These factors create a potential ascertainment bias whereby the inclusion of less severely ill patients in sepsis case counts over time leads to a perceived increase in sepsis incidence and decrease in sepsis mortality rates. Analyses that rely on administrative data alone are further confounded by changing coding practices in response to new policies, financial incentives, and efforts to improve documentation. An alternate strategy for measuring sepsis incidence, outcomes, and trends is to use objective and consistent clinical criteria rather than administrative codes or registries to identify sepsis. This is feasible using data routinely found in electronic health record systems, such as blood culture draws and sustained courses of antibiotics to identify infection and laboratory values, vasopressors, and mechanical ventilation to measure acute organ dysfunction. Recent surveillance studies using this approach suggest that sepsis incidence and mortality rates have been essentially stable over the past decade. In this review, we summarize the major epidemiologic studies of sepsis trends, potential biases in these analyses, and the recent change in the surveillance paradigm toward using objective clinical data from electronic health records to more accurately characterize sepsis trends.
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Affiliation(s)
- Chanu Rhee
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Michael Klompas
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
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18
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Jabaley CS, Groff RF, O'Reilly-Shah VN. Asthma Information Seeking via Wikipedia between 2015 and 2018: Implications for Awareness Promotion. Am J Respir Crit Care Med 2020; 199:531-533. [PMID: 30521354 DOI: 10.1164/rccm.201809-1649le] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Craig S Jabaley
- 1 Emory University Atlanta, Georgia.,2 Atlanta Veterans Affairs Medical Center Decatur, Georgia and
| | - Robert F Groff
- 1 Emory University Atlanta, Georgia.,2 Atlanta Veterans Affairs Medical Center Decatur, Georgia and
| | - Vikas N O'Reilly-Shah
- 1 Emory University Atlanta, Georgia.,3 Children's Healthcare of Atlanta Atlanta, Georgia
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19
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Athamanolap P, Hsieh K, O'Keefe CM, Zhang Y, Yang S, Wang TH. Nanoarray Digital Polymerase Chain Reaction with High-Resolution Melt for Enabling Broad Bacteria Identification and Pheno-Molecular Antimicrobial Susceptibility Test. Anal Chem 2019; 91:12784-12792. [PMID: 31525952 DOI: 10.1021/acs.analchem.9b02344] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Toward combating infectious diseases caused by pathogenic bacteria, there remains an unmet need for diagnostic tools that can broadly identify the causative bacteria and determine their antimicrobial susceptibilities from complex and even polymicrobial samples in a timely manner. To address this need, a microfluidic and machine-learning-based platform that performs broad bacteria identification (ID) and rapid yet reliable antimicrobial susceptibility testing (AST) is developed. Specifically, this platform builds on "pheno-molecular AST", a strategy that transforms nucleic acid amplification tests (NAATs) into phenotypic AST through quantitative detection of bacterial genomic replication, and utilizes digital polymerase chain reaction (PCR) and digital high-resolution melt (HRM) to quantify and identify bacterial DNA molecules. Bacterial species are identified using integrated experiment-machine learning algorithm via HRM profiles. Digital DNA quantification allows for rapid growth measurement that reflects susceptibility profiles of each bacterial species within only 30 min of antibiotic exposure. As a demonstration, multiple bacterial species and their susceptibility profiles in a spiked-in polymicrobial urine specimen were correctly identified with a total turnaround time of ∼4 h. With further development and clinical validation, this platform holds the potential for improving clinical diagnostics and enabling targeted antibiotic treatments.
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Affiliation(s)
- Pornpat Athamanolap
- Department of Biomedical Engineering , Johns Hopkins School of Medicine , Baltimore , Maryland 21205 , United States
| | | | - Christine M O'Keefe
- Department of Biomedical Engineering , Johns Hopkins School of Medicine , Baltimore , Maryland 21205 , United States
| | - Ye Zhang
- Department of Biomedical Engineering , Johns Hopkins School of Medicine , Baltimore , Maryland 21205 , United States
| | - Samuel Yang
- Department of Emergency Medicine , Stanford University , Stanford , California 94304 , United States
| | - Tza-Huei Wang
- Department of Biomedical Engineering , Johns Hopkins School of Medicine , Baltimore , Maryland 21205 , United States.,The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins , Baltimore , Maryland 21287 , United States
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20
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Jabaley CS, Groff RF, Barnes TJ, Caridi-Scheible ME, Blum JM, O’Reilly-Shah VN. Sepsis information-seeking behaviors via Wikipedia between 2015 and 2018: A mixed methods retrospective observational study. PLoS One 2019; 14:e0221596. [PMID: 31437248 PMCID: PMC6705833 DOI: 10.1371/journal.pone.0221596] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/09/2019] [Indexed: 12/29/2022] Open
Abstract
Raising public awareness of sepsis, a potentially life-threatening dysregulated host response to infection, to hasten its recognition has become a major focus of physicians, investigators, and both non-governmental and governmental agencies. While the internet is a common means by which to seek out healthcare information, little is understood about patterns and drivers of these behaviors. We sought to examine traffic to Wikipedia, a popular and publicly available online encyclopedia, to better understand how, when, and why users access information about sepsis. Utilizing pageview traffic data for all available language localizations of the sepsis and septic shock pages between July 1, 2015 and June 30, 2018, significantly outlying daily pageview totals were identified using a seasonal hybrid extreme studentized deviate approach. Consecutive outlying days were aggregated, and a qualitative analysis was undertaken of print and online news media coverage to identify potential correlates. Traffic patterns were further characterized using paired referrer to resource (i.e. clickstream) data, which were available for a temporal subset of the pageviews. Of the 20,557,055 pageviews across 65 linguistic localizations, 47 of the 1,096 total daily pageview counts were identified as upward outliers. After aggregating sequential outlying days, 25 epochs were examined. Qualitative analysis identified at least one major news media correlate for each, which were typically related to high-profile deaths from sepsis and, less commonly, awareness promotion efforts. Clickstream analysis suggests that most sepsis and septic shock Wikipedia pageviews originate from external referrals, namely search engines. Owing to its granular and publicly available traffic data, Wikipedia holds promise as a means by which to better understand global drivers of online sepsis information seeking. Further characterization of user engagement with this information may help to elucidate means by which to optimize the visibility, content, and delivery of awareness promotion efforts.
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Affiliation(s)
- Craig S. Jabaley
- Department of Anesthesiology, Emory University, Atlanta, Georgia, United States of America
- Anesthesiology Service Line, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, United States of America
- * E-mail:
| | - Robert F. Groff
- Department of Anesthesiology, Emory University, Atlanta, Georgia, United States of America
- Anesthesiology Service Line, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, United States of America
| | - Theresa J. Barnes
- Department of Anesthesiology, Emory University, Atlanta, Georgia, United States of America
| | | | - James M. Blum
- Department of Anesthesiology, Emory University, Atlanta, Georgia, United States of America
- Anesthesiology Service Line, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, United States of America
- Department of Biomedical Informatics, Emory University, Atlanta, Georgia, United States of America
| | - Vikas N. O’Reilly-Shah
- Department of Anesthesiology, University of Washington, Seattle, Washington, United States of America
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21
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Affiliation(s)
- Rebecca E Glover
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine
| | | | - Nicholas Mays
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine
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22
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Nwankwor OC, McKelvie B, Frizzola M, Hunter K, Kabara HS, Oduwole A, Oguonu T, Kissoon N. A National Survey of Resources to Address Sepsis in Children in Tertiary Care Centers in Nigeria. Front Pediatr 2019; 7:234. [PMID: 31245338 PMCID: PMC6579914 DOI: 10.3389/fped.2019.00234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/22/2019] [Indexed: 01/11/2023] Open
Abstract
Background: Infections leading to sepsis are major contributors to mortality and morbidity in children world-wide. Determining the capacity of pediatric hospitals in Nigeria to manage sepsis establishes an important baseline for quality-improvement interventions and resource allocations. Objectives: To assess the availability and functionality of resources and manpower for early detection and prompt management of sepsis in children at tertiary pediatric centers in Nigeria. Methods: This was an online survey of tertiary pediatric hospitals in Nigeria using a modified survey tool designed by the World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS). The survey addressed all aspects of pediatric sepsis identification, management, barriers and readiness. Results: While majority of the hospitals 97% (28/29) reported having adequate triage systems, only 60% (16/27) follow some form of guideline for sepsis management. There was no consensus national guideline for management of pediatric sepsis. Over 50% of the respondents identified deficit in parental education, poor access to healthcare services, failure to diagnose sepsis at referring institutions, lack of medical equipment and lack of a definitive protocol for managing pediatric sepsis, as significant barriers. Conclusions: Certain sepsis-related interventions were reportedly widespread, however, there is no standardized sepsis protocol, and majority of the hospitals do not have pediatric intensive care units (PICU). These findings could guide quality improvement measures at institutional level, and healthcare policy/spending at the national level.
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Affiliation(s)
- Odiraa C Nwankwor
- Division of Critical Care Medicine, Department of Pediatrics, Alfred I. DuPont Hospital for Children, Wilmington, DE, United States.,Division of Critical Care Medicine, Department of Pediatrics, Cooper University Hospital, Camden, NJ, United States
| | - Brianna McKelvie
- Department of Pediatrics, Children's Hospital, Western University, London, ON, Canada
| | - Meg Frizzola
- Division of Critical Care Medicine, Department of Pediatrics, Alfred I. DuPont Hospital for Children, Wilmington, DE, United States
| | - Krystal Hunter
- Cooper University Hospital, Cooper Research Institute, Cooper Medical School of Rowan University, Camden, NJ, United States
| | - Halima S Kabara
- Department of Anaesthesia/Intensive Care Unit, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Abiola Oduwole
- Department of Paediatrics, Lagos University Teaching Hospital/College of Medicine, University of Lagos, Lagos, Nigeria
| | - Tagbo Oguonu
- Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Niranjan Kissoon
- Department of Pediatrics and Emergency Medicine, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada
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23
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Hopkins ZH, Secrest AM. An international comparison of Google searches for sunscreen, sunburn, skin cancer, and melanoma: Current trends and public health implications. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2018; 35:87-92. [PMID: 30198586 DOI: 10.1111/phpp.12425] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 08/13/2018] [Accepted: 09/02/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Google Trends® (GT) offers insight into public interests and behaviors and holds potential for guiding public health campaigns. OBJECTIVES This study explored international trends in English-speaking countries (United States, United Kingdom, Canada, Australia, New Zealand) in searches for sunscreen, sunburn, skin cancer, and melanoma to better guide skin cancer prevention campaigns. METHODS Google Trends® was queried for search terms from January 1, 2004 to December 31, 2017. Respective national databases were queried for melanoma outcome data from 2004 to 2014 and compared with time-matched search data. Correlations between search terms, time, and melanoma outcomes were assessed for each country. Quantitative analyses were performed to evaluate differences in search volumes between countries with varying melanoma incidence. RESULTS In all countries, the strongest intra-term correlation was between sunscreen and sunburn. Searches for sunscreen and sunburn are increasing for all countries. For all countries except the United Kingdom and New Zealand, searches for skin cancer and melanoma are decreasing for one or both terms. Correlations between search terms and melanoma outcomes were variable and specific to each country. Quantitative analysis revealed that countries with higher melanoma incidence had higher search volumes for all terms. Search volumes were especially high for skin cancer and melanoma in Australia compared with other countries. Comparisons between moderate melanoma incidence countries were less clear. CONCLUSIONS Online skin cancer prevention campaigns should focus on the search terms sunburn and sunscreen, especially given the declining interest between 2004 and 2016 in the terms skin cancer and melanoma seen in multiple countries. Search term interests varied with melanoma outcomes and between countries, suggesting the importance of customizing approaches based on local population interests and geographic areas.
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Affiliation(s)
| | - Aaron M Secrest
- Departments of Dermatology and Population Health Sciences, University of Utah, Salt Lake City, Utah
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Rhee C, Dantes RB, Epstein L, Klompas M. Using objective clinical data to track progress on preventing and treating sepsis: CDC's new 'Adult Sepsis Event' surveillance strategy. BMJ Qual Saf 2018; 28:305-309. [PMID: 30254095 DOI: 10.1136/bmjqs-2018-008331] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Chanu Rhee
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA .,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Raymund Barretto Dantes
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.,Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lauren Epstein
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael Klompas
- Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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