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Boyanton BL, Frenner RA, Ingold A, Ambroggio L, Kennedy JL. SARS-CoV-2 pandemic non-pharmacologic interventions temporally associated with reduced pediatric infections due to Mycoplasma pneumoniae and co-infecting respiratory viruses in Arkansas. Microbiol Spectr 2024; 12:e0290823. [PMID: 38488365 DOI: 10.1128/spectrum.02908-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 02/12/2024] [Indexed: 03/26/2024] Open
Abstract
Non-pharmacologic interventions (NPIs), such as universal masking, implemented during the SARS-CoV-2 pandemic have reduced respiratory infections among children. This study evaluated the impact of NPIs on Mycoplasma pneumoniae infections in children, analyzing data from two hospitals in Arkansas and examining age-related differences and co-infections with other respiratory viruses. The study was approved by the Institutional Review Board and included patients (≤18 years) with upper respiratory tract symptoms. Data generated from the FilmArray Respiratory Panel were divided into pre-NPI, NPI, and post-NPI periods for analysis. Overall test positivity rate and positivity rate interval changes were evaluated. Statistical differences were determined by Chi-square (χ2 independence) analysis. A total of 100,077 tests were performed, with a statistical increase in testing volume during the NPI and post-NPI periods. The number of positive M. pneumoniae tests decreased by 77% (77 to 18) during the NPI period, then increased by 50% (18 to 27) during the post-NPI period. Preschool and elementary school age groups had the highest number of positive tests during the study at 59 (48%) and 40 (33%), respectively. Reduced M. pneumoniae infections were consistent across age groups. Co-infections with other respiratory viruses, particularly human rhinovirus/enterovirus, were observed at much lower levels. Pediatric M. pneumoniae infections in Arkansas were temporally associated with implementation and discontinuation of NPIs. Specific viral co-infections still occurred, albeit at lower levels during the SARS-CoV-2 pandemic. Because of the slower growth of this bacterium, we expect M. pneumoniae infections to return to pre-pandemic levels within approximately 2 years. IMPORTANCE Non-pharmacologic interventions (NPIs) effectively curtailed the spread of SARS-CoV-2 and, fortuitously, many other aerosol-transmitted respiratory pathogens. This study included the largest data set of symptomatic, pediatric patients from within the United States spanning a period from November 2017 through December 2023, and encompassed individuals residing in both rural and urban settings. We observed a strong correlation between the implementation and cessation of NPIs with the rate of respiratory infections due to Mycoplasma pneumoniae and viral co-infections. These infections are returning to baseline levels approximately 2 years following NPI cessation. This observation was not unexpected since the replication time for viruses is exponentially faster than that of bacteria. The resurgence of M. pneumoniae and likely other atypical bacterial pathogens is currently in process. Healthcare providers should strongly consider these pathogens in individuals presenting with respiratory tract illnesses.
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Affiliation(s)
- Bobby L Boyanton
- Department of Pathology, Arkansas Children's Hospital, Little Rock, Arkansas, USA
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Rachel A Frenner
- Department of Pathology, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Ashton Ingold
- Arkansas Children's Research Institute, Little Rock, Arkansas, USA
| | - Lilliam Ambroggio
- Sections of Emergency Medicine and Hospital Medicine, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado, Aurora, Colorado, USA
| | - Joshua L Kennedy
- Arkansas Children's Research Institute, Little Rock, Arkansas, USA
- Departments of Pediatrics and Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Veltri GA, Steinert JI, Sternberg H, Galizzi MM, Fasolo B, Kourtidis P, Büthe T, Gaskell G. Assessing the perceived effect of non-pharmaceutical interventions on SARS-Cov-2 transmission risk: an experimental study in Europe. Sci Rep 2024; 14:4857. [PMID: 38418636 PMCID: PMC10902314 DOI: 10.1038/s41598-024-55447-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024] Open
Abstract
We conduct a large (N = 6567) online experiment to measure the features of non-pharmaceutical interventions (NPIs) that citizens of six European countries perceive to lower the risk of transmission of SARS-Cov-2 the most. We collected data in Bulgaria (n = 1069), France (n = 1108), Poland (n = 1104), Italy (n = 1087), Spain (n = 1102) and Sweden (n = 1097). Based on the features of the most widely adopted public health guidelines to reduce SARS-Cov-2 transmission (mask wearing vs not, outdoor vs indoor contact, short vs 90 min meetings, few vs many people present, and physical distancing of 1 or 2 m), we conducted a discrete choice experiment (DCE) to estimate the public's perceived risk of SARS-CoV-2 transmission in scenarios that presented mutually exclusive constellations of these features. Our findings indicate that participants' perception of transmission risk was most influenced by the NPI attributes of mask-wearing and outdoor meetings and the least by NPI attributes that focus on physical distancing, meeting duration, and meeting size. Differentiating by country, gender, age, cognitive style (reflective or intuitive), and perceived freight of COVID-19 moreover allowed us to identify important differences between subgroups. Our findings highlight the importance of improving health policy communication and citizens' health literacy about the design of NPIs and the transmission risk of SARS-Cov-2 and potentially future viruses.
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Affiliation(s)
| | - Janina Isabel Steinert
- TUM School of Social Sciences and Technology & TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Henrike Sternberg
- TUM School of Social Sciences and Technology & TUM School of Management, Technical University of Munich, Munich, Germany
- Munich School of Politics and Public Policy & TUM School of Social Sciences and Technology & TUM School of Management, Technical University of Munich, Munich, Germany
| | - Matteo M Galizzi
- Department of Psychological and Behavioural Science and LSE Behavioural Lab, London School of Economics and Political Science, London, UK
| | - Barbara Fasolo
- Department of Management, London School of Economics and Political Science, London, UK
| | - Ploutarchos Kourtidis
- Department of Psychological and Behavioural Science and LSE Behavioural Lab, London School of Economics and Political Science, London, UK
| | - Tim Büthe
- TUM School of Social Sciences and Technology & TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- Sanford School of Public Policy, Duke University, Durham, USA
| | - George Gaskell
- Department of Psychological and Behavioural Science and LSE Behavioural Lab, London School of Economics and Political Science, London, UK
- Department of Methodology, London School of Economics and Political Science, London, UK
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Terziotti C, Ceolin C, Devita M, Raffaelli C, Antenucci S, Bazzano S, Capasso A, Castellino M, Signore SD, Lubian F, Maiotti M, Monacelli F, Mormile MT, Sgarito C, Vella F, Sergi G, Gareri P, Trevisan C, Bellio A, Fini F, Malara A, Mossello E, Fumagalli S, Volpato S, Monzani F, Bellelli G, Zia G, Incalzi RA, Coin A. Frailty, psychological well-being, and social isolation in older adults with cognitive impairment during the SARS-CoV-2 pandemic: data from the GeroCovid initiative. Psychogeriatrics 2023; 23:1007-1018. [PMID: 37679953 DOI: 10.1111/psyg.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/26/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND The containment measures linked to the COVID-19 pandemic negatively affected the phyco-physical well-being of the population, especially older adults with neurocognitive disorders (NCDs). This study aims to evaluate whether the frailty of NCD patients was associated with different changes in multiple health domains, in particular in relation to loneliness and social isolation, pre- and post-lockdown. MATERIALS AND METHODS Patients were recruited from 10 Italian Centers for Cognitive Disorders and Dementia. Data were collected in the pre-pandemic period (T0), during the pandemic lockdown (T1), and 6-9 months post-lockdown (T2). The UCLA Loneliness Scale-3, Activities of Daily Living (ADL), Instrumental ADL (IADL), Mini-Mental State Examination, and Neuropsychiatric Inventory (NPI) were administered. Caregivers' burden was also tested. Patients were categorized as non-frail, pre-frail, and frail according to the Fatigue, Resistance, Ambulation, Illness, and Loss of Weight scale. RESULTS The sample included 165 subjects (61.9% women, mean age 79.5 ± 4.9 years). In the whole sample, the ADL, IADL, and NPI scores significantly declined between T0 and T2. There were no significative variations in functional and cognitive domains between the frail groups. During lockdown we recorded higher Depression Anxiety Stress Scales and Perceived Stress Scale scores in frail people. In multivariable logistic regression, frailty was associated with an increase in social isolation, and a loss of IADL. CONCLUSIONS We observed a global deterioration in functional and neuro-psychiatric domains irrespective of the degree of frailty. Frailty was associated with the worsening of social isolation during lockdown. Frail patients and their caregivers seemed to experience more anxiety and stress disorders during SARS-CoV-2 pandemic.
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Affiliation(s)
- Camilla Terziotti
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | - Chiara Ceolin
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | - Maria Devita
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
- Department of General Psychology, University of Padova, Padova, Italy
| | - Cecilia Raffaelli
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | | | | | - Andrea Capasso
- Territorial Care Department, ASL NA2 Nord, Naples, Italy
| | - Manuela Castellino
- "B.V. Consolata" Rehabilitation Hospital-Fatebenefratelli, San Maurizio Canavese, Italy
| | | | | | | | - Fiammetta Monacelli
- Section of Geriatrics, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
| | | | - Claudia Sgarito
- UOC Involutive Degenerative Diseases, Territorial Psychogeriatrics, ASP of Agrigento, Agrigento, Italy
| | | | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | - Pietro Gareri
- Center for Cognitive Disorders and Dementia-Catanzaro Lido ASP, Catanzaro, Italy
| | - Caterina Trevisan
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Andrea Bellio
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | - Filippo Fini
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | | | - Enrico Mossello
- Geriatric Intensive Care Unit, Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Stefano Fumagalli
- Geriatric Intensive Care Unit, Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Stefano Volpato
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Fabio Monzani
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, Acute Geriatric Unit, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | | | - Raffaele Antonelli Incalzi
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
| | - Alessandra Coin
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
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Cuoco S, Ponticorvo S, Abate F, Tepedino MF, Erro R, Manara R, Di Salle G, Di Salle F, Pellecchia MT, Esposito F, Barone P, Picillo M. Frequency and imaging correlates of neuropsychiatric symptoms in Progressive Supranuclear Palsy. J Neural Transm (Vienna) 2023; 130:1259-1267. [PMID: 37535119 PMCID: PMC10480260 DOI: 10.1007/s00702-023-02676-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023]
Abstract
Neuropsychiatric symptoms are intrinsic to Progressive Supranuclear Palsy (PSP) and a spoonful of studies investigated their imaging correlates. Describe (I) the frequency and severity of neuropsychiatric symptoms in PSP and (II) their structural imaging correlates. Twenty-six PSP patients underwent Neuropsychiatric Inventory (NPI) and brain 3D T1-weighted MRI. Spearman's rho with Bonferroni correction was used to investigate correlations between NPI scores and volumes of gray matter regions. More than 80% of patients presented at least one behavioral symptom of any severity. The most frequent and severe were depression/dysphoria, apathy, and irritability/lability. Significant relationships were found between the severity of irritability and right pars opercularis volume (p < 0.001) as well as between the frequency of agitation/aggression and left lateral occipital volume (p < 0.001). Depression, apathy, and irritability are the most common neuropsychiatric symptoms in PSP. Moreover, we found a relationship between specific positive symptoms as irritability and agitation/aggression and greater volume of the right pars opercularis cortex and lower volume of the left occipital cortex, respectively, which deserve further investigations.
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Affiliation(s)
- Sofia Cuoco
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Neuroscience Section, Via Allende, 84081, Baronissi (Salerno), Italy
| | - Sara Ponticorvo
- Center for Magnetic Resonance Research (CMRR), Department of Radiology, University of Minnesota, 2021 6th St. SE, Minneapolis, MN, 55455, USA
| | - Filomena Abate
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Neuroscience Section, Via Allende, 84081, Baronissi (Salerno), Italy
| | - Maria Francesca Tepedino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Neuroscience Section, Via Allende, 84081, Baronissi (Salerno), Italy
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Neuroscience Section, Via Allende, 84081, Baronissi (Salerno), Italy
| | - Renzo Manara
- Department of Neurosciences, Neuroradiology Unit, University of Padua, 35128, Padua, Italy
| | - Gianfranco Di Salle
- Scuola Superiore Di Studi Universitari E Perfezionamento Sant'Anna, Classe Di Scienze Sperimentali, Pisa, Italy
| | - Francesco Di Salle
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Neuroscience Section, Via Allende, 84081, Baronissi (Salerno), Italy
| | - Maria Teresa Pellecchia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Neuroscience Section, Via Allende, 84081, Baronissi (Salerno), Italy
| | - Fabrizio Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Paolo Barone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Neuroscience Section, Via Allende, 84081, Baronissi (Salerno), Italy
| | - Marina Picillo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Neuroscience Section, Via Allende, 84081, Baronissi (Salerno), Italy.
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Hysing-Dahl T, Magnussen LH, Faleide AGH, Inderhaug E. Feasibility of return to sports assessment 6 months after patellar instability surgery. BMC Musculoskelet Disord 2023; 24:662. [PMID: 37596551 PMCID: PMC10439663 DOI: 10.1186/s12891-023-06767-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/29/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND The evidence regarding the usefulness of assessment tools to support decisions of return-to-sport after surgery for patellar instability is scarce. The purpose of this study was therefore to explore the feasibility of functional tests assessing readiness for return-to-sport six months after patellar stabilizing surgery. However, there is little evidence on what a functional assessment should include to support these decisions following surgery for patellar instability. Therefore the purpose of this study was to explore the feasibility of functional tests assessing readiness for return-to-sport six months after patellar stabilizing surgery. METHODS In this cross-sectional study a prospective cohort of 78 patients were subjected to a range of return-to-sport readiness tests at six months after surgery for patellar instability with an "a la carte" approach. Lower Quarter Y-Balance Test (YBT-LQ), single-legged hop tests and isokinetic strength tests were performed. In addition, self-reported function was measured with the Banff Patellofemoral Instability Instrument 2.0 (BPII) and Norwich Patellar Instability score (NPI). Return-to-sport clearance criteria were defined as: ≤4 cm YBT-LQ anterior reach difference between legs, leg-symmetry-index (LSI) ≥ 95% in the YBT-LQ composite score, mean sum score LSI ≥ 85% of all single-leg hop tests and LSI ≥ 90% in isokinetic quadriceps strength. RESULTS Sixty-four patients (82%) were able to complete all functional tests, while only eleven (14%) patients were deemed ready for return-to-sport, passing all return-to-sport clearance criteria. Patients with bilateral problems demonstrated worse performance in the contralateral leg, which resulted in higher LSI scores compared to individuals with unilateral instability. A supplementary finding was that the extent of surgery (MPFL-R only versus combined surgery) did not predict and mainly did not affect self-reported function or functional performance at the follow-up. CONCLUSION The functional assessment used in the current study seems feasible to conduct at six months after patellar stabilizing surgery. However, current suggested clearance standards and the use of leg-symmetry-index seems inappropriate for patients with patellar instability. Therefore, further exploration of appropriate tests and return-to-sport clearance criteria is justified. TRIAL REGISTRATION clinicaltrial.gov, NCT05119088. Registered 12.11.2021 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05119088 .
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Affiliation(s)
- Trine Hysing-Dahl
- Haraldsplass Deaconess Hospital, V/Avdeling for Rehabiliteringstjenester Postboks 6165, Bergen, 5892, Norway.
- University of Bergen, Bergen, Norway.
| | - L H Magnussen
- Western Norway University of Applied Science, Haugesund, Norway
| | - A G H Faleide
- Haraldsplass Deaconess Hospital, V/Avdeling for Rehabiliteringstjenester Postboks 6165, Bergen, 5892, Norway
| | - E Inderhaug
- Haukeland University Hospital, Bergen, Norway
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Boyanton BL, Frenner RA, Ingold A, Ambroggio L, Kennedy JL. SARS-CoV-2 Pandemic Non-Pharmacologic Interventions Temporally Associated with Reduced Pediatric Infections Due to Mycoplasma pneumoniae and Co-Infecting Respiratory Viruses in Arkansas. medRxiv 2023:2023.08.05.23293566. [PMID: 37609274 PMCID: PMC10441508 DOI: 10.1101/2023.08.05.23293566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Introduction Non-pharmacologic interventions (NPIs), such as universal masking, implemented during the SARS-CoV-2 pandemic have reduced respiratory infections among children. This study focuses on evaluating the impact of NPIs on Mycoplasma pneumoniae infections in children, analyzing data from two hospitals in Arkansas, and examining age-related differences and coinfections with other viruses. Methods The study was approved by the Institutional Review Board and included patients aged ≤18 years with upper respiratory tract symptoms. Data from the FilmArray® Respiratory Panel (FARP) were collected and divided into pre-NPI and NPI periods for analysis. Total test positivity rate and interval change in the positivity rate were evaluated. Statistical differences were determined by Chi-square (χ2-independence) analysis. Results A total of 68,949 tests were performed with a statistical increase in testing during the NPI period. The overall test positivity rate for M. pneumoniae decreased by 74% (0.86% to 0.03%) during the NPI period, and the preschool age group had the highest number of positive tests in the pre- and NPI periods (Pre-NPI: n=40, NPI: n=12 positive tests, p=<0.001). The reduction in M. pneumoniae infections was consistent across age groups. Coinfections with other respiratory viruses, particularly human rhinovirus/enterovirus, were observed at much lower levels. Conclusions NPIs effectively reduced M. pneumoniae in pediatric patients in Arkansas, and coinfections with specific viruses still occurred, albeit at lower levels during the SARS-CoV-2 pandemic. As NPIs are relaxed and the pandemic ends, we expect M. pneumoniae infections to return to pre-pandemic levels within the next 1-2 years.
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Affiliation(s)
- Bobby L. Boyanton
- Departments of Pathology, Arkansas Children’s Hospital, Little Rock, AR 72202, and University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | - Rachel A. Frenner
- Department of Pathology, Arkansas Children’s Hospital, Little Rock, AR 72202
| | - Ashton Ingold
- Arkansas Children’s Research Institute, Little Rock, AR 72202
| | - Lilliam Ambroggio
- Sections of Emergency Medicine and Hospital Medicine, Children’s Hospital Colorado and Department of Pediatrics, University of Colorado, Aurora, Colorado
| | - Joshua L. Kennedy
- Arkansas Children’s Research Institute, Little Rock, AR 72202
- Departments of Pediatrics and Internal Medicine, University of Arkansas for Medical Sciences Little Rock, AR, 72205
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7
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Diallo I, Ndejjo R, Leye MMM, Egbende L, Tusubira A, Bamgboye EA, Fall M, Namuhani N, Bosonkie M, Salawu MM, Ndiaye Y, Kabwama SN, Sougou NM, Bello S, Bassoum O, Babirye Z, Afolabi RF, Gueye T, Kizito S, Adebowale AS, Dairo MD, Sambisa W, Kiwanuka SN, Fawole OI, Mapatano MA, Wanyenze RK, Seck I. Unintended consequences of implementing non-pharmaceutical interventions for the COVID-19 response in Africa: experiences from DRC, Nigeria, Senegal, and Uganda. Global Health 2023; 19:36. [PMID: 37280682 DOI: 10.1186/s12992-023-00937-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/19/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION The coronavirus (COVID 19) pandemic is one of the most terrifying disasters of the twenty-first century. The non-pharmaceutical interventions (NPIs) implemented to control the spread of the disease had numerous positive consequences. However, there were also unintended consequences-positively or negatively related to the nature of the interventions, the target, the level and duration of implementation. This article describes the unintended economic, Psychosocial and environmental consequences of NPIs in four African countries. METHODS We conducted a mixed-methods study in the Democratic Republic of Congo (DRC), Nigeria, Senegal and Uganda. A comprehensive conceptual framework, supported by a clear theory of change was adopted to encompass both systemic and non-systemic interventions. The data collection approaches included: (i) review of literature; (ii) analysis of secondary data for selected indicators; and (ii) key informant interviews with policy makers, civil society, local leaders, and law enforcement staff. The results were synthesized around thematic areas. RESULTS Over the first six to nine months of the pandemic, NPIs especially lockdowns, travel restrictions, curfews, school closures, and prohibition of mass gathering resulted into both positive and negative unintended consequences cutting across economic, psychological, and environmental platforms. DRC, Nigeria, and Uganda observed reduced crime rates and road traffic accidents, while Uganda also reported reduced air pollution. In addition, hygiene practices have improved through health promotion measures that have been promoted for the response to the pandemic. All countries experienced economic slowdown, job losses heavily impacting women and poor households, increased sexual and gender-based violence, teenage pregnancies, and early marriages, increased poor mental health conditions, increased waste generation with poor disposal, among others. CONCLUSION Despite achieving pandemic control, the stringent NPIs had several negative and few positive unintended consequences. Governments need to balance the negative and positive consequences of NPIs by anticipating and instituting measures that will support and protect vulnerable groups especially the poor, the elderly, women, and children. Noticeable efforts, including measures to avoid forced into marriage, increasing inequities, economic support to urban poor; those living with disabilities, migrant workers, and refugees, had been conducted to mitigate the negative effects of the NIPs.
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Affiliation(s)
- Issakha Diallo
- Public Health Department, Faculty of Health Sciences, University Amadou Hampaté Ba, Dakar, Senegal.
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mamadou Makhtar Mbacké Leye
- Preventive Medicine and Public Health Department within the Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Landry Egbende
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Andrew Tusubira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Eniola A Bamgboye
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Manel Fall
- Epidemiology Department of Pasteur Institute of Dakar, Dakar, Senegal
| | - Noel Namuhani
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Marc Bosonkie
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Mobolaji M Salawu
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Youssoupha Ndiaye
- Health Economics Unit of the Ministry of Health and Social Action, Dakar, Senegal
| | - Steven Ndugwa Kabwama
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Ndeye Mareme Sougou
- Preventive Medicine and Public Health Department within the Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Segun Bello
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Omar Bassoum
- Preventive Medicine and Public Health Department within the Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Ziyada Babirye
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rotimi Felix Afolabi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Thiané Gueye
- Health Economics Unit of the Ministry of Health and Social Action, Dakar, Senegal
| | - Susan Kizito
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ayo S Adebowale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Magbagbeola David Dairo
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Suzanne N Kiwanuka
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Olufunmilayo I Fawole
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mala Ali Mapatano
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ibrahima Seck
- Preventive Medicine and Public Health Department within the Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop of Dakar, Dakar, Senegal
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8
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Tizzani M, De Gaetano A, Jarvis CI, Gimma A, Wong K, Edmunds WJ, Beutels P, Hens N, Coletti P, Paolotti D. Impact of tiered measures on social contact and mixing patterns of in Italy during the second wave of COVID-19. BMC Public Health 2023; 23:906. [PMID: 37202734 PMCID: PMC10195658 DOI: 10.1186/s12889-023-15846-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 05/02/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Most countries around the world enforced non-pharmaceutical interventions against COVID-19. Italy was one of the first countries to be affected by the pandemic, imposing a hard lockdown, in the first epidemic wave. During the second wave, the country implemented progressively restrictive tiers at the regional level according to weekly epidemiological risk assessments. This paper quantifies the impact of these restrictions on contacts and on the reproduction number. METHODS Representative (with respect to age, sex, and region of residence) longitudinal surveys of the Italian population were undertaken during the second epidemic wave. Epidemiologically relevant contact patterns were measured and compared with pre-pandemic levels and according to the level of interventions experienced by the participants. Contact matrices were used to quantify the reduction in the number of contacts by age group and contact setting. The reproduction number was estimated to evaluate the impact of restrictions on the spread of COVID-19. RESULTS The comparison with the pre-pandemic baseline shows a significant decrease in the number of contacts, independently from the age group or contact settings. This decrease in the number of contacts significantly depends on the strictness of the non-pharmaceutical interventions. For all levels of strictness considered, the reduction in social mixing results in a reproduction number smaller than one. In particular, the impact of the restriction on the number of contacts decreases with the severity of the interventions. CONCLUSIONS The progressive restriction tiers implemented in Italy reduced the reproduction number, with stricter interventions associated with higher reductions. Readily collected contact data can inform the implementation of mitigation measures at the national level in epidemic emergencies to come.
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Affiliation(s)
| | | | | | - Amy Gimma
- London School of Hygiene and Tropical Medicine, London, UK
| | - Kerry Wong
- London School of Hygiene and Tropical Medicine, London, UK
| | - W John Edmunds
- London School of Hygiene and Tropical Medicine, London, UK
| | - Philippe Beutels
- Centre for Health Economic Research and Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Niel Hens
- Centre for Health Economic Research and Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
- UHasselt, Data Science Institute and I-BioStat, Hasselt, Belgium
| | - Pietro Coletti
- UHasselt, Data Science Institute and I-BioStat, Hasselt, Belgium
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9
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Cecchi M, Ninot G, Rebillard X, Thuret R, Droupy S, Ayuso D, Poinas G. [Which non pharmacological interventions should be offered to patients treated with androgen deprivation therapy for prostate cancer? A systematic review]. Prog Urol 2023; 33:287-306. [PMID: 37121810 DOI: 10.1016/j.purol.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/24/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023]
Abstract
AIM Prostate cancer is a frequent disease and one of the main treatments used is androgen deprivation therapy, which is a therapy with disabling side effects. Non-pharmacological interventions (NPIs) are evidenced based, non-invasive interventions on human health. They are classified into five categories (physical, psychological, nutritional, digital, elemental). The NPIs sphere is booming and still remains underused in this context. METHODS A systematic review concerning randomized controlled trials was executed according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We used the "Medline" and "Kalya Research" databases. After searching and selecting eligible publications, we included 37 randomized controlled trials. RESULTS The majority of articles concerned physical NPIs with 30 clinical studies, 3 publications dealt with nutritional NPIs, 2 with psychological NPIs and 2 articles concerned elemental NPIs. No publication about digital NPI was found. All of the studies aimed to manage and improve the side effects of treatment. No elemental NPI has demonstrated benefit. Only one psychological NPI and one nutritional NPI were effective. Five types of physical NPI protocols have shown efficacy. The main benefits related to physical abilities, body composition, osteoporosis, quality of life, fatigue, reduced cardiovascular risk and finally anxiety and depression. CONCLUSION Non-pharmacological interventions, especially physical ones, are effective in managing and reducing the side effects associated with androgen deprivation therapy and should be offered to patients in this context.
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Affiliation(s)
- M Cecchi
- Urologie, clinique Beau Soleil, 149, rue de la Taillade, 34070 Montpellier, France.
| | - G Ninot
- Institut Desbrest d'épidémiologie et de santé publique (Université de Montpellier-Inserm), 641, avenue du Doyen Gaston-Giraud, 34093 Montpellier, France
| | - X Rebillard
- Urologie, clinique Beau Soleil, 149, rue de la Taillade, 34070 Montpellier, France
| | - R Thuret
- Urologie et transplantation rénale, CHU Lapeyronie, 371, avenue du Doyen Gaston-Giraud, 34090 Montpellier, France
| | - S Droupy
- Urologie andrologie, CHU de Nîmes, 4, rue du Professeur Robert-Debré, 30900 Nîmes, France
| | - D Ayuso
- Urologie, centre hospitalier du Bassin de Thau, 11, boulevard Camille-Blanc, 34200 Sète, France
| | - G Poinas
- Urologie, clinique Beau Soleil, 149, rue de la Taillade, 34070 Montpellier, France
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10
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Tiwari NK, Mohanty TR, Das Gupta S, Roy S, Swain HS, Baitha R, Ramteke MH, Das BK. Hemato-biochemical alteration in the bronze featherback Notopterus notopterus (Pallas, 1769) as a biomonitoring tool to assess riverine pollution and ecology: a case study from the middle and lower stretch of river Ganga. Environ Sci Pollut Res Int 2023; 30:46826-46846. [PMID: 36723843 DOI: 10.1007/s11356-023-25519-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
Fishes are poikilothermic animals and are rapid responders to any sort of ecological alteration. The responses in the fish can be easily assessed from their hematological and biochemical responses. To study the variation in the hemato-biochemical parameters in retort to ecological alteration and ecological regime, a study was conducted at six different sampling stations of the middle and lower stretches of river Ganga. Various hematological and biochemical responses of fishes were also monitored in response to multiple ecological alterations. For the assessment of ecological alteration, various indices were calculated such as the water pollution index (WPI), National Sanitation Foundation-water quality index (NSF-WQI), and Nemerow's pollution index (NPI) has been calculated based on various water quality parameters such as dissolved oxygen (DO), pH, total dissolved solids (TDS), total alkalinity (TA), total hardness (TH), electrical conductivity (EC), biochemical oxygen demand (BOD), chlorinity (CL), total nitrogen (TN), and total phosphorus (TP). The hematological parameters such as WBC, RBC, platelet, hemoglobin, and hematocrit were monitored. The serum biochemical parameters such as SGPT, SGOT, ALP, amylase, bilirubin, glucose, triglyceride (TRIG), and cholesterol (CHOL) were investigated. The study revealed that NSF-WQI varied from 45.08 at Buxar to 110.63 at Rejinagar and showed a significantly positive correlation with SGPT, SGOT, ALP, TRIG, CHOL, and WBC, whereas a significantly negative correlation was observed between TRIG and RBC. WPI varied from 19 to 23 and showed a significant positive correlation with SGOT and a negative correlation was observed with total nitrogen. The PCA analysis illustrated the significance of both natural as well as anthropogenic factors on riverine ecology. Strong positive loading was observed with SGPT, SGOT, ALP, and platelet. The study signified the need for monitoring the hemato-biochemical responses of fishes in response to alterations in the ecological regime.
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Affiliation(s)
- Nitish Kumar Tiwari
- National Mission For Clean Ganga Laboratory, ICAR-Central Inland Fisheries Research Institute, Barrackpore, 700120, Kolkata, India
| | - Trupti Rani Mohanty
- National Mission For Clean Ganga Laboratory, ICAR-Central Inland Fisheries Research Institute, Barrackpore, 700120, Kolkata, India
| | - Subhadeep Das Gupta
- National Mission For Clean Ganga Laboratory, ICAR-Central Inland Fisheries Research Institute, Barrackpore, 700120, Kolkata, India
| | - Shreya Roy
- National Mission For Clean Ganga Laboratory, ICAR-Central Inland Fisheries Research Institute, Barrackpore, 700120, Kolkata, India
| | - Himanshu Sekhar Swain
- National Mission For Clean Ganga Laboratory, ICAR-Central Inland Fisheries Research Institute, Barrackpore, 700120, Kolkata, India
| | - Raju Baitha
- National Mission For Clean Ganga Laboratory, ICAR-Central Inland Fisheries Research Institute, Barrackpore, 700120, Kolkata, India
| | - Mitesh Hiradas Ramteke
- National Mission For Clean Ganga Laboratory, ICAR-Central Inland Fisheries Research Institute, Barrackpore, 700120, Kolkata, India
| | - Basanta Kumar Das
- National Mission For Clean Ganga Laboratory, ICAR-Central Inland Fisheries Research Institute, Barrackpore, 700120, Kolkata, India.
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Abstract
This paper studies continuing optimal lockdowns (can also be interpreted as quarantines or self-isolation) in the long run if a disease (Covid-19) is endemic and immunity can fail, that is, the disease has SIRS dynamics. We model how disease related mortality affects the optimal choices in a dynamic general equilibrium neoclassical growth framework. An extended welfare function that incorporates loss from mortality is used. In a disease endemic steady state, without this welfare loss even if there is continuing mortality, it is not optimal to impose even a partial lockdown. We characterize how the optimal restriction and equilibrium outcomes vary with the effectiveness of the lockdown, the productivity of working from home, the rate of mortality from the disease, and failure of immunity. We provide the sufficiency conditions for economic models with SIRS dynamics with disease related mortality-a class of models which are non-convex and have endogenous discounting so that no existing results are applicable.
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Affiliation(s)
- Aditya Goenka
- Department of Economics, University of Birmingham, Birmingham, England
| | - Lin Liu
- Management School, University of Liverpool, Liverpool, England
| | - Manh-Hung Nguyen
- Toulouse School of Economics, INRAE, University of Toulouse Capitole, Toulouse, France
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12
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Torres AR, Rodrigues AP, Sousa-Uva M, Kislaya I, Silva S, Antunes L, Dias C, Nunes B. Impact of stringent non-pharmaceutical interventions applied during the second and third COVID-19 epidemic waves in Portugal, 9 November 2020 to 10 February 2021: an ecological study. Euro Surveill 2022; 27. [PMID: 35686568 PMCID: PMC9198658 DOI: 10.2807/1560-7917.es.2022.27.23.2100497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Non-pharmaceutical interventions (NPIs) were implemented worldwide to control the spread of SARS-CoV-2. Aim To evaluate the impact of tiered NPIs and a nationwide lockdown on reduction of COVID-19 incidence during the second and third epidemic waves in Portugal. Methods Surveillance data on laboratory-confirmed COVID-19 cases were used to conduct an interrupted time series analysis to estimate changes in daily incidence during a second wave tiered NPI period (9 November–18 December 2020), and a third wave lockdown period without (15–21 January 2021) and with school closure (22 January–10 February 2021). Results Significant changes in trends were observed for the overall incidence rate; declining trends were observed for tiered NPIs (−1.9% per day; incidence rate ratio (IRR): 0.981; 95% confidence interval (CI): 0.973–0.989) and a lockdown period without (−3.4% per day; IRR: 0.966; 95% CI: 0.935–0.998) and with school closure (−10.3% per day, IRR: 0.897; 95% CI: 0.846–0.951). Absolute effects associated with tiered NPIs and a lockdown on a subsequent 14-day period yielded 137 cases and 437 cases per 100,000 population potentially averted, respectively. Conclusion Our results indicate that tiered NPIs implemented during the second wave caused a decline in COVID-19 incidence, although modest. Moreover, a third wave lockdown without school closure was effective in reducing COVID-19 incidence, but the addition of school closure provided the strongest effect. These findings emphasise the importance of early and assertive decision-making to control the pandemic.
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Affiliation(s)
- Ana Rita Torres
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Ana Paula Rodrigues
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Mafalda Sousa-Uva
- Comprehensive Health Research Center (CHRC), Lisbon, Portugal.,Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal.,Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Irina Kislaya
- Comprehensive Health Research Center (CHRC), Lisbon, Portugal.,Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal.,Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Susana Silva
- Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Liliana Antunes
- Centre of Statistics and its Applications, Faculty of Sciences, University of Lisbon, Portugal.,Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Carlos Dias
- Comprehensive Health Research Center (CHRC), Lisbon, Portugal.,Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal.,Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Baltazar Nunes
- Comprehensive Health Research Center (CHRC), Lisbon, Portugal.,Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal.,Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
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13
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Hatemi PK, Fazekas Z. The role of grandiose and vulnerable narcissism on mask wearing and vaccination during the COVID-19 pandemic. Curr Psychol 2022; 42:1-11. [PMID: 35437342 PMCID: PMC9008371 DOI: 10.1007/s12144-022-03080-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2022] [Indexed: 11/24/2022]
Abstract
In a large nationally representative study in the United States, we explored the role of grandiose and vulnerable narcissism on adhering to protective measures against COVID-19. Controlling for one's politics, perception of risk, state policies, and important demographics, we find higher grandiose narcissism predicts less vaccination and less mask-wearing, but more telling other people to wear a mask, if one wears a mask. The individual facets of higher entitlement/exploitativeness predicted less mask-wearing and less vaccination while higher authority/leadership-seeking predicted telling others to wear a mask, but not getting vaccinated. Regarding vulnerable narcissism, higher self-centered/egocentrism predicted less mask-wearing or vaccination, while higher oversensitivity-to-judgement predicted more mask-wearing and vaccination. Our results are consistent with expectations that reflect narcissism's multidimensionality, and present a nuanced picture of narcissism's role in adhering to protective policies. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-03080-4.
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Affiliation(s)
- Peter K. Hatemi
- Political Science, Microbiology, The Pennsylvania State University, 307 Pond Lab, University Park, State College, PA 16802 USA
| | - Zoltán Fazekas
- Copenhagen Business School, POR 24.B-2.54, Porcelænshaven 24, 2000 Frederiksberg, , Copenhagen Denmark
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14
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Lüdecke D, von dem Knesebeck O. Decline in Mental Health in the Beginning of the COVID-19 Outbreak Among European Older Adults-Associations With Social Factors, Infection Rates, and Government Response. Front Public Health 2022; 10:844560. [PMID: 35359766 PMCID: PMC8963994 DOI: 10.3389/fpubh.2022.844560] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Governments across the world have deployed a wide range of non-pharmaceutical interventions (NPI) to mitigate the spread of COVID-19. Certain NPIs, like limiting social contacts or lockdowns, had negative consequences for mental health in the population. Especially elder people are prone to mental illnesses during the current pandemic. This article investigates how social factors, infections rates, and stringency of NPIs are associated with a decline in mental health in different European countries. Methods Data stem from the eighth wave of the SHARE survey. Additional data sources were used to build macro indicators for infection rates and NPIs. Two subsamples of persons with mental health problems were selected (people who reported being depressed, n = 9.240 or nervous/anxious, n = 10.551). Decline in mental health was assessed by asking whether depressive symptoms or nervousness/anxiety have become worse since the beginning of the COVID-19 outbreak. For each outcome, logistic regression models with survey-design were used to estimate odds ratios (OR), using social factors (age, gender, education, living alone, and personal contacts) and macro indicators (stringency of NPIs and infection rates) as predictors. Results Higher age was associated with a lower likelihood of becoming more depressed (OR 0.87) or nervous/anxious (OR 0.88), while female gender increased the odds of a decline in mental health (OR 1.53 for being more depressed; OR 1.57 for being more nervous/anxious). Higher education was only associated with becoming more nervous/anxious (OR 1.59), while living alone or rare personal contacts were not statistically significant. People from countries with higher infection rates were more likely to become more depressed (OR 3.31) or nervous/anxious (OR 4.12), while stringency of NPIs showed inconsistent associations. Conclusion A majority of European older adults showed a decline in mental health since the beginning of the COVID-19 outbreak. This is especially true in countries with high prevalence rates of COVID-19. Among older European adults, age seems to be a protective factor for a decline in mental health while female gender apparently is a risk factor. Moreover, although NPIs are an essential preventative mechanism to reduce the pandemic spread, they might influence the vulnerability for elderly people suffering from mental health problems.
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Affiliation(s)
- Daniel Lüdecke
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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15
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Kohanovski I, Obolski U, Ram Y. Inferring the effective start dates of non-pharmaceutical interventions during COVID-19 outbreaks. Int J Infect Dis 2022; 117:361-8. [PMID: 34986406 DOI: 10.1016/j.ijid.2021.12.364] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/19/2021] [Accepted: 12/26/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND During Feb-Apr. 2020, many countries implemented non-pharmaceutical interventions (NPIs), such as school closures and lockdowns, to control the COVID-19 pandemic caused by the SARS-CoV-2 virus. Overall, these interventions seem to have reduced the spread of the pandemic. We hypothesized that the official and effective start dates of NPIs can be noticeably different, for example, due to slow adoption by the population, and that these differences can lead to errors in the estimation of the impact of NPIs. METHODS SEIR models were fitted to case data from 12 regions to infer the effective start dates of interventions and compare these with the official dates. The impact of NPIs was estimated from the inferred model parameters. RESULTS We infer mostly late effective start dates of interventions. For example, Italy implemented a lockdown on Mar 11, but we infer the effective start date on Mar 17 (+3.05-2.01 days 95% CI). Moreover, we find that the impact of NPIs can be underestimated if it is assumed they start on their official date. CONCLUSIONS Differences between the official and effective start of NPIs are likely. Neglecting such differences can lead to underestimation of the impact of NPIs, which could cause decision-makers to escalate interventions and guidelines.
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16
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Bezzini D, Schiavetti I, Manacorda T, Franzone G, Battaglia MA. First Wave of COVID-19 Pandemic in Italy: Data and Evidence. Adv Exp Med Biol 2022; 1353:91-113. [PMID: 35137370 DOI: 10.1007/978-3-030-85113-2_6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Unexpectedly, Italy was the first Western country to face COVID-19 outbreak, but promptly it was the first one to adopt stringent procedures to stem the spread of infection. The objective of this study was to describe the epidemiological situation and comorbidities in Italy, in addition to containment measures and health system and social protection strengthening ones applied in this country. METHODS Available population data were collected, managed, and analysed from the daily reports on COVID-19 published every day, from 1 February to 8 June 2020. RESULTS Lombardia, a northern region of Italy, is considered the epicentre for the wave of the infection with the first diagnosed case, but in a few weeks other regions were involved (with Piemonte, Emilia-Romagna, and Veneto covering more than 70% of the Italian total cases). In the European context, after 3 months of containing measures of the sanitary emergency, Italy is the fourth country for the number of total positive cases (with 235,278 total case as at 8 June 2020), after Russia, the United Kingdom, and Spain, whereas it is the second for the number of deaths (with 33,964 deaths as at 8 June 2020), only after the United Kingdom. Regarding incidence, the curve of daily new cases shows an increasing trend up to 22 March 2020 with 6557 new daily cases and then a decreasing trend up to 280 as at 8 June. This turnaround can be explained by the application of national lockdown starting from 9 March and by the following 14 days of incubation of infection. Profiles of subjects at major risk of poor prognosis and death for COVID-19 are elderly (mean age of 80 years) and with three or more comorbidities. These characteristics can partially explain the high lethality rate for coronavirus observed in Italy, which is the European country with the highest share of elderly. In addition, other possible explanations of this high lethality are differences in testing policies among countries that influence the number of asymptomatic or pauci-symptomatic patients diagnosed as coronavirus positive, together with differences in definition and in the way of recording deaths for coronavirus. In the absence of a vaccine, severe nonpharmaceutical interventions (NPIs), including national lockdown, quarantine, social distancing, and use of facial masks, have been applied with success to reduce the virus spread and the burden on the National Health System. In addition to these stringent containment measures to fight the pandemic, other policies have been adopted searching to ensure economic sustainability, social safety, and stability. CONCLUSION Italy was the first Western country with a wide spread of COVID-19, but it was the first one to introduce containment restrictions, tightening them week by week and subjecting the 60 million people living in the country to unprecedented limitations. Many measurements have been adopted by the government, such as lockdown during the early stages of infection and subsequent social distancing and wearing face masks in public areas. Italians were compliant with all the measures ordered by the government and their discipline reflected in the COVID numbers: the curve of daily new cases after a peak at the end of March now shows a consistent decreasing trend up. In this phase of current reduction of virus diffusion, it is crucial to accommodate the need to continue protecting citizens from the risk of infection with the undeferrable, although gradual, restart of the economic and social system. This new scenario requires an active collaboration among all the actors: statutory bodies, employers, civil society, and the third sector.
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Affiliation(s)
- Daiana Bezzini
- Department of Life Sciences, University of Siena, Siena, Italy.
| | - Irene Schiavetti
- Department of Health Sciences, Biostatistics Unit, University of Genoa, Genoa, Italy
| | - Tommaso Manacorda
- Italian Multiple Sclerosis Foundation, Genoa, Italy.,Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Giorgia Franzone
- Welfare Observatory, Italian Multiple Sclerosis Society, Genoa, Italy
| | - Mario A Battaglia
- Department of Life Sciences, University of Siena, Siena, Italy.,Italian Multiple Sclerosis Foundation, Genoa, Italy
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17
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Wang Y, Zhao B, Zhang W, Li K. Simulation Experiment and Analysis of GNSS/INS/LEO/5G Integrated Navigation Based on Federated Filtering Algorithm. Sensors (Basel) 2022; 22:550. [PMID: 35062513 PMCID: PMC8778158 DOI: 10.3390/s22020550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/29/2021] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
Abstract
This article examines the positioning effect of integrated navigation after adding an LEO constellation signal source and a 5G ranging signal source in the context of China's new infrastructure construction. The tightly coupled Kalman federal filters are used as the algorithm framework. Each signal source required for integrated navigation is simulated in this article. At the same time, by limiting the range of the azimuth angle and visible height angle, different experimental scenes are simulated to verify the contribution of the new signal source to the traditional satellite navigation, and the positioning results are analyzed. Finally, the article compares the distribution of different federal filtering information factors and reveals the method of assigning information factors when combining navigation with sensors with different precision. The experimental results show that the addition of LEO constellation and 5G ranging signals improves the positioning accuracy of the original INS/GNSS by an order of magnitude and ensures a high degree of positioning continuity. Moreover, the experiment shows that the federated filtering algorithm can adapt to the combined navigation mode in different scenarios by combining different precision sensors for navigation positioning.
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Affiliation(s)
- Yuqiang Wang
- Technology and Engineering Center for Space Utilization, Chinese Academy of Sciences, Beijing 100094, China; (Y.W.); (K.L.)
- Key Laboratory of Space Utilization, Chinese Academy of Sciences, Beijing 100094, China
- College of Computer Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Bohao Zhao
- Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100094, China;
| | - Wei Zhang
- Technology and Engineering Center for Space Utilization, Chinese Academy of Sciences, Beijing 100094, China; (Y.W.); (K.L.)
- Key Laboratory of Space Utilization, Chinese Academy of Sciences, Beijing 100094, China
| | - Keman Li
- Technology and Engineering Center for Space Utilization, Chinese Academy of Sciences, Beijing 100094, China; (Y.W.); (K.L.)
- Key Laboratory of Space Utilization, Chinese Academy of Sciences, Beijing 100094, China
- College of Computer Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
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18
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Bushman M, Kahn R, Taylor BP, Lipsitch M, Hanage WP. Population impact of SARS-CoV-2 variants with enhanced transmissibility and/or partial immune escape. Cell 2021; 184:6229-6242.e18. [PMID: 34910927 PMCID: PMC8603072 DOI: 10.1016/j.cell.2021.11.026] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 12/20/2022]
Abstract
SARS-CoV-2 variants of concern exhibit varying degrees of transmissibility and, in some cases, escape from acquired immunity. Much effort has been devoted to measuring these phenotypes, but understanding their impact on the course of the pandemic-especially that of immune escape-has remained a challenge. Here, we use a mathematical model to simulate the dynamics of wild-type and variant strains of SARS-CoV-2 in the context of vaccine rollout and nonpharmaceutical interventions. We show that variants with enhanced transmissibility frequently increase epidemic severity, whereas those with partial immune escape either fail to spread widely or primarily cause reinfections and breakthrough infections. However, when these phenotypes are combined, a variant can continue spreading even as immunity builds up in the population, limiting the impact of vaccination and exacerbating the epidemic. These findings help explain the trajectories of past and present SARS-CoV-2 variants and may inform variant assessment and response in the future.
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Affiliation(s)
- Mary Bushman
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Rebecca Kahn
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bradford P Taylor
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marc Lipsitch
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - William P Hanage
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Khatatbeh M, Al-Maqableh HO, Albalas S, Al Ajlouni S, A'aqoulah A, Khatatbeh H, Kasasbeh MA, Khatatbeh I, Albalas R, Al-Tammemi AB. Attitudes and Commitment Toward Precautionary Measures Against COVID-19 Amongst the Jordanian Population: A Large-Scale Cross-Sectional Survey. Front Public Health 2021; 9:745149. [PMID: 34820350 PMCID: PMC8606566 DOI: 10.3389/fpubh.2021.745149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/30/2021] [Indexed: 12/21/2022] Open
Abstract
Aims: This study aimed to (1) assess the non-pharmaceutical intervention (NPI) measures that were used by the Jordanian population against COVID-19, and (2) determine the sociodemographic and behavioral predictors of contracting COVID-19 with a focus on the utilization of personal precautionary measures. Methods: A descriptive questionnaire-based cross-sectional survey was used in this study. A structured web-based questionnaire was disseminated to the Jordanian community through social media platforms. Participants were asked a series of questions about socio-demographic characteristics, in addition to the knowledge, attitudes, and commitment toward using various personal precautionary measures (e.g., face mask, hand washing, social distancing) against the COVID-19. Data were analyzed using descriptive statistics, cross-tabulation, and binary logistic regression through SPSS®. Results: Responses from 7,746 participants were included in our final analyses. Descriptive statistics showed that most participants (82.6%) believed that face mask protects against COVID-19. Around 69.5% of the participants were completely committed to wearing a face mask, while 65% of the participants were completely committed to hand washing. The results of the regression analysis revealed that female gender (AOR = 1.2; 95% CI: 1.07-1.35; p = 0.002), having a family member infected with COVID-19 (AOR = 8.5; 95% Cl: 7.51-9.70; p = 0.001), having a health-related work or study (AOR = 1.2; 95% Cl: 1.09-1.38; p = 0.001), believing that face masks do not protect against COVID-19 (AOR = 1.3; 95% Cl: 1.12-1.47; p = 0.001), and partial commitment to handwashing (AOR = 1.2; 95% Cl: 1.11-1.75; p = 0.006) were all associated with an increased odds of contracting COVID-19 among the participants. Conclusion: Overall, commitment to non-pharmaceutical intervention (NPI) measures, such as wearing a face mask, hand washing, and physical distancing, was not optimal among Jordanians. This might explain the dramatic increase in the infectivity rate of the COVID-19 virus in the past few months in the country. More sustainable efforts regarding health promotion and strict policies are required to prevent a third wave of hitting the country and to prevent similar infectious threats in the future.
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Affiliation(s)
- Moawiah Khatatbeh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Hindya O. Al-Maqableh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Samir Albalas
- Department of Health Service Administration, Yarmouk University, Irbid, Jordan
| | - Sara Al Ajlouni
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Ashraf A'aqoulah
- Department of Health Systems Management, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Haitham Khatatbeh
- Doctoral School of Health Sciences, University of Pecs, Pecs, Hungary
| | - Mohammed A. Kasasbeh
- School of Nursing, Faculty of Health Sciences, Higher Colleges of Technology, Fujaira, United Arab Emirates
| | - Ibdaa Khatatbeh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Rahaf Albalas
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Ala'a B. Al-Tammemi
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
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20
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Abubakar M, Guo C, Koka H, Zhu B, Deng J, Hu N, Zhou B, Garcia-Closas M, Lu N, Yang XR. Impact of breast cancer risk factors on clinically relevant prognostic biomarkers for primary breast cancer. Breast Cancer Res Treat 2021; 189:483-95. [PMID: 34185195 DOI: 10.1007/s10549-021-06294-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/12/2021] [Indexed: 12/13/2022]
Abstract
Purpose In addition to impacting incidence, risk factors for breast cancer may also influence recurrence and survival from the disease. However, it is unclear how these factors affect combinatorial biomarkers for aiding treatment decision-making in breast cancer. Methods Patients were 8179 women with histologically confirmed invasive breast cancer, diagnosed and treated in a large cancer hospital in Beijing, China. Individual clinicopathological (tumor size, grade, lymph nodes) and immunohistochemical (IHC: ER, PR, HER2, KI67) markers were used to define clinically relevant combinatorial prognostic biomarkers, including the Nottingham Prognostic Index (NPI: combining size, grade, nodes) and IHC4 score (combining ER, PR, HER2, KI67). Odds ratios (ORs) and 95% confidence intervals (CIs) for associations between breast cancer risk factors and quartiles (Q1–Q4) of NPI and IHC4 were assessed in multivariable polytomous logistic regression models. Results Overall, increasing parity (ORtrend(95% CI) = 1.20(1.05–1.37);Ptrend = 0.007), overweight (OR(95% CI)vs normal = 1.60(1.29–1.98)), and obesity (OR(95% CI) vs normal = 2.12(1.43–3.14)) were associated with higher likelihood of developing tumors with high (Q4) versus low (Q1) NPI score. Conversely, increasing age (ORtrend(95% CI) = 0.75(0.66–0.84);Ptrend < 0.001) and positive family history of breast cancer (FHBC) (OR(95% CI) = 0.66(0.45–0.95)) were inversely associated with NPI. Only body mass index (BMI) was associated with IHC4, with overweight (OR(95% CI) vs normal = 0.82(0.66–1.02)) and obese (OR(95% CI) vs normal = 0.52(0.36–0.76)) women less likely to develop high IHC4 tumors. Notably, elevated BMI was associated with higher NPI irrespective of hormone receptor-expression status. Conclusions Our findings indicate that factors affecting breast cancer incidence, particularly age, parity, FHBC, and BMI, may impact clinically relevant prognostic biomarkers with implications for surveillance, prognostication, and counseling. Supplementary Information The online version contains supplementary material available at 10.1007/s10549-021-06294-5.
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21
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Soveri A, Karlsson LC, Antfolk J, Lindfelt M, Lewandowsky S. Unwillingness to engage in behaviors that protect against COVID-19: the role of conspiracy beliefs, trust, and endorsement of complementary and alternative medicine. BMC Public Health 2021; 21:684. [PMID: 33832446 PMCID: PMC8027965 DOI: 10.1186/s12889-021-10643-w] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND We investigated if people's response to the official recommendations during the COVID-19 pandemic is associated with conspiracy beliefs related to COVID-19, a distrust in the sources providing information on COVID-19, and an endorsement of complementary and alternative medicine (CAM). METHODS The sample consisted of 1325 Finnish adults who filled out an online survey marketed on Facebook. Structural regression analysis was used to investigate whether: 1) conspiracy beliefs, a distrust in information sources, and endorsement of CAM predict people's response to the non-pharmaceutical interventions (NPIs) implemented by the government during the COVID-19 pandemic, and 2) conspiracy beliefs, a distrust in information sources, and endorsement of CAM are related to people's willingness to take a COVID-19 vaccine. RESULTS Individuals with more conspiracy beliefs and a lower trust in information sources were less likely to have a positive response to the NPIs. Individuals with less trust in information sources and more endorsement of CAM were more unwilling to take a COVID-19 vaccine. Distrust in information sources was the strongest and most consistent predictor in all models. Our analyses also revealed that some of the people who respond negatively to the NPIs also have a lower likelihood to take the vaccine. This association was partly related to a lower trust in information sources. CONCLUSIONS Distrusting the establishment to provide accurate information, believing in conspiracy theories, and endorsing treatments and substances that are not part of conventional medicine, are all associated with a more negative response to the official guidelines during COVID-19. How people respond to the guidelines, however, is more strongly and consistently related to the degree of trust they feel in the information sources, than to their tendency to hold conspiracy beliefs or endorse CAM. These findings highlight the need for governments and health authorities to create communication strategies that build public trust.
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Affiliation(s)
- Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland.
| | - Linda C Karlsson
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Jan Antfolk
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Mikael Lindfelt
- Department of Theological Ethics, Åbo Akademi University, Turku, Finland
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychological Science, University of Western Australia, Perth, Australia
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22
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Lagacé-Wiens P, Sevenhuysen C, Lee L, Nwosu A, Smith T. Impact of nonpharmaceutical interventions on laboratory detections of influenza A and B in Canada. ACTA ACUST UNITED AC 2021; 47:142-8. [PMID: 34012338 DOI: 10.14745/ccdr.v47i03a04] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background The first coronavirus disease 2019 (COVID-19) case was reported in Canada on January 25, 2020. In response to the imminent outbreak, many provincial and territorial health authorities implemented nonpharmaceutical public health measures to curb the spread of disease. "Social distancing" measures included restrictions on group gatherings; cancellation of sports, cultural and religious events and gatherings; recommended physical distancing between people; school and daycare closures; reductions in non-essential services; and closures of businesses. Objectives To evaluate the impact of the combined nonpharmaceutical interventions imposed in March 2020 on influenza A and B epidemiology by comparing national laboratory surveillance data from the intervention period with 9-year historical influenza season control data. Methods We obtained epidemiologic data on laboratory influenza A and B detections and test volumes from the Canadian national influenza surveillance system for the epidemiologic period December 29, 2019 (epidemiologic week 1) through May 2, 2020 (epidemiologic week 18). COVID-19-related social distancing measures were implemented in Canada from epidemiologic week 10 of this period. We compared influenza A and B laboratory detections and test volumes and trends in detection during the 2019-20 influenza season with those of the previous nine influenza seasons for evidence of changes in epidemiologic trends. Results While influenza detections the week prior to the implementation of social distancing measures did not differ statistically from the previous nine seasons, a steep decline in positivity occurred between epidemiologic weeks 10 and 14 (March 8-April 4, 2020). Both the percent positive on week 14 (p≤0.001) and rate of decline between weeks 10 and 14 (p=0.003) were significantly different from mean historical data. Conclusion The data show a dramatic decrease in influenza A and B laboratory detections concurrent with social distancing measures and nonpharmaceutical interventions in Canada. The impact of these measures on influenza transmission may be generalizable to other respiratory viral illnesses during the study period, including COVID-19.
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23
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Wood SN. Inferring UK COVID-19 fatal infection trajectories from daily mortality data: Were infections already in decline before the UK lockdowns? Biometrics 2021; 78:1127-1140. [PMID: 33783826 PMCID: PMC8251436 DOI: 10.1111/biom.13462] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/03/2021] [Accepted: 03/17/2021] [Indexed: 12/18/2022]
Abstract
The number of new infections per day is a key quantity for effective epidemic management. It can be estimated relatively directly by testing of random population samples. Without such direct epidemiological measurement, other approaches are required to infer whether the number of new cases is likely to be increasing or decreasing: for example, estimating the pathogen-effective reproduction number, R, using data gathered from the clinical response to the disease. For coronavirus disease 2019 (Covid-19/SARS-Cov-2), such R estimation is heavily dependent on modelling assumptions, because the available clinical case data are opportunistic observational data subject to severe temporal confounding. Given this difficulty, it is useful to retrospectively reconstruct the time course of infections from the least compromised available data, using minimal prior assumptions. A Bayesian inverse problem approach applied to UK data on first-wave Covid-19 deaths and the disease duration distribution suggests that fatal infections were in decline before full UK lockdown (24 March 2020), and that fatal infections in Sweden started to decline only a day or two later. An analysis of UK data using the model of Flaxman et al. gives the same result under relaxation of its prior assumptions on R, suggesting an enhanced role for non-pharmaceutical interventions short of full lockdown in the UK context. Similar patterns appear to have occurred in the subsequent two lockdowns.
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Affiliation(s)
- Simon N Wood
- School of Mathematics, University of Edinburgh, UK
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24
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Dubuque EM, Yingling ME, Allday RA. The Misclassification of Behavior Analysts: How National Provider Identifiers ( NPIs) Fail to Adequately Capture the Scope of the Field. Behav Anal Pract 2021; 14:214-229. [PMID: 33732592 PMCID: PMC7900299 DOI: 10.1007/s40617-020-00451-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
To remain in compliance with the Health Insurance Portability and Accountability Act of 1996, U.S. health care providers are required to register for a National Provider Identifier (NPI). When applying for an NPI, providers must select the Healthcare Provider Taxonomy Code(s) that most closely describes the services they offer. Three distinct taxonomies describe the services offered by behavior analysts. Two of these codes, the Behavior Analyst (103K00000X) and the Assistant Behavior Analyst (106E00000X) taxonomies, specify that the health care provider must hold either a certification from the Behavior Analyst Certification Board or a state-issued credential to practice behavior analysis. The purpose of this study was to investigate the concordance between health care providers who utilize these behavior-analytic NPI taxonomy classifications and health care providers who meet the credential qualifications specified in the code descriptions. Results indicated that there are potentially more than 20,000 U.S. health care providers who do not hold the behavior analyst credentials specified in the taxonomy descriptions linked to their accounts. The implications of providers being mistakenly classified as credentialed behavior analysts and credentialed assistant behavior analysts in federal data and how the field should respond are discussed.
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Affiliation(s)
- Erick M. Dubuque
- Department of Special Education, Early Childhood, and Prevention Science, University of Louisville, Woodford R. & Harriett B. Porter Building, 1905 South 1st Street, Louisville, KY 40208 USA
| | - Marissa E. Yingling
- Kent School of Social Work, University of Louisville, Louisville, KY 40208 USA
| | - R. Allan Allday
- Department of Early Childhood, Special Education and Rehabilitation Counseling, University of Kentucky, Lexington, KY USA
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25
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Zammit NW, Seeberger KL, Zamerli J, Walters SN, Lisowski L, Korbutt GS, Grey ST. Selection of a novel AAV2/TNFAIP3 vector for local suppression of islet xenograft inflammation. Xenotransplantation 2020; 28:e12669. [PMID: 33316848 DOI: 10.1111/xen.12669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/24/2020] [Accepted: 11/26/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Neonatal porcine islets (NPIs) can restore glucose control in mice, pigs, and non-human primates, representing a potential abundant alternative islet supply for clinical beta cell replacement therapy. However, NPIs are vulnerable to inflammatory insults that could be overcome with genetic modifications. Here, we demonstrate in a series of proof-of-concept experiments the potential of the cytoplasmic ubiquitin-editing protein A20, encoded by the TNFAIP3 gene, as an NPI cytoprotective gene. METHODS We forced A20 expression in NPI grafts using a recombinant adenovirus 5 (Ad5) vector and looked for impact on TNF-stimulated NF-κB activation and NPI graft function. As adeno-associated vectors (AAV) are clinically preferred vectors but exhibit poor transduction efficacy in NPIs, we next screened a series of AAV serotypes under different transduction protocols for their ability achieve high transduction efficiency and suppress NPI inflammation without impacting NPI maturation. RESULTS Forcing the expression of A20 in NPI with Ad5 vector blocked NF-κB activation by inhibiting IκBα phosphorylation and degradation, and reduced the induction of pro-inflammatory genes Cxcl10 and Icam1. A20-expressing NPIs also exhibited superior functional capacity when transplanted into diabetic immunodeficient recipient mice, evidenced by a more rapid return to euglycemia and improved GTT compared to unmodified NPI grafts. We found AAV2 combined with a 14-day culture period maximized NPI transduction efficiency (>70% transduction rate), and suppressed NF-κB-dependent gene expression without adverse impact upon NPI maturation. CONCLUSION We report a new protocol that allows for high-efficiency genetic modification of NPIs, which can be utilized to introduce candidate genes without the need for germline engineering. This approach would be suitable for preclinical and clinical testing of beneficial molecules. We also report for the first time that A20 is cytoprotective for NPI, such that A20 gene therapy could aid the clinical development of NPIs for beta cell replacement.
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Affiliation(s)
- Nathan W Zammit
- Immunology Department, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,St Vincent's Clinical School, Faculty of Medicine, University of New South Wales Sydney, Sydney, NSW, Australia
| | | | - Jad Zamerli
- Immunology Department, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Stacey N Walters
- Immunology Department, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Leszek Lisowski
- Translational Vectorology Unit, Children's Medical Research Institute, The University of Sydney, Westmead, NSW, Australia.,Military Institute of Medicine, Laboratory of Molecular Oncology and Innovative Therapies, Warsaw, Poland
| | | | - Shane T Grey
- Immunology Department, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,St Vincent's Clinical School, Faculty of Medicine, University of New South Wales Sydney, Sydney, NSW, Australia
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26
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Xu H, Gan Y, Zheng D, Wu B, Zhu X, Xu C, Liu C, Tao Z, Hu Y, Chen M, Li M, Lu Z, Chen J. Relationship Between COVID-19 Infection and Risk Perception, Knowledge, Attitude, and Four Nonpharmaceutical Interventions During the Late Period of the COVID-19 Epidemic in China: Online Cross-Sectional Survey of 8158 Adults. J Med Internet Res 2020; 22:e21372. [PMID: 33108317 PMCID: PMC7669364 DOI: 10.2196/21372] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/26/2020] [Accepted: 10/24/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND So far, there have been no published population studies on the relationship between a COVID-19 infection and public risk perception, information source, knowledge, attitude, and behaviors during the COVID-19 outbreak in China. OBJECTIVE This study aims to understand the relationships between COVID-19 infection; four personal nonpharmaceutical interventions (NPIs; handwashing, proper coughing habits, social distancing, and mask wearing); and public risk perception, knowledge, attitude, and other social demographic variables. METHODS An online survey of 8158 Chinese adults between February 22 and March 5, 2020, was conducted. Bivariate associations between categorical variables were examined using Fisher exact test. We also explored the determinants of four NPIs as well as their association with COVID-19 infection using logistic regression. RESULTS Of 8158 adults included, 57 (0.73%) were infected with COVID-19. The overwhelming majority of respondents showed a positive attitude (n=8094, 99.2%), positive risk perception (n=8146, 99.9%), and high knowledge levels that were among the strongest predictors of the four adopted NPIs (handwashing: n=7895, 96.8%; proper coughing: 5997/6444, 93.1%; social distancing: n=7104/8158, 87.1%; and mask wearing: 5011/5120, 97.9%). There was an increased risk of COVID-19 infection for those who did not wash their hands (2.28% vs 0.65%; risk ratio [RR] 3.53, 95% CI 1.53-8.15; P=.009), did not practice proper coughing (1.79% vs 0.73%; RR 2.44, 95% CI 1.15-5.15; P=.03), did not practice social distancing (1.52% vs 0.58%; RR 2.63, 95% CI 1.48-4.67; P=.002), and did not wear a mask (7.41% vs 0.6%; RR 12.38, 95% CI 5.81-26.36; P<.001). For those who did practice all other three NPIs, wearing a mask was associated with a significantly reduced risk of infection compared to those who did not wear a mask (0.6% vs 16.7%; P=.04). Similarly, for those who did not practice all or part of the other three NPIs, wearing a mask was also associated with a significantly reduced risk of infection. In a penalized logistic regression model including all four NPIs, wearing a mask was the only significant predictor of COVID-19 infection among the four NPIs (odds ratio 7.20, 95% CI 2.24-23.11; P<.001). CONCLUSIONS We found high levels of risk perception, positive attitude, desirable knowledge, as well as a high level of adopting the four NPIs. The relevant knowledge, risk perception, and attitude were strong predictors of adapting the four NPIs. Mask wearing, among the four personal NPIs, was the most effective protective measure against COVID-19 infection, with added preventive effect among those who practiced all or part of the other three NPIs.
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Affiliation(s)
- Hong Xu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhai, China.,School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yong Gan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhai, China
| | - Daikun Zheng
- Chongqing Three Gorges Medical College, Chongqing, China
| | - Bo Wu
- Wanzhou District Center for Disease Control and Prevention, Chongqing, China
| | - Xian Zhu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Chang Xu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Chenglu Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Zhou Tao
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yaoyue Hu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Min Chen
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Mingjing Li
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Zuxun Lu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhai, China
| | - Jack Chen
- School of Public Health and Management, Chongqing Medical University, Chongqing, China.,Ingham Institute & University of New South Wales, Sydney, Australia
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27
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Bahrami M, Zarei AR, Rostami F. Temporal and spatial assessment of groundwater contamination with nitrate by nitrate pollution index ( NPI) and GIS (case study: Fasarud Plain, southern Iran). Environ Geochem Health 2020; 42:3119-3130. [PMID: 32146561 DOI: 10.1007/s10653-020-00546-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/28/2020] [Indexed: 05/20/2023]
Abstract
Groundwater resources in arid and semi-arid regions are the most and sometimes the only water resource used for agricultural, industrial, and urban water supply. Irregular and immense application of nitrogen fertilizers in the lands under cultivation and nitrate leakage from livestock farming have affected the groundwater quality. In such areas, nitrate is one of the main pollutants in the groundwater. In this study, the temporal and spatial trend of nitrate contamination in 31 wells in Fasarud Plain, southern Iran, from April 2017 to March 2018 were assessed. To survey the geochemical quality of the plain, a geographic information system to expand geographic location maps and spatial distribution maps of nitrate concentration and nitrate pollution index (NPI) was applied. Nitrate concentrations ranged between 2.43 and 96 mg L-1. Results indicated that nitrate temporal trend was increased significantly in most of the wells, and the spatial trend of area percentage of nitrate class 3 (not permissible limit of more than 50 mg L-1) was positive. The greatest quantities of this variable in groundwater samples detected in northern, western, and eastern areas of the plain have a direct relation with the fertilization of agricultural lands. Generally, by ending the irrigation season, nitrate concentration and NPI reduced temporally in the samples and the percentage area of nitrate class 3 decreased gradually, again beginning the agricultural season, the NPI, nitrate concentration, and percentage area of nitrate class 3 began to increase. Overall, the change of nitrate concentration and distribution of agricultural regions have illustrated that nitrate originated from nitrogenous inorganic fertilizers applied within irrigation periods.
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Affiliation(s)
- Mehdi Bahrami
- Department of Water Engineering, Faculty of Agriculture, Fasa University, Fasa, Iran.
| | - Abdol Rassoul Zarei
- Department of Range and Watershed Management (Nature Engineering), Faculty of Agriculture, Fasa University, Fasa, Iran
| | - Farideh Rostami
- Department of Water Engineering, Faculty of Agriculture, Fasa University, Fasa, Iran
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28
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Abstract
Much attention has focused on the social, institutional, and mobilization factors that influence political participation, with a renewed interest in psychological motivations. One trait that has a deep theoretical connection to participation, but remains underexplored, is narcissism. Relying on three studies in the United States and Denmark, two nationally representative, we find that those scoring higher in narcissism, as measured by the Narcissistic Personality Inventory-40 (NPI-40), participate more in politics, including contacting politicians, signing petitions, joining demonstrations, donating money, and voting in midterm elections. Both agentic and antagonistic components of narcissism were positively and negatively related to different types of political participation when exploring the subfactors independently. Superiority and Authority/Leadership were positively related to participation, while Self Sufficiency was negatively related to participation. In addition, the combined Entitlement/Exploitativeness factor was negatively related to turnout, but only in midterm elections. Overall, the findings support a view of participation that arises in part from instrumental motivations.
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29
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Romano MR, Montericcio A, Montalbano C, Raimondi R, Allegrini D, Ricciardelli G, Angi M, Pagano L, Romano V. Facing COVID-19 in Ophthalmology Department. Curr Eye Res 2020; 45:653-658. [PMID: 32253942 DOI: 10.1080/02713683.2020.1752737] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose: To provide useful guidelines, targeted at ophthalmology professionals, to minimize COVID-19 infection of both health-care workers and patients.Methods: In this review we present updated literature merged with our experience from hospitals in Bergamo, the epicenter of the COVID-19 European outbreak.Results: Non-pharmaceutical interventions, hygienic recommendations and personal protective equipment to contain viral spread as well as a suggested risk assessment for postponement of non-urgent cases should be applied in ophthalmologist activity. A triage for ophthalmic outpatient clinic is mandatory.Conclusion: Ophthalmology practice should be reorganized in order to face COVID-19.
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Affiliation(s)
- Mario R Romano
- Department of Ophthalmology, Humanitas Gavazzeni - Castelli, Bergamo, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Clara Montalbano
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Raffaele Raimondi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Davide Allegrini
- Department of Ophthalmology, Humanitas Gavazzeni - Castelli, Bergamo, Italy
| | | | - Martina Angi
- Ocular Oncology Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luca Pagano
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Department of Ophthalmology, Royal Liverpool University Hospital, Liverpool, UK
| | - Vito Romano
- Department of Ophthalmology, Royal Liverpool University Hospital, Liverpool, UK
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Roitto HM, Kautiainen H, Laurila J, Pitkälä KH. Severity of both neuropsychiatric symptoms and dementia is associated with quality of life in nursing home residents. Eur Geriatr Med 2019; 10:793-800. [PMID: 34652697 DOI: 10.1007/s41999-019-00213-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The primary focus in long-term care is to maintain quality of life. The aim of this study was to investigate the association of severity of neuropsychiatric symptoms (NPS) and health-related quality of life (HRQoL) and their interaction with dementia severity among institutionalized older people with dementia. METHODS 352 long-term care residents aged 65 years or over with dementia participated in this cross-sectional study. NPS were measured with Neuropsychiatric Inventory (NPI). HRQoL was measured with 15D. Dementia severity was measured with Clinical Dementia Rating (CDR). RESULTS The severity of NPS was significantly associated with better HRQoL in 15D. Residents with severe dementia (CDR 3) had worse HRQoL than residents with mild-moderate dementia (CDR < 3). There was a significant interaction between NPI and CDR (p = 0.037 for NPI, p < 0.001 for CDR, p < 0.001 for interaction). HRQoL correlated positively with all NPS subgroups in residents with severe dementia, but in residents with mild-moderate dementia, no significant correlation existed. In severe dementia, higher NPI correlated positively with such dimensions of 15D as mobility, vision, eating, speech, excretion, usual activities, mental functions, and vitality, whereas in residents with mild-moderate dementia only with mobility. In mild-moderate dementia, NPI correlated negatively with depression, distress and vitality. CONCLUSION Dementia severity and NPS burden are important determining factors of HRQoL in long-term care. NPS have a distinct impact on HRQoL at different stages of dementia. In severe dementia, higher NPS and better HRQoL indicate better functioning and higher vitality.
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Vergallo A, Giampietri L, Pagni C, Giorgi FS, Nicoletti V, Miccoli M, Libertini P, Petrozzi L, Bonuccelli U, Tognoni G. Association Between CSF Beta-Amyloid and Apathy in Early-Stage Alzheimer Disease. J Geriatr Psychiatry Neurol 2019; 32:164-169. [PMID: 30913958 DOI: 10.1177/0891988719838627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIM The apathetic syndrome is a common clinical feature in patients with Alzheimer diseases (AD), from preclinical phases to late stages of dementia, and it is strongly related to major disease outcomes. Unfortunately, no specific pharmacological treatments for apathy have been accomplished so far. Translational evidences have previously shown that a link between apathy and hallmarks of AD-related pathophysiology, that is, β-amyloid (Aβ) plaques and neurofibrillary tangles, exists. However, only few studies investigated the association between core biomarkers of AD and apathy scores, finding conflicting results. METHODS Thirty-seven patients were identified as having AD dementia according to National Institute on Aging-Alzheimer Association 2011 criteria. All participants underwent an extensive diagnostic workup including cerebrospinal fluid (CSF) assessment to measure the concentrations of Aβ42, t-tau, and pTau181. To follow, they were stratified as: apathy absence, apathy mild, and apathy severe according to the Neuro Psychiatric Inventory-apathy item scores. We investigated for potential associations between apathy scores and CSF biomarkers concentrations as well as for differences in terms of clinical and CSF biomarkers data across the 3 apathy groups. RESULTS The CSF Aβ42 concentrations were negatively correlated with apathy scores. In addition, patients with severe apathy had significantly lower Aβ42 levels compared to nonapathetic ones. CONCLUSION Based on our results, we encourage further studies to untangle the potential association between the complex pathophysiological dynamics of AD and apathy which may represent an innovative reliable clinical outcome measure to use in clinical trials, investigating treatments with either a symptomatic or a disease-modifying effect.
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Affiliation(s)
- A Vergallo
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - L Giampietri
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - C Pagni
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - F S Giorgi
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - V Nicoletti
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Miccoli
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - P Libertini
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - L Petrozzi
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - U Bonuccelli
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Tognoni
- 1 Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
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Roitto HM, Kautiainen H, Öhman H, Savikko N, Strandberg TE, Raivio M, Laakkonen ML, Pitkälä KH. Relationship of Neuropsychiatric Symptoms with Falls in Alzheimer's Disease - Does Exercise Modify the Risk? J Am Geriatr Soc 2018; 66:2377-2381. [PMID: 30320427 DOI: 10.1111/jgs.15614] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/13/2018] [Accepted: 08/18/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To explore how neuropsychiatric symptoms (NPS) are associated with number of falls and how exercise modifies the risk of falling in community-dwelling people with Alzheimer's disease (AD) and NPS. DESIGN Secondary analysis of a randomized controlled trial. SETTING Community. PARTICIPANTS Community-dwelling individuals with AD (N=210) who completed the Neuropsychiatric Inventory (NPI) (N = 179). INTERVENTION Participants were randomized into 3 groups: group-based exercise (4-hour sessions with approximately 1 hour of training) and tailored home-based exercise (1 hour of training) twice a week for 1 year and a control group receiving usual community care. In this secondary analysis, we merged the home-based and group-based exercise groups and compared this group with the control group. MEASUREMENTS NPS were measured using the NPI at baseline, and spousal caregivers recorded falls in daily fall diaries during 1 year of follow-up. RESULTS The number of falls increased linearly with NPI score in the control group. Fall rates were 1.48 (95% confidence interval (CI)=1.26-1.73) per person-year in the intervention group and 2.87 (95% CI=2.43-3.35) in the control group. Adjusted for age, sex, Mini-Mental State Examination (MMSE) score, and Short Physical Performance Battery (SPPB) score, incidence rate ratio (IRR) was 0.48 (95% Cl=0.39-0.60, p < .001). Main effects for fall rate were significant for group (p < .001) and NPI total (p < .02); the interaction effect was also significant (p = .009) (adjusted for sex, age, MMSE score, SPPB score, and psychotropic medication use). CONCLUSION Exercise may decrease the risk of falling in community-dwelling individuals with AD and NPS. Future exercise trials should confirm this finding in participants with significant NPS. TRIAL REGISTRATION ACTRN12608000037303. J Am Geriatr Soc 66:2377-2381, 2018.
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Affiliation(s)
- Hanna-Maria Roitto
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Hannareeta Öhman
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland
| | - Niina Savikko
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Home Care, City of Espoo, Espoo, Finland
| | - Timo E Strandberg
- Department of Medicine, University of Helsinki, Helsinki, Finland.,Geriatric Clinic, Helsinki University Hospital, Helsinki, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Minna Raivio
- Department of General Practice, University of Helsinki, Helsinki, Finland
| | - Marja-Liisa Laakkonen
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Department of Social Services and Health Care, Helsinki Hospital, Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
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Bawazeer S, Sabry D, Mahmoud RH, Elhanbuli HM, Yassen NN, Abdelhafez MN. Association of SPARC gene polymorphisms rs3210714 and rs7719521 with VEGF expression and utility of Nottingham Prognostic Index scoring in breast cancer in a sample of Egyptian women. Mol Biol Rep 2018; 45:2313-2324. [PMID: 30259245 DOI: 10.1007/s11033-018-4394-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 09/17/2018] [Indexed: 02/06/2023]
Abstract
Breast cancer is the most common malignancy in women. To our knowledge, there is no single study conducted on the role of secreted protein acidic and rich in cysteine (SPARC) gene polymorphism in breast cancer risk or prognosis. The present study aims to investigate the probable role of SPARC genetic polymorphisms in development of breast cancer; their correlation with immunohistochemical expression of VEGF; and their association with breast cancer prognosis in the Egyptian population. The study sample included 238 Egyptian females who were divided into two groups: breast cancer group (118 patients) and healthy control group (120 subjects). SPARC gene single nucleotide polymorphisms rs3210714 and rs7719521 were genotyped. Allelic and genotypic frequencies were determined in both groups and association with ductal breast carcinoma, clinicopathological and prognostic characters were determined. For SPARC rs3210714, a significant difference was observed in the codominant model and both A and G alleles' frequencies between breast cancer patients and control group (P < 0.001). For rs7719521, a significant difference in codominant and dominant models as well as in both A and C alleles' frequencies between breast cancer and control groups (P < 0.001) was observed. A significant relation was found between SPARC rs3210714 and rs7719521, and immunohistochemical expression of VEGF (P = 0.046 and P = 0.027, respectively). SPARC rs7719521 showed a significant association with Nottingham Prognostic Index (NPI) (P = 0.032). The present study revealed that SPARC rs3210714 and rs7719521 polymorphisms are associated with breast cancer risk and its prognosis. Therefore, these SNPs may be useful in predicting the increased risk of breast cancer.
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Affiliation(s)
- Sultan Bawazeer
- Umm Al-Qura University, Mecca, Saudi Arabia.,Asklepios Hospital, Hamburg University, Hamburg, Germany
| | - Dina Sabry
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rania H Mahmoud
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
| | - Hala M Elhanbuli
- Department of Pathology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | | | - Marwa N Abdelhafez
- Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
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Abstract
The incidence of infant opioid withdrawal has grown rapidly in many countries, including Canada, in the last decade, presenting significant health and early brain development concerns. Increased prenatal exposure to opioids reflects rising prescription opioid use as well as the presence of both illegal opiates and opioid-substitution therapies. Infants are at high risk for experiencing symptoms of abstinence or withdrawal that may require assessment and treatment. This practice point focuses specifically on the effect(s) of opioid withdrawal and current management strategies in the care of infants born to mothers with opioid dependency.
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Affiliation(s)
| | - Pat O'Flaherty
- Canadian Paediatric Society, Fetus and Newborn Committee, Ottawa, Ontario
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Abstract
Parkinson disease (PD) is not an unambiguous entity, and there is a general consensus for the statement that an akinetic-rigid dominant type of presentation has a worse prognosis, in the follow-up. The aim of our study was to examine the differences in frontal tasks and behavior, in 2 PD naive groups: the rigid and the tremor-dominant types of presentation, according to motor scores. Our study has showed some important differences in frontal tasks and in behavior, performing more apathy, aggressiveness, and irritability in the rigid type, and more depression and anxiety in the tremor-dominant type. The former group causes the caregiver more distress and has a very rapid disease progression. It can be argued that rigid type PD presentation needs specific dedicated cares and more strong clinical attention.
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Affiliation(s)
- Rita Moretti
- Clinica Neurologica, Dipartimento Universitario Clinico di Scienze Mediche, Chirurgiche e della Salute, Ospedale di Cattinara, Università degli Studi di Trieste, Trieste, Italy
| | - Vera Milner
- Clinica Neurologica, Dipartimento Universitario Clinico di Scienze Mediche, Chirurgiche e della Salute, Ospedale di Cattinara, Università degli Studi di Trieste, Trieste, Italy
| | - Paola Caruso
- Clinica Neurologica, Dipartimento Universitario Clinico di Scienze Mediche, Chirurgiche e della Salute, Ospedale di Cattinara, Università degli Studi di Trieste, Trieste, Italy
| | - Silvia Gazzin
- Italian Liver Foundation, Centro Studi Fegato, Trieste, Italy
| | - Raffaella Rumiati
- Scuola Internazionale Superiore Studi Avanzati, SISSA, Trieste, Italy
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Gentry-Maharaj A, Karpinskyj C, Glazer C, Burnell M, Bailey K, Apostolidou S, Ryan A, Lanceley A, Fraser L, Jacobs I, Hunter MS, Menon U. Prevalence and predictors of complementary and alternative medicine/non-pharmacological interventions use for menopausal symptoms within the UK Collaborative Trial of Ovarian Cancer Screening. Climacteric 2017; 20:240-247. [PMID: 28326899 PMCID: PMC5448394 DOI: 10.1080/13697137.2017.1301919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 01/26/2017] [Accepted: 02/19/2017] [Indexed: 12/04/2022]
Abstract
OBJECTIVES The negative publicity about menopausal hormone therapy (MHT) has led to increased use of complementary and alternative medicines (CAM) and non-pharmacological interventions (NPI) for menopausal symptom relief. We report on the prevalence and predictors of CAM/NPI among UK postmenopausal women. METHOD Postmenopausal women aged 50-74 years were invited to participate in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). A total of 202 638 women were recruited and completed a baseline questionnaire. Of these, 136 020 were sent a postal follow-up-questionnaire between September 2006 and May 2009 which included ever-use of CAM/NPI for menopausal symptom relief. Both questionnaires included MHT use. RESULTS A total of 88 430 (65.0%) women returned a completed follow-up-questionnaire; 22 206 (25.1%) reported ever-use of one or more CAM/NPI. Highest use was reported for herbal therapies (43.8%; 9725/22 206), vitamins (42.6%; 9458/22 206), lifestyle approaches (32.1%; 7137/22 206) and phytoestrogens (21.6%; 4802/22 206). Older women reported less ever-use of herbal therapies, vitamins and phytoestrogens. Lifestyle approaches, aromatherapy/reflexology/acupuncture and homeopathy were similar across age groups. Higher education, Black ethnicity, MHT or previous oral contraceptive pill use were associated with higher CAM/NPI use. Women assessed as being less hopeful about their future were less likely to use CAM/NPI. CONCLUSION One in four postmenopausal women reported ever-use of CAM therapies/NPI for menopausal symptom relief, with lower use reported by older women. Higher levels of education and previous MHT use were positive predictors of CAM/NPI use. UKCTOCS Trial registration: ISRCTN22488978.
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Affiliation(s)
- A. Gentry-Maharaj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - C. Karpinskyj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - C. Glazer
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
- Department of Occupational and Environmental Medicine, Bispebjerg - Frederiksberg Hospital, Institute of Public Health, University of CopenhagenCopenhagenDenmark
| | - M. Burnell
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - K. Bailey
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - S. Apostolidou
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - A. Ryan
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - A. Lanceley
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - L. Fraser
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
| | - I. Jacobs
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
- UNSW AustraliaSydneyAustralia
- Centre for Women's Health, Institute of Human Development, University of ManchesterManchesterUK
| | - M. S. Hunter
- Department of Psychology, Institute of Psychiatry, Guy’s Campus, King's College LondonLondonUK
| | - U. Menon
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women's Health, University College LondonLondonUK
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Masarwah A, Auvinen P, Sudah M, Dabravolskaite V, Arponen O, Sutela A, Oikari S, Kosma VM, Vanninen R. Prognostic contribution of mammographic breast density and HER2 overexpression to the Nottingham Prognostic Index in patients with invasive breast cancer. BMC Cancer 2016; 16:833. [PMID: 27806715 DOI: 10.1186/s12885-016-2892-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 10/25/2016] [Indexed: 01/19/2023] Open
Abstract
Background To investigate whether very low mammographic breast density (VLD), HER2, and hormone receptor status holds any prognostic significance within the different prognostic categories of the widely used Nottingham Prognostic Index (NPI). We also aimed to see whether these factors could be incorporated into the NPI in an effort to enhance its performance. Methods This study included 270 patients with newly diagnosed invasive breast cancer. Patients with mammographic breast density of <10 % were considered as VLD. In this study, we compared the performance of NPI with and without VLD, HER2, ER and PR. Cox multivariate analysis, time-dependent receiver operating characteristic curve (tdROC), concordance index (c-index) and prediction error (0.632+ bootstrap estimator) were used to derive an updated version of NPI. Results Both mammographic breast density (VLD) (p < 0.001) and HER2 status (p = 0.049) had a clinically significant effect on the disease free survival of patients in the intermediate and high risk groups of the original NPI classification. The incorporation of both factors (VLD and HER2 status) into the NPI provided improved patient outcome stratification by decreasing the percentage of patients in the intermediate prognostic groups, moving a substantial percentage towards the low and high risk prognostic groups. Conclusions Very low density (VLD) and HER2 positivity were prognostically significant factors independent of the NPI. Furthermore, the incorporation of VLD and HER2 to the NPI served to enhance its accuracy, thus offering a readily available and more accurate method for the evaluation of patient prognosis.
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van der Pol CC, Lacle MM, Witkamp AJ, Kornegoor R, Miao H, Bouchardy C, Borel Rinkes I, van der Wall E, Verkooijen HM, van Diest PJ. Prognostic models in male breast cancer. Breast Cancer Res Treat 2016; 160:339-346. [PMID: 27671991 PMCID: PMC5065611 DOI: 10.1007/s10549-016-3991-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 09/19/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE Breast cancer in men is uncommon; it accounts for 1 % of all patients with primary breast cancer. Its treatment is mostly extrapolated from its female counterpart. Accurate predictions are essential for adjuvant systemic treatment decision-making and informing patients. Several predictive models are available for female breast cancer (FBC) including the Morphometric Prognostic Index (MPI), Nottingham Prognostic Index (NPI), Adjuvant! Online and Predict. The aim of this study was to examine and compare the prognostic performance of these models for male breast cancer (MBC). METHODS The population of this study consists of 166 MBC patients. The prognostic scores of the patients are categorized by good, (moderate) and poor, defined by the test itself (MPI and NPI) or based on tertiles (Adjuvant! Online and Predict). Survival according to prognostic score was compared by Kaplan-Meier analysis and differences were tested by logRank. The prognostic performances were evaluated with C-statistics. Calibration was done with the aim to estimate to what extent the survival rates predicted by Predict were similar to the observed survival rates. RESULTS All prediction models were capable of discriminating between good, moderate and poor survivors. P-values were highly significant. Comparison between the models using C-statistics (n = 88) showed equal performance of MPI (0.67), NPI (0.68), Adjuvant! Online (0.69) and Predict (0.69). Calibration of Predict showed overestimation for MBC patients. CONCLUSION In conclusion, MPI, NPI, Adjuvant! and Predict prognostic models, originally developed and validated for FBC patients, also perform quite well for MBC patients.
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Affiliation(s)
- Carmen C van der Pol
- Department of Surgical Oncology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Miangela M Lacle
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Arjen J Witkamp
- Department of Surgical Oncology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Robert Kornegoor
- Department of Pathology, Gelre Ziekenhuis, Apeldoorn, The Netherlands
| | - Hui Miao
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Christine Bouchardy
- Geneva Cancer Registry, Institute for Social and Preventive Medicine, Geneva University, Geneva, Switzerland
| | - Inne Borel Rinkes
- Department of Surgical Oncology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Elsken van der Wall
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Helena M Verkooijen
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
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Fahlén M, Zhang H, Löfgren L, Masironi B, VON Schoultz E, VON Schoultz BO, Sahlin L. Expression of Estrogen Receptors in Relation to Hormone Levels and the Nottingham Prognostic Index. Anticancer Res 2016; 36:2839-2847. [PMID: 27272795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/13/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Estrogen hormones have a large impact on both normal development and tumorigenesis of the breast. MATERIALS AND METHODS Breast tissue samples from 49 women undergoing surgery were included. The estrogen receptors (ERα and ERβ), ERα36 and G-coupled estrogen receptor-1 (GPER) were determined in benign and malignant breast tissue. RESULTS The ERα36 and ERα mRNA levels were highest in malignant tumors. Stromal ERβ immunostaining in benign tumors was higher than in the paired normal tissue. GPER expression was lowest in benign tumors. In the malignant tumors, the Nottingham Prognostic Index (NPI) correlated positively with stromal GPER and the serum testosterone level. The serum insulin-like growth factor-1 (IGF-1) level correlated negatively with GPER mRNA and glandular ERα. CONCLUSION The expression of ERα36 is stronger in malignant breast tissue. The strong positive correlation between NPI and GPER in malignant breast stroma indicates an important role for GPER in breast cancer prognosis.
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Affiliation(s)
- Mia Fahlén
- Capio St Göran's Hospital, Stockholm, Sweden Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden Pediatric Endocrinology Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Hua Zhang
- Pediatric Endocrinology Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China
| | | | - Britt Masironi
- Pediatric Endocrinology Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Eva VON Schoultz
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - B O VON Schoultz
- Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Lena Sahlin
- Pediatric Endocrinology Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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D'Amico F, Rehill A, Knapp M, Lowery D, Cerga-Pashoja A, Griffin M, Iliffe S, Warner J. Cost-effectiveness of exercise as a therapy for behavioural and psychological symptoms of dementia within the EVIDEM-E randomised controlled trial. Int J Geriatr Psychiatry 2016; 31:656-65. [PMID: 26489776 DOI: 10.1002/gps.4376] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/18/2015] [Accepted: 09/23/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Although available evidence is modest, exercise could be beneficial in reducing behavioural and psychological symptoms of dementia. We aim to evaluate the cost-effectiveness of a dyadic exercise regimen for individuals with dementia and their main carer as therapy for behavioural and psychological symptoms of dementia. METHODS Cost-effectiveness analysis within a two-arm, pragmatic, randomised, controlled, single-blind, parallel-group trial of a dyadic exercise regimen (individually tailored, for 20-30 min at least five times per week). The study randomised 131 community-dwelling individuals with dementia and clinically significant behavioural and psychological symptoms with a carer willing and able to participate in the exercise regimen; 52 dyads provided sufficient cost data for analyses. RESULTS Mean intervention cost was £284 per dyad. For the subsample of 52 dyads, the intervention group had significantly higher mean cost from a societal perspective (mean difference £2728.60, p = 0.05), but costs were not significantly different from a health and social care perspective. The exercise intervention was more cost-effective than treatment as usual from both societal and health and social care perspectives for the measure of behavioural and psychological symptoms (Neuropsychiatric Inventory). It does not appear cost-effective in terms of cost per quality-adjusted life year gain. CONCLUSIONS The exercise intervention has the potential to be seen as cost-effective when considering behavioural and psychological symptoms but did not appear cost-effective when considering quality-adjusted life year gains.
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Affiliation(s)
- Francesco D'Amico
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Amritpal Rehill
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Martin Knapp
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - David Lowery
- Central and North West London NHS Foundation Trust (CNWL), London, UK
| | - Arlinda Cerga-Pashoja
- Central and North West London NHS Foundation Trust (CNWL), London, UK.,University College London (UCL), London, UK
| | | | | | - James Warner
- Central and North West London NHS Foundation Trust (CNWL), London, UK.,Imperial College London, London, UK
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Klimkowicz-Mrowiec A, Krzywoszanski L, Szyper-Maciejewska A, Dziedzic T, Pera J, Slowik A. Emotional Decoding Abilities Do Not Influence Neuropsychiatric Disturbances in Patients With Frontotemporal Dementia. J Geriatr Psychiatry Neurol 2016; 29:108-12. [PMID: 26232407 DOI: 10.1177/0891988715598230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The ability to accurately recognize emotional information belongs to very important interpersonal communication skills in humans. Disturbance of emotional processing is present in behavioral variant of frontotemporal dementia (bvFTD), and the severity of pathological behavior may be linked to misunderstanding of other people's emotions. In our study, we examined hypothesis that patients with worse ability to decode emotions have more behavioral and psychopathological disturbances--the most challenging manifestations of dementia--than those who decode emotions better. We were not able to prove this hypothesis. The ability to decode emotions in patients with bvFTD did not influenced their behavior.
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Affiliation(s)
| | | | | | - Tomasz Dziedzic
- Department of Neurology, Medical College, Jagiellonian University, Krakow, Poland
| | - Joanna Pera
- Department of Neurology, Medical College, Jagiellonian University, Krakow, Poland
| | - Agnieszka Slowik
- Department of Neurology, Medical College, Jagiellonian University, Krakow, Poland
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Abstract
Dementia with Lewy bodies (DLB) is considered the second most common form of dementia in the elderly. The cognitive fluctuations, hallucinations and extrapyramidal symptoms and signs suggest simultaneous neurodegeneration in multiple neuronal pathways including both dopaminergic and cholinergic transmission. In the past few years, several small studies have demonstrated the benefit of acetylcholinesterase inhibitors (AChEIs) on the cognitive and behavioral symptoms of DLB. These drugs, by reversibly blocking the hydrolytic activity of AChE, increase the availability of synaptic acetylcholine. Neuropathological and neuroimaging studies demonstrated that cholinergic neurotransmission is more defective in DLB than in Alzheimer's disease (AD). Despite the relevance of AChEIs to DLB, there are no FDA-approved drugs for its management. The aim of this review is to summarize the literature on the application of donepezil in DLB. Although the results are inconclusive, when one compares and contrasts them to the results of the AD-donepezil trials, the effect size appears larger. Placebo-controlled, randomized, well-powered studies of adequate length are needed to avoid underutilization of a potentially efficacious drug.
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Affiliation(s)
- K Szigeti
- University of Buffalo, Department of Neurology, Buffalo, New York, USA.
| | - M U Hafeez
- University of Buffalo, Department of Neurology, Buffalo, New York, USA
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Tang M, Mudd GM. The pollution intensity of Australian power stations: a case study of the value of the National Pollutant Inventory ( NPI). Environ Sci Pollut Res Int 2015; 22:18410-18424. [PMID: 26233750 DOI: 10.1007/s11356-015-5108-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 07/21/2015] [Indexed: 06/04/2023]
Abstract
This paper presents a comprehensive analysis of the pollutant emissions from electrical generation facilities reported to Australia's National Pollutant Inventory (NPI). The data, in terms of pollutant intensity with respect to generation capacity and fuel source, show significant variability. Based on reported data, the dominant pathway and environmental segment for emissions is point-source air emissions. Surprisingly, pollutant emissions from power stations are generally a very small fraction of Australia's facility and diffuse emissions, except for F, HCl, NO(x), PM2.5, SO2 and H2SO4 (where it constitutes between 30 and 90% of emissions). In general, natural gas and diesel facilities have higher organic pollutant intensities, while black and brown coal have higher metal/metalloid pollutant intensities and there is a wide variability for inorganic pollutant intensities. When examining pollutant intensities with respect to capacity, there is very little evidence to show that increased scale leads to more efficient operation or lower pollutant intensity. Another important finding is that the pollutant loads associated with transfers and reuse are substantial, and often represent most of the reported pollutants from a given generation facility. Finally, given the issues identified with the NPI data and its use, some possible improvements include the following: (i) linking site generation data to NPI data (especially generation data, i.e., MWh); (ii) better validation and documentation of emissions factors, especially the methods used to derive and report estimates to the NPI; (iii) using NPI data to undertake comparative life cycle impact assessment studies of different power stations and fuel/energy sources, or even intensive industrial regions (especially from a toxicity perspective) and (iv) linking NPI data in a given region to ongoing environmental monitoring, so that loads can be linked to concentrations for particular pollutants and the relevant guidelines (e.g., air, water, human health). Pollutant inventory systems are clearly valuable tools in understanding pollution burdens and ongoing analysis of the growing body of data should help to further improve environmental and public health outcomes. Overall, this study provides a valuable insight into the current status of pollutant intensities from Australia's electrical generation facilities and should be a valuable benchmark for future studies and international comparisons.
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Affiliation(s)
- Minmeng Tang
- Environmental Engineering, Department of Civil Engineering, Monash University, Clayton, 3800, Australia.
| | - Gavin M Mudd
- Environmental Engineering, Department of Civil Engineering, Monash University, Clayton, 3800, Australia
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Tiel C, Sudo FK, Alves GS, Ericeira-Valente L, Moreira DM, Laks J, Engelhardt E. Neuropsychiatric symptoms in Vascular Cognitive Impairment: a systematic review. Dement Neuropsychol 2015; 9:230-236. [PMID: 29213966 PMCID: PMC5619363 DOI: 10.1590/1980-57642015dn93000004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Neuropsychiatric symptoms or Behavioral and Psychological Symptoms of Dementia
(BPSD) are common and invariably appear at some point during the course of the
disease, mediated both by cerebrovascular disease and neurodegenerative
processes. Few studies have compared the profiles of BPSD in Vascular Cognitive
Impairment (VCI) of different subtypes (subcortical or cortical) and clinical
stages (Vascular Cognitive Impairment No Dementia [VaCIND] and Vascular Dementia
[VaD]).
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Affiliation(s)
- Chan Tiel
- Instituto de Neurologia Deolindo Couto, Setor de Neurologia Cognitiva e do Comportamento-INDC-CDA/IPUB, UFRJ, Rio de Janeiro RJ, Brazil
| | - Felipe Kenji Sudo
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro RJ, Brazil
| | - Gilberto Sousa Alves
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro RJ, Brazil.,Departamento de Medicina Clínica, Universidade Federal do Ceará, Fortaleza CE, Brazil
| | - Letice Ericeira-Valente
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro RJ, Brazil
| | - Denise Madeira Moreira
- Serviço de Radiologia, Instituto de Neurologia Deolindo Couto (UFRJ); Hospital Pró-Cardíaco, Rio de Janeiro RJ, Brazil
| | - Jerson Laks
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro RJ, Brazil.,Universidade do Estado do Rio de Janeiro, Rio de Janeiro RJ, Brazil
| | - Eliasz Engelhardt
- Instituto de Neurologia Deolindo Couto, Setor de Neurologia Cognitiva e do Comportamento-INDC-CDA/IPUB, UFRJ, Rio de Janeiro RJ, Brazil
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Denormandie P, Dubost V, Marigot-Outtandy D, Bertin-Hugault F, Hermann F, Treffel S, Jeandel C. [Comparative study of two on aged care-based occupational (professional) training in medical home for aged and dependent patients with neuropsychiatric behaviors]. ACTA ACUST UNITED AC 2014; 12:163-79. [PMID: 24939404 DOI: 10.1684/pnv.2014.0477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neuropsychiatric behaviours of the elderly is the main issue for caregivers' distress, burn out and high turn-over. This situation will steadily worsen with longer lifetime. AIM OF THE STUDY Specialised training of medical staff may decrease their distress: we compare both training programs Humanitude® et Formadep® outcomes. METHODS A comparative open multicentric non randomised study included 459 elderlies of 9 EHPAD of Korian Company into 3 training groups: Humanitude®, Formadep® and a group control, with 29 weeks follow-up. We studied the scoring NPI-ES (FG and R), BMS-10, ECPA and GIR, medications, caregivers' burn out/absences/turn-over levels. Statistical significance were done by Wilcoxon signed-rank test, Ancova and linear regression. RESULTS 320 caregivers and 3 groups of nearly 150 elderlies each, with around 50% dementia. In Formadep® group : lower scoring for a short time of total NPI-R (p<0.05), sustained lower scoring of NPI-FG « agitation/agressivity» (p=0.035) but transitional for its NPI-R (p<0.05), sustained higher scoring of NPI-FG «apathy/indifference» (p=0.002) but transitional for its NPI-R (p=0 .003), sustained lower scoring of NPI-R (p=0.0039) for Motor Aberrant Behaviours (MAB). In Humanitude® group: transitional higher scoring of NPI-R (p=0.025) for MAB et transitional lower scoring NPI-R (p=0.0032) for depression (Alzheimer Disease sub-groupe). No change for other parameters. CONCLUSION Despite high variability of the neuropsychiatric behaviours in elderly, Formadep® training has shown a positive impact on the global distress and on three main challenging behaviours, compared to Humanitude®: this may be depend on their own philosophy. But caregivers' burden in dementia is not a one-factor problem.
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Amar BR, Yadav R, Janardhan Reddy YC, Pal PK. A clinical profile of patients with Parkinson's disease and psychosis. Ann Indian Acad Neurol 2014; 17:187-92. [PMID: 25024570 PMCID: PMC4090845 DOI: 10.4103/0972-2327.132625] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 10/25/2013] [Accepted: 12/03/2013] [Indexed: 11/04/2022] Open
Abstract
AIMS The aim of the study was to study the clinical profile of the patients with Parkinson's disease (PD) and psychosis. SETTINGS AND DESIGN This was a prospective, cross sectional, hospital-based study done at the Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India from September 2009 to January 2011. All patients with PD, diagnosed by United Kingdom PD Society Brain Bank criteria, having with features of psychosis as diagnosed by the neuropsychiatric inventory (NPI) were included. Patients without a caregiver who could validate the patient's symptoms were excluded. RESULTS A total of 40 patients (5 women, 35 men) with PD with psychosis (mean age: 54.2 ± 11.5 years, mean duration of illness: 6.5 ± 4.5 years, and mean duration of psychosis: 4.3 ± 4.3 years) were included in the study. The Global NPI score was 19.1 ± 11.5. Majority of the patients had pure hallucinations (85%), while the rest had either pure delusions (7.5%) or a combination of delusions and hallucinations (7.5%). In those with hallucinations, visual hallucinations were the commonest (60%) (pure only in 22.5%), followed by auditory (45%), minor hallucinations (45%), and tactile (20%). Only one person reported having olfactory hallucinations (2.5%). Loss of insight was most often observed during the visual hallucinations (52%), followed by tactile (44.4%), auditory (38.9 %), and minor hallucinations (33.3%). CONCLUSIONS In patients with PD and psychosis, pure hallucinations are common and visual hallucinations are the commonest among the hallucinations. A large proportion of patients have minor hallucinations, which need to be recognized early for effective and early management. The limitations of the study were small sample size, use of a single scale to assess psychosis and subjective assessment of insight.
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Affiliation(s)
- B R Amar
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Y C Janardhan Reddy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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47
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Freund-Levi Y, Jedenius E, Tysen-Bäckström AC, Lärksäter M, Wahlund LO, Eriksdotter M. Galantamine versus risperidone treatment of neuropsychiatric symptoms in patients with probable dementia: an open randomized trial. Am J Geriatr Psychiatry 2014; 22:341-8. [PMID: 24035407 DOI: 10.1016/j.jagp.2013.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Revised: 04/25/2013] [Accepted: 05/15/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine the effects of galantamine and risperidone on neuropsychiatric symptoms in dementia (NPSD) and global function. METHODS Using a randomized, controlled and open-blind, one-center trial at an in- and outpatient clinic at a university hospital, we studied 100 adults with probable dementia and NPSD. Participants received galantamine (N = 50, target dose 24 mg) or risperidone (N = 50, target dose 1.5 mg) for 12 weeks. The primary outcome was effects on NPSD assessed by the Neuropsychiatric Inventory (NPI). Secondary measures included the Mini-Mental State Examination (MMSE), Clinical Dementia Rating, Clinical Global Impression, and Simpson Angus scales. All tests were performed before and after treatment. RESULTS Outcome measures were analyzed using analysis of covariance. Ninety-one patients (67% women, mean age 79 ± 7.5 years) with initial NPI score of 51.0 (± 25.8) and MMSE of 20.1 (± 4.6) completed the trial. Both galantamine and risperidone treatments resulted in improved NPSD symptoms and were equally effective in treating several NPI domains. However, risperidone showed a significant treatment advantage in the NPI domains irritation and agitation, F(1, 97) = 5.2, p = 0.02. Galantamine treatment also ameliorated cognitive functions where MMSE scores increased 2.8 points compared with baseline (95% confidence interval: 1.96-3.52). No treatment-related severe side effects occurred. CONCLUSIONS These results support that galantamine, with its benign safety profile, can be used as first-line treatment of NPSD symptoms, unless symptoms of irritation and agitation are prominent, where risperidone is more efficient.
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Affiliation(s)
- Yvonne Freund-Levi
- Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden.
| | - Erik Jedenius
- Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | | | - Marie Lärksäter
- Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Lars-Olof Wahlund
- Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
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Yang AC, Wang SJ, Lai KL, Tsai CF, Yang CH, Hwang JP, Lo MT, Huang NE, Peng CK, Fuh JL. Cognitive and neuropsychiatric correlates of EEG dynamic complexity in patients with Alzheimer's disease. Prog Neuropsychopharmacol Biol Psychiatry 2013; 47:52-61. [PMID: 23954738 DOI: 10.1016/j.pnpbp.2013.07.022] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 07/18/2013] [Accepted: 07/31/2013] [Indexed: 10/26/2022]
Abstract
This study assessed the utility of multiscale entropy (MSE), a complexity analysis of biological signals, to identify changes in dynamics of surface electroencephalogram (EEG) in patients with Alzheimer's disease (AD) that was correlated to cognitive and behavioral dysfunction. A total of 108 AD patients were recruited and their digital EEG recordings were analyzed using MSE methods. We investigate the appropriate parameters and time scale factors for MSE calculation from EEG signals. We then assessed the within-subject consistency of MSE measures in different EEG epochs and correlations of MSE measures to cognitive and neuropsychiatric symptoms of AD patients. Increased severity of AD was associated with decreased MSE complexity as measured by short-time scales, and with increased MSE complexity as measured by long-time scales. MSE complexity in EEGs of the temporal and occipitoparietal electrodes correlated significantly with cognitive function. MSE complexity of EEGs in various brain areas was also correlated to subdomains of neuropsychiatric symptoms. MSE analysis revealed abnormal EEG complexity across short- and long-time scales that were correlated to cognitive and neuropsychiatric assessments. The MSE-based EEG complexity analysis may provide a simple and cost-effective method to quantify the severity of cognitive and neuropsychiatric symptoms in AD patients.
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Affiliation(s)
- Albert C Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Center for Dynamical Biomarkers and Translational Medicine, National Central University, Chungli, Taiwan
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Peters ME, Rosenberg PB, Steinberg M, Norton MC, Welsh-Bohmer KA, Hayden KM, Breitner J, Tschanz JT, Lyketsos CG; Cache County Investigators. Neuropsychiatric symptoms as risk factors for progression from CIND to dementia: the Cache County Study. Am J Geriatr Psychiatry 2013; 21:1116-24. [PMID: 23567370 DOI: 10.1016/j.jagp.2013.01.049] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 04/17/2012] [Accepted: 06/19/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To examine the association of neuropsychiatric symptom (NPS) severity with risk of transition to all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD). DESIGN Survival analysis of time to dementia, AD, or VaD onset. SETTING Population-based study. PARTICIPANTS 230 participants diagnosed with cognitive impairment, no dementia (CIND) from the Cache County Study of Memory Health and Aging were followed for a mean of 3.3 years. MEASUREMENTS The Neuropsychiatric Inventory (NPI) was used to quantify the presence, frequency, and severity of NPS. Chi-squared statistics, t-tests, and Cox proportional hazard ratios were used to assess associations. RESULTS The conversion rate from CIND to all-cause dementia was 12% per year, with risk factors including an APOE ε4 allele, lower Mini-Mental State Examination, lower 3MS, and higher CDR sum-of-boxes. The presence of at least one NPS was a risk factor for all-cause dementia, as was the presence of NPS with mild severity. Nighttime behaviors were a risk factor for all-cause dementia and of AD, whereas hallucinations were a risk factor for VaD. CONCLUSIONS These data confirm that NPS are risk factors for conversion from CIND to dementia. Of special interest is that even NPS of mild severity are a risk for all-cause dementia or AD.
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50
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Adama B, Benjamin C, Jean-Pierre C, Miche DC, Prado-Jean A. French version of the Rating Scale for aggressive behaviour in the Elderly (F-RAGE): psychometric properties and diagnostic accuracy. Dement Neuropsychol 2013; 7:278-285. [PMID: 29213851 PMCID: PMC5619199 DOI: 10.1590/s1980-57642013dn70300008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Aggressive behaviour is the most disturbing and distressing behaviour displayed
by elderly people. The prevalence of aggressive behaviour is around 50% among
psychogeriatric patients.
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Affiliation(s)
- Barry Adama
- University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
| | - Calvet Benjamin
- CMRR. Limousin County Memory Center for Resource and Research, Hospital Center Esquirol of Limoges, France.,INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France.,University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
| | - Clément Jean-Pierre
- CMRR. Limousin County Memory Center for Resource and Research, Hospital Center Esquirol of Limoges, France.,INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France.,University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
| | - Druet-Cabanac Miche
- Center of Occupational Medicine, University Hospital Center, Limoges, France.,INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France.,University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
| | - Annie Prado-Jean
- CMRR. Limousin County Memory Center for Resource and Research, Hospital Center Esquirol of Limoges, France.,INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France.,University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
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