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Schmidt RA, Everett K, Perez-Brumer A, Strike C, Rush B, Gomes T. A population-based time-series analysis of opioid agonist treatment dispensed during pregnancy. Addiction 2024. [PMID: 38476027 DOI: 10.1111/add.16459] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/25/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND AND AIMS Identifying effective opioid treatment options during pregnancy is a high priority due to the growing prevalence of opioid use disorder across North America. We assessed the temporal impact of three population-level interventions on the use of opioid agonist treatment (OAT) during pregnancy in Ontario, Canada. DESIGN This was a population-based time-series analysis to identify trends in the monthly prevalence of pregnant people dispensed methadone and buprenorphine. The impact of adding buprenorphine/naloxone to the public drug formulary, the release of pregnancy-specific guidance and the start of the COVID-19 pandemic were assessed. SETTING AND PARTICIPANTS The study was conducted in Ontario, Canada between 1 July 2013 and 31 March 2022, comprising people who delivered a live or stillbirth in any Ontario hospital during the study period. MEASUREMENTS We identified any prescription for methadone or buprenorphine dispensed between the estimated conception date and delivery date and calculated the monthly prevalence of OAT-exposed pregnancies among all pregnant people in Ontario. FINDINGS Overall, rates of OAT during pregnancy have declined since mid-2018. Methadone-exposed pregnancies decreased from 0.46% of all pregnancies in Ontario in 2015 to a low of 0.16% in 2022. In the primary analysis, none of the interventions had a statistically significant impact on overall OAT rates; however, in the stratified analyses, there was a small increase in buprenorphine after the formulary change [0.006%, 95% confidence interval (CI) = 0.0032-0.0081, P < 0.0001] and a decrease in buprenorphine after the release of the 2017 guidelines (-0.005%, 95% CI = -0.0080 to -0.0020, P = 0.001) and the start of the COVID-19 pandemic (-0.003%, 95% CI = -0.0054 to -0.0006, P = 0.015). CONCLUSION Despite changes in guidance and funding, opioid agonist treatment during pregnancy has been declining in Ontario, Canada since 2018.
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Affiliation(s)
- Rose A Schmidt
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Canada
- ICES, Toronto, Canada
| | | | - Amaya Perez-Brumer
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Carol Strike
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Brian Rush
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research, Toronto, Canada
| | - Tara Gomes
- ICES, Toronto, Canada
- Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Management and Evaluation at the University of Toronto, Institute of Health Policy, Toronto, Ontario, Canada
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Méndez-Molina R, Villela-Oriza AK, Espinosa-Couoh AA, Huchim-Lara O. Snakebites epidemiology in Mexico: a 13-year ecological analysis. Trans R Soc Trop Med Hyg 2024; 118:118-126. [PMID: 37746875 DOI: 10.1093/trstmh/trad070] [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] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/30/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Globally, snakebites have a significant impact on public health and represent substantial costs for health services. Their severity is particularly relevant in developing countries due to the lack of resources and accessibility to health facilities. Additionally, the number of cases may be underestimated, highlighting the urgent need for improved prevention measures. METHODS An observational ecological study was undertaken using the records identified with X200-X209 codes registered in the Ministry of Health injuries database during 2010-2022. Variables included information related to the patient, the snakebite and the healthcare provided. Statistical analysis was carried out with STATA 16 and Microsoft Excel 2020. RESULTS A total of 10 420 snakebites were registered. The average number of cases per year was 788 (IQR 615, 875) and 82.74% occurred during the rainy season. The median age was 35 (IQR 19, 52) y and early adulthood was the most affected age group; bites were most common on the hand and in the living place. The Eastern region of Mexico registered the highest number of cases, with 3496 (33.71%) of snakebites. The lethality rate was 18.23 per 10 000. CONCLUSIONS Snakebites are a significant health problem in Mexico. Most injuries occur among men in early adulthood, in households and in the upper extremities.
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Cerón-Zamora E, Scougall-Vilchis RJ, Contreras-Bulnes R, González-López BS, Veras-Hernández MA, Lucas-Rincón SE, Escoffié-Ramirez M, Medina-Solís CE, Maupomé G. Trends in Cleft lip and/or Palate Prevalence at Birth in Mexico: A National (Ecological) Study Between 2003 and 2019. Cleft Palate Craniofac J 2023; 60:1353-1358. [PMID: 35668609 DOI: 10.1177/10556656221106881] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To describe trends in cases and prevalence at birth rates of cleft lip and/or palate (CL/P) in Mexico between 2003 and 2019. DESIGN Ecological study. SETTING Multiple data sources systematically collected into a national epidemiological surveillance data warehouse. PARTICIPANTS National Live Birth Information System. MAIN OUTCOME MEASURE(S) Both cases and prevalence at birth rates of CL/P in Mexico within a 17-year period were used as dependent variables. RESULTS At the national level there were 23 184 new cases of CL/P (average of 1364 per year) in the 32 states of Mexico, with an average prevalence at birth rate of 0.53 per 1000 live births. The states with the highest prevalence at birth rates of CL/P during the period were Hidalgo (1.59) and Jalisco (1.32), while the states with the lowest rates were Nayarit (0.22) and Durango (0.29). A slight decrease in both cases (z = -2.41, P = .016) and prevalence at birth rates (z = -2.58, P = .010) of CL/P was observed at the national level. States such as Durango, Puebla, Chiapas, Guerrero, Oaxaca, Mexico City, State of Mexico, Coahuila and Jalisco showed a clear downward trend (P < .05) in their prevalence at birth of CL/P between 2003 and 2019, while in Hidalgo its trend was upward (P = .05). Significant differences by sex and region were observed (P < .05). CONCLUSION Some states consistently had the highest or lowest prevalence of CL/P. Decreasing trends in the overall prevalence at birth rates were observed. More detailed, epidemiological studies are necessary to adequately characterize CL/P in the Mexican population.
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Affiliation(s)
- Eduardo Cerón-Zamora
- Advanced Studies and Research Center in Dentistry "Dr Keisaburo Miyata" of Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico
| | - Rogelio José Scougall-Vilchis
- Advanced Studies and Research Center in Dentistry "Dr Keisaburo Miyata" of Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico
| | - Rosalía Contreras-Bulnes
- Advanced Studies and Research Center in Dentistry "Dr Keisaburo Miyata" of Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico
| | - Blanca Silvia González-López
- Advanced Studies and Research Center in Dentistry "Dr Keisaburo Miyata" of Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico
| | | | | | | | - Carlo Eduardo Medina-Solís
- Advanced Studies and Research Center in Dentistry "Dr Keisaburo Miyata" of Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca, México
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University/Purdue University, Indianapolis, USA
- Indiana University Network Science Institute, Bloomington, USA
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Nakamura A, Kotani K, Hatakeyama S, Obayashi S, Nagai R. Regional Variations in Coronavirus Disease 2019 Mortality in Japan: An Ecological Study. JMA J 2023; 6:397-403. [PMID: 37941702 PMCID: PMC10628200 DOI: 10.31662/jmaj.2023-0052] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/07/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction As the characteristics of coronavirus disease 2019 (COVID-19) vary across regions and countries, the relationship between regional characteristics, such as the distribution of physicians and hospital beds, and COVID-19 mortality was assessed in the 47 prefectures of Japan. Methods This ecological study was based on the number of patients with COVID-19 by prefecture during the seventh wave of COVID-19 in Japan (June-October 2022). COVID-19 mortality was indexed as the number of COVID-19 deaths divided by the number of new COVID-19 cases. Data on regional factors, such as population size, number of physicians, and hospital beds by prefecture, were obtained from government statistics. Correlations between regional characteristics and COVID-19 mortality index were analyzed by dividing the 47 prefectures into two groups at the median level of population size (more populated group [MPG] ≥ 1.6 million and less populated group [LPG] < 1.6 million). Results The COVID-19 mortality index (mean 12.7, minimum-maximum: 4.7-25.7) was correlated negatively with the number of physicians per hospital bed (r = -0.386, p = 0.007) and positively with the number of long-term care facilities per 10,000 population (r = 0.397, p = 0.006) and aging rate (the proportion of population aged ≥ 65 years) (r = 0.471, p = 0.001). The two groups varied with respect to the number of physicians (28.7 physicians in the LPG vs. 26.1 physicians in the MPG, p = 0.038) and hospital beds (156 beds in the LPG vs. 119 beds in the MPG, p < 0.001) per 10,000 population. In the multiple regression analysis, the COVID-19 mortality index was correlated negatively with the number of physicians per hospital bed (β = -0.543, p = 0.024) and positively with the aging rate (β = 0.434, p = 0.032) in the LPG, with nonsignificant correlations in the MPG. Conclusions The data may suggest a need of improvement in the distribution of physicians and hospital beds in the healthcare system in regions with smaller and older populations to reduce the rate of COVID-19.
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Affiliation(s)
- Akihisa Nakamura
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Kazuhiko Kotani
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Shuji Hatakeyama
- Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Japan
- Division of Infectious Diseases, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Senichi Obayashi
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
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Genitrini M, Fritz J, Stöggl T, Schwameder H. Performance Level Affects Full Body Kinematics and Spatiotemporal Parameters in Trail Running-A Field Study. Sports (Basel) 2023; 11:188. [PMID: 37888515 PMCID: PMC10611210 DOI: 10.3390/sports11100188] [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: 07/15/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 10/28/2023] Open
Abstract
Trail running is an emerging discipline with few studies performed in ecological conditions. The aim of this work was to investigate if and how biomechanics differ between more proficient (MP) and less proficient (LP) trail runners. Twenty participants (10 F) were recruited for a 9.1 km trail running time trial wearing inertial sensors. The MP athletes group was composed of the fastest five men and the fastest five women. Group differences in spatiotemporal parameters and leg stiffness were tested with the Mann-Whitney U-test. Group differences in joint angles were tested with statistic parametric mapping. The finish time was 51.1 ± 6.3 min for the MP athletes and 60.0 ± 5.5 min for the LP athletes (p < 0.05). Uphill sections: The MP athletes expressed a tendency to higher speed that was not significant (p > 0.05), achieved by combining higher step frequency and higher step length. They showed a tendency to shorter contact time, lower duty factor and longer flight time that was not significant (p > 0.05) as well as significantly lower knee flexion during the stance phase (p < 0.05). Downhill sections: The MP athletes achieved significantly higher speed (p < 0.05) through higher step length only. They showed significantly higher knee and hip flexion during the swing phase as well as higher trunk rotation and shoulder flexion during the stance phase (p < 0.05). No differences were found with respect to leg stiffness in the uphill or downhill sections (p > 0.05). In the uphill sections, the results suggest lower energy absorption and more favorable net mechanical work at the knee joint for the MP athletes. In the downhill sections, the results suggest that the more efficient motion of the swing leg in the MP athletes could increase momentum in the forward direction and full body center of mass' velocity at toe off, thus optimizing the propulsion phase.
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Affiliation(s)
- Matteo Genitrini
- Department of Sport and Exercise Science, University of Salzburg, 5400 Hallein-Rif, Austria
| | | | - Thomas Stöggl
- Red Bull Athlete Performance Center, 5303 Thalgau, Austria
| | - Hermann Schwameder
- Department of Sport and Exercise Science, University of Salzburg, 5400 Hallein-Rif, Austria
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Barbosa JDS, Tartaro L, Vasconcelos LDR, Nedel M, Serafini JF, Svirski SGS, de Souza LS, Agranonik M. Assessment of incompleteness of Mortality Information System records on deaths from external causes in the state of Rio Grande do Sul, Brazil, 2000-2019. Epidemiol Serv Saude 2023; 32:e2022301. [PMID: 37466561 PMCID: PMC10365544 DOI: 10.1590/s2237-96222023000200006] [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] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 03/27/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE to evaluate the incompleteness of Mortality Information System (Sistema de Informações sobre Mortalidade - SIM) data on deaths from external causes (ECs) in the state of Rio Grande do Sul, Brazil, 2000-2019. METHODS This was an ecological study, using SIM data on all deaths from external causes and, specifically, from transport accident, homicides, suicides and falls; the analysis of the trend of incompleteness was performed by means of Prais-Winsten regression, with a 5% significance level. RESULTS A total of 146,882 deaths were evaluated; sex (0.1%), place of death (0.1%) and age (0.4%) showed the lowest incompleteness in 2019; the proportion of incompleteness showed a decreasing trend for the place of death and schooling, an increasing trend for marital status and a stable trend for age and race/skin color, among all types of death evaluated. CONCLUSION the variables analyzed reached a high degree of completion; with the exception of marital status and schooling, for which unsatisfactory scores persisted for deaths from ECs, both total and by subgroups.
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Affiliation(s)
- Juliane de Souza Barbosa
- Universidade do Vale do Rio dos Sinos, Programa de Pós-Graduação em Saúde Coletiva, São Leopoldo, RS, Brazil
| | - Luiza Tartaro
- Universidade do Vale do Rio dos Sinos, Faculdade de Medicina, São Leopoldo, RS, Brazil
| | | | - Marcela Nedel
- Universidade do Vale do Rio dos Sinos, Faculdade de Medicina, São Leopoldo, RS, Brazil
| | | | | | - Leandra Soares de Souza
- Universidade do Vale do Rio dos Sinos, Programa de Pós-Graduação em Saúde Coletiva, São Leopoldo, RS, Brazil
| | - Marilyn Agranonik
- Secretaria de Planejamento, Governança e Gestão do Estado do Rio Grande do Sul, Departamento de Economia e Estatística, Porto Alegre, RS, Brazil
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Meira KC, Simões TC, Guimarães RM, Beserra da Silva PG, Mendonça AB, Cristina de Jesus J, Covre-Sussai M. Female Homicides in Brazil and Its Major Regions (1980-2019): An Analysis of Age, Period, and Cohort Effects. Violence Against Women 2023:10778012231183657. [PMID: 37415498 DOI: 10.1177/10778012231183657] [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] [Indexed: 07/08/2023]
Abstract
The objective was to analyze the temporal effects of age, period, and cohort on mortality from all female homicides, and from female homicides and by firearms, in Brazil from 1980 to 2019. Data were accessed from Brazilian health records. There was an increase in the risk of death in the 2000s in the North and Northeast regions and a decrease in the Southeast, South, and Midwest. Younger women had a higher risk of death than women born between 1950 and 1954. The findings may be correlated with the inefficiency of the Brazilian state in protecting female victims of violence.
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Affiliation(s)
- Karina Cardoso Meira
- Health School, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Taynãna César Simões
- René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | | | - Pedro Gilson Beserra da Silva
- Onofre Lopes University Hospital of the Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Jordana Cristina de Jesus
- Department of Demography and Actuarial Sciences of the Federal University of Rio Grande do Norte, Brazil
| | - Maira Covre-Sussai
- Institute of Social Sciences/Social Sciences Institute (ICS), Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Salazar A, Moreno-Pulido S, Prego-Meleiro P, Henares-Montiel J, Pulido J, Donat M, Sotres-Fernandez G, Sordo L. Correlation Between Opioid Drug Prescription and Opioid-Related Mortality in Spain as a Surveillance Tool: Ecological Study. JMIR Public Health Surveill 2023; 9:e43776. [PMID: 37379061 PMCID: PMC10365608 DOI: 10.2196/43776] [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] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 05/08/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Opioid drug prescription (ODP) and opioid-related mortality (ORM) have increased in Spain. However, their relationship is complex, as ORM is registered without considering the type of opioid (legal or illegal). OBJECTIVE This ecological study aimed to examine the correlation between ODP and ORM in Spain and discuss their usefulness as a surveillance tool. METHODS This was an ecological descriptive study using retrospective annual data (2000-2019) from the Spanish general population. Data were collected from people of all ages. Information on ODP was obtained from the Spanish Medicines Agency in daily doses per 1000 inhabitants per day (DHD) for total ODP, total ODP excluding those with better safety protocols (codeine and tramadol), and each opioid drug separately. Rates of ORM (per 1,000,000 inhabitants) were calculated based on deaths registered (International Classification of Diseases, 10th Revision codes) as opioid poisoning by the National Statistics Institute, derived from the drug data recorded by medical examiners in death certificates. Opioid-related deaths were considered to be those that indicated opioid consumption (accidental, infringed, or self-inflicted) as the main cause of death: death due to accidental poisoning (X40-X44), intentional self-inflicted poisoning (X60-X64), drug-induced aggression (X85), and poisoning of undetermined intention (Y10-Y14). A descriptive analysis was carried out, and correlations between the annual rates of ORM and DHD of the prescribed opioid drugs globally, excluding medications of the least potential risk of overdose and lowest treatment tier, were analyzed using Pearson linear correlation coefficient. Their temporal evolution was analyzed using cross-correlations with 24 lags and the cross-correlation function. The analyses were carried out using Stata and StatGraphics Centurion 19. RESULTS The rate of ORM (2000-2019) ranged between 14 and 23 deaths per 1,000,000 inhabitants, with a minimum in 2006 and an increasing trend starting in 2010. The ODP ranged between 1.51 to 19.94 DHD. The rates of ORM were directly correlated with the DHD of total ODP (r=0.597; P=.006), total ODP without codeine and tramadol (r=0.934; P<.001), and every prescribed opioid except buprenorphine (P=.47). In the time analysis, correlations between DHD and ORM were observed in the same year, although not statistically significant (all P≥.05). CONCLUSIONS There is a correlation between greater availability of prescribed opioid drugs and an increase in opioid-related deaths. The correlation between ODP and ORM may be a useful tool in monitoring legal opiates and possible disturbances in the illegal market. The role of tramadol (an easily prescribed opioid) is important in this correlation, as is that of fentanyl (the strongest opioid). Measures stronger than recommendations need to be taken to reduce off-label prescribing. This study shows that not only is opioid use directly related to the prescribing of opioid drugs above what is desirable but also an increase in deaths.
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Affiliation(s)
- Alejandro Salazar
- Observatory of Pain, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cadiz, Cádiz, Spain
- Department of Statistics and Operational Research, University of Cádiz, Puerto Real, Spain
| | | | - Pablo Prego-Meleiro
- Department of Public Health and Maternal-Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Department of Analytical Chemistry, Physical Chemistry and Chemical Engineering, Faculty of Pharmacy, University of Alcalá, Alcalá de Henares, Spain
| | - Jesús Henares-Montiel
- Center for Biomedical Research in Epidemiology and Public Health (CIBER), Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | - José Pulido
- Department of Public Health and Maternal-Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health (CIBER), Madrid, Spain
| | - Marta Donat
- National School of Health, Salud Carlos III Health Institute, Madrid, Spain
| | - Gabriel Sotres-Fernandez
- Oncology Department, Hospital Quirón Salud, Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Luis Sordo
- Department of Public Health and Maternal-Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health (CIBER), Madrid, Spain
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Adelman S, Charifson M, Seok E, Mehta-Lee SS, Brubaker SG, Liu M, Kahn LG. State-specific fertility rate changes across the USA following the first two waves of COVID-19. Hum Reprod 2023; 38:1202-1212. [PMID: 37038265 PMCID: PMC10233281 DOI: 10.1093/humrep/dead055] [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: 11/14/2022] [Revised: 03/02/2023] [Indexed: 04/12/2023] Open
Abstract
STUDY QUESTION How did the first two coronavirus disease 2019 (COVID-19) waves affect fertility rates in the USA? SUMMARY ANSWER States differed widely in how their fertility rates changed following the COVID-19 outbreak and these changes were influenced more by state-level economic, racial, political, and social factors than by COVID-19 wave severity. WHAT IS KNOWN ALREADY The outbreak of the COVID-19 pandemic contributed to already declining fertility rates in the USA, but not equally across states. Identifying drivers of differential changes in fertility rates can help explain variations in demographic shifts across states in the USA and motivate policies that support families in general, not only during crises. STUDY DESIGN, SIZE, DURATION This is an ecological study using state-level data from 50 US states and the District of Columbia (n = 51). The study period extends from 2020 to 2021 with historical data from 2016 to 2019. We identified Wave 1 as the first apex for each state after February 2020 and Wave 2 as the second apex, during Fall/Winter 2020-2021. PARTICIPANTS/MATERIALS, SETTING, METHODS State-level COVID-19 wave severity, defined as case acceleration during each 3-month COVID-19 wave (cases/100 000 population/month), was derived from 7-day weekly moving average COVID-19 case rates from the US Centers for Disease Control and Prevention (CDC). State-level fertility rate changes (change in average monthly fertility rate/100 000 women of reproductive age (WRA)/year) were derived from the CDC Bureau of Vital Statistics and from 2020 US Census and University of Virginia 2021 population estimates 9 months after each COVID-19 wave. We performed univariate analyses to describe national and state-level fertility rate changes following each wave, and simple and multivariable linear regression analyses to assess the relation of COVID-19 wave severity and other state-level characteristics with fertility rate changes. MAIN RESULTS AND THE ROLE OF CHANCE Nationwide, fertility dropped by 17.5 births/month/100 000 WRA/year following Wave 1 and 9.2 births/month/100 000 WRA/year following Wave 2. The declines following Wave 1 were largest among majority-Democrat, more non-White states where people practiced greater social distancing. Greater COVID-19 wave severity was associated with steeper fertility rate decline post-Wave 1 in simple regression, but the association was attenuated when adjusted for other covariates. Adjusting for the economic impact of the pandemic (hypothesized mediator) also attenuated the effect. There was no relation between COVID-19 wave severity and fertility rate change following Wave 2. LIMITATIONS, REASONS FOR CAUTION Our study harnesses state-level data so individual-level conclusions cannot be inferred. There may be residual confounding in our multivariable regression and we were underpowered to detect some effects. WIDER IMPLICATIONS OF THE FINDINGS The COVID-19 pandemic initially impacted the national fertility rate but, overall, the fertility rate rebounded to the pre-pandemic level following Wave 2. Consistent with prior literature, COVID-19 wave severity did not appear to predict fertility rate change. Economic, racial, political, and social factors influenced state-specific fertility rates during the pandemic more than the severity of the outbreak alone. Future studies in other countries should also consider whether these factors account for internal heterogeneity when examining the impact of the COVID-19 pandemic and other crises on fertility. STUDY FUNDING/COMPETING INTEREST(S) L.G.K. received funding from the National Institute of Environmental Health Sciences (R00ES030403), M.C. from the National Science Foundation Graduate Research Fellowship Program (20-A0-00-1005789), and M.L. and E.S. from the National Institute of Environmental Health Sciences (R01ES032808). None of the authors have competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Sarah Adelman
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Mia Charifson
- Vilcek Institute of Biomedical Graduate Sciences, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Eunsil Seok
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Mengling Liu
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Linda G Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Sugihara N, Shirai Y, Imai T, Sezaki A, Abe C, Kawase F, Miyamoto K, Inden A, Kato T, Sanada M, Shimokata H. The Global Association between Egg Intake and the Incidence and Mortality of Ischemic Heart Disease-An Ecological Study. Int J Environ Res Public Health 2023; 20:4138. [PMID: 36901143 PMCID: PMC10001696 DOI: 10.3390/ijerph20054138] [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: 12/19/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The relationship between egg consumption and ischemic heart disease (IHD) remains controversial as there is still no clear answer regarding the relationship, with research limited to a few geographical regions. In the current study, we conducted a longitudinal analysis of the association between egg intake and IHD incidence (IHDi) and mortality (IHDd) using 28 years of international data from 1990 to 2018. Egg intake (g/day/capita) by country was obtained from the Global Dietary Database. Age-standard IHDi and IHDd rates per 100,000 subjects in each country were obtained from the 2019 Global Burden of Disease database. The analysis included a total of 142 countries with populations of at least one million, for which all data were available from 1990 to 2018. Eggs are consumed worldwide, and regional differences in consumption are also shown. Utilizing IHDi and IHDd as objective variables and egg intake as an explanatory variable, the analysis was conducted using linear mixed models, which controlled for inter- and intra-country variation from year to year. The results showed a significant negative association between egg intake, and IHDi (-0.253 ± 0.117, p < 0.05) and IHDd (-0.359 ± 0.137, p < 0.05). The analysis was carried out using R 4.0.5. The results suggest that adequate egg intake might suppress IHDi and IHDd on a global scale.
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Affiliation(s)
- Norie Sugihara
- Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka 238-8550, Japan
- Faculty of Core Research, Ochanomizu University, Tokyo 112-8610, Japan
| | - Yoshiro Shirai
- Department of Human Life and Environment, Kinjo Gakuin University, Nagoya 463-8521, Japan
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
| | - Tomoko Imai
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Department of Food Science and Nutrition, Doshisha Women’s College of Liberal Arts, Kyoto 602-0893, Japan
| | - Ayako Sezaki
- Department of Food Science and Human Nutrition, Ryukoku University, Otsu 520-2194, Japan
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
| | - Chisato Abe
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Department of Food and Nutrition, Tsu City College, Tsu 514-0112, Japan
| | - Fumiya Kawase
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota 444-2351, Japan
| | - Keiko Miyamoto
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Department of Nursing, Nagoya University of Arts and Sciences, Nagoya 460-0001, Japan
| | - Ayaka Inden
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Clinical Nutrition Unit, Hamamatsu University Hospital, Hamamatsu 431-3192, Japan
| | - Takumi Kato
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Nutrition Division, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya 466-8650, Japan
| | - Masayo Sanada
- Department of Nursing, Heisei College of Health Sciences, Gifu 501-1131, Japan
| | - Hiroshi Shimokata
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
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11
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Sanchez T, Mavragani A, Pandey AK, Verma M, Koushal V. Utility of the Comprehensive Health and Stringency Indexes in Evaluating Government Responses for Containing the Spread of COVID-19 in India: Ecological Time-Series Study. JMIR Public Health Surveill 2023; 9:e38371. [PMID: 36395334 PMCID: PMC9924057 DOI: 10.2196/38371] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 10/25/2022] [Accepted: 01/18/2023] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Many nations swiftly designed and executed government policies to contain the rapid rise in COVID-19 cases. Government actions can be broadly segmented as movement and mass gathering restrictions (such as travel restrictions and lockdown), public awareness (such as face covering and hand washing), emergency health care investment, and social welfare provisions (such as poor welfare schemes to distribute food and shelter). The Blavatnik School of Government, University of Oxford, tracked various policy initiatives by governments across the globe and released them as composite indices. We assessed the overall government response using the Oxford Comprehensive Health Index (CHI) and Stringency Index (SI) to combat the COVID-19 pandemic. OBJECTIVE This study aims to demonstrate the utility of CHI and SI to gauge and evaluate the government responses for containing the spread of COVID-19. We expect a significant inverse relationship between policy indices (CHI and SI) and COVID-19 severity indices (morbidity and mortality). METHODS In this ecological study, we analyzed data from 2 publicly available data sources released between March 2020 and October 2021: the Oxford Covid-19 Government Response Tracker and the World Health Organization. We used autoregressive integrated moving average (ARIMA) and seasonal ARIMA to model the data. The performance of different models was assessed using a combination of evaluation criteria: adjusted R2, root mean square error, and Bayesian information criteria. RESULTS implementation of policies by the government to contain the COVID-19 crises resulted in higher CHI and SI in the beginning. Although the value of CHI and SI gradually fell, they were consistently higher at values of >80% points. During the initial investigation, we found that cases per million (CPM) and deaths per million (DPM) followed the same trend. However, the final CPM and DPM models were seasonal ARIMA (3,2,1)(1,0,1) and ARIMA (1,1,1), respectively. This study does not support the hypothesis that COVID-19 severity (CPM and DPM) is associated with stringent policy measures (CHI and SI). CONCLUSIONS Our study concludes that the policy measures (CHI and SI) do not explain the change in epidemiological indicators (CPM and DPM). The study reiterates our understanding that strict policies do not necessarily lead to better compliance but may overwhelm the overstretched physical health systems. Twenty-first-century problems thus demand 21st-century solutions. The digital ecosystem was instrumental in the timely collection, curation, cloud storage, and data communication. Thus, digital epidemiology can and should be successfully integrated into existing surveillance systems for better disease monitoring, management, and evaluation.
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Affiliation(s)
| | | | - Anuj Kumar Pandey
- Department of Health Research, International Institute of Health Management Research, New Delhi, India
| | - Madhur Verma
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bhatinda, India
| | - Vipin Koushal
- Department of Biostatistics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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12
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Pagnotta VF, King N, Donnelly PD, Thompson W, Walsh SD, Molcho M, Ng K, Malinowska-Cieślik M, Pickett W. Access to medical care and its association with physical injury in adolescents: a cross-national analysis. Inj Prev 2023; 29:42-49. [PMID: 36167714 DOI: 10.1136/ip-2022-044701] [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: 07/12/2022] [Accepted: 08/27/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Strong variations in injury rates have been documented cross-nationally. Historically, these have been attributed to contextual determinants, both social and physical. We explored an alternative, yet understudied, explanation for variations in adolescent injury reporting-that varying access to medical care is, in part, responsible for cross-national differences. METHODS Age-specific and gender-specific rates of medically treated injury (any, serious, by type) were estimated by country using the 2013/2014 Health Behaviour in School-aged Children study (n=209 223). Available indicators of access to medical care included: (1) the Healthcare Access and Quality Index (HAQ; 39 countries); (2) the Universal Health Service Coverage Index (UHC; 37 countries) and (3) hospitals per 100 000 (30 countries) then physicians per 100 000 (36 countries). Ecological analyses were used to relate injury rates and indicators of access to medical care, and the proportion of between-country variation in reported injuries attributable to each indicator. RESULTS Adolescent injury risks were substantial and varied by country and sociodemographically. There was little correlation observed between national level injury rates and the HAQ and UHC indices, but modest associations between serious injury and physicians and hospitals per 100 000. Individual indicators explained up to 9.1% of the total intercountry variation in medically treated injuries and 24.6% of the variation in serious injuries. CONCLUSIONS Cross-national variations in reported adolescent serious injury may, in part, be attributable to national differences in access to healthcare services. Interpretation of cross-national patterns of injury and their potential aetiology should therefore consider access to medical care as a plausible explanation.
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Affiliation(s)
- Valerie F Pagnotta
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Nathan King
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | | | - Wendy Thompson
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Sophie D Walsh
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
| | - Michal Molcho
- Department of Children's Studies, School of Education, University of Galway, Galway, Ireland
| | - Kwok Ng
- Faculty of Education, University of Turku, Turku, Finland.,Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.,School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.,Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Marta Malinowska-Cieślik
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University, Medical College, Krakow, Poland
| | - William Pickett
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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13
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Modenese A. Correlations between SARS-CoV-2 Infections and the Number of COVID-19 Vaccine Doses Administered in Three Italian Provinces. Healthcare (Basel) 2023; 11. [PMID: 36766933 DOI: 10.3390/healthcare11030358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 02/01/2023] Open
Abstract
The aim of this ecological study is to evaluate correlations between the number of COVID-19 vaccine doses administered in three Italian provinces-one in the south, one in the center and one in the north of the country-and the registered numbers of COVID-19 cases in the same areas. The period of January 2021-September 2022 was considered, with specific analysis for fractions of times corresponding to the spread in Italy of the different SARS-CoV-2 variants. The results confirm the reduction of the effectiveness of the vaccines in preventing new COVID-19 cases in Italy, regardless of latitude, after the appearance of the first omicron variants. The new variants omicron 4 and 5 showed an extremely high spread during the Italian summer months; fortunately, the effects of the vaccinations in preventing new cases was improved compared to the previous omicron variants, showing a negative correlation between the new COVID-19 cases and the number of vaccine doses administered.
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14
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Hattori S, Sakata N, Ishimaru M, Tamiya N. Consolidation of the perinatal care system and workload of obstetricians: an ecological study in Japan. Front Glob Womens Health 2023; 4:1030443. [PMID: 37187592 PMCID: PMC10175585 DOI: 10.3389/fgwh.2023.1030443] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 03/07/2023] [Indexed: 05/17/2023] Open
Abstract
Objectives We examined the relationship between consolidation of delivery and the workload of obstetricians working at perinatal centers. Methods We conducted a descriptive analysis using perinatal care areas classified into three types (metropolitan, provincial, and rural). We calculated the Herfindahl-Hirschman Index (HHI) as an index of consolidation and the proportion of the deliveries at clinics as an indicator of the low-risk deliveries and the deliveries per center obstetrician as an indicator of obstetricians' workload. We used >150 deliveries yearly as an excess indicator. The correlation between the HHI and obstetricians' workload and the proportion of deliveries at clinics was examined using the Pearson correlation coefficient. Results The proportion of areas with >150 deliveries yearly was higher in the consolidated areas. In provincial areas, obstetricians' workload was positively correlated with the HHI and was negatively correlated with the proportion of deliveries at clinics. Conclusions The obstetricians' workload may be increasing where more consolidation occurs. In provincial areas, the center obstetrician's workload could be reduced not only by consolidation but also by sharing the role of handling low-risk deliveries with clinics and hospitals with obstetric units other than perinatal centers.
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Affiliation(s)
- Sanae Hattori
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Nobuo Sakata
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
- Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan
- Correspondence: Nobuo Sakata
| | - Miho Ishimaru
- Department of Oral Health Promotion, Graduated School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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15
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Chalmers N, St-Hilaire S. Airborne Pollution: A Potential Risk Factor for Multiple Sclerosis in Colder Climates. Inquiry 2023; 60:469580231171018. [PMID: 37232356 DOI: 10.1177/00469580231171018] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Multiple Sclerosis (MS), a neurodegenerative disease of unknown etiology, which affects approximately 450 of every 100 000 women in the USA. Using an ecological observational study design and publicly available data from the Center for Disease Control and Prevention in the USA, we assessed trends in county-level, age-adjusted female MS mortality rates between 1999 and 2006 to determine if they were correlated with environmental factors, including the county's PM2.5. In counties with colder winters, there was a significant positive association between the average PM2.5 index and the MS mortality rate, after controlling for the county's UV index and median household income. This relationship was not apparent in counties with warmer winters. We also found that colder counties had higher MS mortality rates, even after controlling for the UV and PM2.5 indices. The findings from this study provide county-level evidence for a temperature-dependent association between PM2.5 pollution and MS mortality rates, which should be further investigated.
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Affiliation(s)
- Nicola Chalmers
- American International School Hong Kong, Kowloon Tong, Hong Kong, SAR PR China
| | - Sophie St-Hilaire
- Department of Infectious Diseases and Public Health, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR PR China
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16
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Hua X, Kehoe ARD, Tome J, Motaghi M, Ofori SK, Lai PY, Ali ST, Chowell G, Spaulding AC, Fung IC. Late Surges in COVID-19 Cases and Varying Transmission Potential Partially Due to Public Health Policy Changes in 5 Western States, March 10, 2020, to January 10, 2021. Disaster Med Public Health Prep 2022; 17:e277. [PMID: 36325878 DOI: 10.1017/dmp.2022.248] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study investigates the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission potential in North Dakota, South Dakota, Montana, Wyoming, and Idaho from March 2020 through January 2021. METHODS Time-varying reproduction numbers, R t , of a 7-d-sliding-window and of non-overlapping-windows between policy changes were estimated using the instantaneous reproduction number method. Linear regression was performed to evaluate if per-capita cumulative case-count varied across counties with different population size or density. RESULTS The median 7-d-sliding-window R t estimates across the studied region varied between 1 and 1.25 during September through November 2020. Between November 13 and 18, R t was reduced by 14.71% (95% credible interval, CrI, [14.41%, 14.99%]) in North Dakota following a mask mandate; Idaho saw a 1.93% (95% CrI [1.87%, 1.99%]) reduction and Montana saw a 9.63% (95% CrI [9.26%, 9.98%]) reduction following the tightening of restrictions. High-population and high-density counties had higher per-capita cumulative case-count in North Dakota on June 30, August 31, October 31, and December 31, 2020. In Idaho, North Dakota, South Dakota, and Wyoming, there were positive correlations between population size and per-capita weekly incident case-count, adjusted for calendar time and social vulnerability index variables. CONCLUSIONS R t decreased after mask mandate during the region's case-count spike suggested reduction in SARS-CoV-2 transmission.
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17
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Català M, Coma E, Alonso S, Andrés C, Blanco I, Antón A, Bordoy AE, Cardona PJ, Fina F, Martró E, Medina M, Mora N, Saludes V, Prats C, Prieto-Alhambra D, Alvarez-Lacalle E. Corrigendum: Transmissibility, hospitalization, and intensive care admissions due to omicron compared to delta variants of SARS-CoV-2 in Catalonia: A cohort study and ecological analysis. Front Public Health 2022; 10:1060328. [PMID: 36743167 PMCID: PMC9894245 DOI: 10.3389/fpubh.2022.1060328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 01/20/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2022.961030.].
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Affiliation(s)
- Martí Català
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Ermengol Coma
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Sergio Alonso
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Cristina Andrés
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain,Biomedical Research Networking Center in Infectious Diseases (CIBERINF), Instituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Blanco
- Clinical Genetics Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Andrés Antón
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain,Biomedical Research Networking Center in Infectious Diseases (CIBERINF), Instituto de Salud Carlos III, Madrid, Spain
| | - Antoni E. Bordoy
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Pere-Joan Cardona
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Cerdanyola, Spain
| | - Francesc Fina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Elisa Martró
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Medina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Núria Mora
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Verónica Saludes
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Clara Prats
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Enrique Alvarez-Lacalle
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain,*Correspondence: Enrique Alvarez-Lacalle
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18
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Purushothaman V, Cuomo RE, Leas E, Li J, Strong D, Mackey TK. Longitudinal analysis of tobacco and vape retail density in California. Tob Induc Dis 2022; 20:87. [PMID: 36317059 PMCID: PMC9574848 DOI: 10.18332/tid/153506] [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] [Received: 05/17/2022] [Revised: 08/05/2022] [Accepted: 09/05/2022] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Tobacco retailer density may be associated with greater youth initiation and reduced success during quit attempts; however, the extent to which tobacco retailer density has changed overtime across multiple categories of retailers has not been reported. METHODS Data on licensed tobacco retailers within California from 2015–2019 were obtained from the California Department of Tax and Fee Administration. Store type was categorized by automated cross-referencing with Yelp. Geolocations were aggregated at county level for analyzing longitudinal trends in changes in tobacco retail density including demographic characteristics. RESULTS The number of active CA tobacco retailer licenses increased from 19825 in 2015 to 25635 in 2019. The highest percent increase in tobacco retailer licenses (9.1%) was observed in 2017. The number of specialized tobacco stores was highest in Los Angeles, San Diego, and Riverside counties. We observed a significant increase in the number of active licenses for non-specialized and specialized tobacco stores, both overall and after controlling for the size of populations within each region. Time was a statistically significant predictor for the number of active licenses for only non-specialized stores, after adjusting for covariates. Regional volume of retailers was positively associated with higher proportion of women, lower median household income, and higher proportion of Hispanic residents. CONCLUSIONS Monitoring the changes in tobacco retail density and associated sociodemographic factors over time can help to identify communities at higher risk for tobacco and nicotine product exposure and access, and its associated health disparities.
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Affiliation(s)
- Vidya Purushothaman
- Department of Anthropology, University of California San Diego, San Diego, United States,Global Health Policy and Data Institute, San Diego, United States
| | - Raphael E. Cuomo
- Department of Anthropology, University of California San Diego, San Diego, United States,Global Health Policy and Data Institute, San Diego, United States,Department of Anesthesiology, University of California San Diego School of Medicine, San Diego, United States
| | - Eric Leas
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, United States
| | - Jiawei Li
- Global Health Policy and Data Institute, San Diego, United States,S-3 Research, San Diego, United States
| | - David Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, United States
| | - Tim K. Mackey
- Department of Anthropology, University of California San Diego, San Diego, United States,Global Health Policy and Data Institute, San Diego, United States,S-3 Research, San Diego, United States
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19
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Català M, Coma E, Alonso S, Andrés C, Blanco I, Antón A, Bordoy AE, Cardona PJ, Fina F, Martró E, Medina M, Mora N, Saludes V, Prats C, Prieto-Alhambra D, Alvarez-Lacalle E. Transmissibility, hospitalization, and intensive care admissions due to omicron compared to delta variants of SARS-CoV-2 in Catalonia: A cohort study and ecological analysis. Front Public Health 2022; 10:961030. [PMID: 36033822 PMCID: PMC9412031 DOI: 10.3389/fpubh.2022.961030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/03/2022] [Accepted: 07/11/2022] [Indexed: 01/24/2023] Open
Abstract
Purpose We aim to compare the severity of infections between omicron and delta variants in 609,352 SARS-CoV-2 positive cases using local hospitalization, vaccination, and variants data from the Catalan Health Care System (which covers around 7. 8 million people). Methods We performed a substitution model to establish the increase in transmissibility of omicron using variant screening data from primary care practices (PCP) and hospital admissions. In addition, we used this data from PCP to establish the two periods when delta and omicron were, respectively, dominant (above 95% of cases). After that, we performed a population-based cohort analysis to calculate the rates of hospital and intensive care unit (ICU) admissions for both periods and to estimate reduction in severity. Rate ratios (RR) and 95% confidence intervals (95% CI) were calculated and stratified by age and vaccination status. In a second analysis, the differential substitution model in primary care vs. hospitals allowed us to obtain a population-level average change in severity. Results We have included 48,874 cases during the delta period and 560,658 during the omicron period. During the delta period, on average, 3.8% of the detected cases required hospitalization for COVID-19. This percentage dropped to 0.9% with omicron [RR of 0.46 (95% CI: 0.43 to 0.49)]. For ICU admissions, it dropped from 0.8 to 0.1% [RR 0.25 (95% CI: 0.21 to 0.28)]. The proportion of cases hospitalized or admitted to ICU was lower in the vaccinated groups, independently of the variant. Omicron was associated with a reduction in risk of admission to hospital and ICU in all age and vaccination status strata. The differential substitution models showed an average RR between 0.19 and 0.50. Conclusion Both independent methods consistently show an important decrease in severity for omicron relative to delta. The systematic reduction happens regardless of age. The severity is also reduced for non-vaccinated and vaccinated groups, but it remains always higher in the non-vaccinated population. This suggests an overall reduction in severity, which could be intrinsic to the omicron variant. The fact is that the RR in ICU admission is systematically smaller than in hospitalization points in the same direction.
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Affiliation(s)
- Martí Català
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Ermengol Coma
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Sergio Alonso
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Cristina Andrés
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain,Biomedical Research Networking Center in Infectious Diseases (CIBERINF), Instituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Blanco
- Clinical Genetics Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Andrés Antón
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain,Biomedical Research Networking Center in Infectious Diseases (CIBERINF), Instituto de Salud Carlos III, Madrid, Spain
| | - Antoni E. Bordoy
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Pere-Joan Cardona
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Cerdanyola, Spain
| | - Francesc Fina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Elisa Martró
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Medina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Núria Mora
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Verónica Saludes
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Clara Prats
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Enrique Alvarez-Lacalle
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain,*Correspondence: Enrique Alvarez-Lacalle
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20
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Yadav RS, Chaudhary D, Avula V, Shahjouei S, Azarpazhooh MR, Abedi V, Li J, Zand R. Social Determinants of Stroke Hospitalization and Mortality in United States' Counties. J Clin Med 2022; 11:jcm11144101. [PMID: 35887865 PMCID: PMC9320068 DOI: 10.3390/jcm11144101] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/29/2022] [Accepted: 06/28/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Background: Stroke incidence and outcomes are influenced by socioeconomic status. There is a paucity of reported population-level studies regarding these determinants. The goal of this ecological analysis was to determine the county-level associations of social determinants of stroke hospitalization and death rates in the United States. (2) Methods: Publicly available data as of 9 April 2021, for the socioeconomic factors and outcomes, was extracted from the Centers for Disease Control and Prevention. The outcomes of interest were “all stroke hospitalization rates per 1000 Medicare beneficiaries” (SHR) and “all stroke death rates per 100,000 population” (SDR). We used a multivariate binomial generalized linear mixed model after converting the outcomes to binary based on their median values. (3) Results: A total of 3226 counties/county-equivalents of the states and territories in the US were analyzed. Heart disease prevalence (odds ratio, OR = 2.03, p < 0.001), blood pressure medication nonadherence (OR = 2.02, p < 0.001), age-adjusted obesity (OR = 1.24, p = 0.006), presence of hospitals with neurological services (OR = 1.9, p < 0.001), and female head of household (OR = 1.32, p = 0.021) were associated with high SHR while cost of care per capita for Medicare patients with heart disease (OR = 0.5, p < 0.01) and presence of hospitals (OR = 0.69, p < 0.025) were associated with low SHR. Median household income (OR = 0.6, p < 0.001) and park access (OR = 0.84, p = 0.016) were associated with low SDR while no college degree (OR = 1.21, p = 0.049) was associated with high SDR. (4) Conclusions: Several socioeconomic factors (e.g., education, income, female head of household) were found to be associated with stroke outcomes. Additional research is needed to investigate intermediate and potentially modifiable factors that can serve as targeted interventions.
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Affiliation(s)
- Randhir Sagar Yadav
- Geisinger Neuroscience Institute, Geisinger Health System, Danville, PA 17822, USA; (R.S.Y.); (D.C.); (S.S.)
- Department of Pediatrics, University of Florida College of Medicine, Jacksonville, FL 32207, USA
| | - Durgesh Chaudhary
- Geisinger Neuroscience Institute, Geisinger Health System, Danville, PA 17822, USA; (R.S.Y.); (D.C.); (S.S.)
- Department of Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Venkatesh Avula
- Department of Molecular and Functional Genomics, Weis Center for Research, Geisinger Health System, Danville, PA 17822, USA; (V.A.); (J.L.)
| | - Shima Shahjouei
- Geisinger Neuroscience Institute, Geisinger Health System, Danville, PA 17822, USA; (R.S.Y.); (D.C.); (S.S.)
| | - Mahmoud Reza Azarpazhooh
- Departments of Clinical Neurological Sciences and Epidemiology, University of Western Ontario, London, ON N6A 3K7, Canada;
| | - Vida Abedi
- Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA 17033, USA;
| | - Jiang Li
- Department of Molecular and Functional Genomics, Weis Center for Research, Geisinger Health System, Danville, PA 17822, USA; (V.A.); (J.L.)
| | - Ramin Zand
- Geisinger Neuroscience Institute, Geisinger Health System, Danville, PA 17822, USA; (R.S.Y.); (D.C.); (S.S.)
- Department of Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
- Neuroscience Institute, The Pennsylvania State University, Hershey, PA 17033, USA
- Correspondence:
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21
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AlQahtani A, Alim B, Almudhaibery F, Mulafikh D, Almutairi S, Almohanna S, Alfawwaz F. The Impact of Climatic, Socioeconomic, and Geographic Factors on the Prevalence of Allergic Fungal Rhinosinusitis: A Worldwide Ecological Study. Am J Rhinol Allergy 2022; 36:423-431. [PMID: 35187957 DOI: 10.1177/19458924211069226] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The prevalence of allergic fungal rhinosinusitis (AFRS) and its associated risk factors have been an issue of debate. Some epidemiological factors have been correlated to the disease prevalence. OBJECTIVES To observe the prevalence pattern of AFRS worldwide and to investigate the effect of specific epidemiological factors on the disease prevalence. METHODS A systematic review was derived from 1983 to December 2018. Data on the prevalence of AFRS were collected from the selected studies. Relevant factors assessing each city's climate, socioeconomics and geography were used to study the association with AFRS prevalence. RESULTS 35 cities across 5 continents were investigated. The worldwide average rate of AFRS in CRS cases is 7.8% (0.2%-26.7%) in which more than half of the investigated cities (57%) had low AFRS prevalence, while the remaining cities had intermediate (11%) and high (32%) prevalence. Cities with higher temperatures were associated with a higher prevalence of AFRS (p-value 0.002), whereas cities with humid continental climate were significantly associated with a low prevalence of AFRS (p-value 0.032). Humidity and wind speed were lower in the cities with higher AFRS prevalence (p-value 0.018 and 0.008, respectively). There were no significant correlations between AFRS prevalence and economic levels, presence of water bodies, rainfall amounts, altitude, and presence of forests. CONCLUSION AFRS has a worldwide distribution pattern with varying prevalence. In this ecological study, we observed a correlation between AFRS prevalence and climatic factors (climate classification, humidity, temperature, and wind speed). Socioeconomic factors should be analyzed on an individual basis for better assessment of the relationship with disease prevalence.
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Affiliation(s)
| | - Bader Alim
- King Fahad Medical City, Riyadh, Saudi Arabia
| | | | | | | | - Saad Almohanna
- Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
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22
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Chung J, Mundy ME, McKenzie S. A Self-Managed Online Mindfulness Program in a University-Wide Learning Management System Orientation Site: A Real-World Ecological Validation Study. Front Psychol 2022; 13:869765. [PMID: 35602693 PMCID: PMC9121920 DOI: 10.3389/fpsyg.2022.869765] [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] [Received: 02/05/2022] [Accepted: 03/28/2022] [Indexed: 11/15/2022] Open
Abstract
The efficacy of mindfulness-based interventions in randomised-controlled trials and large experimental studies has been demonstrated in university student populations. Whilst these investigations have provided insight into the nature of the delivery of mindfulness-based practices, there has been little research in the implementation of self-managed online student wellbeing and mindfulness programs at university. This ecological validation study conducted in 2020 evaluated a real-world implementation of a large, university-wide, online mindfulness-based program that was accessible fully online via the tertiary institutions’ Learning Management System (LMS) student orientation site. The total sample included 833 participants from a range of disciplines and faculties at Monash University, Australia. At the end of the study, 236 (28.3%) participants were retained and completed the follow-up survey. Participants had the option to engage with the fully self-managed online mindfulness program for a 12-week semester. The mindfulness practices were pre-recorded, audio-guided sessions, and 10–15 min in length. Baseline and end of semester questionnaires included the 14-item Warwick-Edinburgh Mental Wellbeing Scale, 10-item Perceived Stress Scale and the 18-item Five Facet Mindfulness Questionnaire. Participants who engaged with the mindfulness program over 3 or more weeks showed significant improvements in all three outcome measures, and all participants showed significant improvements in wellbeing at the end of semester. Learning analytics obtained via the LMS revealed that 58.6% (n = 489) had not logged into the mindfulness program at all, almost a third (31.0%, n = 259) logged into the program materials once or twice, and 10.2% (n = 85) of the whole sample engaged with the program actively, having logged in three or more times. The total number of student logins peaked in week 2, reduced between week 2 and week 7 and thereafter activity remained stable until the end of the semester. We hypothesise that the changes in wellbeing, stress and mindfulness at the end of the semester seen in the low engagement participants may partly be explained by the circumstances of COVID-19 restrictions improving. This study has revealed and discusses the complexities of student behaviour and implications for implementing an online mindfulness program in the real- world setting of a university.
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Affiliation(s)
- Jennifer Chung
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Matthew E Mundy
- Monash Centre for Professional Development and Monash Online Education, Monash University, Melbourne, VIC, Australia
| | - Stephen McKenzie
- School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
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23
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Hellwig F, Ewerling F, Coll CVN, Barros AJD. The role of female permanent contraception in meeting the demand for family planning in low- and middle-income countries. Contraception 2022; 114:41-48. [PMID: 35568087 DOI: 10.1016/j.contraception.2022.05.002] [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: 11/29/2021] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Our aim was to describe the reliance on female permanent contraception among women with demand for family planning satisfied with modern methods (mDFPS) in low- and middle-income countries (LMICs) and to describe socio-economic and demographic patterns of permanent contraception in countries with high use. METHODS Using data from the latest national health survey carried out in LMICs we estimated mDFPS and the share of each contraceptive method used. Countries with a share of more than 25% of female permanent contraception were further explored for differences by wealth, number of living children, woman's age, and by the intersection of woman's age and number of living children. RESULTS In the 20 countries studied, between 6% and 94% of the contracepting population used modern methods. Female permanent contraception accounted for more than half of women using modern contraceptives in India, Dominican Republic, El Salvador, Mexico, and Colombia. In India and Tonga, more than 20% of women using contraceptives with fewer than two living children were using female permanent contraception. Among women with two living children, countries with the highest reliance on permanent contraception were India (79%), El Salvador (61%), Cuba (55%), Colombia (52%), and Thailand (51%). Dominican Republic, El Salvador, India, and Mexico presented high levels of permanent contraception among younger women, with reliance higher than 30% among women aged 25 to 29 and 50% or more among women aged 30 to 34. CONCLUSIONS Reliance on permanent contraception was high in several countries and among women aged less than 35 years.
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Affiliation(s)
- Franciele Hellwig
- Federal University of Pelotas; International Center for Equity in Health; Pelotas Brazil; Federal University of Pelotas; Post-graduation Program in Epidemiology; Pelotas Brazil.
| | - Fernanda Ewerling
- Federal University of Pelotas; International Center for Equity in Health; Pelotas Brazil
| | - Carolina V N Coll
- Federal University of Pelotas; International Center for Equity in Health; Pelotas Brazil
| | - Aluísio J D Barros
- Federal University of Pelotas; International Center for Equity in Health; Pelotas Brazil; Federal University of Pelotas; Post-graduation Program in Epidemiology; Pelotas Brazil
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24
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Yamamura N, Umeda M. [Changes in long-term care certification rate and related factors in municipalities affected by the heavy rain disaster in July 2018]. Nihon Koshu Eisei Zasshi 2022; 69:251-261. [PMID: 35082222 DOI: 10.11236/jph.21-028] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objectives The purpose of this study was to determine the change in the certification rate for long-term care (LTC) in the municipalities affected by the heavy rain disaster in July 2018, and to clarify the relationships between the change in the LTC certification rate and the damage situation and regional characteristics.Methods The subjects were 108 municipalities to which the Disaster Relief Act was applied. Interrupted time series analyses were conducted of the monthly LTC certification rate for a total of 37 months from July 2016 to July 2019, and the changes in the LTC, mild LTC (requiring support 1 and 2), moderate LTC (requiring long-term care 1 to 3), and severe LTC (requiring long-term care 4 and 5) certification rates after the disaster were determined. Multinomial logistic regression analyses were performed to clarify the relationship between trends of changes in the LTC certification rate after the disaster, the damage situation (number of damaged houses, number of dead and missing), and the regional characteristics (population rate of people aged 65 and over, population density, taxable income, population per public health nurse, capacity of long-term care insurance facilities, number of hospital beds, number of clinics, specific health examination implementation rate, and specific health guidance implementation rate).Results The LTC and mild LTC certification rates showed significant increases in the month of the disaster and changes in trends after the disaster. The change in the post-disaster trend of the moderate LTC certification rate was significantly lower. The severe LTC certification rate showed a significant increase only in the month of the disaster; however, there was no significant change seen in the post-disaster trend. The downward change in the trend of the moderate LTC certification rate was negatively related to the population rate of people aged 65 and over, and positively related to the number of clinics. No significant associations of the LTC, mild LTC, and severe LTC certification rates with any of the variables related to the disaster situation and regional characteristics were found.Conclusion The results of this study suggest that the demand for long-term care insurance services may increase as a result of disasters experienced by elderly requiring mild LTC certification who have a relatively high degree of independence.
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Affiliation(s)
- Natsuko Yamamura
- Research Strategy Center, Hyogo Earthquake Memorial 21st Century Research Institute
| | - Maki Umeda
- Research Institute of Nursing Care for People and Community, University of Hyogo
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25
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Yang Y, Huang J, Wu W, Luu HN, Moy FM, Tan S, Fu J, Ying T, Withers M, Hung DT, Mao D, Chen S, Wong MCS, Xu W. A global view of adherence to colonoscopy follow-up in cascade screening of colorectal cancer. Eur J Cancer Care (Engl) 2022; 31:e13577. [PMID: 35315165 DOI: 10.1111/ecc.13577] [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: 09/12/2021] [Revised: 01/11/2022] [Accepted: 03/11/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To overview the colonoscopy adherence in cascade screening of colorectal cancer (CRC) and evaluate potential influence of the initial tests based on an ecological evaluation. METHODS The performance of the initial screening tests and adherence to subsequent colonoscopy were extracted from relevant studies published up to 16 October 2020. The age-standardised incidence (ASRi) of CRC in populations in the year of screening was derived from the Cancer Statistics. RESULTS One hundred sixty-six observational studies and 60 experimental studies were identified. Most studies applied cascade screening with faecal occult blood tests (FOBTs) as an initial test. The adherence to colonoscopy varied greatly across populations by continents, gross national income and type of initial tests, with a median (interquartile range) of 79.8% (63.1%-87.8%) in observational studies and 82.1% (66.7%-90.4%) in randomised trials. The adherence was positively correlated with the ASRi of CRC (r = 0.145, p = 0.023) and positive predictive value (PPV) of the initial tests (r = 0.206, p = 0.002) in observational studies and correlated with ASRi of CRC (r = 0.309, p = 0.002) and sensitivity of the initial tests (r = -0.704, p = 0.003) in experimental studies. CONCLUSIONS Adherence to colonoscopy varies greatly across populations and is related with performance of the initial tests, indicating the importance to select appropriate initial tests.
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Affiliation(s)
- Yihui Yang
- Global Health Institute, School of Public Health, Fudan University, Shanghai, China
| | - Junjie Huang
- J.C. School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Weimiao Wu
- Global Health Institute, School of Public Health, Fudan University, Shanghai, China
| | - Hung N Luu
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Foong-Ming Moy
- Julius Centre, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Songsong Tan
- Global Health Institute, School of Public Health, Fudan University, Shanghai, China
| | - Jiongxing Fu
- Global Health Institute, School of Public Health, Fudan University, Shanghai, China
| | - Tao Ying
- Global Health Institute, School of Public Health, Fudan University, Shanghai, China
| | - Mellissa Withers
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Dang The Hung
- Laboratory Center, Hanoi University of Public Health, Hanoi, Vietnam
| | - Dandan Mao
- Global Health Institute, School of Public Health, Fudan University, Shanghai, China
| | - Sikun Chen
- Global Health Institute, School of Public Health, Fudan University, Shanghai, China
| | - Martin C S Wong
- J.C. School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Wanghong Xu
- Global Health Institute, School of Public Health, Fudan University, Shanghai, China
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Sata M, Okamura T, Nishi N, Kadota A, Nakamura M, Kondo K, Okami Y, Kitaoka K, Ojima T, Yoshita K, Miura K. Trends in Prevalence, Treatment, and Control of Hypertension According to 40-Year-Old Life Expectancy at Prefectures in Japan from the National Health and Nutrition Surveys. Nutrients 2022; 14:nu14061219. [PMID: 35334876 PMCID: PMC8950354 DOI: 10.3390/nu14061219] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/03/2022] [Accepted: 03/10/2022] [Indexed: 01/18/2023] Open
Abstract
The prevalence of hypertension has been decreasing in Japan due to improved medical treatment and a decrease in dietary salt intake. However, disparities in the prevalence, treatment, and control of hypertension are expected to occur in different regions. This study aimed to investigate the trends in the prevalence, treatment, and control of hypertension at the prefectural level of life expectancy among Japanese population. We used data from the National Health and Nutrition Survey and analysed the individual survey information of individuals aged 40–69 years by dividing it into six terms, i.e., 1995–1997, 1999–2001, 2003–2005, 2007–2009, 2012, and 2016. Prefectures were classified into four groups according to their 40-year-old life expectancy in 2000. Outcome values were standardised to the population by 10-year age groups in 2010, and they were tested by two-way analysis of variance according to six terms and life expectancies. The prevalence of hypertension tended to decrease, especially among women, whereas the treatment and control tended to improve from the first to the sixth period in both men and women. The prevalence and treatment of hypertension in men with longer life expectancy tended to be lower than that in other groups, and there was no obvious difference in the control. In women, there were no obvious differences in the prevalence, treatment, or control. Reducing the prevalence of hypertension by improving lifestyle factors, such as high salt intake in each prefecture with a relatively short life expectancy, may be important to resolve the disparity in life expectancy among prefectures.
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Affiliation(s)
- Mizuki Sata
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku 160-8582, Japan;
- Correspondence: ; Tel.: +81-3-5363-3758
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku 160-8582, Japan;
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku 162-8636, Japan;
| | - Aya Kadota
- NCD Epidemiology Research Center, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu-shi 520-2192, Japan; (A.K.); (K.K.); (Y.O.); (K.K.); (K.M.)
| | - Mieko Nakamura
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi 431-3192, Japan; (M.N.); (T.O.)
| | - Keiko Kondo
- NCD Epidemiology Research Center, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu-shi 520-2192, Japan; (A.K.); (K.K.); (Y.O.); (K.K.); (K.M.)
| | - Yukiko Okami
- NCD Epidemiology Research Center, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu-shi 520-2192, Japan; (A.K.); (K.K.); (Y.O.); (K.K.); (K.M.)
| | - Kaori Kitaoka
- NCD Epidemiology Research Center, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu-shi 520-2192, Japan; (A.K.); (K.K.); (Y.O.); (K.K.); (K.M.)
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi 431-3192, Japan; (M.N.); (T.O.)
| | - Katsushi Yoshita
- Department of Food and Human Health Sciences, Graduate School of Human Life Science, Osaka City University, 3-3-138 Sugimoto Sumiyoshi-ku, Osaka-shi 558-8585, Japan;
| | - Katsuyuki Miura
- NCD Epidemiology Research Center, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu-shi 520-2192, Japan; (A.K.); (K.K.); (Y.O.); (K.K.); (K.M.)
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27
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Huo S, Liu Y, Sun A, Zhang B. Environmental and social determinants of thyroid cancer: A spatial analysis based on the Geographical Detector. Front Endocrinol (Lausanne) 2022; 13:1052606. [PMID: 36523594 PMCID: PMC9745063 DOI: 10.3389/fendo.2022.1052606] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/08/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Thyroid cancer has increased sharply in China in recent years. This change may be attributable to multiple factors. The current study aimed to explore the environmental and social determinants of thyroid cancer. METHODS Incidence data from 487 cancer registries in 2016 were collected. Eight factors were considered, namely, air pollution, green space, ambient temperature, ultraviolet radiation, altitude, economic status, healthcare, and education level. A geographical detector (measured by q statistic) was used to evaluate the independent and interactive impact of the eight factors on thyroid cancer. RESULTS Social factors, especially economic status and healthcare level (q > 0.2), were most influential on thyroid cancer.Ultraviolet radiation, air pollution, and temperature had more impact on women, while green space and altitude had more influence on men. Enhanced effects were observed when two factors interacted. Spatially, economic status, healthcare, and air pollution were positively associated with thyroid cancer, while education level, green space, and altitude were negatively related to thyroid cancer. CONCLUSION The socio-environmental determinants and spatial heterogeneity of thyroid cancer were observed in this study. These findings may improve our understanding of thyroid cancer epidemiology and help guide public health interventions.
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Affiliation(s)
- Shirui Huo
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Liu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Anyi Sun
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Bo Zhang
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing, China
- *Correspondence: Bo Zhang,
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Kim M, You S, You JS, Kim SY, Park JH. Income-Related Mortality Inequalities and Its Social Factors among Middle-Aged and Older Adults at the District Level in Aging Seoul: An Ecological Study Using Administrative Big Data. Int J Environ Res Public Health 2021; 19:383. [PMID: 35010641 PMCID: PMC8751095 DOI: 10.3390/ijerph19010383] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/21/2021] [Accepted: 12/28/2021] [Indexed: 12/27/2022]
Abstract
This study investigated income-related health inequality at sub-national level, focusing on mortality inequality among middle-aged and older adults (MOAs). Specifically, we examined income-related mortality inequality and its social factors among MOAs across 25 districts in Seoul using administrative big data from the National Health Insurance Service (NHIS). We obtained access to the NHIS's full-population micro-data on both incomes and demographic variables for the entire residents of Seoul. Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were calculated. The effects of social attributes of districts on SIIs and RIIs were examined through ordinary least squares and spatial regressions. There were clear income-related mortality gradients. Cross-district variance of mortality rates was greater among the lowest income group. SIIs were smaller in wealthier districts. Weak spatial correlation was found in SIIs among men. Lower RIIs were linked to lower Gini coefficients of income for both genders. SIIs (men) were associated with higher proportions of special occupational pensioners and working population. Lower SIIs and RIIs (women) were associated with higher proportions of female household heads. The results suggest that increasing economic activities, targeting households with female heads, reforming public pensions, and reducing income inequality among MOAs can be good policy directions.
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Affiliation(s)
- Minhye Kim
- Department of Sociology, College of Social Science, Changwon National University, Changwon-si 51140, Korea;
| | - Suzin You
- Inequality and Social Policy Institute, Gachon University, Seongnam-si 13120, Korea;
| | - Jong-sung You
- Inequality and Social Policy Institute, Gachon University, Seongnam-si 13120, Korea;
| | - Seung-Yun Kim
- Department of Urban Society Research, Seoul Institute, Seoul 06756, Korea;
| | - Jong Heon Park
- Big Data Steering Department, National Health Insurance Service, Wonju-si 26464, Korea;
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Fallani E, Orsi A, Signori A, Icardi G, Domnich A. An exploratory study to assess patterns of influenza- and pneumonia-related mortality among the Italian elderly. Hum Vaccin Immunother 2021; 17:5514-5521. [PMID: 34965179 PMCID: PMC8916782 DOI: 10.1080/21645515.2021.2005381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/16/2022] Open
Abstract
Older adults are at disproportionately high risk of severe influenza-related outcomes and represent the main target of the annual influenza vaccination. The protective effect of seasonal influenza vaccination on the observed mortality indicators is controversial. In this ecological study, spatiotemporal patterns of pneumonia- and influenza-related mortality registered in the Italian elderly over seven (2011–2017) consecutive seasons were explored and the epidemiological association between the observed local pneumonia- and influenza-related mortality and influenza vaccination campaign features were modeled by using both fixed- and random-effects panel regression models. The descriptive spatiotemporal analysis showed a clear North–South gradient, where northern regions tended to report more pneumonia- and influenza-related deaths. After adjustment for potential confounders, it was found that each 1% increase in influenza vaccination coverage rate would be associated (P < .001) with a 1.6–1.9% decrease in pneumonia- and influenza-related mortality. Moreover, each 1% increase in the use of MF59®-adjuvanted trivalent influenza vaccine would be associated (P < .05) with a further 0.4% decrease in pneumonia- and influenza-related mortality. This study supports the increase in annual influenza vaccination in Italy and suggests that a higher level of use of the adjuvanted influenza vaccine in the elderly may be beneficial.
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Affiliation(s)
- Elettra Fallani
- Seqirus S.R.L., Monteriggioni, Italy.,Department of Life Sciences, University of Siena, Siena, Italy
| | - Andrea Orsi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Giancarlo Icardi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
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30
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Miani C. Medical abortion ratios and gender equality in Europe: an ecological correlation study. Sex Reprod Health Matters 2021; 29:1985814. [PMID: 34730066 PMCID: PMC8567957 DOI: 10.1080/26410397.2021.1985814] [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] [Indexed: 11/20/2022] Open
Abstract
Medical abortion (MA) is recommended by the WHO as a safe and effective pregnancy termination method in the first trimester. From a feminist perspective, it is a non-medicalised, self-managed, emancipating procedure allowing persons seeking abortion to be more in control of their abortion, as opposed to surgical procedures. In European countries where MA is legal, the proportion of MA (relative to surgical abortions) varies greatly. We hypothesised that this ratio may be partly explained by country-level dimensions of gender equality. We assessed the association between MA ratios and gender equality in Europe in correlation and regression analyses, using several country-level gender equality indices. The relevance of other factors, i.e. date of introduction of MA and pregnancy week until which MA is permitted, was also investigated. MA ratios ranged from 24.4% (Italy) to 97.7% (Finland). MA was more frequent relative to surgical abortion in countries with higher levels of gender equality. All gender equality indices were associated with MA ratios (e.g. Global Gender Gap Index corr. coeff: 0.761, p < 0.0001). Specifically, markers of economic and political gender equality seemed to drive the correlations. The pregnancy week until which MA is permitted was associated with both gender equality and MA ratios. Our study suggests that women’s participation in the economic and political sphere may have repercussions on the methods offered and used through abortion services. It highlights the link between feminist perspectives, reproductive health policies and practices, and gender equality, especially in terms of access to economic resources and political representation.
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Affiliation(s)
- Céline Miani
- Junior Research Group Leader, School of Public Health, Department of Epidemiology and International Public Health, Bielefeld University, Bielefeld, Germany. Correspondence:
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31
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Wollschläger D, Auvinen A, Blettner M, Zeeb H. Methodological considerations for interrupted time series analysis in radiation epidemiology: an overview. J Radiol Prot 2021; 41:609-618. [PMID: 34261051 DOI: 10.1088/1361-6498/ac149c] [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] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
Interrupted time series analysis (ITSA) is a method that can be applied to evaluate health outcomes in populations exposed to ionizing radiation following major radiological events. Using aggregated time series data, ITSA evaluates whether the time trend of a health indicator shows a change associated with the radiological event. That is, ITSA checks whether there is a statistically significant discrepancy between the projection of a pre-event trend and the data empirically observed after the event. Conducting ITSA requires one to consider specific methodological issues due to unique threats to internal validity that make ITSA prone to bias. We here discuss the strengths and limitations of ITSA with respect to bias and confounding, data quality, and statistical aspects. We provide recommendations to strengthen the robustness of ITSA studies and reduce their susceptibility to producing spurious results as a consequence of arbitrary modelling decisions.
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Affiliation(s)
- Daniel Wollschläger
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Anssi Auvinen
- Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland
- STUK - Radiation and Nuclear Safety Authority, Helsinki, Finland
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
- Wissenschaftsschwerpunkt Gesundheitswissenschaften, Universität Bremen, Bremen, Germany
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32
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Yu Y, Matsuyama R, Tsunematsu M, Kakehashi M. Quantifying the Effects of Medical Examination and Possible Risk Factors against the Incidence of Cervical Cancer in a Low Human Papillomavirus Vaccination Coverage: An Ecological Study in Japan. Cancers (Basel) 2021; 13:cancers13194784. [PMID: 34638269 PMCID: PMC8508384 DOI: 10.3390/cancers13194784] [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] [Received: 08/06/2021] [Revised: 09/08/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022] Open
Abstract
Cervical cancer (CC) is one of the most common gynecological malignancies in females, mainly caused by human papillomavirus (HPV). In countries with lower HPV vaccine coverage, such as Japan, medical examination may play a key role in decreasing CC incidence. This study aimed to quantify the effect of medical examination on cervical cancer (CC) incidence in Japan, considering the effects of possible risk factors. By collecting Japan's Prefectural data on CC incidence (2013-2017), incidence of sexually transmitted diseases (STDs; Chlamydia, Herpes, Condyloma, and Gonorrhea; 1993-2012), screening and detailed examination rate against CC (2013-2016), smoking rate (2001-2013), economic status (disposable income and economic surplus; 2014-2015), and education status (2015), we analyzed associations among them using Pearson's correlation coefficients. Additionally, assuming that the incidence of STDs reflects the frequency of risky sexual behavior at the co-infection point with HPV, we constructed generalized linear models to predict CC incidence, taking a 5-20-year time-lag between incidences of STDs and the CC incidence. Against CC incidence, Chlamydia in females and Gonorrhea in males with a 15-year time-lag showed positive associations, while Condyloma in both genders with a 15-year time-lag, screening rate, economic status, and smoking rate showed negative associations. An increase in screening test rate by 10% was estimated to decrease CC incidence by 9.6%. This means that screening tests decrease CC incidence effectively, but not drastically, suggesting the need for additional countermeasures for CC prevention.
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Pasdar Z, Pana TA, Ewers KD, Szlachetka WA, Perdomo-Lampignano JA, Gamble DT, Bhattacharya S, Carter B, Myint PK. An Ecological Study Assessing the Relationship between Public Health Policies and Severity of the COVID-19 Pandemic. Healthcare (Basel) 2021; 9:1221. [PMID: 34574999 PMCID: PMC8470125 DOI: 10.3390/healthcare9091221] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/26/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022] Open
Abstract
Reliance on government-led policies have heightened during the COVID-19 pandemic. Further research on the policies associated with outcomes other than mortality rates remains warranted. We aimed to determine associations between government public health policies on the severity of the COVID-19 pandemic. This ecological study including countries reporting ≥25 daily COVID-related deaths until end May 2020, utilised public data on policy indicators described by the Blavatnik school of Government. Associations between policy indicators and severity of the pandemic (mean mortality rate, time to peak, peak deaths per 100,000, cumulative deaths after peak per 100,000 and ratio of mean slope of the descending curve to mean slope of the ascending curve) were measured using Spearman rank-order tests. Analyses were stratified for age, income and region. Among 22 countries, containment policies such as school closures appeared effective in younger populations (rs = -0.620, p = 0.042) and debt/contract relief in older populations (rs = -0.743, p = 0.009) when assessing peak deaths per 100,000. In European countries, containment policies were generally associated with good outcomes. In non-European countries, school closures were associated with mostly good outcomes (rs = -0.757, p = 0.049 for mean mortality rate). In high-income countries, health system policies were generally effective, contrasting to low-income countries. Containment policies may be effective in younger populations or in high-income or European countries. Health system policies have been most effective in high-income countries.
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Affiliation(s)
- Zahra Pasdar
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK; (Z.P.); (T.A.P.); (K.D.E.); (W.A.S.); (J.A.P.-L.); (D.T.G.); (S.B.)
| | - Tiberiu A. Pana
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK; (Z.P.); (T.A.P.); (K.D.E.); (W.A.S.); (J.A.P.-L.); (D.T.G.); (S.B.)
| | - Kai D. Ewers
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK; (Z.P.); (T.A.P.); (K.D.E.); (W.A.S.); (J.A.P.-L.); (D.T.G.); (S.B.)
| | - Weronika A. Szlachetka
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK; (Z.P.); (T.A.P.); (K.D.E.); (W.A.S.); (J.A.P.-L.); (D.T.G.); (S.B.)
| | - Jesus A. Perdomo-Lampignano
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK; (Z.P.); (T.A.P.); (K.D.E.); (W.A.S.); (J.A.P.-L.); (D.T.G.); (S.B.)
| | - David T. Gamble
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK; (Z.P.); (T.A.P.); (K.D.E.); (W.A.S.); (J.A.P.-L.); (D.T.G.); (S.B.)
| | - Sohinee Bhattacharya
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK; (Z.P.); (T.A.P.); (K.D.E.); (W.A.S.); (J.A.P.-L.); (D.T.G.); (S.B.)
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK;
| | - Phyo K. Myint
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK; (Z.P.); (T.A.P.); (K.D.E.); (W.A.S.); (J.A.P.-L.); (D.T.G.); (S.B.)
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34
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Pasdar Z, Pana TA, Ewers KD, Szlachetka WA, Perdomo-Lampignano JA, Gamble DT, Bhattacharya S, Carter B, Myint PK. An Ecological Study Assessing the Relationship between Public Health Policies and Severity of the COVID-19 Pandemic. Healthcare (Basel) 2021; 9:healthcare9091221. [PMID: 34574999 DOI: 10.2139/ssrn.3634847] [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] [Received: 06/23/2021] [Revised: 08/26/2021] [Accepted: 09/10/2021] [Indexed: 05/24/2023] Open
Abstract
Reliance on government-led policies have heightened during the COVID-19 pandemic. Further research on the policies associated with outcomes other than mortality rates remains warranted. We aimed to determine associations between government public health policies on the severity of the COVID-19 pandemic. This ecological study including countries reporting ≥25 daily COVID-related deaths until end May 2020, utilised public data on policy indicators described by the Blavatnik school of Government. Associations between policy indicators and severity of the pandemic (mean mortality rate, time to peak, peak deaths per 100,000, cumulative deaths after peak per 100,000 and ratio of mean slope of the descending curve to mean slope of the ascending curve) were measured using Spearman rank-order tests. Analyses were stratified for age, income and region. Among 22 countries, containment policies such as school closures appeared effective in younger populations (rs = -0.620, p = 0.042) and debt/contract relief in older populations (rs = -0.743, p = 0.009) when assessing peak deaths per 100,000. In European countries, containment policies were generally associated with good outcomes. In non-European countries, school closures were associated with mostly good outcomes (rs = -0.757, p = 0.049 for mean mortality rate). In high-income countries, health system policies were generally effective, contrasting to low-income countries. Containment policies may be effective in younger populations or in high-income or European countries. Health system policies have been most effective in high-income countries.
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Affiliation(s)
- Zahra Pasdar
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Tiberiu A Pana
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Kai D Ewers
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Weronika A Szlachetka
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Jesus A Perdomo-Lampignano
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - David T Gamble
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Sohinee Bhattacharya
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London WC2R 2LS, UK
| | - Phyo K Myint
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
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Taira K, Mori T, Ishimaru M, Iwagami M, Sakata N, Watanabe T, Takahashi H, Tamiya N. Regional Inequality in Dental Care Utilization in Japan: An Ecological Study Using the National Database of Health Insurance Claims. Lancet Reg Health West Pac 2021; 12:100170. [PMID: 34527966 PMCID: PMC8356097 DOI: 10.1016/j.lanwpc.2021.100170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Received: 02/05/2021] [Revised: 04/15/2021] [Accepted: 05/06/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study examined regional inequalities in dental care utilization in Japan and the association of dental care utilization with socioeconomic factors. METHODS Using the Fourth National Database of Health Insurance Claims and Specific Health Checkups of Japan Open data, this ecological study analyzed 216 million pieces of aggregated data from April 2017 to March 2018. Nine indicators of dental care utilization were used: outpatient visits, outreach services, cavity fillings, pulpectomies, dental calculus removals, periodontal surgeries, tooth extractions, dental bridges, and dentures. Standardized claim ratios (SCRs) for these indicators were calculated for Japan's 47 prefectures, which were divided into three groups based on the number of dental clinics per population, average income per capita, and the proportion of university enrollments. Associations of the dental care utilization with dental supply and regional socioeconomic factors were examined. FINDINGS The ratios of maximum to minimum of SCRs were 1·4 for outpatient visits, 19·3 for outreach services, and 17·6 for periodontal surgeries. Dental supply was positively associated with outpatient visits, outreach services, dental calculus removal, and periodontal surgeries. Regional average income and educational level were positively associated with dental calculus removals, and negatively associated with pulpectomies, tooth extractions, dental bridges, and dentures. INTERPRETATION In Japan, regional inequalities in dental care utilization exist for periodontal care and outreach services but are smaller for urgent and substantial dental care. Regional income and educational levels appear to have influence on dental care utilization. FUNDING Ministry of Health, Labour and Welfare of Japan (H31-19FA1001).
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Affiliation(s)
- Kento Taira
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takahiro Mori
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Department of General Medical Science, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
- Department of General Internal Medicine, Eastern Chiba Medical Center, Togane, Chiba, Japan
| | - Miho Ishimaru
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Nobuo Sakata
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Taeko Watanabe
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hideto Takahashi
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- National Institute of Public Health, Wako, Saitama, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Barboza Solís C, Reyes-Carmona J, Fantin R. Social inequality in incidence and mortality of malignant neoplasms of lip, oral cavity and pharynx: Is Costa Rica an international paradox? Community Dent Oral Epidemiol 2021; 50:243-250. [PMID: 34076287 DOI: 10.1111/cdoe.12658] [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: 10/14/2020] [Revised: 04/13/2021] [Accepted: 04/20/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Low socioeconomic position (SEP) has been associated with higher incidences and mortality of lip, oral cavity and pharynx (LOP) cancers in the vast majority of countries with available data. The origins of health inequalities in cancer are socioeconomic, although they vary by time and country. Evidence from Low-and Middle-income Countries (LMICs) remains scarce. This study aims to identify and describe socioeconomic inequalities in LOP cancers incidence and mortality in Costa Rica. The hypothesis tested is that people leaving in low-SEP districts in Costa Rica have greater incidence and mortality rates of lip, oral cavity and pharynx cancers. METHODS The 10th revision of the International Classification of Diseases (ICD-10) was used to define cancer sites. Data come from a national population-based Cancer Registry with 100% completeness to study incidence. Incidence rate included all new cases of LOP cancer diagnosed from January 1, 2011, and December 31, 2015, for a total of 2 798 517 individuals, 13 832 524 years of follow-up and 601 LOP cases. Mortality rate was extracted from the National Death Index, including 2 739 733 individuals, 23 950 240 person-years of follow-up and 586 LOP cancer deaths, from January 1, 2010, to December 31, 2018. The 2011 Census (with 94% of Costa Rican inhabitants) was used to characterize the urbanicity and wealth of 477 districts. Survival models were performed for both incidence and mortality, allowing to consider existing competitive risks. Cox models were used for incidence, and parametric survival models based on a Gompertz distribution for mortality. RESULTS The study found that people who lived in the most socioeconomically disadvantaged areas had lower probabilities of developing LOP cancers than people in the richest districts. The same pattern for mortality, however, was not significant. CONCLUSIONS The hypothesis that incidence and mortality of LOP cancers will show a positive social gradient was not confirmed in this study, contradicting the existing literature. This could be explained by the social distribution of risky health behaviours, more frequent in socially advantaged populations.
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Affiliation(s)
| | | | - Romain Fantin
- Centro Centroamericano de Población, Universidad de Costa Rica, San José, Costa Rica.,Escuela de Salud Pública, Facultad de Medicina, Universidad de Costa Rica, San José, Costa Rica.,Escuela de Medicina, Facultad de Medicina, Universidad de Costa Rica, San José, Costa Rica
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37
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Druetz T, Stresman G, Ashton RA, Joseph V, van den Hoogen L, Worges M, Hamre KES, Fayette C, Monestime F, Impoinvil D, Rogier E, Chang MA, Lemoine JF, Drakeley C, Eisele TP. The Immediate Effects of a Combined Mass Drug Administration and Indoor Residual Spraying Campaign to Accelerate Progress towards Malaria Elimination in Grande-Anse, Haiti. J Infect Dis 2021; 225:1611-1620. [PMID: 33993294 PMCID: PMC9071345 DOI: 10.1093/infdis/jiab259] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Haiti is planning targeted interventions to accelerate progress toward malaria elimination. In the most affected department (Grande-Anse), a combined mass drug administration (MDA) and indoor residual spraying (IRS) campaign was launched in October 2018. This study assessed the intervention’s effectiveness in reducing Plasmodium falciparum prevalence. Methods An ecological quasi-experimental study was designed, using a pretest and posttest with a nonrandomized control group. Surveys were conducted in November 2017 in a panel of easy access groups (25 schools and 16 clinics) and were repeated 2–6 weeks after the campaign, in November 2018. Single-dose sulfadoxine-pyrimethamine and primaquine was used for MDA, and pirimiphos-methyl as insecticide for IRS. Results A total of 10 006 participants were recruited. Fifty-two percent of the population in the intervention area reported having received MDA. Prevalence diminished between 2017 and 2018 in both areas, but the reduction was significantly larger in the intervention area (ratio of adjusted risk ratios, 0.32 [95% confidence interval, .104–.998]). Conclusions Despite a moderate coverage, the campaign was effective in reducing P. falciparum prevalence immediately after 1 round. Targeted MDA plus IRS is useful in preelimination settings to rapidly decrease the parasite reservoir, an encouraging step to accelerate progress toward malaria elimination.
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Affiliation(s)
- Thomas Druetz
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA.,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal QC, Canada.,Centre de Recherche en Santé Publique, Montreal QC, Canada
| | - Gillian Stresman
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ruth A Ashton
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Vena Joseph
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Lotus van den Hoogen
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Matt Worges
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
| | - Karen E S Hamre
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA.,CDC Foundation, Atlanta GA, USA
| | | | | | - Daniel Impoinvil
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Eric Rogier
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Michelle A Chang
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta GA, USA
| | - Jean Frantz Lemoine
- Programme National de Contrôle de la Malaria, Ministère de la Santé Publique et de la Population (MSPP), Port-au-Prince, Haiti
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Thomas P Eisele
- Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans LA, USA
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Huang KS, Guha-Sapir D, Tao QL, Wang YY, Deng XJ, Xiao T, Yang YQ, He DX. Disability-Adjusted Life Years (DALYs) Due to Ischemic Heart Disease (IHD) Associated with Natural Disasters: A Worldwide Population-Based Ecological Study. Glob Heart 2021; 16:30. [PMID: 34040943 DOI: 10.5334/gh.919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Recent studies have reported an association between natural disasters of various kinds and ischemic heart disease (IHD). We investigated the association between Disability-adjusted life years (DALYs) due to IHD and natural disasters and aimed to assess DALYs as a quantification of the burden of IHD related to natural disasters at the global level. Methods: Country-specific data of natural disaster impacts DALYs due to IHD and socioeconomic variables were obtained from open sources over the period of 1990–2013 and 2014–2017. A population-based trend ecological design was conducted to estimate the association between trends in DALYs and natural disasters (occurrence, casualties and total damage), adjusting for socioeconomic variables. Results: Most countries have experienced increases in natural disaster occurrences and decreases in DALYs during this study period. The unadjusted correlation analysis demonstrated a positive and significant correlation between DALYs and natural disasters for females and for both sexes (R = 0.163 and 0.146, p = 0.024 and 0.043), and a marginally significant correlation for males (R = 0.128, p = 0.076). After adjusting for socioeconomic variables, multiple linear regression demonstrated independent associations between the occurrence and DALYs due to IHD for males, females and both sexes (standardized coefficients = 0.192, 0.23 and 0.187, p = 0.016, 0.004 and 0.022). Conclusions: A weak but significantly positive association between natural disaster and IHD was confirmed and quantified at the global level by this DALY metric analysis. Adaptation strategies for natural disaster responses and IHD disease burden reduction need to be developed.
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Duus KS, Moos C, Frederiksen P, Andersen V, Heitmann BL. Prenatal and Early Life Exposure to the Danish Mandatory Vitamin D Fortification Policy Might Prevent Inflammatory Bowel Disease Later in Life: A Societal Experiment. Nutrients 2021; 13:nu13041367. [PMID: 33921832 PMCID: PMC8072780 DOI: 10.3390/nu13041367] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/09/2021] [Accepted: 04/17/2021] [Indexed: 02/06/2023] Open
Abstract
This register-based national cohort study of 206,900 individuals investigated whether prenatal exposure to small extra doses of vitamin D from fortified margarine prevented inflammatory bowel disease (IBD) later in life; whether the risk of IBD varied according to month or season of birth; and finally, whether there was an interaction between exposure to extra D vitamin and month or season of birth. Fortification of margarine with vitamin D was mandatory in Denmark from the mid-1930s until 1st June 1985, when it was abolished. Two entire birth cohorts, each including two years, were defined: one exposed and one unexposed to the fortification policy for the entire gestation. All individuals were followed for 30 years from the day of birth for an IBD diagnosis in Danish hospital registers. Logistic regression analyses were used to estimate odds ratios (OR) and 95% confidence intervals (CI). Odds for IBD was lower among those exposed to extra D vitamin compared to those unexposed, OR = 0.87 (95% CI: 0.79; 0.95). No association with month or season of birth was found. However, estimates suggested that particularly children born during autumn may have benefitted from the effect of small extra doses of vitamin D. This is, to our knowledge, the first study to explore if prenatal exposure to vitamin D from fortification influenced the risk of IBD. Our results suggest that prenatal exposure to small amounts of extra vitamin D from food fortification may protect against the development of IBD before 30 years of age.
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Affiliation(s)
- Katrine S. Duus
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, 2000 Frederiksberg, Denmark; (C.M.); (P.F.); (B.L.H.)
- Focused Research Unit for Molecular Diagnostic and Clinical Research, Institute of Regional Health Research, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark;
- Correspondence:
| | - Caroline Moos
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, 2000 Frederiksberg, Denmark; (C.M.); (P.F.); (B.L.H.)
- Focused Research Unit for Molecular Diagnostic and Clinical Research, Institute of Regional Health Research, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark;
| | - Peder Frederiksen
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, 2000 Frederiksberg, Denmark; (C.M.); (P.F.); (B.L.H.)
| | - Vibeke Andersen
- Focused Research Unit for Molecular Diagnostic and Clinical Research, Institute of Regional Health Research, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark;
- Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense, Denmark
| | - Berit L. Heitmann
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, 2000 Frederiksberg, Denmark; (C.M.); (P.F.); (B.L.H.)
- The Department of Public Health, Section for General Practice, University of Copenhagen, 1017 Copenhagen, Denmark
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Breitling LP. Global epidemiology and socio-economic development correlates of the reproductive ratio of COVID-19. Int Health 2021; 13:514-519. [PMID: 33684196 PMCID: PMC7989226 DOI: 10.1093/inthealth/ihab006] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/25/2020] [Accepted: 02/12/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The most commonly cited argument for imposing or lifting various restrictions in the context of the coronavirus disease 2019 (COVID-19) pandemic is an assumed impact on the reproductive ratio of the pathogen. It has furthermore been suggested that less-developed countries are particularly affected by this pandemic. Empirical evidence for this is lacking. METHODS Based on a dataset covering 170 countries, patterns of empirical 7-d reproductive ratios during the first months of the COVID-19 pandemic were analysed. Time trends and associations with socio-economic development indicators, such as gross domestic product per capita, physicians per population, extreme poverty prevalence and maternal mortality ratio, were analysed in mixed linear regression models using log-transformed reproductive ratios as the dependent variable. RESULTS Reproductive ratios during the early phase of a pandemic exhibited high fluctuations and overall strong declines. Stable estimates were observed only several weeks into the pandemic, with a median reproductive ratio of 0.96 (interquartile range 0.72-1.34) 6 weeks into the analysis period. Unfavourable socio-economic indicators showed consistent associations with higher reproductive ratios, which were elevated by a factor of 1.29 (95% confidence interval 1.15 to 1.46), for example, in the countries in the highest compared with the lowest tertile of extreme poverty prevalence. CONCLUSIONS The COVID-19 pandemic has allowed for the first time description of the global patterns of reproductive ratios of a novel pathogen during pandemic spread. The present study reports the first quantitative empirical evidence that COVID-19 net transmissibility remains less controlled in socio-economically disadvantaged countries, even months into the pandemic. This needs to be addressed by the global scientific community as well as international politics.
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Affiliation(s)
- Lutz P Breitling
- Augsburg University Hospital, Department of Gastroenterology, Rheumatology and Infectiology, Stenglinstr. 2, 86156 Augsburg, Germany
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Ke Y, Cui J, Wong Y. Ecological Study on Differences in COVID-19 Fatality among Wuhan, Rest of Hubei, and Rest of China. J Epidemiol Glob Health 2021; 11:42-45. [PMID: 33009735 PMCID: PMC7958285 DOI: 10.2991/jegh.k.200902.001] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/22/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND China's vigorous anti-COVID-19 campaign has been going on for three months since January 20, which has contained the spread of the virus across China. OBJECTIVES Epidemiological investigations found that COVID-19 fatality rates in Wuhan, rest parts of Hubei province except Wuhan (Rest of Hubei) and rest parts of Mainland China except Hubei province (Rest of China) were different. An ecological study was conducted to analyze the reasons and provide the world with China's anti-COVID-19 epidemic experiences. METHODS Infected cases from Mainland China were divided into three populations: Wuhan, Rest of Hubei and Rest of China. Methods were based on The Novel Coronavirus Infected Pneumonia Diagnosis and Treatment Standards. Total confirmed cases, daily severe cases, total deaths from February 12 to April 20 were collected for statistical analysis. RESULTS 50,333 total confirmed cases in Wuhan made up the most substantial part by comparison with 17,795 in Rest of Hubei and 14,630 in Rest of China, respectively. In the early stage of the COVID-19 epidemic, daily severe cases in Wuhan accounted for the majority, and as the epidemic controlled, severe cases in all three populations decreased. Total deaths in Wuhan constituted the most significant proportion, with the highest 3869 in contrast to 643 in Rest of Hubei and 120 in Rest of China. The fatality rates in Wuhan ranged from 2.82% to 7.69%, much higher than 1.80-3.61% in Rest of Hubei, and 0.49-0.88% in Rest of China. Pearson chi-square test for fatality rates in the three populations demonstrated significant differences (p < 0.01). CONCLUSION The ecological comparison study among the three populations have proved that social distancing, quarantine, lockdown, cutting off sources of infection and transmission routes, early detection, early isolation, early treatment are all vital to control the epidemic by reducing COVID-19 confirmed cases, severe cases and the fatality rate.
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Affiliation(s)
- Youfu Ke
- Clinical Division, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China,Corresponding author.
| | - Jianli Cui
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria 3083, Australia
| | - Yunkeung Wong
- Hong Kong Institute of Vocational Education, Hong Kong, 999077, China
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Millar JA, Dao HDN, Stefopulos ME, Estevam CG, Fagan-Garcia K, Taft DH, Park C, Alruwaily A, Desai AN, Majumder MS. Risk factors for increased COVID-19 case-fatality in the United States: A county-level analysis during the first wave. medRxiv 2021:2021.02.24.21252135. [PMID: 33655256 PMCID: PMC7924276 DOI: 10.1101/2021.02.24.21252135] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The ongoing COVID-19 pandemic is causing significant morbidity and mortality across the US. In this ecological study, we identified county-level variables associated with the COVID-19 case-fatality rate (CFR) using publicly available datasets and a negative binomial generalized linear model. Variables associated with decreased CFR included a greater number of hospitals per 10,000 people, banning religious gatherings, a higher percentage of people living in mobile homes, and a higher percentage of uninsured people. Variables associated with increased CFR included a higher percentage of the population over age 65, a higher percentage of Black or African Americans, a higher asthma prevalence, and a greater number of hospitals in a county. By identifying factors that are associated with COVID-19 CFR in US counties, we hope to help officials target public health interventions and healthcare resources to locations that are at increased risk of COVID-19 fatalities.
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Affiliation(s)
- Jess A. Millar
- University of Michigan - Department of Epidemiology, Department of Computational Medicine and Bioinformatics (Ann Arbor, MI, United States)
| | - Hanh Dung N. Dao
- University of Oklahoma Health Sciences Center - Department of Biostatistics and Epidemiology (Oklahoma City, OK, United States)
| | | | - Camila G. Estevam
- State University of Campinas - Department of Public Health (Campinas, SP, Brazil)
| | | | - Diana H. Taft
- University of California Davis - Department of Food Science and Technology (Davis, CA, United States)
| | - Christopher Park
- New York University - College of Global Public Health (New York, NY, United States)
| | - Amaal Alruwaily
- Saudi Center for Disease Prevention and Control - Department of Non-Communicable Disease (Riyadh, Saudi Arabia)
| | - Angel N. Desai
- Department of Internal Medicine, Division of Infectious Disease, University of California Davis Medical Center (Sacramento, CA, United States)
| | - Maimuna S. Majumder
- Harvard Medical School and Boston Children’s Hospital (Boston, MA, United States)
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Periyakoil D, Das HP, Miller C, Spanos CJ, Prata N. Environmental Exposures in Singapore Schools: An Ecological Study. Int J Environ Res Public Health 2021; 18:1843. [PMID: 33672818 PMCID: PMC7917725 DOI: 10.3390/ijerph18041843] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 11/25/2022]
Abstract
Global climate change is a clear and present danger to our environment, but the impacts of climate change on human health are less known. People in Asian countries are more susceptible to the negative impacts of climate change and the subsequent environmental exposures because of the high population density, rapid urbanization, and natural geography of the region. The objective of this multidisciplinary collaborative ecological study was to explore the impact of environmental exposures such as temperature (°C), noise (db), humidity (%rh), air conditioning exposure time (hours), and distance traveled to school (km) on the comfort and academic success of school children in Singapore. Analysis of a large dataset from the Singapore National Science Experiment revealed a positive correlation between the distance traveled to school and favorable environmental conditions (moderate temperatures, low noise, low humidity, and higher amount of air conditioning time) and student academic performance. The analysis revealed that the distance traveled between home and school for public school students falls within a larger range than that for independent (private) school students. On average, students traveled farther distances to attend schools of higher academic caliber thereby increasing their exposure to environmental pollution. Student exposure to pollution can be minimized if all schools adhere to higher standards of environmental comfort and standardized academic caliber. If students can attend the school closest to their homes, they can minimize their daily pollution exposure due to traffic/commute, thereby mitigating the resultant negative health consequences.
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Affiliation(s)
- Divya Periyakoil
- UC Berkeley Department of Electrical Engineering and Computer Science, Berkeley, CA 94720, USA; (H.P.D.); (C.J.S.)
| | - Hari Prasanna Das
- UC Berkeley Department of Electrical Engineering and Computer Science, Berkeley, CA 94720, USA; (H.P.D.); (C.J.S.)
| | - Clayton Miller
- School of Design and Environment, National University of Singapore, Singapore 119077, Singapore;
| | - Costas J. Spanos
- UC Berkeley Department of Electrical Engineering and Computer Science, Berkeley, CA 94720, USA; (H.P.D.); (C.J.S.)
| | - Ndola Prata
- UC Berkeley School of Public Health, Berkeley, CA 94704, USA;
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Hansen MB, Thorsted AB, Ivarsson S, Tyrstrup M, Hedin K, Melander E, Arpi M, Jakobsen HN, Brogaard E, Jensen JN. Antibiotic use in pre-school children and the correlation with adult educational levels in two Nordic counties: a replication of a 20-year-old study. Infect Dis (Lond) 2021; 53:281-290. [PMID: 33579169 DOI: 10.1080/23744235.2021.1882696] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to describe the change of antibiotic prescribing in pre-school children in the municipalities of the former Copenhagen County in Denmark and Skåne County in Sweden after 20 years of antibiotic stewardship effort. Furthermore, the variation in the prescribing of antibiotics between the municipalities and the correlation between municipal adult educational level and antibiotic prescribing in pre-school children was assessed. METHODS In this ecological study, information on antibiotic prescribing in pre-school children was obtained from a central pharmacy settlement system in each Region. The antibiotic prescribing rate was expressed in defined daily doses per 1,000 inhabitants per day (DDD/TID) and number of prescriptions/1000 inhabitants. Information on municipal adult educational levels was obtained from Statistics Denmark and Statistics Sweden. RESULTS The antibiotic prescribing rate during 2017 was higher in the municipalities of Copenhagen County (5.6-7.9 DDD/TID) compared to the municipalities of Skåne County (4.2-6.6 DDD/TID). In 1998 a higher rate was found in Skåne County (9.6-17.7 DDD/TID) compared to Copenhagen County (8.0-12.9 DDD/TID). A non-significant negative correlation between adult educational levels and antibiotic prescribing was observed in the municipalities of Copenhagen County (r= -0.233, p = .352) while the correlation was positive in the municipalities of Skåne County (r= +0.410, p = .018). The same correlations were observed in 1998. CONCLUSION We found higher antibiotic prescribing in pre-school children in the municipalities of Copenhagen County compared to Skåne County in 2017, suggesting a possible overuse of antibiotics in Denmark. Further research should try to elucidate the reasons for the observed variation.
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Affiliation(s)
- Matilde Bøgelund Hansen
- Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Anne Bonde Thorsted
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Stina Ivarsson
- Lundbergsgatan Primary Health Care Centre, Malmö, Sweden
| | - Mia Tyrstrup
- Department of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, Sweden
| | - Katarina Hedin
- Department of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, Sweden.,Futurum, Region Jönköping County and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Eva Melander
- Department of Translational Medicine, Lund University, Malmö, Sweden.,Regional Centre of Communicable Disease Control, Malmö, Sweden
| | - Magnus Arpi
- Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Helle Neel Jakobsen
- Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Emma Brogaard
- Department of Medicines Resource, Skåne Region, Malmö, Sweden
| | - Jette Nygaard Jensen
- Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.,Committee for the Prevention of Hospital Infections, Capital Region of Denmark, Copenhagen, Denmark
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Kellemen M, Ye J, Moreno-Madriñan MJ. Exploring for Municipality-Level Socioeconomic Variables Related to Zika Virus Incidence in Colombia. Int J Environ Res Public Health 2021; 18:1831. [PMID: 33668584 PMCID: PMC7918893 DOI: 10.3390/ijerph18041831] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/24/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022]
Abstract
Colombia experienced an outbreak of Zika virus infection during September 2015 until July 2016. This study aimed to identify the socioeconomic factors that at the municipality level correlate with this outbreak and therefore could have influenced its incidence. An analysis of publicly available, municipality-aggregated data related to eight potential explanatory socioeconomic variables was conducted. These variables are school dropout, low energy strata, social security system, savings capacity, tax, resources, investment, and debt. The response variable of interest in this study is the number of reported cases of Zika virus infection per people (projected) per square kilometer. Binomial regression models were performed. Results show that the best predictor variables of Zika virus occurrence, assuming an expected inverse relationship with socioeconomic status, are "school", "energy", and "savings". Contrary to expectations, proxies of socioeconomic status such as "investment", "tax", and "resources" were associated with an increase in the occurrence of Zika virus infection, while no association was detected for "social security" and "debt". Energy stratification, school dropout rate, and the percentage of the municipality's income that is saved conformed to the hypothesized inverse relationship between socioeconomic standing and Zika occurrence. As such, this study suggests these factors should be considered in Zika risk modeling.
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Affiliation(s)
- Marie Kellemen
- Department of Global Health, Indiana University, Indianapolis, IN 46202, USA;
| | - Jun Ye
- Department of Statistics, University of Akron, Akron, OH 44325, USA;
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Mori Y, Suzuki H, Miyatake N, Bando M, Kinoshita H, Tanaka N, Okada S. Relationship between the Number of Deaths Due to Renal Failure and Air Temperature Parameters in Hokkaido and Okinawa Prefectures, Japan. Epidemiologia (Basel) 2021; 2:68-74. [PMID: 36417190 DOI: 10.3390/epidemiologia2010006] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/20/2021] [Accepted: 02/01/2021] [Indexed: 12/14/2022]
Abstract
Background: The aim of the present study was to investigate the relationship between the number of deaths due to renal failure and air temperature parameters in Hokkaido (the northernmost region) and Okinawa (the southernmost region) prefectures, Japan. Methods: Monthly data on the number of deaths due to renal failure between January 2008 and December 2016 and annual population data were collected from the Hokkaido and Okinawa official prefecture websites. Air temperature parameters were obtained from the Japan Meteorological Agency. The relationship between the number of deaths due to renal failure and air temperature parameters was evaluated by an ecological study. Results: The number of deaths due to renal failure (per 100,000 people/month) in Hokkaido and Okinawa were 2.28 ± 0.30 and 1.17 ± 0.31. In Hokkaido, the number of deaths due to renal failure negatively correlated with air temperature parameters in both sexes. The number of deaths due to renal failure was significantly higher in January than from June to September in all subjects. However, in Okinawa, no significant difference was observed among months. Conclusions: The present results suggest that the relationship between the number of deaths due to renal failure and air temperature parameters differs between Hokkaido and Okinawa.
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Wirawan GBS, Januraga PP. Correlation of Demographics, Healthcare Availability, and COVID-19 Outcome: Indonesian Ecological Study. Front Public Health 2021; 9:605290. [PMID: 33598443 PMCID: PMC7882903 DOI: 10.3389/fpubh.2021.605290] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/05/2021] [Indexed: 01/19/2023] Open
Abstract
Objective: To analyze the correlation between demographic and healthcare availability indicators with COVID-19 outcome among Indonesian provinces. Methods: We employed an ecological study design to study the correlation between demographics, healthcare availability, and COVID-19 indicators. Demographic and healthcare indicators were obtained from the Indonesian Health Profile of 2019 by the Ministry of Health while COVID-19 indicators were obtained from the Indonesian COVID-19 website in August 31st 2020. Non-parametric correlation and multivariate regression analyses were conducted with IBM SPSS 23.0. Results: We found the number of confirmed cases and case growth to be significantly correlated with demographic indicators, especially with distribution of age groups. Confirmed cases and case growth was significantly correlated (p < 0.05) with population density (correlation coefficient of 0.461 and 0.491) and proportion of young people (-0.377; -0.394). Incidence and incidence growth were correlated with ratios of GPs (0.426; 0.534), hospitals (0.376; 0.431), primary care clinics (0.423; 0.424), and hospital beds (0.472; 0.599) per capita. For mortality, case fatality rate (CFR) was correlated with population density (0.390) whereas mortality rate was correlated with ratio of hospital beds (0.387). Multivariate analyses found confirmed case independently associated with population density (β of 0.638) and demographic structure (-0.289). Case growth was independently associated with density (0.763). Incidence growth was independently associated with hospital bed ratio (0.486). Conclusion: Pre-existing inequality of healthcare availability correlates with current reported incidence and mortality rate of COVID-19. Lack of healthcare availability in some provinces may have resulted in artificially low numbers of cases being diagnosed, lower demands for COVID-19 tests, and eventually lower case-findings.
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Affiliation(s)
| | - Pande Putu Januraga
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Bali, Indonesia
- Discipline of Public Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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Murata S, Takegami M, Onozuka D, Nakaoku Y, Hagihara A, Nishimura K. Incidence and Mortality of Dementia-Related Missing and Their Associated Factors: An Ecological Study in Japan. J Epidemiol 2021; 31:361-368. [PMID: 32595183 PMCID: PMC8126676 DOI: 10.2188/jea.je20200113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Indexed: 12/04/2022] Open
Abstract
Background Dementia-related missing and subsequent deaths are becoming serious problems with increases in people with dementia. However, there are no sufficient studies investigating the incidence rate, the mortality rate, and their risk factors. Methods An ecological study aggregated at the Japanese prefectural level was conducted. Dementia-related missing persons cases and deaths in 2018 were extracted from the statistics of the National Police Agency in Japan. We extracted variables about older adults’ characteristics, care, and safety as candidate variables considered to be relevant to dementia-related missing persons cases and deaths. Associations of the candidate variables with the incidence and mortality rates were analyzed using the generalized linear model (family: quasi-poisson, link: log) adjusted for confounding factors (proportion of older adults and gross prefectural product). Results The incidence rate and mortality rate per 100,000 person-year was 21.72 and 0.652 in Japan, respectively. One facility increase in the number of nursing care facilities for older adults per 100,000 persons aged 65-years-old or more was associated with a 7.9% (95% confidence interval [CI], 3.3–12.4%) decrease in the incidence rate. One increase in the number of public health nurses per 100,000 persons was associated with a 3.2% (95% CI, 1.6–4.9%) decrease in the incidence rate. A ten percent increase in the proportion of people who live in an urban area was associated with a 20.3% (95% CI, 8.7–33.2%) increase in the incidence rate and a 12.9% (95% CI, 5.6–19.8%) decrease in the mortality rate. Conclusions Identified associated factors may be useful for managing or predicting dementia-related missing persons cases and associated deaths.
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Affiliation(s)
- Shunsuke Murata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute
| | - Daisuke Onozuka
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute
| | - Yuriko Nakaoku
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute
| | - Akihito Hagihara
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute
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Bondi D, Verratti V, Nori R, Piccardi L, Prete G, Pietrangelo T, Tommasi L. Spatial Abilities at High Altitude: Exploring the Role of Cultural Strategies and Hypoxia. High Alt Med Biol 2021; 22:157-165. [PMID: 33416426 DOI: 10.1089/ham.2020.0115] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Bondi, Danilo, Vittore Verratti, Raffaella Nori, Laura Piccardi, Giulia Prete, Tiziana Pietrangelo, and Luca Tommasi. Spatial abilities at high altitude: Exploring the role of cultural strategies and hypoxia. High Alt Med Biol. 22: 157-165, 2021. Background: Over the past couple of decades, the number of people of different cultures traveling to places of high altitude (HA) increased. At HA, a decline in cognitive abilities has been described, including spatial skills. However, it is still unknown whether people accustomed to hypobaric hypoxia are less susceptible to cognitive decline. Method: We aimed to determine if three ethnic groups would show any difference in the performance of spatial abilities. Italian trekkers (46.20 ± 15.83 years), Nepalese porters (30.33 ± 8.55 years), and lowlander and highlander Sherpas (30.33 ± 8.55 and 37.00 ± 16.51 years) were tested with a building photograph recognition, a map orienting, and a mental rotation task during a Himalayan expedition. Accuracy and response times were collected at low altitude (LA) and HA. Results: Nepalese performed the worst (photograph task: p = 0.015, η2p = 0.36; map task: p = 0.016, η2p = 0.36), but the difference was mitigated after correcting for length of schooling. Participants took more time to respond at LA than in HA condition (photograph task: 24.0 ± 15.3 seconds vs. 12.7 ± 6.3 seconds, p = 0.008, η2p = 0.57; map task: 12.5 ± 1.8 seconds vs. 7.8 ± 0.6 seconds, p = 0.038, η2p = 0.40). In the map task, participants performed with greater accuracy at LA (5.1 ± 0.4 vs. 4.4 ± 0.4 number of correct responses, p = 0.006, η2p = 0.59). Conclusions: Altitude hypoxia elicited impairments in cognitive spatial tasks. This may be due to the inability to acquire new unfamiliar patterns, and to the difficulty in managing a high cognitive workload. The ethnic differences were ascribed to schooling, even we consider the different system of reference usually exploited in each culture (egocentric: dependent, or allocentric: independent from the personal viewpoint), and that Westerners are more likely to focus on specific details of the scene. Further studies should investigate the diverse strategies to complete spatial tasks.
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Affiliation(s)
- Danilo Bondi
- Department of Neuroscience, Imaging and Clinical Sciences and Health and Territorial Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Raffaella Nori
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Laura Piccardi
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Cognitive and Motor Rehabilitation Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Giulia Prete
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Tiziana Pietrangelo
- Department of Neuroscience, Imaging and Clinical Sciences and Health and Territorial Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Luca Tommasi
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
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Xin Q, Paudel D, Li L, Zhang B, Yin H. Relationship between suicide rate and antidepressant prescription: An ecological study in the People's Republic of China. Hum Psychopharmacol 2021; 36:1-9. [PMID: 32976675 DOI: 10.1002/hup.2760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/18/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The objective of this study was to estimate the features of suicide rate and its association with antidepressant prescriptions during the past decade in China. METHODS Official data on suicides were obtained and stratified by four age groups, gender, urban/rural areas, and regions (East, Central, and West). The annual antidepressant prescriptions were expressed in pills per 100 persons calculated as the volume of prescriptions divided by the total population. Negative binomial regression was carried out to examine the association between suicide and other variables. RESULTS Suicide rates in each stratum typically decreased from 2008 to 2015, while annual antidepressant prescriptions were generally increased by the year. The suicide rate increased with age and was greater in adult males than in females; higher in the central area and greater in rural than in urban areas. Suicide rates are negatively associated with antidepressant prescriptions including selective serotonin reuptake inhibitors (Incidence rate ratio [IRR] 0.983, 95% confidence interval [CI] 0.983-0.983), serotonin-norepinephrine reuptake inhibitors (IRR 0.951, 95% CI 0.951-0.951), tricyclic antidepressant (IRR 0.925, 95% CI 0.925-0.925) and total antidepressants (IRR 0.990, 95% CI 0.990-0.990) during 2008-2012. CONCLUSION Suicide varied among different studied stratum. Suicide rates are negatively associated with antidepressant prescriptions.
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Affiliation(s)
- Qianqian Xin
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Southern Medical University, Guangzhou, China
| | - Dhirendra Paudel
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Southern Medical University, Guangzhou, China
| | - Liping Li
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Southern Medical University, Guangzhou, China
| | - Honglei Yin
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Southern Medical University, Guangzhou, China
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