ABSTRACT
Contexte: Pour mesurer les inegalites dans la vaccination contre la COVID-19 chez les adultes au Canada, nous avons analyse les donnees de l'Enquete sur la sante dans les collectivites canadiennes de juin a septembre 2021 et identifie les facteurs sociodemographiques associes a la non-vaccination et a l'intention de ne pas se faire vacciner. Methodes: Les donnees proviennent d'une enquete annuelle transversale et representative a l'echelle nationale menee par Statistique Canada. Des modeles de regression logistique ajustes ont ete utilises pour mesurer les associations entre, d'une part, des variables sociodemographiques et liees a la sante (region, age, sexe, scolarite, statut autochtone, statut de minorite visible, etat de sante percu et acces regulier a un professionnel de la sante) et d'autre part la non-vaccination et l'intention de ne pas se faire vacciner. Resultats: La non-vaccination etait associee a un faible niveau de scolarite (RCa jusqu'a 3,5), a la presence d'enfants de moins de 12 ans dans le menage (RCa 1,6), a l'absence d'acces regulier a un professionnel de la sante (RCa 1,6) et a une mauvaise perception de sa propre sante (RCa 1,8). Seuls 5 % des adultes n'avaient pas l'intention de se faire vacciner. L'intention de ne pas se faire vacciner etait associe au jeune age (RCa jusqu'a 4,0), a une scolarite moindre (RCa jusqu'a 3,8), a la non-appartenance a une minorite visible (RCa 3,0), a la presence d'enfants de moins de 12 ans (RCa 1,8) et a une mauvaise perception de sa propre sante (RCa 2,0). Discussion/Conclusion: Des disparites ont ete observees dans la couverture vaccinale et l'intention de ne pas se faire vacciner. Les strategies de promotion de la vaccination devraient tenir compte de ces disparites. Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets.Copyright © 2022
ABSTRACT
Introduction: The COVID pandemic effects on the control of chronic diseases such as diabetes has been a growing concern. UK based studies have shown that during the pandemic, there were unfortunate reductions in A1c testing, an increase in diabetes related mortality, and an increased concern of subpar care in the outpatient setting. With the pandemic currently present in the US over a year, we retrospectively analyzed the trends of diabetic emergencies as it relates to A1c ordering frequency and telemedicine utilization. Methods: Using the EPIC database, patients with type 1 and type 2 diabetes that were affiliated with the institution's primary care and endocrinology outpatient centers were selected. From this patient population, diabetes related ER visits/ admissions (hyperglycemia, DKA, HHS), A1c ordering frequency, average A1c and telemedicine utilization (telephone visits/ virtual visits) were reviewed under the following phases from January 1, 2019 - August 31, 2021: PRE-COVID (January 1, 2019 - February 29, 2020);COVID (March 1, 2020 - December 31, 2020) and VACCINATION (Jan 1, 2021 - August 31, 2021). Generalized linear models were used to assess the impact of COVID-19 on ED visits/admissions, telemedicine and A1c ordering frequency;while their numbers were compared between the three phases. Spearman correlation was used to assess correlation between variables of interest. Results: A total of 10,083 patients were included in the study. There were statistically significant differences in the average monthly ED visits and admissions between the phases COVID and VACCINATION as compared to PRE-COVID with an average increase of 4 visits during COVID as compared to PRE-COVID (p = 0. 0061) and an average increase of 5 visits during VACCINATION as compared to PRE-COVID (p = 0. 0048). Telemedicine utilization increased by an average of 284 during COVID as compared to PRE-COVID (p < 0. 0001). On the other hand, there was a significant decrease in A1c ordering during the COVID phase as compared to PRE-COVID by an average of 294 (p = 0. 0003) which returned to similar ordering frequencies to PRE-COVID during the VACCINATION phase. Of note there were no statistically significant difference of average A1c throughout each phase. There was significant positive correlation between telemedicine visits and ED visits/ admission where hospital visits increased with increased telemedicine utilization (ρ = 0.49;p = 0. 0049) . On the other hand there was significant negative correlation between telemedicine and A1c ordering frequency (ρ = -0.46;p = 0. 0076). There was no significant correlation between ED visits/hospital admissions with A1c ordering frequency however. Conclusion: Correlations between telemedicine utilization, hospital visits and A1c monitoring suggest a negative impact of telemedicine utilization on A1c monitoring and the frequency of acute diabetic complications during the COVID pandemic.Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
ABSTRACT
Attempts to control the current pandemic through public health interventions have been driven by predictions based on modelling, thus bringing epidemiological models to the forefront of policy and public interest. It is almost inevitable that there will be further pandemics and controlling, suppressing and ameliorating their effects will undoubtedly involve the use of models. However, the accuracy and usefulness of models are highly dependent on the data that are used to calibrate and validate them. In this article, we consider the data needed by the two main types of epidemiological modelling (compartmental and agent-based) and the adequacy of the currently available data sources. We conclude that at present the data for epidemiological modelling of pandemics is seriously deficient and we make suggestions about how it would need to be improved. Finally, we argue that it is important to initiate efforts to collect appropriate data for modelling now, rather than waiting for the next pandemic. Copyright © 2021 Nigel Gilbert, Edmund Chattoe-Brown, Christopher Watts, Duncan Robertson
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This article examines the comparative impact of COVID-19 in terms of the number of cases per capita and the per capita mortality rate and an-alyzes the relationships between these impact estimates and three policy measures in 20 OECD countries, controlling for the population over age 65. The policy measures involve public and private health expenditures prior to the pandemic onset and per capita fiscal expenditures devoted to policies designed to address the pandemic, which are identified in the International Monetary Fund’s policy tracker. The findings show no rela-tionship between the policy measures and COVID-19 when controlling for the population over 65 years of age. © 2021, Western Michigan University. All rights reserved.
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This paper reviews recent demographic and familial changes in the Middle East and North African countries (MENA), which parallel the developments associated with the second demographic transition that has transformed population profiles and family life in the more developed OECD countries. The emerging needs for family-oriented policies are analysed in relation to these changes. And the current levels of social protection in the MENA region are assessed along with the recent measures initiated in response to the COVID-19 pandemic. The paper offers evidence of the demographic transition underway in the region, as many countries are experiencing declining fertility rates combined with an increase in life expectancy, which creates a rising old age dependency ratio. This in turn adds an additional burden of elderly dependents on the working age population and on the state's capacity to care for elderly dependents, which generates an increasing need to expand social protection in the MENA region. © The Author(s), 2022. Published by Cambridge University Press on behalf of Social Policy Association.
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Background: The coronavirus disease 2019 (COVID-19) pandemic has caused instability in the education system and has compelled higher education institutions (HEIs) to find alternative ways of teaching and learning by making use of the latest online teaching approaches. Aim: The purpose of the study was to explore how COVID-19 could serve as an enabler for the enhancement of online learning and teaching skills for nurse educators at the University of Namibia with specific emphasis on prospects and challenges. Setting: Semi-structured interviews were conducted in English at a public nursing education institution located in the northeast of Namibia. Methods: A qualitative explorative, descriptive and contextual research design was used. Data were collected by means of in-depth semi-structured interviews with 18 nurse educators from the School of Nursing. Data were analysed using thematic analysis. Field notes were simultaneously taken to enrich the data. Results: The study revealed three themes: nurse educators' experiences of the use of online learning and teaching skills, COVID-19 as an enabler for enhancing online learning and teaching skills and strategies to sustain online teaching and learning. Conclusion: Internet technology has generated a surge in demand for web-based teaching and learning. The online learning mode was not effectively utilised during the COVID-19 era because of inadequate technological skills on the part of nurse educators. Contribution: These findings can be used by universities to equip students and academic staff with skills to adapt to e-learning as the new modus operandi in learning and teaching in the post-COVID-19 era.
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Aims: While the DiRECT study reported positive outcomes in a predominantly White population, little is known about the acceptability of remission programmes using Total Diet Replacement (TDR) in more ethnically diverse and deprived UK populations. We report on early uptake of the Momenta Diabetes Remission Programme (DRP), launched in Birmingham and Solihull during the second wave of the covid-19 pandemic. Methods: Using routine service delivery data (October 2020-January 2021) we analysed uptake, attendance and early weight loss, exploring variations for ethnicity and deprivation. Results: n = 69 eligible referrals (18-65 years, type 2 diabetes duration<6 years, not on insulin) were received (49% male, age 47.3 years, body mass index (BMI) 35.5kg/m2, 70% from black and minority ethnic (BAME) backgrounds, 70% from the four lowest index of multiple deprivation (IMD) deciles). BAME referrals were similar to White in age and sex, but had lower BMI (33.4 v 40.3kg/m2 sd:6.4, p < 0.05) and greater deprivation (IMD decile: 2.9 v 4.0;sd: 2.6, p > 0.1). 93% of referrals were contactable, 81% completed initial assessment and 77% were booked onto programmes, with no disproportionate drop-off for BAME backgrounds or the most deprived areas. Of n = 50 programme starters, early session attendance by BAME participants is high (90%) and similar to White participants (96%). Initial retention is 100%, with weight losses for those more than halfway through TDR aligned to DiRECT findings. Summary: Despite the challenges of covid restrictions, virtual delivery of a group-based DRP appears inclusive and acceptable across ethnicities and socio-economic backgrounds. Initial uptake, attendance and weight loss are encouraging.
ABSTRACT
The COVID-19 pandemic is causing a dramatic loss of lives worldwide, challenging the sustainability of our health care systems, threatening economic meltdown, and putting pressure on the mental health of individuals (due to social distancing and lock-down measures). The pandemic is also posing severe challenges to the scientific community, with scholars under pressure to respond to policymakers’ demands for advice despite the absence of adequate, trusted data. Understanding the pandemic requires fine-grained data representing specific local conditions and the social reactions of individuals. While experts have built simulation models to estimate disease trajectories that may be enough to guide decision-makers to formulate policy measures to limit the epidemic, they do not cover the full behavioural and social complexity of societies under pandemic crisis. Modelling that has such a large potential impact upon people’s lives is a great responsibility. This paper calls on the scientific community to improve the transparency, access, and rigour of their models. It also calls on stakeholders to improve the rapidity with which data from trusted sources are released to the community (in a fully responsible manner). Responding to the pandemic is a stress test of our collaborative capacity and the social/economic value of research. © 2020, University of Surrey. All rights reserved.