ABSTRACT
Background: In mid-2022, New York City (NYC) became the epicenter of the US mpox epidemic. Health authorities were in need of forecasts to anticipate the timing and magnitude of the outbreak. We provided mathematical modelbased projections with methodologies that evolved alongside the epidemic. Here, we retrospectively evaluate our mpox case projections and reflect on potential reasons for accuracies and inaccuracies. Method(s): Early in the outbreak (July 1 - 15, 2022), when the size of the at-risk population was unknown, we performed short-term (2-week) forecasting using exponential regression. Once epidemic growth was no longer exponential (July 15 - Aug. 9), we consulted with the NYC Department of Health and Mental Hygiene regarding populations most-at-risk of mpox based on available epidemiological data. Modelers and epidemiologists collaboratively developed an estimate of 70,180 people at risk, informed by estimates of LGBTQ adults with male sex at birth who had 2+ partners in the last 3 months. We combined this with NYC case count data, NYC vaccination data, and global mpox natural history data to develop a Susceptible-Exposed-Infected-Recovered (SEIR) model, taking into account immunity accrued through vaccination and prior exposure, for longer-term forecasting. Result(s): Initial exponential forecasts of the NYC mpox outbreak were only accurate for very short-term predictions (< 2 weeks) (Figure, top panel). Forecasts were more accurate after 1 week (mean absolute error: 83.0 cases/ wk) than after 2 weeks (mean absolute error: 351.4 cases/wk). In contrast, the SEIR model accurately predicted the decline in cases through the end of Sept. 2022, when cases fell to < 70/wk. Over the period from Aug. 10 to Sept. 24 2022, the mean absolute error of the SEIR-based projection was 8.2 cases per week (Figure, bottom panel). Conclusion(s): Model-based NYC mpox projections provided only short-term accuracy in the early epidemic, but long-term accuracy once the epidemic exited exponential growth and an SEIR model was developed. Cumulative cases and vaccinations when exiting exponential growth, and the epidemiology of those most-at-risk, provided evidence for the likely size of the most-at-risk population - a crucial input for an accurate SEIR model. The ability of the SEIR model to accurately forecast mpox cases was in part attributable to lack of vaccine or immune escape by mpox, in contrast to more rapidly-evolving viruses such as SARS-CoV-2.
ABSTRACT
Purpose: The purpose of this study was to examine the relationship between coronavirus disease 2019 (COVID-19)-related knowledge, preventive behaviors, risk perception, nursing professional values, and COVID-19 psychological distress among nursing students, and to identify factors associated with senior nursing students' COVID-19 psychological distress. Methods: This descriptive cross-sectional study included fourth-year nursing students (n=183). Data were collected using a structured questionnaire between May and June 2022. Data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, the Scheffé test, Pearson's correlation coefficients, and multiple linear regression analysis, using SPSS version 27.0 for Windows. Results: COVID-19 risk perception (β=.39, p<.001) had the strongest association with COVID-19-related psychological distress, followed by COVID-19 knowledge (β=.37, p<.001), major satisfaction (β=-.19, p=.004), and COVID-19 preventive behavior (β=-.16, p=.023). These variables accounted for approximately 27% of the variance in COVID-19-related psychological distress. Conclusion: Nursing educators should work to develop interventions to reduce nursing students' COVID-19-related psychological distress and should consider COVID-19 knowledge, COVID-19 risk perception, and COVID-19 preventive behavior. Furthermore, plans should be developed to enhance students' satisfaction with the nursing major by improving the clinical practicum suited to their needs. © 2023 Korean Academy of Fundamentals of Nursing.
ABSTRACT
Since the COVID-19 epidemic, the response of educational facilities regarding infectious diseases has been through software quarantine guidelines that involved installing partitions and keeping distance. However, this is a temporary prevention method, and hardware supplementation is needed with consideration of the placement of space or movement path of infectious diseases that could occur in the future. Therefore, the purpose of this study is to analyze the infectious disease guidelines of educational facilities that could occur even afterwards, and derive implications through surveys and interviews with related officials and experts. Reports and documents from the Ministry of Education and the provincial education office related to infection prevention management and response manuals were analyzed. This study was divided into institutional and spatial aspects that entailed the prevention of infectious diseases related to school facilities after 2019. Opinions were collected through a survey conducted on operators of these educational facility guidelines and implications were derived from status analysis based upon interviews and surveys taken from architectural design experts. Finally, the direction for improving these guidelines for preventative COVID-19 measures in school facilities was suggested from the responses of school operators and architectural experts. © 2022 Architectural Institute of Korea.
ABSTRACT
Introduction: Following assessment of the effectiveness and feasibility based on the results from a two-year population-based nationwide prospective multi-center trial, the Korean government implemented a national lung cancer screening program using low-dose computed tomography (LDCT) for high-risk smokers in 2019. Methods: National Health Insurance Corporation selected high risk targets who are current smokers aged 54 to 74 years with 30 packs per year or more smoking history on the basis of national health-screening database. (Figure 1). Those eligible were offered lung cancer screening by invitation letters in every two years. Screening units provide LDCT using radiation less than 3mGy by at least 16-row multi-detector CT scanners. Screening results were reported by Lung Imaging Reporting and Data System (Lung-RADS). The examinee received results by mail or e-mail;after then, counseling on results and mandatory smoking cessation counselling were provided by certified doctors. National Cancer Center monitored participation rates, post-counseling rates and statistics of screening result for quality control. Screening positive rate is defined as proportion of Lung-RADS category 3 and 4 nodules. Results: The participation rate gradually increased from 24.8% among 332,244 eligible targets in 2019, 25.9% in 2020, to 38.7% among 310,260 targets in 2021, however, the proportion of examinees who participated in post-counseling decreased from 46.3% in 2019 to 32.7% in 2021 due to the COVID-19 pandemic (Figure 2). The positive rates slightly decreased from 9.2% in 2019 to 8.7% in 2021. The variation in positive rates of screening units showed a tendency to decrease (in 2019, the 1st quartile was 4.3%, and the 3rd quartile was 12.9%;and in 2021, 5.2% and 12.5% respectively). Conclusions: National lung cancer screening program has been implemented successfully in Korea with controlling screening positive rates not so high. Controlling false negatives and strengthening post-screening management including smoking cessation counselling needs to improve. [Formula presented] [Formula presented] Keywords: National Lung Cancer Screening, Quality control
ABSTRACT
Purpose: This study examined the practical training experiences of nursing students during the coronavirus disease 2019 (COVID-19) pandemic and investigated their experience during their practical training. Methods: Data were collected between April 29 and June 24, 2021. The 29 participants chosen from three universities in the study were either fourth-year students or graduated in 2021 after attending nursing college, and they had taken at least one semester of practical training including alternative practice training after the onset of the COVID-19 pandemic. Inductive content analysis was employed for data analysis. Results: Based on the analysis of data from focus group interviews, the following four categories and 11 theme clusters were drawn from 235 key statements: (1) situational change in the clinical practice environment;(2) perceived difficulties in developing core competencies as a nursing student;(3) unstandardized alternative practical training procedures;and (4) demand for systematic improvement in practical training while maintaining social distancing. Conclusion: The results of this study demonstrate the need for effective and constructive practical clinical training in order for nursing students to achieve productive learning from practical training while maintaining social distancing, Alternative training modalities should continue to be developed and reviewed. © 2022 Korean Academy of Fundamentals of Nursing.
ABSTRACT
OBJECTIVE: This study aimed to determine the relative and independent contributions of impaired metabolic health and obesity to coronavirus disease 2019 (COVID-19) outcomes. METHODS: We analyzed 4,069 COVID-19 patients between January and June 2020 in South Korea, classified into four groups according to metabolic health status and body mass index (BMI): metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). The primary outcome was a composite of intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), extracorporeal membrane oxygenation (ECMO), and death. Multivariable Cox proportional hazard regression models were used to estimate the hazard ratio (HR) for the outcome. RESULTS: The incidence rate (per 100 person-months) of severe COVID-19 outcomes was the lowest in the MHNW group (0.90), followed by the MHO (1.64), MUNW (3.37), and MUO (3.37) groups. Compared with MHNW, a significantly increased risk of severe COVID-19 was observed in MUNW (HR, 1.41;95% CI, 1.01-1.98) and MUO (HR, 1.77;95% CI, 1.39-2.44) but not in MHO (HR, 1.48;95% CI, 0.98-2.23). The risk of ICU admission or IMV/ECMO was increased only in MUO;however, the risk of death was significantly higher in MUNW and MUO. The risk of severe COVID-19 increased insignificantly by 2% per 1 kg/m2 BMI increase but significantly by 13% per 1 metabolically unhealthy component increase, even after mutually adjusting for BMI and metabolic health status. CONCLUSION: Metabolic health is more important to COVID-19 outcomes than obesity.
ABSTRACT
At the beginning of the COVID-19 pandemic, people from around the world made numerous homemade masks for themselves and their community due to shortage of medical masks as well as to stop the spread of COVID-19. The purpose of the current study was to conduct cross cultural exploration of the reasons for making masks, self-construal and wellbeing associated with masks making by collecting data from residents across US, India, and China. The finding of this study presented different reasons for making masks as well as self-construal, and wellbeing in people who made masks versus those who did not. Differences were also observed among three different cultural groups. This study offers a unique contribution to the public health research engaging in craft making related activities to gain a better perspective of the state of health of a population and the understanding of cross-cultural study of craft making behavior during the pandemic.
ABSTRACT
OBJECTIVE: We compared demographic and clinic-pathological variables related to the number of surgeries for thyroid conditions or for cancer, morbidity, and fine needle aspiration (FNA) practices among Covid19 pandemic phases I, II, III and the same seasonal periods in 2019. METHODS: The prospective database of the Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Changchun, China was used for this study. Covid19 emergency levels were stratified according to the World Health Organization: phase I (January 25-February 25, 2020), phase II (February 26-March 19), phase III (March 20-April 20). RESULTS: There were fewer outpatient FNAs and surgeries in 2020 than in 2019. There were no thyroid surgeries during phase I. There were also fewer surgeries for cancer with a significant reduction of advanced stage cancer treatments, mainly stage T1b N1a in phase II and T3bN1b in phase III. Operative times and postoperative stays were significantly shorter during the pandemic compared to our institutional baseline. In phase III, vocal cord paralysis (VCP) increased to 4.3% of our baseline numbers (P = 0.001). There were no cases of Covid19-related complications during the perioperative period. No patients required re-admission to the hospital. CONCLUSION: The Covid19 outbreak reduced thyroid surgery patient volumes. The decrease of Covid19 emergency plans contributed to unexpected outcomes (reduction of early stage cancer treatment, decreased operative times and hospital stays, increased VCP rate).