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Introduction: Cancer patients have a high risk of severe COVID-19 and complications from it. Although the COVID-19 pandemic has led to an increase in the conduction of clinical trials (CTs), there is a scarcity of data on CT participation among cancer patients. We aimed to describe the level of participation in a COVID-19 CT, willingness to participate, as well as trust in sources of information for CTs among persons with and without a previous cancer diagnosis in Puerto Rico. Method(s): Data collected from November 2021 to March 2022 from two cross-sectional studies were merged and used for analysis. Informed consent, telephone, face-to-face, and online interviews were conducted among participants >=18 years old living in Puerto Rico (n=987). Descriptive statistics and bivariate analysis (Fisher's exact text and chi-squared test) was done to describe the outcomes of interest, overall and by cancer status. Result(s): Mean age of participants was 41+/-15.5 years. Most participants were women (71.3%), with an educational level greater than high school (89.5%) and with an annual family income below $20,000 (75.1%). Overall, 4.4% of participants (n=43) reported history of cancer diagnosis. Only 1.8% of the population reported to have participated in a COVID-19 CT to receive either a treatment or vaccine;stratifying by cancer, none of the cancer patients had participated in a COVID-19 CT, and only 1.9% of non-cancer patients participated. While 37.0% of the participants indicated being very willing to sign up for a CT assessing COVID-19 treatment, willingness was higher in cancer patients (55.8%) than among participants without cancer (36.1%). Regarding trust in sources of information for CTs, the level of trust ("a great deal/a fair amount") was higher for their physicians (87.6%), researchers (87.0%), the National Institute of Health (86.7%), their local clinics (82.9%), and a university hospital (82.7%), while it was lower for a pharmaceutical company (64.0%), and for friend, relative, or community leader (37.6%);no differences were observed by cancer status. Conclusion(s): While participation in COVID-19 CTs was extremely low in the study population, the willingness to participate was higher among cancer patients. Education on CTs and their availability are necessary to increase participation in this understudied group. Such efforts will enhance the representation of Hispanic and vulnerable populations, such as cancer patients, on COVID-19 CTs, and thus proper generalizability of study findings in the future.
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Out-of-class communication between teachers and students is essential throughout university engineering courses for in-depth explanations of the concepts covered in class. This study evaluates this aspect throughout the COVID-19 pandemic. Thus, a survey that addressed this issue was administered to students at the beginning (March 2020) and at the end (May 2020) of the COVID-19 lockdown in Spain, and at the end of each semester of the 2020/21 and 2021/22 academic years. The results were analyzed with statistical, qualitative, and mixed methods. E-mail usage was widely observed at the beginning of the pandemic, while the use of online videoconferencing tools progressed during that time, thanks to their temporal and spatial flexibility, and the direct and personal nature of student-teacher contact through those channels. Its success was linked to the prior training of teachers in the use of videoconferencing, the establishment of fixed schedules for the meetings, and the use of digital whiteboards that instantaneously display writing when discussing problems. According to the opinions of students, videocalls could be used for questions on theoretical and easy practical aspects despite the resumption of out-of-class face-to-face meetings. Videoconferencing tools for educational communication between engineering students and teachers seem to be here to stay. © 2023 Informa UK Limited, trading as Taylor & Francis Group.
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INTRODUCTION: Puerto Rico has endured three major environmental and public health crises (Hurricane Irma, Hurricane Maria, the unprecedented seismic activity of January 2020) and the coronavirus disease 2019 (COVID-19) pandemic during the past 5 years. All these events might lead to an unquestionable deleterious impact in the prevention of cancer and across the cancer continuum, exacerbating cancer health disparities in the future. Cancer screening plays a critical role in early cancer detection. COVID-19 has significantly hampered screening programs in many countries' cancer screening infrastructure and services, affecting adherence. Cancer is the leading cause of morbidity and mortality in Puerto Rico. Limited information is available about the impact the current pandemic on colorectal cancer screening. In this study, we aim to describe the impact of the COVID-19 pandemic on colorectal cancer screening in 2020 and assess if this impact varied by health regions. METHOD(S): This study analyzed administrative data claims from the Public Health System of Puerto Rico which is managed by the Government of Puerto Rico through the Health Insurance Administration. The Current Procedural Terminology (CPT) codes included for this study were (81528, 82270, G0104, G0105, G0121, G0328, G0464). To assess changes in the numbers of colorectal cancer screening claims between the incurred year (2016 and 2020), Poisson regression was used. Initially, we fitted this model with only the incurred year as the predictor and offsetting the model with the annual average of total insured (univariate model). Based on this model, we estimate the magnitude of association between the number of claims and incurred year using the Prevalence Ratio (PR) of claims. Lastly, Poisson univariate regression model were used for each of the seven health regions (Ponce, Bayamon, Caguas, Mayaguez, Metro, Arecibo and Fajardo) to assess potential geographic disparities. RESULT(S): The numbers of colorectal cancer screening claims significantly decreased by 40% (PRcrude: 0.60, 95%CI: 0.59, 0.62) in 2020 when compared to 2016. However, when adjusting for claim incurred month, sex, health region and offsetting the model with the annual average of total insured, the numbers of colorectal cancer screening claims significantly decreased by 34%, (PRadj: 0.66, 95%CI: 0.64, 0.67). The numbers of colorectal cancer screening claims significantly decreased in all health regions in 2020 when compared to 2016 (p<0.05). However, the most impacted region was the Eastern region, Fajardo, with a 64% (PRFajardocrude: 0.36, 95%CI: 0.30, 0.42) significant decrease in numbers of colorectal cancer screening claims. CONCLUSION(S): COVID-19 had a profound negative effect on colorectal screening in Puerto Rico. Moreover, despite the beneficiaries of this governmental health plan sharing similar sociodemographic and socioeconomic background, regional differences were observed.
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Introduction: The COVID-19 pandemic has caused major changes to healthcare services, especially those related to early detection and screening practices like breast cancer. In Puerto Rico, breast cancer is the main cause of death, representing 18.9% of cancer deaths in women, making early detection even more important to prevent morbidity and mortality. This study aims to describe the impact of COVID-19 on breast cancer screening and assess differences in health utilization by age group and health regions in Puerto Rico. Method(s): This study used data on breast cancer screening medical claims from Puerto Rico Track, a project in collaboration with the Puerto Rico Public Health System and the Puerto Rico Institute of Statistics that aims to assess health access and utilization patterns in Puerto Rico. Claims including unilateral and bilateral mammography, sonommamography, and MRI were analyzed. Descriptive statistics and percentual changes between the COVID-19 baseline year (2016) compared with 2020 and 2021 were performed (overall, by age-group and health region). Result(s): A total of 193,793 screening tests were performed in 2016, compared to 66,463 in 2020, and 89,322 in 2021. Overall, a third of the medical claims for breast cancer screening (33.2%) were in the age group of 51-60 years. An overall decreasing percentual change was observed comparing 2016 vs. 2020 (65.7%), where the age group with the broadest gap reduction were among women 41-50 years old (68.2%). When comparing medical claims of 2016 (193,750) versus 2021 (89,320) (pre and post pandemic), an important decreasing change (53.9%) was observed. The age group with the highest decrease comparing 2016 to 2021 was the 41-50 years one (68.2%). The Western region of Mayaguez/Aguadilla had the highest decreasing percentual change, with a reduction of 73.6% in 2020 compared to 2016, and 62.6% when compared 2021 with 2016. Conclusion(s): Breast cancer screening was notably affected by the COVID-19 pandemic in Puerto Rico. A pattern of decreasing breast cancer screening was observed by health regions and by age. These efforts provide evidence of the need of tailored evidence-based interventions to increase breast cancer screening in the island.
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Background: In March 2020, the state of alarm was declared in Spain due to the health crisis caused by SARS-COV-2. The rapid spread of the virus generated uncertainty and concern about the impact it could have on patients with severe asthma (SA) and boosted for the first time the use of teleconsultation for the management of these patients. For this reason, it was necessary to facilitate the transition to a hybrid model that combines face-to-face and digital consultations. Objective(s): Development of the first document designed for SA patients, aimed to support the preparation of the telematic follow-up consultations with their specialist. Method(s): Nine experts in SA from different specialties: 4 allergists, 3 pulmonologists and 2 asthma unit nurses contributed to the conceptualization and development of the document. In a first phase of conceptualization, the profile of patients to which the material is addressed was defined and the minimum content needed to be useful to both patients and healthcare professionals (HCPs) was established. A first draft was prepared and refined after evaluation by adult patients and parents of pediatric patients through cognitive interviews. Result(s): Onasm@ is the first document intended for SA patients to prepare the telematic follow-up consultation with their specialist. It consists of three blocks: A first one with general considerations to be applied on the telematic consultation, a second one to collect all the information that might be requested by the healthcare professional (HCP) during the off-site visit (asthma medications, dosage, adherence, asthma crisis events, emergency visits and oral corticosteroid use) and the third block with tips for achieving and maintaining asthma control. The asthma control test (ACTTM) for adults and the children's version (cACTTM) is also incorporated. Conclusion(s): The transition to a hybrid healthcare model due to the pandemic situation makes it essential to support SA patients to face the telematic follow-up consultation with their specialist. Onasm@ is the first document designed to help patients to appreciate the information needed to face this type of visit, with the aim to promote a fluid communication with their HCP and more efficient visits. This type of document could be applied to the management of other conditions and as such have broader impact on the future of healthcare, which is currently immersed in far-reaching change and transformation.
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Mathematical models SIR and ARIMA were used, within an epidemiological approach, to adjust them to the COVID-19 pandemic data in Panama to establish a scientific criterion for taking decisions for the effects control that this pandemic has brought. Based on the predictions made from the adjustments of these models, it was concluded that they can be adjusted correctly to the data, allowing to make short-term predictions in a satisfactory way, however, if a more accurate model were to be carried out, independent variables could be included, besides time, such as mobility restrictions. This work lays down the foundations for future investigations of epidemiological models in Panama due to its exposition of mathematical model's comparison used to analyze the behavior of the COVID-19 Pandemic. Jupyter Notebook, GitHub, Machine Learning libraries and mathematical software such as Wolfram Mathematica were used. Adjustment of data was performed through statistical techniques and, for this prediction, statistical software Minitab and E-Views were also used. © 2022 IEEE.
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Purpose: Knee osteoarthritis (OA) is a common joint disorder associated with pain, disability, and joint damage. An unmet need remains for safe, efficacious treatments for symptoms and disease modification. Lorecivivint (LOR), a novel intra-articular (IA) CLK/DYRK inhibitor thought to modulate Wnt and inflammatory pathways, has previously appeared safe, demonstrated patient-reported outcome (PRO) improvements compared with placebo (PBO), and maintenance of radiographic medial joint space width (mJSW). A LOR trial, OA-11, enrolled participants with structurally advanced (mJSW 1.5-4 mm) knee OA. OA-11 did not meet its primary endpoint;however, greater treatment effects were observed in subjects with less advanced/earlier (Kellgren Lawrence [KL] grade 2) OA. Additionally, the COVID pandemic potentially confounded pain reporting and expected mJSW progression. An ongoing 4-year extension study, OA-07 (NCT04520607), continues to evaluate LOR safety and efficacy with primary and secondary efficacy outcomes of mJSW (mm) and Pain Numerical Rating Scale (NRS [0-10]) respectively. Data up to 30 months from this study are reported. Method(s): Subjects who completed OA-11, a 13-month Phase 3 LOR trial, were enrolled into OA-07, an extension study designed to evaluate safety and efficacy of long-term LOR treatment. During the single-blinded Year 1 of OA-07, subjects received repeat injection according to their randomized treatment received in OA-11 (LOR or PBO). In Year 2 and annually thereafter, all subjects (LOR and PBO) received an open-label 0.07 mg IA LOR injection. OA-07 commenced in July 2020 and is planned to continue over a 4-year period with clinic visits every six months. Result(s): 277 subjects (mean age 61.0 +/- 8.2 years, BMI 31.8 +/- 4.9 kg/m2, female 62.8%, KL3 45.5%, 67.1% bilaterally symptomatic, mean baseline mJSW 2.63 +/- 0.69 mm, 68.6% mJSW < 3 mm) were enrolled. LOR appears safe and well-tolerated, consistent with its previously observed safety profile. At 24 months, the LOR treatment arm shows reduced mJSW loss compared to placebo, LOR -0.13 (+/- 0.06) mm (n=103) vs. PBO -0.22 (+/- 0.05) mm (n=112) (DELTA=0.10 mm, 95% CI [-0.05, 0.25], P=0.199, Figure 1A) for Full Analysis Set (FAS) and LOR +0.02 (+/- 0.07) mm (n=61) vs. PBO -0.15 (+/- 0.07) mm (n=63) (DELTA=0.17 mm, 95% CI [-0.02, 0.37], P=0.077, Figure 1B) for KL2. Average change from OA-07 baseline to 24 months in Pain NRS is -0.25 (+/- 0.19) for LOR (n=121) compared to 0.11 (+/- 0.19) for placebo (n=130) (DELTA=-0.36, 95% CI [-0.89, 0.17], P=0.179, Figure 2A). For WOMAC Function, LOR (n=96) change from baseline was -5.33 (+/- 1.84) vs PBO (n=104) -0.43 (+/-1.76), (DELTA=-4.90, 95% CI [-9.92, 0.13], P=0.056, Figure 2B);for WOMAC Pain, LOR (n=96) change from baseline of -4.80 (+/-1.87) vs PBO (n=106) 0.38 (+/-1.78), (DELTA=-5.18, 95% CI [-10.28, -0.08], P=0.047, Figure 2C). At 30 months (Figure 2A), unblinded IA injection of LOR (n=60) shows additional Pain NRS improvements with change from OA-07 baseline of -0.57 (+/-0.39) and cross-over to LOR from PBO (n=76) shows an improvement of -0.37 (+/-0.26). Larger improvements in PROs were observed in the KL2 subgroup, with month 24 improvements for LOR over PBO (DELTA= -0.48 (95% CI -1.20, 0.23), P=0.183 in Pain NRS, (DELTA -6.05 (95% CI -12.87, 0.78), P=0.082 in WOMAC Function, and (DELTA -6.58 (95% CI -13.18, 0.02), P=0.051, in WOMAC Pain. Conclusion(s): LOR continues to appear safe and well tolerated. A potential benefit of LOR 0.07 mg compared with PBO in mJSW is observed 12 months after OA-07 baseline injection. Potential LOR benefit compared to PBO is also seen across PROs. Within this structurally advanced knee OA cohort, both mJSW and PROs treatment effects appear enhanced in earlier/ less advanced KL2 knee OA subjects relative to those with more advanced KL3 graded knees. This study is ongoing. [Formula presented] [Formula presented]Copyright © 2023
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Background Patients with celiac disease (CeD) reported increased COVID-19 vaccine hesitancy due to a fear of adverse events (AEs). However, the risk of AEs post-COVID-19 vaccination in patients with CeD is unknown. Purpose To assess whether the rate of common side effects (SEs) and AEs due to COVID vaccines are higher in patients with CeD compared to a non-CeD population. Method We conducted a collaborative international cross-sectional study in 16 countries between April 2022 and July 2022. An online survey was distributed to patients with CeD through patients' local societies, and to non-CeD from the general population in each country through social media posts, word-of-mouth, and through academic institutions. We collected data on participant demographics, medical conditions, CeD diagnosis, GFD adherence, history of COVID-19 vaccinations (type and doses) and self-reported SEs and AEs post-COVID-19 vaccine. SEs included pain/swelling at the site, fatigue, fever, chills, nausea and/or headaches. AEs included thrombosis, myocarditis, anaphylactic reaction, and hospitalization related to the vaccine. Logistic regression models were used to assess predictors such as CeD diagnosis, age, gender, vaccine type and comorbidities on the likelihood of reporting SEs and AEs post-vaccine. Result(s) : A total of 17,795 participants completed the survey, 13,638 with CeD (median age of 45[27]) and 4,157 non-CeD controls (median age of 43[20]). There were no significant differences in sex between CeD and controls. Overall, CeD patients had similar odds of SEs compared with non-CeD individuals (aOR=1.02;95% CI=0.92-1.14). SEs were slightly increased only in the second dose of the vaccine in the CeD population compared to non-CeD individuals (aOR= 1.35;95% CI=1.19-1.53). The most common reported SEs in CeD and controls were pain/swelling at the injection site (29% vs 23 %, p< 0.0001) and fatigue (29% vs 24%, p<0.0001). The odds of SEs were higher with Moderna Spikevax, AstraZeneca/Oxford and Johnson and Johnson vaccines than after the Pfizer vaccine (p< 0.0001). The overall rate of AEs post-vaccine was similar between patients with CeD and non-CeD individuals (aOR= 1.29;95% CI= 0.89-1.87). Overall, female gender, older age, GFD adherence, respiratory conditions, obesity and receiving immunosuppressive medications increased the odds of SEs, while only age and a history of allergies increased the odds of AEs. Conclusion(s) In this large international study, patients with CeD reported similar rates of SEs and AEs post-COVID vaccine compared to non-CeD individuals. This information is highly relevant as it addresses the main concern leading to COVID-19 vaccine hesitancy in CeD patients. Disclosure of Interest None Declared
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Background: Exclusive enteral Nutrition (EEN) is considered a first line therapy for children with active Crohn disease (CD). CD Exclusion Diet (CDED)+Partial Enteral Nutrition (PEN) is effective for induction of remission in mild-moderate CD at weeks 6 and 12, with better tolerance than EEN. We assessed whether a 2-week course of EEN, followed by CDED+PEN is superior to 8 weeks of EEN in sustaining clinical remission at week 14, outcomes of CDED up to 24 weeks, and the utility of CDED in mild-severe CD. Method(s): This international, multicenter, randomized-controlled trial compared 2 weeks of EEN (Modulen, Nestle Health Science) followed by 3 phases of the CDED+PEN to 8 weeks of EEN, followed by PEN with free diet, both up to week 24. Children aged 8-18 with CD<3 years, mild-severe disease [paediatric CD activity index (PCDAI) 15-47.5], and active inflammation [elevated C-reactive protein (CRP) or faecal calprotectin (FCP)] were included. Stable immunomodulator (IM) treatment was allowed. Naive patients were allowed to start an IM from week 4. Result(s): Of the 63 eligible patients enrolled, 55 were randomized and included in the final intention to treat analysis (target recruitment failed due to COVID);Group 1 (CDED+PEN;29) and group 2 (EEN;26), mean age 12.7+/-2.4. Steroids-free sustained remission at week 14 was obtained in 20/29(69%) in group 1 and 16/26(61.5%) in group 2, p=0.56. Remission at week 8 was obtained in 22/29(76%) in group 1 and 14/26(54%) in group 2, p=0.08. 16/29(55%) in group 1 and 9/26(34%) in group 2 maintained clinical remission at week 24;p=0.12. Median PCDAI declined from 32.5[20-36.2] to 2.5[0-5.6] and 1.2[0-5.6] in group 1 (p<0.001 for all), and from 22.5[20-29.3] to 0[0-4.3] and 0[0-2.5] in group 2 (p<0.005 for all) at baseline, week 8 and 14 respectively. Median CRP improved in group 1 from 32 mg/L[6-69] to 5[2-16] and 3[2-10.1] (p<0.001 for both) and in group 2 from 10.35 mg/L[5-33] to 3.7[2.2-7.2], p=0.012 and 3.2[2.8-5], p=0.006 at baseline, week 8 and 14 respectively. Median FCP declined in group 1 from 1946 mug/g [862-3304] to 802[196-1312] at week 8 and 241[82-1175] at week 14 (p<0.01 for both), and in group 2 from 1615[605-2692] at baseline to 436[252-1389] at week 8, which then increased to 731[349-1305] at week 14 (p<0.01 for both). At week 14, 12/22(54%) received IM from group 1 and 15/16(93%) from group 2;p= 0.009. Conclusion(s): Two weeks of EEN followed by CDED&lPEN and EEN were successful in induction of clinical and biochemical remission in mild-severe paediatric CD, and most CDED+PEN patients-maintained remission to 24 weeks. Sustained clinical remission at week 14 was similar despite higher IM use in the EEN Group, suggesting that CDED might prevents diet-induced inflammation regardless of IM use.
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Background: Our study aimed to explore the experiences of stakeholders from local government units, health facilities and higher education institutions on the delivery of non-COVID-19 health services after the initial wave of the pandemic. Methods: Twenty-nine public health workers, thirteen university staff, and four hospital administrators in the Philippines participated. Using a descriptive phenomenological approach, we analysed transcripts from six focus group discussions conducted online between March and June 2021. Findings: The COVID-19 pandemic made the routine health programs inaccessible due to hesitancy among patients to visit health facilities, a shift in public health priorities, and lack of students to augment the existing workforce. Public health workers reported stress and mental health exhaustion. Apart from fear of infection during service provision, public health workers and university staff experienced work overload, pressure to learn new technology, and webinar fatigue. Mental health problems have surfaced as health workers and young people have become more affected while support services remain insufficient. Public health workers have reported actions to maintain service delivery in the new normal such as use of telehealth and social media. However, issues on workforce wellbeing and digital equity posed adaptation challenges. Participants suggested partnership with higher education institutions as pivotal to position local health systems towards recovery. Interpretation: The rapid change in the service landscape highlights the importance of sustainable partnerships, effective workforce management, equitable digital innovations, and promoting mental wellbeing to preserve community, school, and occupational health and rebuild resilient local health systems in low-resourced areas. Funding: This research is proudly supported by the Australia-ASEAN Council, Australian Government Department of Foreign Affairs and Trade. © 2022 The Author(s)
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Background: The human papillomavirus (HPV) vaccine is a cancer prevention tool, yet vaccination coverage among adolescents remains suboptimal in the United States. Research shows significant disparate incidence and mortality rates of HPV-related cancers in Puerto Rico (PR). In 2018, the PR Department of Health (DOH) enacted an HPV vaccine school-entry requirement for adolescents 11 to 12 years old, and on August 2020 extended the requirement to include adolescents up to 16 years old. Amid the COVID-19 pandemic in the US, during March-August 2020, national data showed that HPV vaccine uptake rates decreased about 75%. Public health measures, such as stay-at-home orders, may have caused this decline by limiting access to preventive services. Our study explored, using a qualitative assessment, the impact of the COVID-19 pandemic on the implementation of the HPV vaccine school-entry requirement in PR. Method(s): We conducted 26 interviews with stakeholders from schools, DOH employees, Department of education staff, health providers, and community-based organizations from 08/2021-03/2022. Interviews were recorded and transcribed in Spanish. Data were analyzed using applied thematic techniques by two trained coders using Atlas-ti 8. We discussed eight of these interviews among the team to identify major barriers related to the HPV school-entry implementation during the pandemic. Result(s): Our analysis identified the following preliminary emergent themes including: (1) lockdown limitations and access barriers to the vaccine and (2) shifting immunization priorities. Most participants noted that the March 2020 lockdown limited parents' ability to get their kids vaccinated and for schools to monitor the vaccine requirements;however, as vaccination centers and schools re-opened, gradually, vaccination processes increased. Participants described how during the pandemic, public health agencies prioritized the COVID-19 vaccine missing other vaccines that are required for school-entry, including the HPV vaccine. Discussion(s): Continuation of the implementation of the HPV vaccine school-entry requirement was challenging during early stages of the pandemic due to public health measures enacted to stop the spread of COVID-19. Moreover, once the COVID-19 vaccine was available, public heath vaccination priorities shifted. Nonetheless these barriers, efforts to increase HPV vaccine to pre-pandemic rates should continue, including providing educational support to parents, increase vaccine promotion, and creating community collaborations. As new guidelines recommend COVID-19 boosters, for everyone ages 5 years and older, this opportunity could serve to vaccinate against HPV as part of the bundling implementation of the HPV vaccine school-entry requirement.
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Prior to the COVID-19 pandemic, Puerto Rico (PR) had one of the highest Human Papillomavirus (HPV) vaccine rates in the United States. Yet, widespread misleading information about the COVID19 vaccine might negatively impact HPV vaccine attitudes. This study aims to assess and compare HPV and COVID-19 vaccines attitudes toward school-entry policies among adults living in PR. A convenience sample of 222 adults (>=21 years old) living in PR were recruited through social media and completed an online survey from November 2021 to January 2022. Participants answered questions about HPV and COVID-19 vaccines knowledge (ranging from 0=none to 3=high knowledge), attitudes toward vaccination policies for school-entry, and perceptions of trusted and untrusted sources of information. Descriptive statistics were computed to identify the demographics characteristics of the participants. We also estimated the prevalence ratio (PRadjusted) using a logistic regression model to assess the magnitude of association between COVID-19 vaccination for the school-entry policy and HPV vaccination for school-entry policy agreement, adjusting for different confounders. The mean age of the study sample was 36.73 +/- 11.18 years. The majority of the sample were female (87%, n=194), with at least some college of education (92%;n=205) and employed (61%;n=165). One-fifth of the participants reported having children between ages 11 and 16 (n=46). Participants' perceived knowledge about the HPV vaccine was moderate (mean=1.72;SD=1.12), while for COVID-19 vaccine was moderately high (mean=2.47;SD=.68). The most trusted form of information for HPV and COVID-19 vaccines were health care providers (42% and 17%, respectively), the Centers for Disease Control and Prevention (35% and 55%, respectively), and the Department of Health (15% and 19%, respectively). The least trusted source of information included social media (40% and 39%, respectively), friends and family (23% n=47, and 17% n=33, respectively), and the Department of Health (15% n=30, and 18% n=36, respectively). More than half of the participants agreed that HPV (76% n=156) and COVID vaccines (69% n=136) should be required for school-entry. Agreement with COVID-19 vaccination for the school-entry policy was significantly associated with HPV vaccination for school-entry policy agreement (PRadjusted:1.96;95% CI:1.48-2.61) after controlling for age, sex, education, and having children between age 11 and 16. Findings suggest that adults living in PR have an overall positive attitude about mandatory HPV and COVID-19 vaccination school-entry policies, and these attitudes are interrelated. Yet, it is concerning that the Department of Health is identified as one of the least trusted sources of information, as it has a prominent role in implementing HPV and COVID-19 vaccine policies in PR. Further research should elucidate why the Department of Health is considered an untrusted source of information among adults living in PR and evaluate the implications of the COVID-19 pandemic on HPV vaccine attitudes and adherence rates.
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Background: Recommendation by a healthcare provider is essential for women to seek preventative cancer screening. Research has shown patients are receptive to information about cancer screening given by health professionals administering influenza vaccines. Promotion of cancer screening during vaccination may be particularly important in Puerto Rico (PR), which, relative to the continental United States, has low cervical and colorectal cancer screening rates. Objective(s): This study aims to determine if receiving the influenza vaccine in the past year or ever receiving the COVID-19 booster is associated with an increased likelihood of women participating in cervical, breast, and colorectal cancer screening in the past year. Method(s): Women older than 18 are recruited weekly in different ongoing community outreach events throughout Puerto Rico as part of the Puerto Rico Community Engagement Alliance (PR-CEAL) against COVID-19 disparities. The PR-CEAL outreach team completes an online community survey as part of their field activities. Initial data was collected from February 17th 2022 through May 28th 2022, with data collection currently ongoing. Pearson chi2 test or Fisher exact test, as appropriate, was used to quantify the association between participation in cancer screening and vaccination status. Result(s): As of May 31st, 253 women with a median age of 59 had been recruited. Of these, 56.1% had received the influenza vaccine in the past year, and 52.6% had received a COVID-19 booster. Nearly 52% of women with the booster and 65% without the booster received cervical cancer screening (p-value =0.29). Women with the booster and those without the booster (75% each) received breast cancer screening (p-value = 0.99). Only 16.1% of women with the booster and 11.8% without the booster had received colorectal cancer screening (p-value = 0.99). Receipt of cancer screening according to influenza vaccine status was as follows: 59.3% vaccinated and 51.5% unvaccinated received cervical cancer screening (p-value = 0.35);31.4% vaccinated and 41.2% unvaccinated received breast cancer screening (p-value = 0.56);and 13.1% vaccinated and 9.3% unvaccinated received colorectal cancer screening (p-value = 0.46). Conclusion(s): No differences in receipt of cancer screening were found by influenza or COVID-19 booster vaccination status among adult women in Puerto Rico. Routine vaccination appointments may therefore represent a missed opportunity to promote cancer screening.
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One such protocol currently enforced by the Philippine government to combat COVID-19 is the mandatory use of face masks in public places. The problem however is that ensuring people follow this protocol is difficult to monitor during a pandemic due to other conflicting health protocols like social distancing and workforce reduction. This study therefore explores on the creation of deep learning models that consider both frontal and side view images of the face for face mask detection. In doing so, improvements to robustness were found when compared to using models that were previously trained on purely frontal images. This was accomplished by first relabeling a subset of images from the FMLD dataset. These images were then split into train, validation, and test sets. Four deep learning models (YOLOv5 Small, YOLOv5 Medium, CenterNet Resnet50 V1 FPN 512x512, CenterNet HourGlass104 512x512) were later trained on the training set of images. These four models were compared with three models (MobileNetV1, ResNet50, VGG16) that were trained previously on purely frontal images. Results show that the four models trained on the relabeled FMLD dataset offer an approximately 20% increase in classification accuracy over the three models that were previously trained on purely frontal images. Copyright © 2022 by SCITEPRESS - Science and Technology Publications, Lda. All rights reserved.
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Background Over the last decades, the prevalence of non-standard employment (NSE) has increased in many countries, with negative implications for worker health and well-being. Research at the micro level, mostly quantitative, has linked NSE with poor health through insecurity. Macro-level studies investigating whether political economic factors buffer the harms of NSE have generated mixed results. This study describes how various types of insecurity are experienced by workers in NSE, in general and during COVID-19, and how this influences their health and well-being, in six countries with different welfare states: Belgium, Canada, Chile, Spain, Sweden and the United States. Methods In-depth interviews with 250 workers in NSE were analysed using a multiple-case study approach and using the welfare state typology as a macro-level framework. Results Despite differences in welfare states, workers in all six countries experienced multiple forms of insecurity as well as relational tension with employers or clients, with clear negative effects on their well-being, in ways that were shaped by broader social inequalities (e.g., related to gender, age, and access to family support). Simultaneously, differences in welfare states were reflected in the level of workers’ exclusion from social protections, the temporality of difficulties they faced in planning their lives (e.g., threats to daily survival or to longer-term life planning), and their ability to derive control from NSE despite the insecurity it created. Workers in less generous welfare states experienced heightened insecurity and greater stress from the COVID-19, but the severity of the health and economic crisis was felt by workers in all study countries. Conclusions This study sheds light on the ways that welfare regimes can support - or fail to support - workers in NSE, and suggests the need in all six countries for stronger state responses to NSE, a pressing social determinant of health. Key messages Employment insecurity is a central dimension of the experience of non-standard employment across the six countries. Differences in state approaches to labour market regulation and social welfare influence how non-standard workers experience insecurities.
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The aim of this COVID-19 Practical Manual for the prevention, detection, control and surveillance of SARS-CoV-2 is to standardize and regulate the best strategy for the prevention and control of SARS-CoV-2 infections. All of this to provide better care quality to patients and their families/caregivers, and to promote a safe working environment for health personnel within the institution. The manual has been prepared with the aim of guiding health personnel in decision-making for the prevention, detection, control and surveillance of SARS-CoV-2 infections. This document describes various multidisciplinary care algorithms in different scenarios, considering the recommendations for isolation, use of personal protective equipment, transfer within various services in the hospital, admission to procedures and recommendations for healthcare personnel. Copyright © 2022 Hospital Infantil de Mexico Federico Gomez. Publicado por Permanyer.
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The covid-19 pandemic brought changes in consumers’ habits derived from initial confinement in the first year and a second year characterized by an attempt to return to activities under the “new normal” label. Several literature reviews that summarize existing research on consumer behavior and the pandemic have recently emerged. Many of them have a regional or country-specific focus. Others emphasize certain factors under study at the beginning of the pandemic. This study, in contrast, separates the most salient topics found in literature in 2020 from those found in 2021 using a global Scopus database showing the evolution of the academic discourse on consumer behavior as the pandemic developed. Interestingly, some differences show consumers’ evolution throughout the pandemic, seen through the eyes of researchers. Topic modeling highlights the main topics under study in both years. Results show the relevance of four major topics that differ from one year to another. Research on online consumption, however, remains equally important in both years. We propose a theoretical model of consumer behavior research that aims to help consumers understand themselves, managers address strategies accordingly, and policymakers regulate the major issues brought by the pandemic. © 2022, Universidad Nacional de Colombia. All rights reserved.
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Purpose: The evidence regarding the clinical effectiveness of COVID-19 vaccination in kidney transplant (KT) recipients is limited so far. Our purpose is to analyze the characteristics and outcomes of a large series of KT with COVID-19 breakthrough infection and compare them with unvaccinated patients. As a secondary objective, we analyzed the evolution according to the type of mRNA vaccine administered. Method(s): From April to October 2021, KT recipients with COVID-19, included in the COVID-19 registry of the Spanish Society of Nephrology, were analyzed. Data regarding vaccination status and type of vaccine were collected and outcomes of unvaccinated or partially vaccinated patients were compared with fully vaccinated patients. Result(s): Clinical picture was similar and survival analysis showed no differences between groups: 21.7% of fully vaccinated patients and 20.8% of unvaccinated or partially vaccinated died (p=.776). In multivariable analysis age and pneumonia were independent risk factors for death, while vaccination status was not related to mortality. These results remained similar when we excluded patients with partial vaccination as well as when we analyzed exclusively hospitalized patients. Patients vaccinated with mRNA-1273 (Moderna) (n=213) showed a significantly lower mortality than those who received BNT162b2 (Pfizer-BioNTech) vaccine (n=121) (16.4% vs. 28.8%, p=.002) (HR: 0.52, CI 95% 0.31-0.85, p=.010). Conclusion(s): COVID-19 severity in KT patients has remained high and has not improved despite receiving 2 doses of an mRNA vaccine, but the mRNA-1273 vaccine shows higher clinical effectiveness than BNT162b2 in KT recipients with breakthrough infection, so it could be considered as the first option in these patients.
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The pandemic caused many changes due to social distancing, one of them is in terms of virtual university classes. Therefore, the objective was to validate an instrument that measures the perception of the effects of COVID-19 on distance education in university students of health sciences and other careers in Peru. An instrumental and cross-sectional study was carried out. Thousands of distance learning students from health sciences and other careers participated during the first wave of the Coronavirus. The survey on the perception that it has of the repercussions caused by the health emergency on face-to-face and distance education was designed and validated;in addition, another scale was exploratory to measure the perception of the spread of the coronavirus. The analysis showed high reliability and good internal consistency, with adequate Cronbach's alpha values. For the Exploratory Factor Analysis (EFA), the Bartlett test and the Kaiser-Meyer-Olkin coefficient were used. All the items received a favorable evaluation by the experts (Aiken's V> 0.70);this with respect to relevance, representativeness and clarity. Three virtual average factors were identified, their use and presence, all saturation indices were greater than 0.50. The survey proved to be reliable and representative, this above all because it was evaluated in students from the different Peruvian departments;which can be used to evaluate this in diverse similar populations.