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1.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-336958

ABSTRACT

Background We examined whether, in adults receiving behavioural support, offering e-cigarettes together with varenicline helps more people stop smoking cigarettes than varenicline alone. Methods A two-group, parallel-arm, pragmatic randomised controlled trial was conducted in six English stop smoking services from 2019-2020. Adults enrolled onto a 12-week programme of in-person one-to-one behavioural smoking cessation support (N=92) were randomised to receive either (i) a nicotine e-cigarette starter-kit alongside varenicline or (ii) varenicline alone. The primary outcome was biochemically-verified abstinence from cigarette smoking between weeks nine-to-12 post quit-date, with those lost to follow-up considered not abstinent. The trial was stopped early due to COVID-19 restrictions and a varenicline recall (92/1266 participants recruited). Results Nine-to-12-week smoking abstinence rates were 47.9% (23/48) in the e-cigarette-varenicline group compared with 31.8% (14/44) in the varenicline-only group, a 51% increase in abstinence among those offered e-cigarettes;however, the confidence interval (CI) was wide, including the possibility of no difference (risk ratio [RR]=1.51, 95%CI=0.91-2.64). The e-cigarette-varenicline group had 43% lower hazards of relapse from continuous abstinence than the varenicline-only group (hazards ratio [HR]=0.57, 95%CI=0.34-0.96). Attendance for 12 weeks was higher in the e-cigarette-varenicline than varenicline-only group (54.2% versus 36.4%;RR=1.49, 95%CI=0.95-2.47), but similar proportions of participants in both groups used varenicline daily for ≥8 weeks after quitting (22.9% versus 22.7%;RR=1.01, 95%CI=0.47-2.20). Estimates were too imprecise to determine how adverse events differed by group. Conclusion Preliminary evidence suggests offering e-cigarettes alongside varenicline to people receiving behavioural support may be more effective for smoking cessation than varenicline alone. Implications Offering e-cigarettes to people quitting smoking with varenicline may help them remain abstinent from cigarettes, but the evidence is preliminary because our sample size was smaller than planned — caused by COVID-19 restrictions and a manufacturing recall. This meant our effect estimates were imprecise, and additional evidence is needed to confirm that providing e-cigarettes and varenicline together helps more people remain abstinent than varenicline alone.

2.
JAC-antimicrobial resistance ; 4(Suppl 1), 2022.
Article in English | EuropePMC | ID: covidwho-1823913

ABSTRACT

Background A minority of patients presenting to hospital with COVID-19 have bacterial coinfection. Procalcitonin testing may help identify patients for whom antibiotics should be prescribed or withheld. The PEACH study describes the use of procalcitonin in English and Welsh hospitals during the first wave of the COVID-19 pandemic to help diagnose bacterial infections and guide antibiotic treatment. There is a lack of clear evidence to support its use in lung infections, which means in some hospitals, clinicians have used the procalcitonin test to guide antibiotic decisions in COVID-19, whilst in other hospitals, they have not. Our study is analysing data from hospitals that did and did not use procalcitonin testing during the first wave of the COVID-19 pandemic. It will determine whether and how procalcitonin testing should be used in the NHS in future waves of COVID-19 to protect patients from antibiotic overuse. Methods To assess whether the use of PCT testing, to guide antibiotic prescribing, safely reduced antibiotic use among patients who were hospitalized with COVID-19 during the first wave of the pandemic, we are answering this question through three different, and complimentary, work streams (WS), each with discrete work packages (WP): (i) Work Stream 1: utilization of PCT testing to guide antibiotic prescribing during the first wave of COVID-19 pandemic;(ii) Work Stream 2: patient-level impact of PCT testing on antibiotic exposure and clinical outcome (main work stream currently in analysis);and (iii) Work Stream 3: health economics analysis of PCT testing to guide antibiotics in COVID-19. Results Our first publication from Work Stream 1 (Antibiotics 2021, 10: 516) used a web-based survey to gather data from antimicrobial leads about the use of procalcitonin testing. Responses were received from 148/151 (98%) eligible hospitals. During the first wave of the COVID-19 pandemic, there was widespread introduction and expansion of PCT use in NHS hospitals. The number of hospitals using PCT in emergency/acute admissions rose from 17 (11%) to 74/146 (50.7%) and use in ICU increased from 70 (47.6%) to 124/147 (84.4%). This increase happened predominantly in March and April 2020, preceding NICE guidance. Approximately half of hospitals used PCT as a single test to guide decisions to discontinue antibiotics and half used repeated measurements. There was marked variation in the thresholds used for empirical antibiotic cessation and guidance about interpretation of values. Conclusions Procalcitonin testing has been widely adopted in the NHS during the COVID-19 pandemic in an unevidenced, heterogeneous way and in conflict with relevant NICE guidance. Further research is needed urgently that assesses the impact of this change on antibiotic prescribing and patient safety. Work Stream 2 is ongoing, and results will be published once available.

3.
BMJ Open ; 12(4): e054897, 2022 04 04.
Article in English | MEDLINE | ID: covidwho-1774961

ABSTRACT

INTRODUCTION: Symptoms of anxiety and depression in Indian adolescents are common. Schools can be opportune sites for delivery of mental health interventions. India, however, is without a evidence-based and integrated whole-school mental health approach. This article describes the study design for the safeguarding adolescent mental health in India (SAMA) project. The aim of SAMA is to codesign and feasibility test a suite of multicomponent interventions for mental health across the intersecting systems of adolescents, schools, families and their local communities in India. METHODS AND ANALYSIS: Our project will codesign and feasibility test four interventions to run in parallel in eight schools (three assigned to waitlist) in Bengaluru and Kolar in Karnataka, India. The primary aim is to reduce the prevalence of adolescent anxiety and depression. Codesign of interventions will build on existing evidence and resources. Interventions for adolescents at school will be universal, incorporating curriculum and social components. Interventions for parents and teachers will target mental health literacy, and also for teachers, training in positive behaviour practices. Intervention in the school community will target school climate to improve student mental health literacy and care. Intervention for the wider community will be via adolescent-led films and social media. We will generate intervention cost estimates, test outcome measures and identify pathways to increase policy action on the evidence. ETHICS AND DISSEMINATION: Ethical approval has been granted by the National Institute of Mental Health Neurosciences Research Ethics Committee (NIMHANS/26th IEC (Behv Sc Div/2020/2021)) and the University of Leeds School of Psychology Research Ethics Committee (PSYC-221). Certain data will be available on a data sharing site. Findings will be disseminated via peer-reviewed journals and conferences.


Subject(s)
Depression , Mental Health , Adolescent , Anxiety/epidemiology , Anxiety/prevention & control , Depression/epidemiology , Depression/prevention & control , Feasibility Studies , Humans , India/epidemiology
4.
Clin Exp Allergy ; 52(5): 604-615, 2022 May.
Article in English | MEDLINE | ID: covidwho-1752512

ABSTRACT

The COVID-19 pandemic raised acute awareness regarding inequities and inequalities and poor clinical outcomes amongst ethnic minority groups. Studies carried out in North America, the UK and Australia have shown a relatively high burden of asthma and allergies amongst ethnic minority groups. The precise reasons underpinning the high disease burden are not well understood, but it is likely that this involves complex gene-environment interaction, behavioural and cultural elements. Poor clinical outcomes have been related to multiple factors including access to health care, engagement with healthcare professionals and concordance with advice which are affected by deprivation, literacy, cultural norms and health beliefs. It is unclear at present if allergic conditions are intrinsically more severe amongst patients from ethnic minority groups. Most evidence shaping our understanding of disease pathogenesis and clinical management is biased towards data generated from white population resident in high-income countries. In conjunction with standards of care, it is prudent that a multi-pronged approach towards provision of composite, culturally tailored, supportive interventions targeting demographic variables at the individual level is needed, but this requires further research and validation. In this narrative review, we provide an overview of epidemiology, sensitization patterns, poor clinical outcomes and possible factors underpinning these observations and highlight priority areas for research.


Subject(s)
Asthma , COVID-19 , COVID-19/epidemiology , Developed Countries , Humans , Minority Groups , Pandemics
6.
Nat Commun ; 13(1): 1073, 2022 02 28.
Article in English | MEDLINE | ID: covidwho-1713164

ABSTRACT

The SARS-CoV-2 virus has altered people's lives around the world. Here we document population-wide shifts in dietary interests in 18 countries in 2020, as revealed through time series of Google search volumes. We find that during the first wave of the COVID-19 pandemic there was an overall surge in food interest, larger and longer-lasting than the surge during typical end-of-year holidays in Western countries. The shock of decreased mobility manifested as a drastic increase in interest in consuming food at home and a corresponding decrease in consuming food outside of home. The largest (up to threefold) increases occurred for calorie-dense carbohydrate-based foods such as pastries, bakery products, bread, and pies. The observed shifts in dietary interests have the potential to globally affect food consumption and health outcomes. These findings can inform governmental and organizational decisions regarding measures to mitigate the effects of the COVID-19 pandemic on diet and nutrition.


Subject(s)
COVID-19 , Diet , Food Preferences , Pandemics , Cooking , Energy Intake , Food , Humans , Nutritional Status , SARS-CoV-2
7.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-320388

ABSTRACT

Wikipedia, the largest encyclopedia ever created, is a global initiative driven by volunteer contributions. When the COVID-19 pandemic broke out and mobility restrictions ensued across the globe, it was unclear whether Wikipedia volunteers would become less active in the face of the pandemic, or whether they would rise to meet the increased demand for high-quality information despite the added stress inflicted by this crisis. Analyzing 223 million edits contributed from 2018 to 2020 across twelve Wikipedia language editions, we find that Wikipedia's global volunteer community responded remarkably to the pandemic, substantially increasing both productivity and the number of newcomers who joined the community. For example, contributions to the English Wikipedia increased by over 20% compared to the expectation derived from pre-pandemic data. Our work sheds light on the response of a global volunteer population to the COVID-19 crisis, providing valuable insights into the behavior of critical online communities under stress.

8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-320024

ABSTRACT

Recent research suggests that not all fact checking efforts are equal: when and what is fact checked plays a pivotal role in effectively correcting misconceptions. In this paper, we propose a framework to study fact checking efforts using Google Trends, a signal that captures search interest over topics on the world's largest search engine. Our framework consists of extracting claims from fact checking efforts, linking such claims with knowledge graph entities, and estimating the online attention they receive. We use this framework to study a dataset of 879 COVID-19-related fact checks done in 2020 by 81 international organizations. Our findings suggest that there is often a disconnect between online attention and fact checking efforts. For example, in around 40% of countries where 10 or more claims were fact checked, half or more than half of the top 10 most popular claims were not fact checked. Our analysis also shows that claims are first fact checked after receiving, on average, 35% of the total online attention they would eventually receive in 2020. Yet, there is a big variation among claims: some were fact checked before receiving a surge of misinformation-induced online attention, others are fact checked much later. Overall, our work suggests that the incorporation of online attention signals may help organizations better assess and prioritize their fact checking efforts. Also, in the context of international collaboration, where claims are fact checked multiple times across different countries, online attention could help organizations keep track of which claims are "migrating" between different countries.

9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-320023

ABSTRACT

We study how the COVID-19 pandemic, alongside the severe mobility restrictions that ensued, has impacted information access on Wikipedia, the world's largest online encyclopedia. A longitudinal analysis that combines pageview statistics for 12 Wikipedia language editions with mobility reports published by Apple and Google reveals massive shifts in the volume and nature of information seeking patterns during the pandemic. Interestingly, while we observe a transient increase in Wikipedia's pageview volume following mobility restrictions, the nature of information sought was impacted more permanently. These changes are most pronounced for language editions associated with countries where the most severe mobility restrictions were implemented. We also find that articles belonging to different topics behaved differently;e.g., attention towards entertainment-related topics is lingering and even increasing, while the interest in health- and biology-related topics was either small or transient. Our results highlight the utility of Wikipedia for studying how the pandemic is affecting people's needs, interests, and concerns.

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311231

ABSTRACT

Timely access to accurate information is crucial during the COVID-19 pandemic. Prompted by key stakeholders' cautioning against an "infodemic", we study information sharing on Twitter from January through May 2020. We observe an overall surge in the volume of general as well as COVID-19-related tweets around peak lockdown in March/April 2020. With respect to engagement (retweets and likes), accounts related to healthcare, science, government and politics received by far the largest boosts, whereas accounts related to religion and sports saw a relative decrease in engagement. While the threat of an "infodemic" remains, our results show that social media also provide a platform for experts and public authorities to be widely heard during a global crisis.

11.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-311230

ABSTRACT

The SARS-CoV-2 virus has altered people's lives around the world, not only through the coronavirus disease (COVID-19) it causes, but also through unprecedented non-pharmaceutical interventions such as full-scale national lockdowns. Here we document population-wide shifts in dietary interests in 12 countries in 2020, as revealed through timeseries of Google search volumes. We find that during the first wave of the COVID-19 pandemic there was an overall surge in food interest, larger and longer-lasting than the surge during typical end-of-year holidays. The changes were strongly associated with population-wide mobility patterns. Using a quasi-experimental regression discontinuity design, we estimate that the shock of decreased mobility manifested as a drastic increase in interest in consuming food at home, with interest in recipes and related entities increasing by 90% on average across countries, and a corresponding decrease in consuming food outside of home, with the interest in restaurants decreasing by 54% on average. We find that, in addition to the volume of searched foods, the nature of searched foods also changed. The most drastic (up to threefold) increases occurred for calorie-dense carbohydrate-based foods such as pastries, bakery products, bread, pies, and desserts. In terms of the relative share (rather than absolute volume) of search interest, the most prominent increases occurred for carbohydrate-based foods, whereas the share of interest in other food categories on average remained robust. The observed shifts in dietary interests have the potential to affect food consumption and health outcomes of people worldwide. These findings can inform governmental and organizational decisions regarding measures to mitigate the effects of the COVID-19 pandemic on diet and nutrition, and thus on population health.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-304732

ABSTRACT

Effective communication during the COVID-19 pandemic can save lives. At the present time, social and physical distancing measures are the lead strategy in combatting the spread of COVID-19. In this pilot, survey-based study, we obtained responses from 705 adults in Switzerland about their support and practice of social distancing measures to examine if these responses are: (1) influenced by whether these measures are supported by an internationally recognized celebrity or a government official, (2) dependent on whether the spokesperson is liked, and (3) age-dependent. We also considered several attitudinal and demographic variables that may influence the degree to which people support and comply with social distancing measures. We found that the government official was more effective, particularly in response to current compliance with social distancing measures, and was substantially stronger among older respondents despite having lower risk perception. Being liked seems to boost this effect. In addition, respondents’ greater support and compliance was positively associated with (1) higher concern for the current situation, (2) higher concern for the well-being of others, (3) greater belief that others are practicing social distancing, (4) feeling greater constraint in freedom of movement, and negatively with (5) city size, and (6) household size. Since different parts of the population appear to have different perceptions of risk and crisis, our preliminary results suggest that different spokespersons may be needed for the younger and the older populations, and for rural and urban populations. The development of evidence-based knowledge is required to further identify who would be the most effective spokesperson, and in particular to groups with low risk perception and low compliance.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-304731

ABSTRACT

It is urgent to understand how to most effectively communicate public health messages during the COVID-19 pandemic. Previously, the focus has been on how to formulate the message, rather than on who should send it, and particularly little is known about the latter during times of crisis. We report on the effectiveness of different public figures at promoting social distancing in 6 countries severely affected by the COVID-19 pandemic. Across countries and demographic strata, immunology expert Dr. Anthony Fauci achieved the highest level of respondents’ willingness to reshare a call to social distancing, followed by a government spokesperson. Celebrity spokespersons were least effective. The likelihood of message resharing increased with age and when respondents expressed positive sentiments towards the spokesperson. Effective messaging during the COVID-19 pandemic can save lives, and the messenger matters.

14.
J Antimicrob Chemother ; 77(4): 1189-1196, 2022 03 31.
Article in English | MEDLINE | ID: covidwho-1684714

ABSTRACT

BACKGROUND: Blood biomarkers have the potential to help identify COVID-19 patients with bacterial coinfection in whom antibiotics are indicated. During the COVID-19 pandemic, procalcitonin testing was widely introduced at hospitals in the UK to guide antibiotic prescribing. We have determined the impact of this on hospital-level antibiotic consumption. METHODS: We conducted a retrospective, controlled interrupted time series analysis of organization-level data describing antibiotic dispensing, hospital activity and procalcitonin testing for acute hospitals/hospital trusts in England and Wales during the first wave of COVID-19 (24 February to 5 July 2020). RESULTS: In the main analysis of 105 hospitals in England, introduction of procalcitonin testing in emergency departments/acute medical admission units was associated with a statistically significant decrease in total antibiotic use of -1.08 (95% CI: -1.81 to -0.36) DDDs of antibiotic per admission per week per trust. This effect was then lost at a rate of 0.05 (95% CI: 0.02-0.08) DDDs per admission per week. Similar results were found specifically for first-line antibiotics for community-acquired pneumonia and for COVID-19 admissions rather than all admissions. Introduction of procalcitonin in the ICU setting was not associated with any significant change in antibiotic use. CONCLUSIONS: At hospitals where procalcitonin testing was introduced in emergency departments/acute medical units this was associated with an initial, but unsustained, reduction in antibiotic use. Further research should establish the patient-level impact of procalcitonin testing in this population and understand its potential for clinical effectiveness.


Subject(s)
COVID-19 , Procalcitonin , Anti-Bacterial Agents/therapeutic use , COVID-19/diagnosis , COVID-19/drug therapy , Hospitals , Humans , Interrupted Time Series Analysis , Pandemics , Retrospective Studies , State Medicine , United Kingdom
15.
Health Policy ; 126(3): 234-244, 2022 03.
Article in English | MEDLINE | ID: covidwho-1620689

ABSTRACT

The COVID-19 pandemic has shone a light on the complex relationship between science and policy. Policymakers have had to make decisions at speed in conditions of uncertainty, implementing policies that have had profound consequences for people's lives. Yet this process has sometimes been characterised by fragmentation, opacity and a disconnect between evidence and policy. In the United Kingdom, concerns about the secrecy that initially surrounded this process led to the creation of Independent SAGE, an unofficial group of scientists from different disciplines that came together to ask policy-relevant questions, review the evolving evidence, and make evidence-based recommendations. The group took a public health approach with a population perspective, worked in a holistic transdisciplinary way, and were committed to public engagement. In this paper, we review the lessons learned during its first year. These include the importance of learning from local expertise, the value of learning from other countries, the role of civil society as a critical friend to government, finding appropriate relationships between science and policy, and recognising the necessity of viewing issues through an equity lens.


Subject(s)
COVID-19 , Pandemics , Communication , Emergencies , Humans , SARS-CoV-2 , United Kingdom
17.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-292039

ABSTRACT

Wikipedia, the largest encyclopedia ever created, is a global initiative driven by volunteer contributions. When the COVID-19 pandemic broke out and mobility restrictions ensued across the globe, it was unclear whether Wikipedia volunteers would become less active in the face of the pandemic, or whether they would rise to meet the increased demand for high-quality information despite the added stress inflicted by this crisis. Analyzing 223 million edits contributed from 2018 to 2020 across twelve Wikipedia language editions, we find that Wikipedia's global volunteer community responded remarkably to the pandemic, substantially increasing both productivity and the number of newcomers who joined the community. For example, contributions to the English Wikipedia increased by over 20% compared to the expectation derived from pre-pandemic data. Our work sheds light on the response of a global volunteer population to the COVID-19 crisis, providing valuable insights into the behavior of critical online communities under stress.

18.
Sci Rep ; 11(1): 21505, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1500509

ABSTRACT

Wikipedia, the largest encyclopedia ever created, is a global initiative driven by volunteer contributions. When the COVID-19 pandemic broke out and mobility restrictions ensued across the globe, it was unclear whether contributions to Wikipedia would decrease in the face of the pandemic, or whether volunteers would withstand the added stress and increase their contributions to accommodate the growing readership uncovered in recent studies. We analyze [Formula: see text] million edits contributed from 2018 to 2020 across twelve Wikipedia language editions and find that Wikipedia's global volunteer community responded resiliently to the pandemic, substantially increasing both productivity and the number of newcomers who joined the community. For example, contributions to the English Wikipedia increased by over [Formula: see text] compared to the expectation derived from pre-pandemic data. Our work sheds light on the response of a global volunteer population to the COVID-19 crisis, providing valuable insights into the behavior of critical online communities under stress.


Subject(s)
COVID-19/epidemiology , Volunteers/statistics & numerical data , COVID-19/pathology , COVID-19/virology , Databases, Factual , Encyclopedias as Topic , Humans , Language , Pandemics , Quarantine , SARS-CoV-2/isolation & purification
19.
Br J Health Psychol ; 26(4): 1238-1257, 2021 11.
Article in English | MEDLINE | ID: covidwho-1379562

ABSTRACT

OBJECTIVES: The Scientific Pandemic Insights group on Behaviours (SPI-B) as part of England's Scientific Advisory Group on Emergencies (SAGE), were commissioned by the UK Cabinet Office to identify strategies to embed infection control behaviours to minimize Covid-19 transmission in the long term. METHODS: With minimal direct evidence available, three sources of information were used to develop a set of proposals: (1) a scoping review of literature on sustaining behaviour change, (2) a review of key principles used in risk and safety management, and (3) prior reports and reviews on behaviour change from SPI-B. The information was collated and refined through discussion with SPI-B and SAGE colleagues to finalize the proposals. RESULTS: Embedding infection control behaviours in the long-term will require changes to the financial, social, and physical infrastructure so that people in all sections of society have the capability, opportunity, and motivation needed to underpin those behaviours. This will involve building Covid-safe educational programmes, regulating to ensure minimum standards of safety in public spaces and workspaces, using communications and social marketing to develop a Covid-safe culture and identity, and providing resources so that all sections of society can build Covid-safe behaviours into their daily lives. CONCLUSIONS: Embedding 'Covid-safe' behaviours into people's everyday routines will require a co-ordinated programme to shape the financial, physical, and social infrastructure in the United Kingdom. Education, regulation, communications, and social marketing, and provision of resources will be required to ensure that all sections of society have the capability, opportunity, and motivation to enact the behaviours long term.


Subject(s)
COVID-19 , Humans , SARS-CoV-2 , United Kingdom
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