Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 209
Filter
1.
Journal of International Students ; 12(3):565-586, 2022.
Article in English | Scopus | ID: covidwho-1965093

ABSTRACT

A large number of Chinese applicants use education agents to apply for overseas programs, and agents are one of the most significant influence factors on Chinese international students’ choice of overseas programs. However, there is limited research around agents’ experiences within the existing information landscape of international higher education. For example, information asymmetries between agents and universities may have an impact on the advice and guidance provided for international applicants. This research investigates agents’ practices with in-service Chinese applicants to UK universities in the context of information asymmetry. COVID-19 serves as a backdrop as an illustrative case of a period of high information uncertainty, which has generated severe challenges for the international higher education sector and for Chinese applicants’ plans to study overseas. This study reports on the findings from in-depth interviews with 16 Chinese agent consultants undertaken in nine cities across China in the immediate aftermath of the pandemic (May 2020). The findings indicate that education agents attempt to mitigate the information asymmetry and emotionally reassure applicants through a four-step information management process. Our contribution generates a new understanding of the role that education agents play in international students’ applications and mobility, voices that are often ignored but essential for international students’ decision-making processes and existing university recruitment services. © Journal of International Students.

2.
4th International Conference on Blockchain Technology, ICBCT 2022 ; : 110-116, 2022.
Article in English | Scopus | ID: covidwho-1962425

ABSTRACT

Location data containing trajectory information is of great value, but its unrestricted sharing also brings problems such as data abuse, privacy threat and lack of audit evidence. Especially when it comes to researchers or governments to collect location data to stem the spread of COVID-19, the authorization of the data owner is often missing. In this paper, we propose a data sharing scheme for location data based on a high-performance consortium blockchain combined with proxy re-encryption, which can guarantee location data sharing under user authorization while ensure the efficiency and security in the process of data sharing. The performance analysis and simulation results illustrate that the proposed scheme can meet the performance requirements in practical scenarios, guarantee the privacy of personal location data while making the data useful for stemming the spread of COVID-19. © 2022 ACM.

3.
5th International Conference on Traffic Engineering and Transportation System, ICTETS 2021 ; 12058, 2021.
Article in English | Scopus | ID: covidwho-1962041

ABSTRACT

Automobile cabin air filters have been ever-increasingly detected since the outburst of COVID-19. However, the dust sources adopted are varied due to the numerous standards. In this study, the effects of different dust sources on the test results of filtration efficiency were explored, and the causes for the different test media used in different standards were analyzed. The study results provide a reference for further improving the performance of vehicle cabin air filters. © 2021 SPIE

4.
14th International Conference on Cross-Cultural Design, CCD 2022 Held as Part of the 24th HCI International Conference, HCII 2022 ; 13311 LNCS:405-416, 2022.
Article in English | Scopus | ID: covidwho-1941428

ABSTRACT

The COVID-19 pandemic caused changes in our living styles severely after 2019 and has accelerated the shift towards a more cyber world. The recent online consumer survey showed that changes in online shopping behaviors are likely to have lasting effects. This study examined the different cultural comparisons of the navigation of website menu and product category layers on e-commerce websites. Our findings indicated that the menu of the Western e-commerce website is more layers than the East Asian website did (H1) through usability testing. In addition, participants spent more time on Western e-commerce websites than on East Asian e-commerce websites did (H2). This research provided a prospective insight for cross-border e-commerce that customized the website menu presentation when worldwide consumers visited them cross-culturally. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

5.
The American Journal of Managed Care ; 28(7), 2022.
Article in English | ProQuest Central | ID: covidwho-1929563

ABSTRACT

COVID-19 hospitalizations among unvaccinated individuals cost billions of dollars. More employers are considering imposing a premium surcharge on employees participating in the company's health plan who are not vaccinated against COVID-19. These employers see this approach as similar to health premium surcharges for tobacco use, justifying the higher premiums on the basis that unvaccinated individuals could cause the plan to experience higher hospitalization and related costs. However, imposing a surcharge on unvaccinated employees will require employers to think through legal and policy implications and the interests of their employees and their businesses. Employers should weigh their vaccination goals against these interests and consider whether a legally compliant surcharge would further their goals. Employers should carefully consider the prevailing culture among their employees and assess whether the policy would be effective and noncoercive. Premium surcharges may be effective for some but not all employers.

6.
Chinese Journal of Disease Control and Prevention ; 26(6):696-702, 2022.
Article in Chinese | EMBASE | ID: covidwho-1928935

ABSTRACT

Objective To analyze the work situation of the personnel in Beijing Centers for Disease Prevention and Control during the novel coronavirns disease 2019 (C0VID-19) epidemic,and to provide references for improving the construction of the capital5 s disease control and prevention system. Methods Cross-sectional survey and cluster sanpling methods were used. A total of 422 municipal-level and 664 district-level professional technicians from CDCs who were mainly involved in epidemic prevention and control in Beijing were included in the study. Self-designed questionnaires were used to collect the basic information, work intensity and satisfaction and other data. The statistical description and test analysis were carried out. Results Among professionals, 64. 36% had nornal workload, and 76. 89% had overload during the epidemic prevention and control period. The proportion of disease control personnel expressing dissatisfaction "with the usual salary level "was 54. 51%, and the satisfaction with the professional title promotion w-as mostly at the average level (45. 58%). The proportions of satisfaction with the prevention and control work arrangements and logistical support during the COVID-19 epidemic were 49. 08% and 54. 42%, respectively. Only 21. 73% professionals were satisfied with the temporar w-ork subsidy. From the perspective of population distribution, staffs at the municipal and district levels and in different job positions were mainly dissatisfied with the salar level (all P<0. 05). Most of staffs who undertook different prevention and control responsibilities were satisfied with the work arrangements and logistics support (all P<0. 05), but they w-ere dissatisfied with the temporar work subsidies (H = 27. 076, P = 0. 012). Among the survey respondents, 44.48% had thoughts of resigning. Regardless of the municipal and district levels, different professional titles or positions, the wdllingness to resign was generally high (all P>0. 05). The primar reason for wanting to leave was the low salary level, followed by difficulty in promotion of professional titles and poor development prospects which were also major considerations. Conclusion It is suggested to improve the stability of CDCs staffs and promote the high-quality and sustainable development of the disease control and prevention system by improving the personnel allocation, strengthening the interdisciplinary talent reserve, improving the salary system and optimizing the professional title appointment mechanism.

7.
Chinese Physics B ; 31(7):12, 2022.
Article in English | Web of Science | ID: covidwho-1927259

ABSTRACT

Under the background of Covid-19 sweeping the world, safe and reasonable passenger flow management strategy in subway stations is an effective means to prevent the spread of virus. Based on the social force model and the minimum cost model, the movement and path selection behavior of passengers in the subway station are modeled, and a strategy for passenger flow management to maintain a safe social distance is put forward. Take Qingdao Jinggangshan Road subway station of China as the simulation scene, the validity of the simulation model is verified by comparing the measured value and simulation value of the time required for passengers from getting off the train to the ticket gate. Simulation results indicate that controlling the time interval between incoming passengers at the entrance can effectively control the social distance between passengers and reduce the risk of epidemic infection. By comparing the evacuation process of passengers under different initial densities, it is found that the greater the initial density of passengers is, the longer the passengers are at risk social distance. In the process of passenger emergency evacuation, the stairs/escalators and ticket gates are bottleneck areas with high concentration of passenger density, which should be strictly disinfected many times on the basis of strictly checking the health code of incoming passengers and controlling the arrival time interval. The simulation results of this paper verify the harmfulness of passenger emergency evacuation without protective measures, and provide theoretical support for the operation and management of subway station under the epidemic situation.

8.
Jiaotong Yunshu Xitong Gongcheng Yu Xinxi/Journal of Transportation Systems Engineering and Information Technology ; 22(3):15-24, 2022.
Article in Chinese | Scopus | ID: covidwho-1924762

ABSTRACT

In order to explore the choice behavior of residents' travel mode in the post-COVID-19 era, a choice behavior experiment was conducted. A mixed Logit model and a latent class conditional Logit model of travel mode choice were constructed based on the data obtained from questionnaire surveys. Stata software was used to calibrate the model parameters, and the main factors influencing residents' travel mode choices were obtained. The results show that both models reflect the heterogeneity of individual travel mode choices. Compared with the mixed Logit model, the latent class conditional Logit model has an improvement of 13% in the goodness of fit and an increase of 3.03% in the prediction accuracy, which provides an effective tool for analyzing individual heterogeneity of travel behavior under public health emergencies. The latent class conditional Logit model divides residents into four and five groups according to the two scenarios of low and medium risk areas. From the perspective of travel mode attributes, the waiting time and the traveling time have become the most important influencing factors for residents to choose the travel modes. From the perspective of personal socio-economic attributes, women with higher incomes are more inclined to choose private cars to travel. The older are more sensitive to travel costs, and men are more willing to choose bus and subway travel. Copyright © 2022 by Science Press.

9.
Chemical, Biological, Radiological, Nuclear, and Explosives (CBRNE) Sensing XXIII 2022 ; 12116, 2022.
Article in English | Scopus | ID: covidwho-1923081

ABSTRACT

A rapid, portable, and cost-effective method to detect the infection of SARS-CoV-2 is fundamental toward mitigating the current COVID-19 pandemic. A localized surface plasmon resonance (LSPR) sensor based on human angiotensin-converting enzyme 2 protein (ACE2) functionalized silver nanotriangle array is developed for rapid coronavirus detection. The sensor is validated by SARS-CoV-2 spike RBD protein and CoV NL63 virus with high sensitivity and specificity. A linear shift of the LSPR wavelength and transmission intensity at a fixed wavelength (750 nm) versus the logarithm of the concentration of the spike RBD protein and CoV NL63 is observed. The limits of detection for the spike RBD protein, CoV NL63 in untreated saliva are determined to be 0.38 pM, and 625 PFU/mL, respectively, while the detection time is found to be less than 20 min. Such a LSPR sensor could serve as a potential rapid point-of-care diagnostic platform for COVID-19. © 2022 SPIE

10.
11th International Conference on Design, User Experience, and Usability, DUXU 2022 Held as Part of the 24th HCI International Conference, HCII 2022 ; 13322 LNCS:185-197, 2022.
Article in English | Scopus | ID: covidwho-1919653

ABSTRACT

In the context of the COIVD-19 pandemic, everyone must maintain social distances in public. Our ability to perceive each other through “distances” in public places has been compromised. However, “distance” is an essential factor in communication that cannot be ignored, like “facial expressions” and “body movements”. This paper reflects on the current fixed “social distancing” in the context of the current viral pandemic. The innovative point of our research is to detect and calculate the differences of brainwave signal data between two people and visualize the differences through programmed 2D moving images. In terms of the research process, first, we explored a new way of interaction, using brainwave signals to express “distances” and moiré patterns as visual representations. Then we wrote an algorithm to generate the dynamic responses of the moiré patterns to different stimuli in real-time to represent the concepts of distances and visualize people’s reactions. Finally, we developed an interactive device to imagine “electroencephalography (EEG) signal discrepancy” to perceive the “distances” in social situations. Nowadays, online meetings, classes, etc., are becoming more and more popular, and the distances between people in virtual spaces will be more ambiguous. In light of this, we plan to explore the visualization of electroencephalography (EEG) signal discrepancy in remote communication to enhance people’s perceptions of each other in the future. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

11.
Reviews in Cardiovascular Medicine ; 23(6), 2022.
Article in English | EMBASE | ID: covidwho-1918320

ABSTRACT

Background: The present study aimed to clarify the impact of the 2020 COVID-19 pandemic on emergency management of acute type A aortic dissection. Methods: We consecutively enrolled 337 acute type A aortic dissection (ATAAD) patients at emergency room in Fuwai Hospital (Beijing, China) from January to June during the 2020 COVID-19 epidemic (n = 148) and the same period in 2019 as the historical control (n = 189). The primary outcome was defined as in-hospital death. Other outcomes included automatic discharge during emergency admission. The factors with significant differences before and after the epidemic were compared and analyzed by stages with the study endpoint to clarify their changes in different stages of the epidemic. Results: There was no significant difference in in-hospital mortality (35 (20.5%) vs. 23 (17.4%), p = 0.472). Compared with year 2019, proportion of patients receiving surgical treatment decreased significantly (74 (50.0%) vs. 129 (68.25%), p < 0.001). The surgery time of ATAAD patients in 2020 was significantly shorter (6.46 [5.52, 7.51] vs. 7.33 [6.00, 8.85] hours, p = 0.01). The length of stay in the emergency department significantly differed at each stage. Conclusions: Our study demonstrated a significant reduction in the number of ATAAD patients and surgical treatment during COVID-19 outbreak. The surgical strategy of patients changed, but the overall mortality was largely the same. Patients undergoing surgery had a trend toward longer interval from the onset to the operating room, but they tended to be normal at the end of the epidemic. Proper epidemic prevention policies may avoid COVID-19 hitting patients who are not infected with the virus to the greatest extent.

13.
Zhonghua Gan Zang Bing Za Zhi ; 30(5): 520-526, 2022 May 20.
Article in Chinese | MEDLINE | ID: covidwho-1911774

ABSTRACT

Objective: To analyze whether there are differences and related influencing factors in liver injury associated with different strains of 2019-nCoV/SARS-CoV-2 infection. Methods: Data of epidemiology, clinical symptoms, laboratory tests, and treatment outcomes of patients with COVID-19 infection confirmed with Alpha and Delta virus strain in Zhejiang Province were retrospectively collected. Statistical analysis was performed using independent samples t-test or Mann-Whitney U test, χ2 test or Fisher's exact test, and logistic regression analysis. Results: A total of 788 and 381 cases with Alpha and Delta virus strain were included. Vaccination ratio was 0% in Alpha and 85.30% in Delta group (P<0.001), The proportion of patients with fever (80.71% vs. 40.94%, P<0.001) was significantly higher in Alpha than Delta strain group. The proportion of critical ill patients was significantly higher in Delta group (9.90% vs. 1.57%, respectively, P<0.001). The virus negative conversion time was significantly longer in Delta than Alpha group (22 d vs. 11 d, P<0.001), but the incidence of liver injury was significantly higher in Alpha than Delta group (20.05% vs. 13.91%, P=0.011). Univariate analysis showed that Alpha virus strain infection, male sex, body mass index, chronic liver disease, fever, diarrhea, shortness of breath, severe/critical illness, elevated creatine kinase (CK), elevated international normalized ratio (INR) and an elevated neutrophil/lymphocyte ratio was significantly associated with an increased risk of liver injury occurrence, and in patients with pharyngeal pain the risk of liver injury occurrence was significantly reduced. Multivariate analysis showed that shortness of breath [OR, 2.667 (CI: 1.389-5.122); P=0.003], increased CK [OR, 2.544 (CI: 1.414-4.576); P=0.002] and increased INR [OR, 1.721] (CI: 1.074-2.758); P=0.024] was significantly associated with an increased risk of liver injury occurrence, and in patients with pharyngeal pain the risk of liver injury occurrence was significantly reduced [OR, 0.424 (CI: 0.254-0.709); P=0.001]. Conclusion: Although the virulence of the Delta is stronger than Alpha strain, most patients infected with Delta strain vaccinated against COVID-19 in Zhejiang province had milder clinical symptoms and a lower incidence and degree of liver injury. Notably, the infection risk even remains after vaccination; however, symptoms and the incidence of severe and critical illness can be significantly reduced.


Subject(s)
COVID-19 , Critical Illness , Dyspnea , Fever , Humans , Liver , Male , Pain , Retrospective Studies , SARS-CoV-2
14.
BMC Health Serv Res ; 22(1): 846, 2022 Jun 30.
Article in English | MEDLINE | ID: covidwho-1910319

ABSTRACT

BACKGROUND: The novel coronavirus of 2019 (COVID-19) has been and continues to be a rapidly developing public health crisis, that has also disrupted routine and maintenance health care for people living with chronic conditions. Some of these chronic conditions also put individuals at increased risk of COVID-19 complications, particularly if the condition is not under control. For these reasons, the exploratory study reported here examined the needs and preparedness of patients at a community health organization that specifically provides hepatitis B virus (HBV) care for high-risk groups that had previously tested positive for HBV. METHODS: Current study utilized exploratory analysis of qualitative COVID-19-related statements collected during calls to a total of 44 patients reached during April and May, 2020 in the Washington D.C. area. Researchers worked with a community based non-profit organization to reach current HBV + and HCV + patients to provide retention in care and assess patient needs in maintaining management of their condition adapted to include offering medication refills, telehealth, and other resources. We gathered emergent themes, using socio-ecological framework, regarding capacity and needs for managing their chronic condition in a vulnerable population during the initial, most interrupted, time period of a global public health crisis. RESULTS: From the notes of the calls, five thematic categories emerged: COVID-19 prevention awareness, assistance program access, medical resource access, access to knowledge and awareness about assistance programs, and needs and barriers. From these five themes, providers can develop strategies to better prepare their patients and provide care to patients with chronic conditions during major disruptions. CONCLUSIONS: Future recommendations include increasing hepatitis and COVID-19 vaccine efforts, collaborating with community partners, and screening and understanding social determinants of health that affect racial and ethnic minorities.


Subject(s)
COVID-19 , Hepatitis B , COVID-19/epidemiology , COVID-19 Vaccines , Chronic Disease , Humans , Patient Care
15.
ACS PHARMACOLOGY & TRANSLATIONAL SCIENCE ; 5(6):400-412, 2022.
Article in English | Web of Science | ID: covidwho-1908094

ABSTRACT

The rampageous transmission of SARS-CoV-2 has been devastatingly impacting human life and public health since late 2019. The waves of pandemic events caused by distinct coronaviruses at present and over the past decades have prompted the need to develop broad-spectrum antiviral drugs against them. In this study, our Pentarlandir ultrapure and potent tannic acids (UPPTA) showed activities against two coronaviral strains, SARSCoV-2 and HCoV-OC43, the earliest-known coronaviruses. The mode of inhibition of Pentarlandir UPPTA is likely to act on 3-chymotrypsin-like protease (3CLpro) to prevent viral replication, as supported by results of biochemical analysis, a 3CLpro assay, and a "gain-of-function" 3CLpro overexpressed cell-based method. Even in the 3CLpro overexpressed environment, Pentarlandir UPPTA remained its antiviral characteristic. Utilizing cell-based virucidal and cytotoxicity assays, the 50% effective concentrations (EC50) and 50% cytotoxicity concentration (CC50) of Pentarlandir UPPTA were determined to be similar to 0.5 and 52.5 mu M against SARS-CoV-2, while they were 1.3 and 205.9 mu M against HCoV-OC43, respectively. In the pharmacokinetic studies, Pentarlandir UPPTA was distributable at a high level to the lung tissue with no accumulation in the body, although the distribution was affected by the food effect. With further investigation in toxicology, Pentarlandir UPPTA demonstrated an overall safe toxicology profile. Taking these findings together, Pentarlandir UPPTA is considered to be a safe and efficacious pancoronal antiviral drug candidate that has been advanced to clinical development.

16.
ENGINEERING ; 10:155-166, 2022.
Article in English | Web of Science | ID: covidwho-1906991

ABSTRACT

The coronavirus disease 2019 (COVID-19) and concerns about several other pandemics in the 21st century have attracted extensive global attention. These emerging infectious diseases threaten global public health and raise urgent studies on unraveling the underlying mechanisms of their transmission from animals to humans. Although numerous works have intensively discussed the cross-species and endemic barriers to the occurrence and spread of emerging infectious diseases, both types of barriers play synergistic roles in wildlife habitats. Thus far, there is still a lack of a complete understanding of viral diffusion, migration, and transmission in ecosystems from a macro perspective. In this review, we conceptualize the ecological barrier that represents the combined effects of cross-species and endemic barriers for either the natural or intermediate hosts of viruses. We comprehensively discuss the key influential factors affecting the ecological barrier against viral transmission from virus hosts in their natural habitats into human society, including transmission routes, contact probability, contact frequency, and viral characteristics. Considering the significant impacts of human activities and global industrialization on the strength of the ecological barrier, ecological barrier deterioration driven by human activities is critically analyzed for potential mechanisms. Global climate change can trigger and expand the range of emerging infectious diseases, and human disturbances promote higher contact frequency and greater transmission possibility. In addition, globalization drives more transmission routes and produces new high-risk regions in city areas. This review aims to provide a new concept for and comprehensive evidence of the ecological barrier blocking the transmission and spread of emerging infectious diseases. It also offers new insights into potential strategies to protect the ecological barrier and reduce the wide-ranging risks of emerging infectious diseases to public health. (c) 2020 THE AUTHORS. Published by Elsevier LTD on behalf of Chinese Academy of Engineering and Higher Education Press Limited Company. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

17.
8th IEEE Asia-Pacific Conference on Computer Science and Data Engineering (IEEE CSDE) ; 2021.
Article in English | Web of Science | ID: covidwho-1895899

ABSTRACT

COVID-19 pandemic has a devastating impact on human health and well-being. Numerous biological tools have been utilised for COVID detection, but most of the tools are costly, time-extensive and need personnel with domain expertise. Thus, a cost-effective classifier can solve the problem where cough audio signals showed potentiality as an screening classifier for COVID-19 diagnosis. Recent ML approaches on cough-based covid-19 detection need costly deep learning algorithms or sophisticated methods to extract informative features. In this paper, we propose a low-cost and efficient envelope approach, called CovidEnvelope, which can classify COVID-19 positive and negative cases from raw data by avoiding above disadvantages. This automated approach can select correct audio signals (cough) from background noises, generate envelope around the informative audio signal, and finally provide outcomes by computing area enclosed by the envelope. It has been seen that reliable data-sets are also important for achieving high performance. Our approach proves that human verbal confirmation is not a reliable source of information. Finally, the approach reaches highest sensitivity, specificity, accuracy, and AUC of 0.96, 0.92, 0.94, and 0.94 respectively to detect Covid-19 coughs. Our approach outperformed other existing models on data pre-processing and inference times, and achieved accuracy and specificity of 0.91 and 0.99 respectively, to distinguish COVID-19 coughs from other coughs, resulted from respiratory diseases. The automatic approach only takes 1.8 to 3.9 minutes to compute these performances. Overall, our approach is fast and sensitive to diagnose the people living with COVID-19, regardless of having COVID-19 related symptoms or not. In this connection, the model can be implemented easily in mobile-devices or web-based applications, and countries with poor health facilities will be highly beneficiary for covid diagnosis and measuring prognostication.

18.
Diabetes Technology and Therapeutics ; 24(SUPPL 2):A9, 2022.
Article in English | EMBASE | ID: covidwho-1895749

ABSTRACT

Background and Aims: Mobile health management platform is a potential way to achieving effective glycemic control in type 2 diabetesmellitus (T2DM) patients, especially during the Covid-19 pandemic. Lilly Connected Care Program (LCCP) is a smartphone-based app providing blood glucose monitoring and diabetes education services to improve diabetes management. This study aimed to evaluate the real-world effectiveness of LCCP platform in glycemic control among Chinese T2DM patients. Methods: This retrospective study included Chinese T2DM patients (age ≥18 years) from January 1, 2015, to January 31, 2020. Data was drawn from mobile app and electronic medical records. Propensity score matching (PSM) was used to match LCCP group and non-LCCP group to reduce confounding, with covariates including age, sex, duration of diabetes, baseline HbA1c, and number of oral diabetes medication classes. We analyzed HbA1c reduction within an average of 4 months and compared the proportions of patients achieving HbA1c reduction ≥0.5% or ≥1% between LCCP and non-LCCP groups. Comparisons were made using independent t-test and Chi-square test. Results: A total of 923 patients were included, among whom 303 pairs of patients were well-matched after PSM (Standardized Mean Difference of covariates <15%). The HbA1c reduction during 4-month follow-up was significantly larger in LCCP group than non-LCCP group (Mean±SD: 2.21 ± 2.37% vs. 1.65 ± 2.29%, P = 0.003). LCCP group had higher proportions of patients with HbA1c reduction ≥1% (69.0% vs. 57.4%, P = 0.003) and ≥0.5% (75.6% vs. 68.0%, P = 0.038). Conclusions: LCCP mobile platform was effective in glycemic control among Chinese T2DM patients in the real world.

19.
Diabetes Research and Clinical Practice ; 186, 2022.
Article in English | EMBASE | ID: covidwho-1894928

ABSTRACT

Background: There were reports on lower rates of hospitalization for acute coronary syndrome during COVID-19 pandemic due to fear to attend to hospitals, resulting in delayed diagnosis and treatment. In addition to fragmented care, hospital capacity strain affects access to care continuity for patients with acute coronary syndrome. Aim: To examine the impact of multicomponent integrated care on hard clinical outcomes in patients with acute coronary syndrome. Method: A literature search was conducted on PubMed, EMBASE, Ovid and Cochrane library databases for randomized controlled trials published in English language between January 1980 and November 2020. Trials were eligible if there was intervention with multicomponent integrated care, defined as 2 or more quality improvement strategies targeting different domains (the healthcare system, health-care providers and patients), for 1 month or more among patients with acute coronary syndrome. The outcomes of interest were mortality, hospital re-admission and emergency department visits, stratified by all-cause and cardiovascular-related. We pooled the risk ratio (RR) with 95% confidence interval (CI) for the association between multicomponent integrated care and clinical outcomes using the Mantel-Haenszel test. Results: We identified a total of 74 eligible trials with 92,625 patients with acute coronary syndrome. The most common quality improvement strategies implemented were team change (83.8%), patient education (62.2%) and facilitated patient-provider relay (54.1%). In random-effect models, compared with usual care, multicomponent integrated care was associated with reduced risk for all-cause mortality (RR 0.84, 95% CI 0.78-0.90;p<0.001;I2=0%), cardiovascular mortality (RR 0.81, 95% CI 0.69-0.95;p=0.009;I2=0%), all-cause hospitalization (RR 0.88, 95% CI, 0.78-0.99;p=0.040;I2=58%) and cardiovascular-related hospitalization (RR 0.89, 95% CI 0.77-1.03;p=0.110;I2=79%). The associations of multicomponent integrated care with emergency department visits (RR 0.98, 95% CI 0.81-1.19;p=0.860;I2=66%) and unplanned outpatient visits (RR 1.03, 95% CI 0.90-1.18;p=0.650;I2=40%) were not statistically significant. Discussion: Multicomponent integrated care can improve patients’ outcomes after acute coronary syndrome. Patients with acute coronary syndrome need to understand their condition, adhere to treatment and perform self-management to prevent recurrence with worse prognosis. Our findings highlight that multicomponent integrated care can reduce risk for mortality and hospitalization in these high-risk patients.

20.
BMC Geriatr ; 22(1): 395, 2022 05 06.
Article in English | MEDLINE | ID: covidwho-1892177

ABSTRACT

BACKGROUND: At the onset of the coronavirus disease 2019 (COVID-19) pandemic, health care systems were severely disrupted in many countries and in particular, elderly people vulnerable to COVID-19 may have been reluctant to receive their medical treatment. METHODS: We conducted interrupted time series analyses (ITSA) using nationwide medical claim data between January 2020 and July 2020, with focus on different disease categories for the patients of 65 to 84-year-olds, i.e., acute upper respiratory infections (AURIs) vs. chronic diseases. RESULTS: AURIs and chronic diseases showed a sharp contrast with respect to the change in healthcare service utilisation. First, the utilisation rate for chronic diseases changed little whereas for AURIs it dropped by 20.4% year-over-year (yoy) at the onset of the pandemic (week 6, 2020). Second, as social distancing relaxed (week 17, 2020), the AURIs patients trended up and even reached to 7.8% above yoy whereas no significant change found for chronic diseases. CONCLUSIONS: The uninterrupted treatment for chronic diseases in contrast to the AURIs implies that the governmental and public responses to the pandemic outbreak worked for efficient healthcare provision to patients in needs of regular check-ups and treatment in the middle of an infectious disease crisis.


Subject(s)
COVID-19 , Pandemics , Aged , COVID-19/epidemiology , Delivery of Health Care , Humans , Patient Acceptance of Health Care , SARS-CoV-2
SELECTION OF CITATIONS
SEARCH DETAIL