The Relationship Between Coronavirus Disease-2019-Positive Patients and Plasma Interleukins and Transforming Growth Factor-γ Levels

Objective: The aim of this study is to reveal the relationship between the cytokine plasma levels and symptoms of coronavirus disease-2019 (COVID-19)-positive patients, which is characterized by serious respiratory syndromes. Materials and Methods: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-positive patients were evaluated in four groups. Group 1 patients had no symptoms. Group 2 patients were mildly symptomatic. Group 3 patients had multiple symptoms. Group 4 patients had all symptoms of acute respiratory distress syndrome. Analysis of interleukin (IL)-17A, transforming growth factor-γ1 (TGF-γ1), and IL-6 concentrations in plasma samples taken from patients were examined by enzyme-linked immunosorbent assay method. Results: IL-17A levels were increased in parallel with the clinical condition in all patients. TGF-γ1 was only observed in patients in Groups 3 and 4, and IL-6 was only observed in Group 4 patients. Conclusion: It is known that many cytokines are involved in the development of different viral infections and viral invasion always triggers an inflammatory response. The profile of inflammatory markers may be used to classify COVID-19 patients. In conclusion of this study, it is suggested that the level of cytokines which is changed according to the patient's clinical status should be used to evaluate the response of SARS-CoV-2 treatment. IL-17A, TGF-γ1, and IL-6 concentrations in plasma levels could be good prognostic indicators of COVID-19. [ FROM AUTHOR]

MATERNAL MORTALITY IN GROBOGAN DURING COVID-19 PANDEMIC 2020-2021

Background: Maternal mortality is one of the health statuses that is considered global. Central Java Province has the highest maternal mortality rate in Indonesia, and one of the regencies with a high MMR (Maternal Mortality Rate) is Grobogan. Purpose: This research wants to describe maternal mortality in Grobogan in 2020-2021. In further research, we can determine the relationship between risk factors that cause maternal death and use them to develop program decisions to reduce maternal mortality in Grobogan. Methods: This study used a descriptive-quantitative study using Maternal and Infant Mortality data from the Health Office of Grobogan in 2020-2021 and analyzed averages and proportions. Results: This study showed that 103 mothers died, 69% mothers at the age of 20-35 years, 46.60% mothers had Junior High School, 8% were in the Purwodadi 2 area, 73% with gestational age >28 weeks, 52% had 2-3 parity, 87.38% of mothers never abortion, 57% of mothers died during the puerperium, and 39% caused by being infected of COVID-19. Conclusion: Maternal mortality in Grobogan Regency during the 2020-2021 COVID-19 pandemic, most of the causes of death were due to COVID-19 infection, which mainly occurred in mothers aged 20-35 years, last educated at junior high school, at gestational age >28 weeks, parity 2-3, more common in mothers who have never had a history of abortion, and is currently experiencing the puerperium. This maternal death occurred in 28 of the 30 Puskesmas in Grobogan. (English) [ FROM AUTHOR] Latar Belakang: Kematian ibu merupakan salah satu status kesehatan yang dianggap global. Provinsi Jawa Tengah memiliki angka kematian ibu tertinggi di Indonesia, dan salah satu kabupaten dengan AKI (Angka Kematian Ibu) yang tinggi adalah Kabupaten Grobogan. Tujuan: Mendeskripsikan angka kematian ibu di Grobogan tahun 2020-2021. Pada penelitian selanjutnya, dapat diketahui hubungan antara faktor-faktor risiko penyebab kematian ibu dan menggunakannya untuk mengembangkan keputusan program penurunan angka kematian ibu di Grobogan. Metode: Penelitian ini menggunakan penelitian deskriptif-kuantitatif dengan menggunakan data Kematian Ibu dan Bayi dari Dinas Kesehatan Grobogan Tahun 2020-2021 dan dianalisis rata-rata dan proporsinya. Hasil: Penelitian ini menunjukkan 103 ibu meninggal, 69% ibu pada usia 20 tahun. -35 tahun, 46,60% ibu SLTP, 8% berada di wilayah Purwodadi 2, 73% dengan usia kehamilan >28 minggu, 52% memiliki paritas 2-3, 87,38% ibu tidak pernah aborsi, 57% ibu meninggal masa nifas, dan 39% disebabkan karena terinfeksi COVID-19. Kesimpulan: Kematian ibu di Kabupaten Grobogan pada masa pandemi COVID-19 2020-2021, sebagian besar penyebab kematian karena infeksi COVID-19, yang terutama terjadi pada ibu berusia 20-35 tahun, pendidikan terakhir di SMP, di usia kehamilan >28 minggu, paritas 2-3, lebih sering terjadi pada ibu yang tidak pernah memiliki riwayat abortus, dan sedang mengalami masa nifas. Kematian ibu ini terjadi di 28 dari 30 Puskesmas di Grobogan. (Indonesian) [ FROM AUTHOR] Copyright of Jurnal Berkala Epidemiologi is the property of Universitas Airlangga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Sentiworld project: global mapping of sentinel surveillance networks in general practice.

BACKGROUND: Sentinel networks composed of general practitioners (GPs) represent a powerful tool for epidemiologic surveillance and ad-hoc studies. Globalization necesitates greater international cooperation among sentinel networks. The aim of this study was to inventory GP sentinel networks involved in epidemiological surveillance on a global scale. METHODS: GP sentinel surveillance networks were inventoried globally between July 2016 and December 2019. Each identified network was required to fill out an electronic descriptive survey for inclusion. RESULTS: A total of 148 networks were identified as potential surveillance networks in general practice and were contacted. Among them, 48 were included in the study. Geographically, 33 networks (68.8%) were located in Europe and 38 (79.2%) had national coverage. The number of GPs registered in these networks represented between 0.1 and 100% of the total number of GPs in the network's country or region, with a median of 2.5%. All networks were involved in continuous epidemiologic surveillance and 47 (97.9%) monitored influenza-like illness. Data collection methods were paper-based forms (n = 26, 55.3%), electronic forms on a dedicated website (n = 18, 38.3%), electronic forms on a dedicated software program (n = 14, 29.8%), and direct extraction from electronic medical records (n = 14, 29.8%). Along with this study, a website has been created to share all data collected. CONCLUSIONS: This study represents the first global geographic mapping of GP sentinel surveillance networks. By sharing this information, collaboration between networks will be easier, which can strengthen the quality of international epidemiologic surveillance. In the face of crises like that of COVID-19, this is more imperative than ever before.

COVID-19 Symptoms and Deaths among Healthcare Workers, United States.

We evaluated whether demographics and COVID-19 symptoms predicted COVID-19 deaths among healthcare workers (HCWs) in the United States by comparing COVID-19 deaths in HCWs with 3 control groups (HCW nondeaths, non-HCW deaths, and non-HCW nondeaths) using a case-control design. We obtained patient-level data of 33 variables reported during January 1, 2020-October 12, 2021, in all US states. We used logistic regression analysis while controlling for confounders. We found that persons who were >50 years of age, male, Black, or Asian experienced significantly more deaths than matched controls. In addition, HCWs who died had higher risks for the most severe clinical indicators. We also found that the most indicative symptoms were preexisting medical conditions, shortness of breath, fever, cough, and gastrointestinal symptoms. In summary, minority, male, and older HCWs had greater risk for COVID-19 death. Severe clinical indicators and specific symptoms may predict COVID-19-related deaths among HCWs.

THE RELATIONSHIP BETWEEN THE COVID-19 VACCINATION RATE AND SOCIAL DETERMINANTS OF HEALTH IN TURKEY: A CORRELATION STUDY

The aim of the research was to evaluate the correlation between the COVID-19 vaccination rate and education, population, health, and income indicators at the provincial level. The study was a descriptive type of research. The first dose COVID-19 vaccination rate was taken from the Turkish Ministry of Health COVID-19 Table. Population, economic, education, and health indicators of the provinces were obtained from the 2019 Health Statistics Yearbook of the Turkish Ministry of Health and the official website of the Turkish Statistical Institute (TUIK). SPSS v.18 program was used for data analysis. Variables associated with the COVID-19 vaccination rate were evaluated by Spearman correlation analysis. p<0.05 was considered significant. There was a very strong positive correlation between the vaccination rate and the 65-year-old population ratio (rs=0.710, p<0.001), and a very strong negative correlation between the mean household size (rs=-0.848, p<0.001). There was a strong positive correlation (rs=0.522, p<0.001) between the rate of university graduates and the vaccination rate, and a strong negative correlation (rs=-0.651, p<0.001) between the rate of illiteracy and the vaccination rate. A strong or very strong relationship was found between vaccination rate and all economic indicators except average earnings and unemployment rate. There was a strong positive correlation between the number of visits to the physician per capita, one of the health indicators, and the vaccination rate (rs=0.639, p<0.001). There are inequalities between provinces in terms of the COVID-19 vaccination rate. Inequalities in vaccination rates are associated with social determinants of health.Alternate : Araştırmanın amacı, il düzeyinde COVID-19 aşılama hızı ile eğitim, nüfus, sağlık, gelir göstergeleri arasındaki korelasyonu değerlendirmekti. Araştırma tanımlayıcı tip epidemiyolojik araştırmaydı. 81 ilin 18 yaş üstü birinci doz COVID-19 aşılama hızı verisi Türkiye Sağlık Bakanlığı COVID-19 Tablosu’ndan alındı. Íllerin nüfus, ekonomi, eğitim ve sağlık durumuna ilişkin göstergeler Türkiye Sağlık Bakanlığı’nın 2019 yılı Sağlık Ístatistikleri Yıllığı ve Türkiye Ístatistik Kurumu’nun (TÜÍK) resmi internet sitesinden elde edildi. Veri analizi için SPSS v.18 programı kullanıldı. COVID-19 aşılama hızı ile ilişkili değişkenler Spearman Korelasyon analizi ile değerlendirildi. p<0,05 ise anlamlı kabul edildi. Aşılama hızı ile 65 yaş nüfus oranı arasında pozitif yönde çok güçlü ilişki, (rs=0,710, p<0,001), ortalama hane halkı büyüklüğü ile negatif yönde çok güçlü ilişki vardı (rs=-0,848, p<0,001). Üniversite mezunu oranı ile aşılama hızı arasında pozitif yönde güçlü bir ilişki (rs=0,522, p<0,001) okuma yazma bilmeyen oranı ile aşılama hızı arasında negatif yönde güçlü ilişki (rs=-0,651, p<0,001) bulundu. Ortalama kazanç ve işsizlik oranı hariç, aşılama hızı ile bütün ekonomik göstergeler arasında güçlü veya çok güçlü ilişki bulundu. Sağlık göstergelerinden kişi başı hekime başvuru sayısı ile aşılama hızı arasında pozitif yönde güçlü ilişki vardı (rs=0,639, p<0,001). COVID-19 aşılama hızı bakımından iller arasında eşitsizlikler mevcuttu. Aşılama hızındaki eşitsizlikler sağlığın sosyal belirleyicileri ile ilişkiliydi.

What is critical about critical public health? Focus on health inequalities

For many years I have discussed with colleagues, and more recently with students, the definition of critical perspectives (plural, for there are many) on public health. Based on those discussions, and with a focus on health inequalities, this article identifies five elements of such perspectives. First, they involve some degree of commitment to health equity. Second, they situate health inequalities with regard to underlying social arrangements or institutions. Third, history matters. Fourth, the potentially pernicious impact of medicalisation and the dominance of medical frames of reference must be acknowledged. Fifth, production of scientific knowledge must be recognized as a social process whose material and institutional contexts matter. The elements of critical perspectives interact and intersect in practice, as shown with illustrations. [ FROM AUTHOR] Copyright of Critical Public Health is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

PSYCHOLOGICAL IMPACT OF COVID-19 ON INNER- CITY CHILDREN

Children between the ages of five and 17 years old are most likely to experience adverse childhood experiences (ACEs) due to traumas related to COVID-19 exposures, such as the illness itself, compounded by school closures, forced at-home virtual learning, illness or death of a family member or acquaintance, and related financial crises. Children of color living in underserved areas infected with COVID-19 are less likely to present with symptoms such as fever, cough, or shortness of breath;they are tested less frequently and are at greatest risk for asthma, obesity, and diabetes. There are many hurdles facing inner city children, teachers, and parents during this COVID-19 pandemic. ACEs are usually preventable, although COVID-19 has added to the list of psychological issues created by the pandemic. It is essential that our communities create a nourishing, safe, and stable environment for children and families in inner-city neighborhoods to help all children reach their full potential. [ FROM AUTHOR] Copyright of Journal of Cultural Diversity is the property of Tucker Publications, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Moving Beyond the Enormity Problem: Tackling the Global Refugee Crisis

The article discusses the mental health issues linked to the global refugee crisis. Also cited are the scientific and cultural advances that led to reduced cost of care for common illnesses like anxiety, depression and stigma due to mental health disorders, and other topics like ecocide, climate change, and the COVID-19 pandemic.

Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID-19 in Brazil: a surveillance database analysis.

OBJECTIVE: To describe clinical characteristics of pregnant and postpartum women with severe COVID-19 in Brazil and to examine risk factors for mortality. DESIGN: Cross-sectional study based on secondary surveillance database analysis. SETTING: Nationwide Brazil. POPULATION OR SAMPLE: 978 Brazilian pregnant and postpartum women notified as COVID-19 Acute Respiratory Distress Syndrome (ARDS) cases with complete outcome (death or cure) up to 18 June 2020. METHODS: Data was abstracted from the Brazilian ARDS Surveillance System (ARDS-SS) database. All eligible cases were included. Data on demographics, clinical characteristics, intensive care resources use and outcomes were collected. Risk factors for mortality were examined by multivariate logistic regression. MAIN OUTCOME MEASURES: Case fatality rate. RESULTS: We identified 124 maternal deaths, corresponding to a case fatality rate among COVID-19 ARDS cases in the obstetric population of 12.7%. At least one comorbidity was present in 48.4% of fatal cases compared with 24.9% in survival cases. Among women who died, 58.9% were admitted to ICU, 53.2% had invasive ventilation and 29.0% had no respiratory support. The multivariate logistic regression showed that the main risk factors for maternal death by COVID-19 were being postpartum at onset of ARDS, obesity, diabetes and cardiovascular disease, whereas white ethnicity had a protective effect. CONCLUSIONS: Negative outcomes of COVID-19 in this population are affected by clinical characteristics but social determinants of health also seem to play a role. It is urgent to reinforce containment measures targeting the obstetric population and ensure high quality care throughout pregnancy and the postpartum period. TWEETABLE ABSTRACT: A total of 124 COVID-19 maternal deaths were identified in Brazil. Symptoms onset at postpartum and comorbidities are risk factors.

Risk factors for adverse outcomes among pregnant and postpartum women with acute respiratory distress syndrome due to COVID-19 in Brazil.

OBJECTIVE: To evaluate whether clinical and social risk factors are associated with negative outcomes for COVID-19 disease among Brazilian pregnant and postpartum women. METHODS: A secondary analysis was conducted of the official Acute Respiratory Syndrome Surveillance System database. Pregnant and postpartum women diagnosed with COVID-19 ARDS until July 14, 2020, were included. Adverse outcomes were a composite endpoint of either death, admission to the intensive care unit (ICU), or mechanical ventilation. Risk factors were examined by multiple logistic regression. RESULTS: There were 2475 cases of COVID-19 ARDS. Among them, 23.8% of women had the composite endpoint and 8.2% died. Of those who died, 5.9% were not hospitalized, 39.7% were not admitted to the ICU, 42.6% did not receive mechanical ventilation, and 25.5% did not have access to respiratory support. Multivariate analysis showed that postpartum period, age over 35 years, obesity, diabetes, black ethnicity, living in a peri-urban area, no access to Family Health Strategy, or living more than 100 km from the notification hospital were associated with an increased risk of adverse outcomes. CONCLUSION: Clinical and social risk factors and barriers to access health care are associated with adverse outcomes among maternal cases of COVID-19 ARDS in Brazil.