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Air pollution is a prevailing environmental problem in cities worldwide. The future vehicle electrification (VE), which in Europe will be importantly fostered by the ban of thermal engines from 2035, is expected to have an important effect on urban air quality. Machine learning models represent an optimal tool for predicting changes in air pollutants concentrations in the context of future VE. For the city of Valencia (Spain), a XGBoost (eXtreme Gradient Boosting package) model was used in combination with SHAP (SHapley Additive exPlanations) analysis, both to investigate the importance of different factors explaining air pollution concentrations and predicting the effect of different levels of VE. The model was trained with 5 years of data including the COVID-19 lockdown period in 2020, in which mobility was strongly reduced resulting in unprecedent changes in air pollution concentrations. The interannual meteorological variability of 10 years was also considered in the analyses. For a 70% VE, the model predicted: 1) improvements in nitrogen dioxide pollution (-34% to -55% change in annual mean concentrations, for the different air quality stations), 2) a very limited effect on particulate matter concentrations (-1 to -4% change in annual means of PM2.5 and PM10), 3) heterogeneous responses in ground-level ozone concentrations (-2% to +12% change in the annual means of the daily maximum 8-h average concentrations). Even at a high VE increase of 70%, the 2021 World Health Organization Air Quality Guidelines will be exceeded for all pollutants in some stations. VE has a potentially important impact in terms of reducing NO2-associated premature mortality, but complementary strategies for reducing traffic and controlling all different air pollution sources should also be implemented to protect human health.
Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Humans , COVID-19/epidemiology , Communicable Disease Control , Air Pollution/analysis , Air Pollutants/toxicity , Air Pollutants/analysis , Particulate Matter/analysis , Environmental Monitoring/methodsABSTRACT
With the acceleration of globalization, the sustained increase of mobility, the intensification of global warming and environmental changes, the transmission of diseases has become more diverse. In recent years, the corona virus disease 2019(COVID-19) has caused huge economic losses and social unrest around the world. A single-discipline has been unable to solve such complex public health problems effectively. The proposal and development of the One Health approach is closely related to the issues on veterinary medicine and zoonoses. One Health focuses on intradisciplinary, multi-sectoral, and cross-fields collaboration at three levels, including local, regional and global levels, to explore the humans-animals-environment interface complexity. In this review, the development process of One Health approach was introduced. The relationship between the One Health and zoonoses, the role of the One Health in the prevention and control of zoonoses, and how to effectively implement the One Health approach in the real world were explored, providing references for research on zoonoses prevention and control, anti-microbial resistance, food safety, and the impact of climate change on health.Copyright © 2022, National Institute of Parasitic Diseases. All rights reserved.
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An analytic cross-sectional study was conducted to quantify the impact of COVID-19 on mortality in Peru. Total excess mortality due to natural and external causes was calculated. The direct and indirect impact of COVID-19 was estimated at two points: when COVID-19 deaths were confirmed by a laboratory test and when they were confirmed by broader criteria (reclassified deaths). This comparison was made in general and by sex, age, and geographical location. The sensitivity of laboratory testing and of death certificates as criteria for confirmation of a COVID-19 death was calculated using reclassified deaths as the gold standard.From epidemiological week (EW) 10 of 2020 to EW 23 of 2021, 349 756 deaths occurred, for an excess of 183 237 deaths, mainly due to natural causes. A total of 100 955 deaths corresponded to deaths confirmed by laboratory tests; however, the reclassification criterion brought this figure to 188 708. Laboratory tests had 53.3% sensitivity; this was lower at the onset of the pandemic (10.6%) and during the first wave (37.8%). The sensitivity of death certificates was higher than laboratory tests (41.7% vs 23.9%) only during the months when little testing was available. These data showed that the impact of COVID-19 on mortality in Peru was mainly direct. Also, in periods with limited access to laboratory testing, death certificates were a useful source for determining deaths directly caused by COVID-19.
Um estudo transversal analítico foi realizado com o objetivo de quantificar o impacto da COVID-19 na mortalidade no Peru. Foi calculada a sobremortalidade total, por causas naturais e externas. O impacto direto e indireto da COVID-19 foi estimado em dois momentos: quando as mortes por COVID-19 foram confirmadas por teste laboratorial e quando foram confirmadas por critérios mais amplos (óbitos reclassificados). Essa comparação foi feita na população geral, por sexo, idade e geografia. Calculou-se a sensibilidade dos critérios laboratoriais e dos atestados de óbito para a confirmação de morte por COVID-19, utilizando os óbitos reclassificados como padrão-ouro.Da semana epidemiológica 10 de 2020 até a 23 de 2021, ocorreram 349.756 óbitos, o que configura um excesso de 183.237 óbitos, principalmente por causas naturais. Considerando os óbitos confirmados por exames laboratoriais, foram encontrados 100.955 óbitos; no entanto, com os critérios de reclassificação, esse número subiu para 188.708. Os exames laboratoriais tiveram uma sensibilidade de 53,3%, sendo menor no início da pandemia (10,6%) e durante a primeira onda (37,8%). A sensibilidade do atestado de óbito foi maior que a do exame laboratorial (41,7% vs 23,9%) apenas nos meses de baixa disponibilidade de exames. Esses dados evidenciaram que, no Peru, o impacto da COVID-19 na mortalidade foi principalmente direto. Além disso, em períodos com acesso limitado a exames laboratoriais, as declarações de óbito foram uma fonte de informação útil para determinar as mortes causadas diretamente pela COVID-19.
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Introduction: An urgent dental care centre (UDCC) was set up at Queen Mary's Hospital in Sidcup, in response to the COVID-19 pandemic. Alongside the reporting of clinical outcomes, it is important to determine the success of a service from a patient's perspective. The aim of this study was to ascertain patient reported outcome measures (PROMs) and patient reported experienced measures (PREMs) of our service. Method(s): The Oral Health Impact Profile 14 (OHIP-14) tool was used to assess the Oral Health-Related Quality of Life (OHRQoL) of patients, and completed before and after attending our UDCC for treatment. Patients were also asked to complete a patient satisfaction questionnaire. Result(s): 146 patients were recruited for our study, with 95 patients completing the OHIP-14 questionnaires pre- and post intervention at our UDCC and 136 patients completing a patient satisfaction questionnaire. A statistically significant reduction in OHIP score when comparing pre- and post-intervention was found across all OHIP-14 domains. The mean positive response rate (strongly agree or agree) for the patient satisfaction questionnaire was 97.1%. Conclusion(s): A significant improvement in OHRQoL was found after treatment at our UDCC, with the majority of patients reporting a positive experience. We conclude that PROMs and PREMs are vital tools to assess service efficacy, help with the planning of service provision and should remain at the forefront even during a crisis such as the COVID-19 pandemic.Copyright © 2021
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Covid-19-a heinous event that had left an eternally unforgettable scar of troubles, setbacks and distress on the entire human population across the globe. No country could evade from the unfavorable consequences of it. All countries across the world found themselves engulfed in the hands of Covid-19. It had taken a serious toll on the healthcare system of every country across the world. In the context of India, which is a nation with a poor coverage of public healthcare facilities and annually 3.2% Indians falling below poverty line, made the country and its population the most vulnerable. During that time, the biggest question arose was the survival of the marginalized and disadvantaged section of the society. However, fortunately a tiny hope of survival for the population of India was ensured and extended by the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). Thus, the authors of this research paper have attempted to figure out and critically examine the role played by AB PM-JAY in not only managing but also mitigating the outbreak of the virus in India and how it helped Indians sail through the storm of Covid-19. Besides, this paper tries to put views forward through analysis for the policy makers and healthcare stakeholders to become well-prepared for any such troublesome crisis in future. Moreover, secondary data is used to collect necessary information and critical descriptive analysis has been used to interpret the results of the study.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Introduction: This article describes the challenges and opportunities that the COVID-19 pandemic presented for providing and coordinating care for children and youth with special health care needs (CYSHCN) who rely on a diverse array of systems to promote their health, education, and well-being. Method(s): Peer-reviewed published literature and reports from the national government and nonprofit organizations that advocate for CYSHCN were examined, particularly concerning systems that impacted CYSHCN during COVID-19. Result(s): Pre-COVID-19, CYSHCN and their families faced challenges accessing and coordinating care across diverse systems. COVID-19 exacerbated these challenges because of disruptions in care and services that negatively impacted CYSHCN. COVID-19 also highlighted opportunities for positive change and care innovations. Discussion(s): Understanding the systems of care that CYSHCN rely on and the effects of COVID-19 on these systems can enhance access to and quality of care. Recommendations are made for practice, leadership, research, and policy.Copyright © 2022 National Association of Pediatric Nurse Practitioners
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Current approaches and cultures for the economic evaluations of environmental and health policies may suffer from excessive reliance on a standard neoclassic economic toolbox that neglects alternative perspectives. This may prematurely limit the spectrum of available policy options. Here we show how the inclusion of neglected currents of thought such as non-Ricardian economics, bioeconomics and a set of qualitative-quantitative methods from post-normal science leads to richer perspectives for a more inclusive uses of quantitative evidence, and opens the analysis to more possible futures. We also present some case studies in the energy, water, health and climate domains that highlight the point in a practical context for a more policy-oriented audience. We situate our analysis in the context of recent calls in the EU for the inclusion of more perspectives from the social sciences and the humanities in environmental assessment works.Copyright © 2023 The Authors
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The present study aimed to investigate the effects of a multi-professional intervention model on the mental health of middle-aged, overweight survivors of COVID-19. A clinical trial study with parallel groups and repeated measures was conducted. For eight weeks, multi-professional interventions were conducted (psychoeducation, nutritional intervention, and physical exercises). One hundred and thirty-five overweight or obese patients aged 46.46 ± 12.77 years were distributed into four experimental groups: mild, moderate, severe COVID, and control group. The instruments were used: mental health continuum-MHC, revised impact scale-IES-r, generalized anxiety disorder-GAD-7, and Patient health questionnaire PHQ-9, before and after eight weeks. The main results indicated only a time effect, with a significant increase in global MHC scores, emotional well-being, social well-being, and psychological well-being, as well as detected a significant reduction in global IES-R scores, intrusion, avoidance, and hyperarousal, in addition to a reduction in GAD-7 and PHQ-9 scores (p < 0.05). In conclusion, it was possible to identify those psychoeducational interventions that effectively reduced anxiety, depression, and post-traumatic stress symptoms in post-COVID-19 patients, regardless of symptomatology, in addition to the control group. However, moderate and severe post-COVID-19 patients need to be monitored continuously since the results of these groups did not follow the response pattern of the mild and control groups.
Subject(s)
COVID-19 , Humans , Middle Aged , Anxiety/psychology , Depression/psychology , Mental Health , Overweight , Survivors/psychologyABSTRACT
BACKGROUND: Care demand exceeded the availability of human and material resources during the COVID-19 pandemic, which is the reason why triage was fundamental. The objective is to know the clinical and sociodemographic factors of confirmed or suspected COVID-19 cases in triage stations from different Ecuadorian provinces. METHOD: A multicenter study with a retrospective and descriptive design. The patients included were those who accessed the Respiratory Triage stations deployed by the Ecuadorian Red Cross in eight Ecuadorian provinces during March and April 2021. Triage allows for selecting patients that need urgent treatment and favors efficacy of health resources. RESULTS: The study population consisted of a total of 21,120 patients, of which 43.1% were men and 56.9% were women, with an age range between 0 and 98 years old. Severity of COVID-19 behaved differently according to gender, with mild symptoms predominating in women and severe or critical symptoms in men. Higher incidence of critical cases was observed in patients over 65 years old. It was observed that overweight predominated in critical, severe, and moderate cases, while the body mass index of patients with mild symptoms was within the normal range. CONCLUSIONS: The Ecuadorian Red Cross units identified some suspected COVID-19 cases, facilitating their follow-up and isolation. Fever was the most significant early finding.
Subject(s)
COVID-19 , Male , Humans , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , COVID-19/epidemiology , Triage , SARS-CoV-2 , Pandemics , Retrospective Studies , Red CrossABSTRACT
Introduction: The COVID-19 pandemic disrupted the preventive services for cervical cancer (CC) control programs in Mexico, which will result in increased mortality. This study aims to assess the impact of the pandemic on the interruption of three preventive actions in the CC prevention program in Mexico. Methods: This study is a retrospective time series analysis based on administrative records for the uninsured population served by the Mexican Ministry of Health. Patient data were retrieved from the outpatient service information system and the hospital discharge database for the period 2017-2021. Data were aggregated by month, distinguishing a pre-pandemic and a pandemic period, considering April 2020 as the start date of the pandemic. A Poisson time series analysis was used to model seasonal and secular trends. Five process indicators were selected to assess the disruption of the CC program, these were analyzed as monthly data (N=39 pre-pandemic, N=21 during the pandemic). HPV vaccination indicators (number of doses and coverage) and diagnostic characteristics of CC cases were analyzed descriptively. The time elapsed between diagnosis and treatment initiation in CC cases was modeled using restricted cubic splines from robust regression. Results: Annual HPV vaccination coverage declined dramatically after 2019 and was almost null in 2021. The number of positive Papanicolaou smears decreased by 67.8% (90%CI: -72.3, -61.7) in April-December 2020, compared to their expected values without the pandemic. The immediate pandemic shock (April 2020) in the number of first-time and recurrent colposcopies was -80.5% (95%CI:-83.5, -77.0) and -77.9% (95%CI: -81.0, -74.4), respectively. An increasing trend was observed in the proportion of advanced stage and metastatic CC cases. The fraction of CC cases that did not receive medical treatment or surgery increased, as well as CC cases that received late treatment after diagnosis. Conclusions: Our analyses show significant impact of the COVID-19 pandemic with declines at all levels of CC prevention and increasing inequalities. The restarting of the preventive programs against CC in Mexico offers an opportunity to put in place actions to reduce the disparities in the burden of disease between socioeconomic levels.
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To assess how the COVID-19 pandemic affected catch-up HPV vaccination among age-eligible adults (ages 18–45). The current study leverages a national, cross-sectional sample of US adults ages 18–45 years to assess the prevalence and determinants of COVID-19 pandemic-related disruptions to catch-up HPV vaccination in 2021. The sample was restricted to adults intending to receive the HPV vaccine. Multinomial logistic regression analysis was conducted to assess the probability of 1) pandemic-related HPV vaccination disruption and 2) uncertainty about pandemic-related HPV vaccination disruption. Report of ‘no pandemic-related HPV vaccination disruption' served as the reference category. Among adults intending to get the HPV vaccine (n = 1,683), 8.6 % reported pandemic-related HPV vaccination disruption, 14.7 % reported uncertainty about vaccination disruption, and 76.7 % reported no disruption. Factors associated with higher odds of pandemic-related vaccination disruption included non-English language preference (OR: 3.20;95 % CI: 1.99–5.13), being a parent/guardian (OR: 1.77;95 % CI: 1.18–2.66), having at least one healthcare visit in the past year (OR: 1.97;95 % CI: 1.10–3.53), being up-to-date on the tetanus vaccine (OR: 1.81;95 % CI: 1.19–2.75), and being a cancer survivor (OR: 2.57;95 % CI: 1.52–4.34). Catch-up HPV vaccination for age-eligible adults is a critical public health strategy for reducing HPV-related cancers. While a small percentage of adults reported pandemic-related disruptions to HPV vaccination, certain adults (e.g., individuals with a non-English language preference and cancer survivors) were more likely to report a disruption. Interventions may be needed that increase accessibility of catch-up HPV vaccination among populations with reduced healthcare access during the pandemic. © 2022 The Authors
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Introduction: The COVID-19 pandemic has had a considerable impact on the biopsychosocial elements of human beings, especially children and teenagers, as vulnerable groups. Social isolation can lead to psychiatric illness, obesity, and sleep disorders in adults. This study aimed to determine the impact of lockdown on children's sleep, diet, physical activity, and behavior. Methods: This was a retrospective observational study conducted from May 1, 2020, to March 31, 2021. Data were collected from four healthcare centers in Cascais (Lisbon, Portugal) by administering a questionnaire in person and online. Descriptive statistical analysis was conducted using Microsoft Excel® and the SPSS® software (version 23). Results: In total, 790 responses were collected (median age 9 years old) without gender predominance. Family routine and behavioral changes were found in 84% and 63% of children, respectively. In addition, dietary changes were observed in 43% of them, with 62% reporting an increase in quantities and 23% reporting weight gain (more than 5 kg in 18%). Regarding physical activity, 44% exercised more than three times a week before the lockdown. Following COVID-19, 18% maintained this routine, and 48% quit sporting activities. Finally, sleep changes occurred in 42%, including nightmares and difficulty falling asleep. Discussion: Childhood and adolescence are periods of considerable social and psychomotor development, and any routine disruption can cause profound changes in personal and interpersonal experience during this period. The findings of this study revealed that lockdown caused changes in children's behavior, diet, physical exercise, and sleep. It is essential to outline strategies to support children and teenagers with a multidisciplinary approach to reduce the effects of social isolation on their development. © Author(s) (or their employer(s)) and Portuguese Journal of Pediatrics 2023.
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COVID-19 has significantly impacted the world and Nepal is no exception. The pandemic has caused a reduction in health service delivery, especially for women's health conditions, resulting in an increase in challenges for an already vulnerable group. Maternity care, reproductive health services, preventive interventions, nutritional advice and mental health care are not being addressed and with an increase in domestic violence, the health and wellbeing of women in Nepal is precarious and needs to be addressed immediately. Copyright © 2020, Kathmandu University. All rights reserved.
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Brexit, COVID-19 and climate change pose challenges of national and global importance. They continue to have impacts across the economy, society, health, and the environment, all of which are determinants of health and well-being. Between 2018 and 2021, Public Health Wales undertook three Health Impact Assessments (HIA) in relation to the impact of the challenges in Wales. Based on these, work has been carried out to map the synergies across the ‘Triple Challenge'. This paper highlights the commonalities in the impact of the three challenges for Wales, discusses the process carried out, learns from it and proposes actions that can be taken to mitigate harm. Results indicate the three components of the Triple Challenge must not be viewed as separate silos as they have cumulative multi-faceted impacts. This affects some population groups more negatively than others and present a ‘Triple Challenge' to nation states in the UK and Europe. A HIA approach can enable a range of stakeholders to critically view similar challenges not just as single issues but as a holistic whole to mobilise action.
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Introduction: The COVID-19 pandemic has had a considerable impact on the biopsychosocial elements of human beings, especially children and teenagers, as vulnerable groups. Social isolation can lead to psychiatric illness, obesity, and sleep disorders in adults. This study aimed to determine the impact of lockdown on children's sleep, diet, physical activity, and behavior. Methods: This was a retrospective observational study conducted from May 1, 2020, to March 31, 2021. Data were collected from four healthcare centers in Cascais (Lisbon, Portugal) by administering a questionnaire in person and online. Descriptive statistical analysis was conducted using Microsoft Excel® and the SPSS® software (version 23). Results: In total, 790 responses were collected (median age 9 years old) without gender predominance. Family routine and behavioral changes were found in 84% and 63% of children, respectively. In addition, dietary changes were observed in 43% of them, with 62% reporting an increase in quantities and 23% reporting weight gain (more than 5 kg in 18%). Regarding physical activity, 44% exercised more than three times a week before the lockdown. Following COVID-19, 18% maintained this routine, and 48% quit sporting activities. Finally, sleep changes occurred in 42%, including nightmares and difficulty falling asleep. Discussion: Childhood and adolescence are periods of considerable social and psychomotor development, and any routine disruption can cause profound changes in personal and interpersonal experience during this period. The findings of this study revealed that lockdown caused changes in children's behavior, diet, physical exercise, and sleep. It is essential to outline strategies to support children and teenagers with a multidisciplinary approach to reduce the effects of social isolation on their development. © Author(s) (or their employer(s)) and Portuguese Journal of Pediatrics 2023.
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Air pollution produces major environmental health problems with a vast number of entropies that can affect healthy, sustainable environments across the globe. Millions of people are dying prematurely each year as a direct cause of poor air quality. According to recent studies, living within 50 meters of any significant road can increase the risk of lung cancer by up to 10%. World Health Organization declares that approximately 3.7 million people died worldwide in 2012 due to outdoor air pollution. In this analysis, we analyzed air pollutants that were released into the air from a wide range of sources, such as motor vehicles, industrial combustion processes, etc. We analyzed the Sentinel-5 precursor data, which provides time series data on a multitude of trace gaseous compounds such as CO, NO2, SO2, O3, PM10, PM2.5 aerosols, etc. with efficient statistics and special resolution. For better comparison, we have trained our statistical atmospheric data with deep learning methodology and analyzed them to obtain a reference for air quality in India. This study describes the scientific aspects and probable atmospheric composition entropy due to pollution. We also presented the overall operational product outcomes and emissions from the energy sectors, which involves the advancement of data analysis in a particular coordinate system. © 2022 Technoscience Publications. All rights reserved.