Evaluation of COVID-19 Vaccines in Primary Prevention Against Infections and Reduction in Severity of Illness Following the Outbreak of Sars-Cov-2 Omicron Variant in Shanghai

Objectives: To evaluate COVID-19 vaccines in primary prevention against infections and lessening the severity of illness following the most recent outbreak of the SARS-CoV-2 Omicron variant in Shanghai. Method(s): To investigate whether inactivated vaccines were effective in protecting against COVID-19 infections, we estimated the odds ratio (OR) of the vaccination in COVID-19 cases vs. matched community-based healthy controls. To evaluate the potential benefits of vaccination in lowering the risk of symptomatic infection (vs. asymptomatic), we estimated the relative risk (RR) of symptomatic infections among diagnosed patients. We also applied the multivariate stepwise Logistic regression analyses to measure the risk of disease severity (symptomatic vs. asymptomatic and moderate/severe vs. mild) in COVID-19 patient cohort with vaccination status as an independent variable while controlling for potential confounding factors. Result(s): Out of the 153,544 COVID-19 patients included in the analysis, 118,124 (76.9%) patients had been vaccinated and 143,225(93.3%) were asymptomatic patients. Of the 10,319 symptomatic patients, 10,031(97.2%), 281(2.7%) and 7(0.1%) experienced mild, moderate, and severe infections, respectively. There is no evidence that the vaccination helped protect from infections (OR=0.82, p=0.613). The vaccination, however, offered a small but significant protection against symptomatic infections (RR=0.92, p < 0.001) and halved the risk of moderate/severe infections (OR=0.48, 95% CI: 0.37 - 0.61). Older age (> 60 years) and malignant tumors were significantly associated with moderate/severe infections. Gender also appeared to be a risk factor for symptomatic infections, with females being associated with a lower risk for moderate/severe illness. Conclusion(s): Inactivated COVID-19 vaccines helped provide a small but significant protection against symptomatic infections and halved risk of moderate/severe illness among symptomatic patients. The vaccination was not effective in blocking COVID-19 Omicron variant community spread.Copyright © 2023

Young people from the Missions locales de Paris and the risk of suicide. Preliminary results of a controlled trial of a psychotherapeutic follow-up suicide prevention (MLADO) proposal

Introduction: Considering its frequency, adolescent and young adult suicidal behavior has become in France a major public health issue. The Mission locale de Paris (MLP) is a publicly financed structure aiming at helping young people in distress to achieve a better social and professional insertion. Method: Since youths without activity have a twofold increased risk of suicidal behavior, we designed MLADO, a controlled and randomized trial to assess the efficacy of offering a weekly psychological follow-up for youths from the Paris MLP with a score at 8 and over on the Adolescent Depression Rating Scale or with a score over threshold at the Child Trauma Questionnaire. This psychological follow-up by a professional was paid for a year. Results: One hundred and sixty five youths, followed up at the five participating MLP agencies, went for an interview for inclusion into MLADO. Among the 128 included, 20.3% had an antecedent of suicidal behavior but no suicidal attempts or even self-harm was observed in the two groups during follow-up. The ADRS score dropped sharply in both groups after the 3rd month of follow up, but it took a year of follow-up for this score to be normalized in the control group. Conclusion: Taking a proactive stance towards vulnerable youths seems acceptable, with the proposition of an assessment and orientation towards a psychological treatment, with a qualified psychologist in town, without any delay nor at any cost for them. This is also effective in reducing depression and suicidal risk. Both the ADRS and the CTQ appear to be good dialogue boxes, allowing for a dialogue about their present mental health and about their past, and helping them to seek help. © 2023 Introduction: En France, et vu sa fréquence, la prévention du suicide est devenue un enjeu de santé publique. La Mission locale de Paris (MLP) est une association ayant une délégation de service. Elle est financée par l'État, la région Île-de-France et le département de Paris. La MLP a pour objectif d'accompagner les jeunes dans leur insertion professionnelle et sociale. Les jeunes en insertion ont environ deux fois plus de risque d'avoir fait une tentative de suicide que les jeunes actifs. Méthode: La recherche MLADO, essai randomisé et contrôlé, a visé à évaluer l'efficacité de la proposition d'un suivi psychologique hebdomadaire pour un an pour les adolescents et jeunes adultes des Missions locales de Paris, ayant un score égal ou supérieur à 8 à l'Adolescent Depression Rating Scale (ADRS/EDA), ou avec un score supérieur au seuil Child Trauma Questionnaire (CTQ/ETE). Résultats: Cent soixante-cinq jeunes suivis sur les cinq sites participants de la MLP se sont rendus à un entretien en vue de leur inclusion et leur randomisation dans MLADO. Parmi les 128 inclus, 20,3 % avaient déjà fait une tentative de suicide. Aucune tentative de suicide n'a été enregistrée pendant toute la période de suivi, dans les deux groupes, et malgré l'isolement dû au Covid-19 pendant la dernière partie de l'étude. Le score à l'ADRS a chuté dès le 3e mois de suivi, dans les deux groupes mais ne s'est régularisé qu'au bout d'un an de suivi dans le groupe contrôle. Conclusion: Aller au-devant de ces jeunes vulnérables en leur proposant une évaluation et l'entrée dans un suivi psychologique en ville, sans coût ni délai pour eux, est une démarche bien acceptée, et qui se montre efficace pour diminuer leur dépression et le risque de suicide. L'ADRS/EDA et la CTQ/ETE dans leurs versions françaises sont de bons outils de dialogue, qui peuvent permettre l'entrée dans une démarche de soin. © 2023

Hiv-Related Kaposi Sarcoma in East Africa: Contemporary Update on Stage and Survival

Background: Stage at time of diagnosis and survival after diagnosis are critical parameters regarding the control of any cancer in any geographical setting. Unlike in resource-rich settings where publicly funded cancer surveillance routinely monitors these parameters, these data are non-existent through routine means in resource-limited areas. This is particularly relevant for Kaposi sarcoma (KS) in East Africa, for which recent changes in HIV treatment and chemotherapy guidelines as well as the COVID-19 pandemic dictate an update regarding stage and survival. Method(s): From October 2021 to August 2022, we evaluated HIV-infected adults (age >= 18 years) with a new diagnosis of KS made in 4 different primary care facilities (or their associated inpatient units) in Kenya and Uganda using a process of rapid case ascertainment. KS diagnosis was confirmed by pathology. Participants were examined, at time of biopsy, to document the extent of lesions and subsequently monitored longitudinally for vital status. Result(s): Among 180 HIV-infected adults identified with new onset KS, 31% were women, and the median (IQR) age was 35 (29-42) years. At time of KS diagnosis, 95% of the participants were taking ART, and the median (IQR) CD4+ T cell count was 197 (46-354) cells/mm3;46%, 20%, 11% and 23% had plasma HIV RNA of < 40, 40-1000, 1001-10,000 and >10,000 copies/ml, respectively. The median number of anatomic sites with KS lesions per participant was 7 (4-11);26% of participants had oral KS lesions that interfered with either eating or speaking, 74% had KS-associated edema, and 86% had ACTG stage T1 (advanced KS). Over a median follow-up of 2.6 months (IQR: 0.75 to 5.5), 56 participants died, and only 3 lost to follow-up. Cumulative incidence of death (95% CI), via Kaplan-Meier estimation, at 2 months, 6 months and 8 months following KS diagnosis was 24% (18%-31%), 33% (26%-42%), and 38% (29- 49%), respectively (Figure). Conclusion(s): In a recently assembled community-based sample of adults with newly-diagnosed HIV-related KS in East Africa, the majority have advanced KS at the time of KS diagnosis, and survival is poor. The findings are stark in absolute terms for the Treat-All era and unchanged from parameters obtained in the 5 years prior, indicating no improvement in these aspects of the control of KS in the region. Along with primary prevention of KS (i.e., reducing its incidence), novel approaches are needed for earlier detection, more efficient linkage to oncologic care, and more potent therapy. Survival Among Adults with HIV-Related Kaposi Sarcoma in East Africa.

Les jeunes des Missions locales de Paris et le risque suicidaire. Résultats préliminaires d'un essai contrôlé de proposition de suivi psychothérapeutique préventif du suicide (MLADO)

Résumé Introduction En France, et vu sa fréquence, la prévention du suicide est devenue un enjeu de santé publique. La Mission locale de Paris (MLP) est une association ayant une délégation de service. Elle est financée par l'État, la région Île-de-France et le département de Paris. La MLP a pour objectif d'accompagner les jeunes dans leur insertion professionnelle et sociale. Les jeunes en insertion ont environ deux fois plus de risque d'avoir fait une tentative de suicide que les jeunes actifs. Méthode La recherche MLADO, essai randomisé et contrôlé, a visé à évaluer l'efficacité de la proposition d'un suivi psychologique hebdomadaire pour un an pour les adolescents et jeunes adultes des Missions locales de Paris, ayant un score égal ou supérieur à 8 à l'Adolescent Depression Rating Scale (ADRS/EDA), ou avec un score supérieur au seuil Child Trauma Questionnaire (CTQ/ETE). Résultats Cent soixante-cinq jeunes suivis sur les cinq sites participants de la MLP se sont rendus à un entretien en vue de leur inclusion et leur randomisation dans MLADO. Parmi les 128 inclus, 20,3 % avaient déjà fait une tentative de suicide. Aucune tentative de suicide n'a été enregistrée pendant toute la période de suivi, dans les deux groupes, et malgré l'isolement dû au Covid-19 pendant la dernière partie de l'étude. Le score à l'ADRS a chuté dès le 3e mois de suivi, dans les deux groupes mais ne s'est régularisé qu'au bout d'un an de suivi dans le groupe contrôle. Conclusion Aller au-devant de ces jeunes vulnérables en leur proposant une évaluation et l'entrée dans un suivi psychologique en ville, sans coût ni délai pour eux, est une démarche bien acceptée, et qui se montre efficace pour diminuer leur dépression et le risque de suicide. L'ADRS/EDA et la CTQ/ETE dans leurs versions françaises sont de bons outils de dialogue, qui peuvent permettre l'entrée dans une démarche de soin. Summary Introduction Considering its frequency, adolescent and young adult suicidal behavior has become in France a major public health issue. The Mission locale de Paris (MLP) is a publicly financed structure aiming at helping young people in distress to achieve a better social and professional insertion. Method Since youths without activity have a twofold increased risk of suicidal behavior, we designed MLADO, a controlled and randomized trial to assess the efficacy of offering a weekly psychological follow-up for youths from the Paris MLP with a score at 8 and over on the Adolescent Depression Rating Scale or with a score over threshold at the Child Trauma Questionnaire. This psychological follow-up by a professional was paid for a year. Results One hundred and sixty five youths, followed up at the five participating MLP agencies, went for an interview for inclusion into MLADO. Among the 128 included, 20.3% had an antecedent of suicidal behavior but no suicidal attempts or even self-harm was observed in the two groups during follow-up. The ADRS score dropped sharply in both groups after the 3rd month of follow up, but it took a year of follow-up for this score to be normalized in the control group. Conclusion Taking a proactive stance towards vulnerable youths seems acceptable, with the proposition of an assessment and orientation towards a psychological treatment, with a qualified psychologist in town, without any delay nor at any cost for them. This is also effective in reducing depression and suicidal risk. Both the ADRS and the CTQ appear to be good dialogue boxes, allowing for a dialogue about their present mental health and about their past, and helping them to seek help.

COVID-19 Lockdown Pandemic Period Effects in Highly Impacted Aquatic Ecosystems.

Human activities severely affect aquatic ecosystems: the lockdown restrictions due to SARS-CoV-2 (COVID-19) have proved that reducing anthropogenic activities can positively influence the environment and mitigate atmospheric pollution. In addition, studies on aquatic ecosystems have highlighted the decrease in suspended matter and pollutant concentrations associated with reduced marine transport and industrial activities. We evaluated the effects of the reduction of anthropogenic activities in highly impacted water ecosystems. Three of the sampling sites were on the Tiber River's lower stretch close to the urban area of Rome (Italy), and the other two were transitional waters located in the southern Latium region coastal area. These sampling sites have been studied by our research group for at least 20 years. The present study involved analysis of chemical and physicochemical parameters, biological communities, and land use. Microbiological fecal indicators and Salmonella spp. were also analyzed. There were two sampling campaigns, the first one in May 2020 (ID II) at the end of lockdown measures, and the second one a year later, in June 2021 (ID III). The data were compared with our old data, collected from 2002 to 2015 (ID I), to evaluate the potential effects of the restrictive measures. Biotic communities were dominated by pollution-tolerant taxa, indicating eutrophication and organic pollution. Furthermore, the high concentrations of microbiological indicators was mainly due to sewage from the urban area. The results of the research indicated no significant changes from past years (ID I) to 2020 (ID II) and 2021 (ID III). In conclusion, the restrictions adopted in Italy during the pandemic period were not sufficient to mitigate the heavy pressure of urbanization and agriculture that have long affected the studied aquatic ecosystems. Environ Toxicol Chem 2023;42:966-977. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Impact Analysis of Aspirin over the Cardiac Activity

Cardiovascular disease (CVD) is the leading cause of death in most developed countries, including the United States, with a significant economic impact. Lifestyle changes and the administration of antiplatelet medication, like aspirin, may significantly contribute to the secondary prevention of CVD in adults. For years, aspirin has been utilized for both secondary and primary cardiovascular disease prevention. Aspirin has been extensively used because of the belief that it may have a positive impact on primary prevention, despite the debate surrounding its usage. This study briefly examines usage patterns and discusses the potential variables and factors that can decrease the ability of aspirin to prevent cardiovascular disease. The present study also explore the key studies of aspirin use in the context of recent recommendations. The risk of bleeding has been observed to significantly rise, although large randomized clinical studies have demonstrated a reduction or absence of CVD events. Prevention strategies for cardiovascular disease with low-dose aspirin are no longer advised for persons at intermediate risk. To determine whether taking aspirin is worth the potential dangers, the benefits must be evaluated.Copyright © 2022 Novyi Russkii Universitet. All rights reserved.

Epidemiology, risk factors, and prevention of colorectal cancer.

Background: Colorectal cancer remains the fourth most common malignancy in Korea, and has been ranked as the third leading cause of cancer deaths in 2020. This study aims to describe the epidemiologic status of colorectal cancer in Korea, and provide basic data for effective primary and secondary prevention methods by summarizing risk factors and screening tools. Current Concepts: Although colorectal cancer incidence and mortality have decreased in recent years in Korea, it still poses a significant public health burden. From the early 1990s until the mid-2000s, the 5-year relative survival of patients with colorectal cancer in Korea continuously increased. This can be attributed to the successful introduction of the government-led screening program;development of improved surgical techniques, anticancer drugs, and adjuvant treatment;and advances medical resources and infrastructure along with economic growth. However, since the late 2000s, the improvement in survival has stagnated. The coronavirus disease 2019 outbreak has reduced hospital visits and screenings, which is assumed to cause delays in diagnosis, leading to a worse prognosis in the patients. To overcome these obstacles, it is essential to explore modifiable environmental risk factors and appropriate screening test methods in Korea. Discussion and Conclusion(s): Primary prevention through risk factor modification and secondary prevention using suitable screening programs can reduce the incidence and mortality rates of colorectal cancer.Copyright © Korean Medical Association.

Online Search Patterns about Vaccination: A National Study

Introduction: Google Trends is an online metadata platform that measures the relative search volume of every topic in online search engines. In medical settings, this behavior has been associated with active changes in people's perceptions and search for healthcare. This study aimed to evaluate the online search patterns of Portuguese extra-program and risk-based vaccination. Method(s): Analysis of the relative search volume was performed for extra-program and risk-based vaccines, in every Portuguese district between 2006 and 2021. Relative search volume was represented between 0 and 100 (highest interest in the query). Result(s): Rotavirus vaccine was consistently the most searched, followed by BCG and flu, the last of which, with abnormal peaks of search in November 2009 and October 2020. We registered a significant increase in the search for every vaccine in the last 5 years (p < 0.01). Particularly, during the COVID-19 pandemic, a more abrupt increase was registered for the flu vaccine, but most importantly for BCG (3,0[69,9] vs. 9,0[528,0]). Lisboa and Porto are the only Portuguese districts where percentual research is spread across all types of vaccines. On the other hand, in Portalegre, 84% of total searches correspond to BCG. Discussion and Conclusion(s): The recent increase in the interest in vaccination may translate into the investment of health professionals in primary prevention measures. However, the mediatic impact of pandemics is not neglectable. Health professionals must fight misinformation as it may have happened with the increasing interest in BCG, probably due to the protective association proposed with the infection by SARS-CoV-2.Copyright © 2022 The Author(s).

Persistent Post-COVID: The first wave, one year after

Introduction: Although many patients recover from a COVID-19 infection, a relevant proportion experiences long term symptoms from 'Post-COVID'. Several questions remain about the cause and duration of Post-COVID. This study assesses the long term burden of patients with COVID-19 during the first wave of the pandemic in the Netherlands from February 2020 until July 2020. The secondary aim was to find potential risk factors for long term symptoms. Method(s): In this prospective cohort study, all participants self-registered and filled in the Assessment of the Burden of COVID-19 (ABCoV) tool (van Noort E, et al. JMIR Form Res 2021;5(3):e22603) directly after their infection and one year later. Curavista kindly provided access to the ABCoV tool and their database. The dataset contained 161 patients at T0 (first time registration) and T1 (one year after registration). We categorized demographics (sex, smoking status, age, weight, BMI, and exercise level), ABCoV overall score, and ABCoV scores per domain (symptom status, mental status and functional status). Risk factors for Post-COVID were explored through linear regression analysis. Result(s): A subgroup of patients (12%) reported substantial symptoms at T1 and is therefore categorized as suffering from persistent Post-COVID. A majority of this group (60%) reported an overall increase in complaints: 89% in mental status, 35% in functional status, and 39% in pulmonary status. Secondary, results show that smoking, high BMI and lack of exercise at baseline are risk factors for developing long term symptoms. No correlations were found between sex or age. Conclusion(s): Due to these specific risk factors, it might imply that behavioral aspects are pivotal in primary prevention of Post-Covid.

Pneumococcal Vaccination is a Challenge of Pediatric Allergists

Objective: An increased risk of invasive pneumococcal disease (IPD) has been reported in children with asthma before the introduction of pneumococcal vaccines (PVs). However, the evidence is limited after PV entered the routine immunization schedule. We aimed to investigate whether pediatric allergists recommend additional PV (aPV) to asthmatic children and if so whether there are any asthma-specific risk factors they consider. We also wanted to determine any changes in their recommendations during the COVID-19 pandemic. Material(s) and Method(s): A questionnaire was e-mailed to all members of the Academy of Pediatric Allergy and Asthma in Turkey. The questionnaire was filled online and consisted of 14 questions. Result(s): The questionnaire was e-mailed to 220 members. The response rate was 56.3% and 60.5% of PA recommended aPV. The most frequent asthma specific factors for aPV were severe asthma (70.2%), long term oral corticosteroid use (65.3%) and frequent exacerbations / hospitalizations (62.9%). COVID-19 pandemic increased the rate of questions asked to PA about aPV for asthmatic children compared to previous periods (75.8 vs 33.9%) (p<0.001) and %27 of PA changed their recommendations in favor of aPV during pandemic. Conclusion(s): Asthmatic children is not infrequent. Severe asthma and related factors seem to be the leading reasons to recommend aPV for asthmatic children. The aPV recommendation by PA is increased during COVID-19 pandemic.Copyright © 2022 Bilimsel Tip Yayinevi. All rights reserved.

Neurological complications of SARS-CoV-2 infection.

SARS-CoV-2 virus was first identified in 2019 in Wuhan (China) and is responsible for the ongoing COVID-19 pandemic. Although the virus causes mild, transient symptoms of an upper respiratory tract infection in most cases, it can also lead to severe pneumonia, respiratory failure and/or death. Approximately 85% of patients experience central and peripheral neurological symptoms. In the acute phase of the disease, ischaemic strokes, intracranial haemorrhages, meningitis and encephalitis, acute demyelinating diseases and acute inflammatory polyneuropathies may occur. However, mild neurological symptoms that can persist for months and significantly affect daily functioning are much more common. These include headache and dizziness, olfactory and gustatory dysfunction, mild cognitive disturbances, as well as depressive, anxiety, and sleep disorders. Some of them are encompassed by popular terms "post-covid syndrome" and "brain fog." The pathogenesis of neurological complications of SARS-CoV-2 infection is still not fully understood;overproduction of cytokines induced by viral infection may be of great importance. There is no causal treatment, while symptomatic treatment is of limited effectiveness. Primary prevention in the form of SARS-CoV-2 vaccinations is of great importance. In the following review, we would like to present the current knowledge on epidemiology, pathology, pathogenesis and treatment of neurological complications after SARS-CoV-2 infection. Further multi-centre, large-scale clinical studies are necessary to identify the exact pathogenetic mechanismsCopyright © 2022 Sawicka et al.

Telehealth as a therapeutic approach in the management of childhood obesity.

Overweight and obesity in childhood and adolescence are not only associated with severe medical and psychological complications and sequelae, but also represent one of the greatest challenges for the healthcare system from an economic point of view. The restrictions imposed by the global COVID-19 (coronavirus disease 2019) pandemic have further aggravated the already high prevalence of juvenile obesity. Since pharmacological treatment options are generally not approved in childhood/adolescence and therefore they are not an option, lifestyle modification has a separate role from a therapeutic perspective. Multimodal training concepts from various disciplines (e.g., psychology, nutrition, sports, medicine) currently show the best prospects of success. The targeted transfer of these training programs into telemedical concepts could sustainably improve their effectiveness and reduce resource requirements on both the therapeutic and patient side.Copyright © 2022, The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

Content Analysis of American Network News Coverage of Prevention Strategies During the Initial Wave of the COVID-19 Pandemic.

BACKGROUND: Broadcast media is a method to communicate health information to the general public and has previously been used in prior public health emergencies. Despite the current ubiquity of social media, traditional news programming retains relatively large audiences, which increased during the COVID-19 pandemic's early days. Viewership of broadcast media networks' evening news skews toward older groups (age 65 and up) which were vulnerable to health complications related to the COVID-19 pandemic. OBJECTIVES: The current study explored the trends in American broadcast network news media coverage of prevention during the initial wave of the COVID-19 pandemic. DESIGN: Quantitative content analysis using the Public Health Framework for Prevention was used to analyze three major US media networks' evening news content for thematic trends in COVID-19 coverage during the first US pandemic wave from March to May 2020. SUBJECTS: A total of 117 episodes of the evening news, 39 from each of the three major US media networks, evenly divided among the first 13 weeks of the pandemic in the US. MAIN MEASURES: Outcome variables included average seconds of coverage per episode devoted to prevention strategies, COVID-19 coverage not related to prevention, and non-COVID-19 coverage. KEY RESULTS: The proportion of coverage dedicated to COVID-19 sharply increased in the first 2 weeks of March and decreased in the last 2 weeks of May. Networks focused approximately half the COVID-19 coverage time on prevention issues (288 seconds/episode) compared to non-prevention issues (538 seconds/episode). Prevention coverage varied over time. CONCLUSIONS: Although coverage included COVID-19 prevention content, more of the coverage was on other pandemic-related issues (e.g., economic impacts). Because public network news outlets have broad reach and accessibility, they could be an effective partner for public health agencies disseminating prevention messaging for current and future disease outbreaks and threats to public health.

Lifelong vaccination strategy as a tool against pandemics in Hungary / Élethosszan át tartó oltási stratégia mint eszköz a pandémiák elleni védekezésben Magyarországon.

Összefoglaló. Különbözo tényezok következtében az új és újra felbukkanó fertozo betegségek megjelenésére a 21. században egyre nagyobb az esély, ezzel párhuzamosan a pandémiák kialakulása is nagyobb valószínuségu. A 2019-ben felbukkant COVID-19-járvány azt is közvetíti számunkra, hogy egyes új és újra jelentkezo fertozo betegségek - az eredményes intézkedések elmaradása, késlekedése esetén - gyorsan terjedhetnek. A fertozo betegségek elleni harc egyik fo eszköze a védooltás segítségével történo immunizáció. A jelen tanulmány célja bemutatni a védooltások elonyeit, fókuszba helyezve az elöregedo társadalomban az élethosszan tartó immunizációs stratégiának a személyes egészségre ható, közegészségügyi, gazdasági, valamint társadalmi érdekeit. Az oltás elonyeinek minél nagyobb fokú kihasználásához egy élethosszan tartó immunizációs stratégia felállítása javasolható, amelynek aspektusait és gyakorlatba ültetésének lehetséges lépéseit foglaltuk össze közleményünkben. Orv Hetil. 2022; 163(14): 535-543. Summary. Due to various factors, the chances of infectious disease emergence or re-emergence have increased in the 21st century, thus, the likelihood of new emerging pandemics has also increased. The COVID-19 pandemic, which appeared in 2019, has highlighted that certain new and re-emerging infectious diseases - in the case of lack or delay in effective measures - can spread very rapidly. The main tool for the fight against infectious diseases is immunization through vaccination. While focusing on the personal health, public health, economic and societal benefits of a lifelong immunization strategy, especially in light of the aging society, the goal of this paper is to present the benefits of vaccines. In order to increase the added value of vaccinations it is recommended to create a lifelong immunization strategy. Our paper summarizes the relevant aspects of such a strategy, highlighting potential practical steps towards implementation. Orv Hetil. 2022; 163(14): 535-543.

Understanding factors affecting implementation success and sustainability of a comprehensive prevention program for cardiovascular disease in primary health care: a qualitative process evaluation study combining RE-AIM and CFIR.

AIM: Our aim was to evaluate the implementation process of a comprehensive cardiovascular disease prevention program in general practice, to enhance understanding of influencing factors to implementation success and sustainability, and to learn how to overcome barriers. BACKGROUND: Cardiovascular disease and its risk factors are the world's leading cause of mortality, yet can be prevented by addressing unhealthy lifestyle behavior. Nevertheless, the transition toward a prevention-oriented primary health care remains limited. A better understanding of factors facilitating or hindering implementation success and sustainability of prevention programs, and how barriers may be addressed, is needed. This work is part of Horizon 2020 project 'SPICES', which aims to implement validated preventive interventions in vulnerable populations. METHODS: We conducted a qualitative process evaluation with participatory action research approach of implementation in five general practices. Data were collected through 38 semi-structured individual and small group interviews with seven physicians, 11 nurses, one manager and one nursing assistant, conducted before, during, and after the implementation period. We applied adaptive framework analysis guided by RE-AIM Qualitative Evaluation for Systematic Translation (RE-AIM QuEST) and Consolidated Framework for Implementation Research (CFIR). FINDINGS: Multiple facilitators and barriers affected reach of vulnerable target populations: adoption by primary health care providers, implementation and fidelity and intention to maintain the program into routine practice. In addition, our study revealed concrete actions, linked to implementation strategies, that can be undertaken to address identified barriers. Prioritization of prevention in general practice vision, ownership, and shared responsibility of all team members, compatibility with existing work processes and systems, expanding nurse's roles and upskilling competence profiles, supportive financial and regulatory frameworks, and a strong community - health care link are crucial to increase implementation success and long-term maintenance of prevention programs. COVID-19 was a major barrier to the implementation. RE-AIM QuEST, CFIR, and participatory strategies are useful to guide implementation of prevention programs in primary health care.

Epidemiology, risk factors, and prevention of colorectal cancer

Background: Colorectal cancer remains the fourth most common malignancy in Korea, and has been ranked as the third leading cause of cancer deaths in 2020. This study aims to describe the epidemiologic status of colorectal cancer in Korea, and provide basic data for effective primary and secondary prevention methods by summarizing risk factors and screening tools. Current Concepts: Although colorectal cancer incidence and mortality have decreased in recent years in Korea, it still poses a significant public health burden. From the early 1990s until the mid-2000s, the 5-year relative survival of patients with colorectal cancer in Korea continuously increased. This can be attributed to the successful introduction of the government-led screening program;development of improved surgical techniques, anticancer drugs, and adjuvant treatment;and advances medical resources and infrastructure along with economic growth. However, since the late 2000s, the improvement in survival has stagnated. The coronavirus disease 2019 outbreak has reduced hospital visits and screenings, which is assumed to cause delays in diagnosis, leading to a worse prognosis in the patients. To overcome these obstacles, it is essential to explore modifiable environmental risk factors and appropriate screening test methods in Korea. Discussion and Conclusion: Primary prevention through risk factor modification and secondary prevention using suitable screening programs can reduce the incidence and mortality rates of colorectal cancer.