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In this Round Table Discussion, an international panel of experts discuss issues related to the use of technology in the delivery of cognitive behavioral therapy for insomnia (CBT-I), in order to increase its reach. Panelists were, in alphabetical order, Carmela Alcántara, PhD, an Associate Professor at Columbia University School of Social Work in New York, USA, Bei Bei, PhD., an Associate Professor at Monash University in Melbourne, Australia, Charles M. Morin, PhD., a Professor of Psychology at Laval University in Quebec City, Canada, and Annemieke A. van Straten, PhD., a Professor of Clinical Psychology at the Vrije Universiteit in Amsterdam, the Netherlands. The session was chaired by Rachel Manber, PhD., a Professor of Psychiatry and Behavioral Sciences at Stanford University, in Palo Alto, California, USA. In their introductions each panelist discussed the use of technology in their respective country. All indicated that the most common way technology is used in the treatment of insomnia is through the use of video calls (telemedicine) to deliver individual CBT-I, and that this is mostly covered by publicly funded health insurance programs such as Medicare, especially since the COVID-19 pandemic. There are also some fully automated insomnia treatment programs, but they're often not covered by Medicare or other health insurance programs. © The Author(s) 2022. Published by Oxford University Press on behalf of Sleep Research Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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The world has seen numerous infectious disease outbreaks in the past decade. In many cases these outbreaks have had considerable perinatal health consequences including increased risk of preterm delivery (e.g., influenza, measles, and COVID-19), and the delivery of low birth weight or small for gestational age babies (e.g., influenza, COVID-19). Furthermore, severe perinatal outcomes including perinatal and infant death are a known consequence of multiple infectious diseases (e.g., Ebola virus disease, Zika virus disease, pertussis, and measles). In addition to vaccination during pregnancy (where possible), pregnant women, are provided some level of protection from the adverse effects of infection through community-level application of evidence-based transmission-control methods. This review demonstrates that it takes almost 2 years for the perinatal impacts of an infectious disease outbreak to be reported. However, many infectious disease outbreaks between 2010 and 2020 have no associated pregnancy data reported in the scientific literature, or pregnancy data is reported in the form of case-studies only. This lack of systematic data collection and reporting has a negative impact on our understanding of these diseases and the implications they may have for pregnant women and their unborn infants. Monitoring perinatal health is an essential aspect of national and global healthcare strategies as perinatal life has a critical impact on early life mortality as well as possible effects on later life health. The unpredictable nature of emerging infections and the potential for adverse perinatal outcomes necessitate that we thoroughly assess pregnancy and perinatal health implications of disease outbreaks and their public health interventions in tandem with outbreak response efforts. Disease surveillance programs should incorporate perinatal health monitoring and health systems around the world should endeavor to continuously collect perinatal health data in order to quickly update pregnancy care protocols as needed. Copyright © 2023 Malange, Hedermann, Lausten-Thomsen, Hoffmann, Voldstedlund, Aabakke, Eltvedt, Jensen, Breindahl, Krebs, Christiansen and Hedley.
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Objectives: During the COVID pandemic, data collected in family medicine were scarce. The COVID-FM project aimed to monitor trends of COVID-related activity in family medicine practices of the canton of Vaud, Switzerland, during the year 2021. Methods: Practitioners were invited to join an ad hoc sentinel surveillance system. Online data collection was based on daily activity reports and monthly questionnaires. Participants categorized daily counts of consultations and phone calls into predefined categories. Data were reported and discussed on a weekly basis with public health authorities. Results: On the target of 50 physicians, 37 general physicians from 32 practices finally constituted the COVID-FM sentinel network, contributing to 901 practice-weeks of surveillance in family medicine and 604 in paediatrics. In paediatrics, COVID-related activity corresponded mostly to COVID-19 diagnostic consultations (2911/25990 face-to-face consultations = 11.2%) while in family medicine, other COVID-related topics—such as questions on vaccination—predominated (4143/42221 = 9.8%). Conclusion: COVID-related consultations constituted an important part of primary care practices' activity in 2021. Monitoring COVID-related activity in primary care provided health authorities with valuable information to guide public health action. Copyright © 2023 Maeder, Auderset, Borel, Masserey, Schwarz and Mueller.
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We compared the performance of ID NOW™ COVID-19 assay nasal swabs with RT-PCR of nasopharyngeal swabs for SARS-CoV-2 in an outbreak setting, determining whether addition of RT-PCR of residual nasal swabs (rNS) (post ID NOW™ elution) would increase overall analytic sensitivity. Devices were placed at 2 long term and 1 acute care sites and 51 participants were recruited. Prospective paired nasopharyngeal and nasal samples were collected for RT-PCR and ID NOW™. ID NOW™ had a positive and negative categorical agreement of 86% and 93% compared to RT-PCR of nasopharyngeal swabs. Sensitivity and specificity of the ID NOW™ was 86% and 100%, positive and negative predictive value was 100% and 95% (COVID-19 positivity rate: 8%). Addition of rNS RT-PCR increased the positive and negative categorical agreement to 93% and 97%. Based on these results, we propose an alternative workflow which includes complementary testing of rNS on a secondary assay. © 2022 Elsevier Inc.
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Bacterial drug resistance has become a global public health threat, among which the infection of carbapenem-resistant Enterobacterales (CRE) is one of the top noticeable issues in the global anti-infection area due to limited therapy options. In recent years, the prevalence of CRE transmission around the world has increased, and the transmission of COVID-19 has intensified the situation to a certain extent. CRE resistance can be induced by carbapenemase, porin, efflux pump, penicillin-binding protein alteration, and biofilm production. Deletion, mutation, insertion, and post-transcriptional modification of corresponding coding genes may affect the sensitivity of Enterobacterales bacteria to carbapenems. Clinical and laboratory methods to detect CRE and explore its resistance mechanisms are being developed. Due to the limited options of antibiotics, the clinical treatment of CRE infection also faces severe challenges. The clinical therapies of CRE include single or combined use of antibiotics, and some new antibiotics and treatment methods are also being developed. Hence, this review summarizes the epidemiology, resistance mechanisms, screening and clinical treatments of CRE infection, to provide references for clinical prevention, control and treatment of CRE infection. © 2022 Elsevier GmbH
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Public health crises like the ongoing COVID-19 pandemic appear to be the perfect breeding ground for misinformation. As influential information sources, mainstream news media have a unique opportunity to use their platform to debunk and educate the public about misinformation. Despite evidence lending support to the potential for mainstream news media to play a larger role in combating misinformation in society, empirical explorations of how they have contributed to the management of misinformation remain scant. This study aims to address these major gaps in research by investigating how mainstream news dailies gatekeep and correct COVID-19 related misinformation in Singapore. The content of 164 news articles published by the mainstream news dailies in Singapore from January 1 to April 30, 2020 on COVID-19 misinformation was analyzed qualitatively and quantitatively. Results show that the two main types of misinformation, fabricated and reconfigured misinformation, were covered almost equally by mainstream news media. Misinformation related to science and health were most frequently reported, followed by scams, and government policy. Statistically significant differences were found between how mainstream news media corrected the various types and topics of misinformation. Significant differences were also found within the various types, topics, and corrections of misinformation across the early stages of the pandemic. Taken together, these findings shed light on the critical role of mainstream news media as public education tools to correct misinformation during public health crises. From a theoretical perspective, these findings contribute to the understanding of media misinformation gatekeeping, and misinformation correction. From a practical perspective, it highlights the capacity and potential roles of the press in supporting government efforts to combat misinformation.
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Aim: Sweden initially chose a different disease prevention and control path during the pandemic than many other European countries. In June 2020, the Swedish Government established a National Commission to examine the management of COVID-19 in Sweden. This paper summarises, and discusses, its findings. Methods: Three reports published by the Commission were analysed. The first focused on the care of older people during the pandemic. The second examined disease and infection transmission and control and health care and public health. The third updated the first two reports and also covered economic aspects, crisis management and public communication. Results: By 25 February 2022, when the final report was published, 15 800 individuals, 1.5 per 1000 Swedish inhabitants, had died after COVID-19. The death rates were high in spring 2020, but overall excess mortality in 2020–2021 was +0.79%, which was lower than in many other European countries. The Commission suggested that the voluntary measures that were adopted were appropriate and maintained Swedes' personal freedom during the pandemic. However, more extensive and earlier measures should have been taken, especially during the first wave. Conclusion: The Swedish COVID-19 Commission felt that earlier and more extensive pandemic action should have been taken, particularly during the first wave. © 2022 The Author. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.
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The article presents commentary on rural distrust of public health interventions in the U.S. Topics include accumulation of mistrust of health care institutions among residents of home communities;and discuss long standing historical patterns and reasons that may promote mistrust of public health interventions.
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The potential utility of wastewater-based epidemiology as an early warning tool has been explored widely across the globe during the current COVID-19 pandemic. Methods to detect the presence of SARS-CoV-2 RNA in wastewater were developed early in the pandemic, and extensive work has been conducted to evaluate the relationship between viral concentration and COVID-19 case numbers at the catchment areas of sewage treatment works (STWs) over time. However, no attempt has been made to develop a model that predicts wastewater concentration at fine spatio-temporal resolutions covering an entire country, a necessary step towards using wastewater monitoring for the early detection of local outbreaks. We consider weekly averages of flow-normalised viral concentration, reported as the number of SARS-CoV-2N1 gene copies per litre (gc/L) of wastewater available at 303 STWs over the period between 1 June 2021 and 30 March 2022. We specify a spatially continuous statistical model that quantifies the relationship between weekly viral concentration and a collection of covariates covering socio-demographics, land cover and virus associated genomic characteristics at STW catchment areas while accounting for spatial and temporal correlation. We evaluate the model's predictive performance at the catchment level through 10-fold cross-validation. We predict the weekly viral concentration at the population-weighted centroid of the 32,844 lower super output areas (LSOAs) in England, then aggregate these LSOA predictions to the Lower Tier Local Authority level (LTLA), a geography that is more relevant to public health policy-making. We also use the model outputs to quantify the probability of local changes of direction (increases or decreases) in viral concentration over short periods (e.g. two consecutive weeks). The proposed statistical framework can predict SARS-CoV-2 viral concentration in wastewater at high spatio-temporal resolution across England. Additionally, the probabilistic quantification of local changes can be used as an early warning tool for public health surveillance. © 2023
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Personal and household hygiene measures are important for preventing upper respiratory tract infections (URTIs) and other infectious diseases, including coronavirus disease 2019 (COVID-19). An online survey recruited 414 eligible parents in Hong Kong to study their hygiene knowledge, attitudes, and practices (KAPs) regarding the prevention of URTIs among their children. The average knowledge score was high (10.2/12.0), but some misconceptions were identified. The majority of the participants agreed that good personal hygiene (93.5%) and good environmental hygiene (92.8%) can prevent URTIs. The average score for hand hygiene practices was high (3.78/4.00), but only 56.8% of the parents always performed hand hygiene before touching their mouths, noses, or eyes. In terms of environmental hygiene, only some household items were disinfected with disinfectants (door handles in 69.8% of the households, toilet seats in 60.4% of the households, the floor in 42.8% of the households, dining chairs in 24.2% of the households, and dining tables in 20.5% of the households). A higher knowledge score was associated with parents having tertiary educational levels or above, working as healthcare professionals, living in private residential flats or staff quarters, or having household incomes of HKD 70,000 or above. The results of multiple regression analyses also indicated that parents who were healthcare professionals and with higher household income had a better parental knowledge of hygiene measures after adjusting the attitude score. For hand hygiene, parents who achieved higher attitude scores obtained higher practice scores. Under the fifth wave of the COVID-19 epidemic, there were some misconceptions regarding hygiene among parents. Any health promotion program should target parents regarding taking proper personal and household hygienic measures, especially for those who had relatively lower socio-economic status and/or from a non-healthcare background. Motivating attitudes toward hand hygiene can lead to better practices. © 2022 by the authors.
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The people living in Onne are highly vulnerable to PAH exposure due to constant exposure to black soot through oral, dermal, and inhalation routes. This work aims to determine the PAHs profile of selected soils in Onne, to determine the health risks associated with PAHs exposure through the soil, and to determine the impact of reduced industrial and other activities on the PAHs profile and associated public health risks. This study evaluated 16 priority polycyclic aromatic hydrocarbon (PAHs) pollutants in soil samples from the four (4) major clans in Onne using a gas chromatography flame ionization detector (GC-FID) during and after the COVID-19 lockdown. The results showed a differential presence of PAHs during and after the lockdown. Of the 16 priority PAHs, 10 and 8 PAHs were respectively detected during and after the COVID-19 lockdown. High molecular weight PAHs such as benzo(k)fluoranthene and benzo(a)anthracene were major contributors during the lockdown, while low molecular weight PAHs such as naphthalene, acenaphthylene, and fluorene were present at higher levels after the lockdown. An assessment of health risk by incremental lifetime cancer risks revealed that the entire population of Onne might be at risk of cancer development across periods, though a higher risk was presented during the lockdown. In addition, children under the age of 18 may be at greater risk. To the best of our knowledge, there is no previous report on the impact of the COVID-19 lockdown on soil PAH profile and health risks, with particular attention to the Onne industrial host community. Earlier work considered the ecological risks of heavy metals on dumpsites in Onne. Taken together, the PAH-contaminated soil in Onne poses an immediate health concern. Therefore, reduced anthropological activities, as evident during the COVID-19 lockdown, may play a role in exposure and cancer risk reduction. While there may not be another lockdown due to the challenging impacts associated with a physical lockdown, firmly controlled economic activity can be a solution if embraced by stakeholders. The COVID-19-lockdown was encumbered with restricted movements and security checks, which limited the number of samples collected. However, the Local Government Council (Department of the Environment) granted permission for the researchers to work with a minimal threat to their lives. © 2022, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
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Objectives: We investigated the trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the COVID-19 outbreak in the Korean adult population. Methods: Data from 60,098 individuals of the Korean National Health and Nutritional examination Survey between 2011 and 2020 aged≥ = 19 were used. The age-standardized prevalence and annual percent changes (APC) were calculated for obesity (body mass index≥ = 25 kg/m 2), hypertension (systolic/diastolic blood pressure≥ = 140/90mmHg or under treatment), diabetes (hemoglobin A1c≥ = 6.5%, fasting glucose≥ = 126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol≥ = 240 mg/dL or under treatment). Results: Over the past decade of 2011-2020, age-standardized APCs (95% confidence interval)during 2011-2020 for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8%), 0.1% (-1.3 to 1.5%), 1.5% (-1.0 to 4.0%) and 8.0% (5.7 to 10.3%), respectively in men;and -0.2% (-1.5 to 1.2%), -0.5% (-1.9 to 0.9%), -0.1% (-2.3 to 2.2%) and 5.9% (3.9 to 8.0%), respectively in women. In 2020 compared to the previous three years (2017-2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (+6.0, + 1.8, + 1.9 and + 2.8 percentage points, respectively), but the increase was not apparent in women (+2.5, -1.1, + 0.8 and + 0.7 percentage points, respectively). Conclusion: An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 epidemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups.
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Purpose: Under uncertain circumstances, digital technologies are taken as digital transformation enablers and driving forces to integrate with medical, healthcare and emergency management research for effective epidemic prevention and control. This study aims to adapt complex systems in emergency management. Thus, a digital transformation-driven and systematic circulation framework is proposed in this study that can utilize the advantages of digital technologies to generate innovative and systematic governance. Design/methodology/approach: Aiming at adapting complex systems in emergency management, a systematic circulation framework based on the interpretive research is proposed in this study that can utilize the advantages of digital technologies to generate innovative and systematic governance. The framework consists of four phases: (1) analysis of emergency management stages, (2) risk identification in the emergency management stages, (3) digital-enabled response model design for emergency management, and (4) strategy generation for digital emergency governance. A case study in China was illustrated in this study. Findings: This paper examines the role those digital technologies can play in responding to pandemics and outlines a framework based on four phases of digital technologies for pandemic responses. After the phase-by-phase analysis, a digital technology-enabled emergency management framework, titled "Expected digital-enabled emergency management framework (EDEM framework)” was adapted and proposed. Moreover, the social risks of emergency management phases are identified. Then, three strategies for emergency governance and digital governance from the three perspectives, namely "Strengthening weaknesses for emergency response,” "Enhancing integration for collaborative governance,” and "Engaging foundations for emergency management” that the government can adopt them in the future, fight for public health emergency events. Originality/value: The novel digital transformation-driven systematic circulation framework for public health risk response and governance was proposed. Meanwhile, an "Expected digital-enabled emergency management framework (EDEM model)” was also proposed to achieve a more effective empirical response for public health risk response and governance and contribute to studies about the government facing the COVID-19 pandemic effectively. © 2022, Emerald Publishing Limited.
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To describe experiences of student nurses and faculty who participated in COVID‐19 vaccine delivery through a multischool collaboration. Cross‐sectional survey. Student nurses and faculty members from five university schools and colleges of nursing who participated in one or more COVID‐19 vaccination or education events in 2021. Surveys were designed for students and faculty to document process and outcome experiences associated with project participation. Surveys were administered through an online survey platform. Overall, 648 students and 68 faculty members participated in the project. The evaluation survey was completed by 115 students (18%) and 58 faculty members (85%). Students valued increasing their clinical skills and reported the experience influenced their perspectives on nursing, fueling their passion and informing future career choices. Students reported that it was personally important to contribute to the vaccination effort. Few students reported challenges in participating in the project. Faculty reported positive experiences including gaining knowledge about public health and their communities, fueling their passion for nursing education, feeling a deeper connection with students, and experiencing personal satisfaction from contributing to the pandemic response. This project resulted in meaningful student learning opportunities, enhanced capacity for the public health emergency response, and strengthened partnerships among nursing programs and between academia and public health community partners.
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Adverse drug reactions (ADRs) are estimated to be between the fourth and sixth most common cause of death worldwide, taking their place among other prevalent causes of mortality such as heart disease, cancer, and stroke. ADRs impact a broad range of populations across a wide variety of global geography and demographics, with significant mortality and morbidity burden in vulnerable groups such as older people, pediatric populations, and individuals in low-income settings. Too large a share of medicines risk management remains limited to signal detection in big ADR databases (USFDA, EMA, WHO, etc.) This resource allocation is antiquated and applied statistical signal detection methodologies have reached their limits of usefulness. In addition, existing databases are designed for short-term reactions, closely related to medication use and, thus, can only partially assess important broader consequences across geography, time, and clinical relevance. There is an urgent need change the dynamic. We need to identify (earlier and more regularly) many of the important but often overlooked or missed ADRs. Rather than assigning blame, we need to identify the root causes of the problem so they can be clearly addressed and fixed. The public health implications are profound—particularly as we recognize the importance of predicting and mitigating the next pandemic. Consequently, medicines risk management must be integrated within a broader global public health vision. To accomplish this, we need to develop the new tools and methodologies critical to assessing these public health imperatives. © 2022, The Author(s), under exclusive licence to The Drug Information Association, Inc.
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Many governments in the world reacted to the coronavirus disease 2019 pandemic by swiftly offering stimulus packages to their populations. While public unpreparedness was dramatic, it was not unexpected: many alarms had been sounded. Strategies by the federal and various provincial governments of Canada in core sectors predisposed the country to the current situation and weakened its capacity to respond adequately. This paper reviews the cumulative effects of these strategic orientations: a deficient investment strategy in fundamental science;disconnect between laboratory work and the country's capacity to produce vaccines and antiviral drugs;the priority of cost efficiency that led to overwhelming dependency on foreign production of medical supplies;and dramatic spending cuts in public health. We will discuss a Mission strategy to exit the crisis that takes a long-term perspective, in which public interest and public health, combined with a strong State leadership, stimulate innovation and collaboration between national and international actors. © 2022
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This article argues that local constructions of risky and safe spaces, as articulated by the notions ‘loob' (inside) and ‘labas' (outside), informed popular and political responses to the COVID-19 pandemic in the Philippines, leading to an overemphasis on staying at home and, conversely, a general avoidance or fear of outdoor spaces that was at times reinforced by public health authorities. Practices and policies related to the pandemic response rendered this binary opposition between ‘loob' and ‘labas' visible, from regulations concerning the use of personal protective equipment to restrictions of access to outdoor spaces. While this emergent form of bodily proxemics was contested and negotiated over time, its tenacity throughout the pandemic underscores the importance of understanding how people spatialize risk in times of health crises. © 2022 Elsevier Ltd
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Maintaining an active medical research career is a multifaceted undertaking, and many challenges arise, even under normal circumstances. Therefore, the Australian government mandated COVID19 lockdowns and worksite restrictions from 2020 2021 inflicted an additional layer of complexity to an already complicated career for most researchers. A critical issue I faced during these COVID19 lockdowns was to establish whether our research focus was considered an essential service during a period of time when the public health advice was to restrict the movement of research staff and students by enacting new laws to ensure they stay at home. My research team members were also rightfully worried about contracting COVID19 during a period when a viable vaccine was not available. In this presentation, I will be covering some of the adaptive changes I implemented during the COVID19 lockdowns to ensure the continuity of our research program, which includes: 1) Proactive engagement with our medical institute and university COVID-19 taskforces to formulate a joint vision of which research areas should be prioritised during these lockdowns in pursuit of both treatments and vaccines;2) Continuous communication with my research team to encourage, motivate and energise staff and students to allow them to contribute to the research program meaningfully;3) Provide flexible working hours for research team members to work within the confinements of a reduced worksite footprint with an appreciation for social distancing;and 4) Contingency planning to ensure if one research team member contracts COVID-19, there are others with the cross-functional skillset to take over their responsibilities. Taking such steps ensured the rapid development of a new treatment regime that was showing impressive results in reversing multi-organ dysfunction in another clinically challenging area in intensive care units (sepsis). Following the preclinical assessment of safety and efficacy of this new treatment regime, we were able to compassionately treat a critically ill COVID19 patient receiving intensive care at Austin Health. In a short period of time, we saw improved regulation of blood pressure, arterial blood oxygen levels and kidney function. The patient was able to be taken off machine ventilation 12 days after starting sodium ascorbate treatment and discharged from hospital without any complications 22 days later. This research has now informed the design and commencement of multi-centre randomised controlled clinical trials at four hospital intensive care units in Australia.