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1.
Cien Saude Colet ; 27(12): 4341-4363, 2022 Dec.
Article in Portuguese, English | MEDLINE | ID: covidwho-20242427

ABSTRACT

The Happy Child Program (Programa Criança Feliz - PCF, in Portuguese) reaches 1.4 million Brazilian children under three years of age with home visits aimed at promoting neuropsychomotor development. Based on a conceptual model, PCF implementation and impact were evaluated in a randomized study in 30 municipalities. A total of 3,242 children were allocated to the intervention (IG) or control (CG) group, 80.0% of whom were prospectively followed up from late 2018 to late 2021. Development was assessed by the Ages and Stages Questionnaire (ASQ3). During the three-year study period, visits were replaced by virtual contacts for an average of 12 months due to COVID-19. At the endline survey, intent-to-treat analyses showed mean scores of 203.3 in the IG and 201.3 in the CG. Additional analyses using instrumental variables and propensity scores matching also showed no effect, since the number of contacts with the program was not associated with ASQ3 scores. No impact was observed on stimulation, responsive interactions or psychological attributes of children. The implementation study revealed low coverage in the IG, contamination of the CG, deficiencies in management and low quality of visits in many municipalities. The study did not demonstrate an impact of PCF implemented under routine conditions, but provides elements for its improvement.


O Programa Criança Feliz (PCF) atinge 1,4 milhão de crianças brasileiras menores de três anos com visitas domiciliares visando o desenvolvimento neuropsicomotor. Com base em modelo conceitual, avaliou-se implementação e impacto do PCF em estudo randomizado, em 30 municípios. Ao todo 3.242 crianças foram alocadas para o grupo intervenção (GI) ou controle (GC), sendo 80,0% acompanhadas prospectivamente durante três anos. O desenvolvimento foi avaliado pelo Ages and Stages Questionnaire (ASQ3). Análises por intenção de tratar mostraram escores médios de 203,3 no GI e 201,3 no GC. Análises adicionais com variáveis instrumentais e emparelhamento por escores de propensão tampouco mostraram efeito, uma vez que o número de contatos recebidos não esteve associado aos escores ASQ3. Tampouco foi observado impacto sobre estimulação, interações responsivas ou atributos psicológicos das crianças. As visitas foram interrompidas durante 12 meses devido à COVID-19, sendo substituídas por contatos virtuais. O estudo de implementação revelou baixa cobertura no GI, contaminação do GC, deficiências na gestão e baixa qualidade das visitas em muitos municípios. O estudo não demonstrou impacto do PCF implementado sob condições de rotina e fornece elementos para seu aprimoramento.


Subject(s)
COVID-19 , Child , Humans , Child, Preschool , Brazil , Cities , Surveys and Questionnaires , Family , Program Evaluation
2.
Cien Saude Colet ; 26(5): 1885-1898, 2021 May.
Article in Portuguese, English | MEDLINE | ID: covidwho-20243734

ABSTRACT

This article explores the use of spatial artificial intelligence to estimate the resources needed to implement Brazil's COVID-19 immu nization campaign. Using secondary data, we conducted a cross-sectional ecological study adop ting a time-series design. The unit of analysis was Brazil's primary care centers (PCCs). A four-step analysis was performed to estimate the popula tion in PCC catchment areas using artificial in telligence algorithms and satellite imagery. We also assessed internet access in each PCC and con ducted a space-time cluster analysis of trends in cases of SARS linked to COVID-19 at municipal level. Around 18% of Brazil's elderly population live more than 4 kilometer from a vaccination point. A total of 4,790 municipalities showed an upward trend in SARS cases. The number of PCCs located more than 5 kilometer from cell towers was largest in the North and Northeast regions. Innovative stra tegies are needed to address the challenges posed by the implementation of the country's National COVID-19 Vaccination Plan. The use of spatial artificial intelligence-based methodologies can help improve the country's COVID-19 response.


O objetivo deste artigo é analisar o uso da inteligência artificial espacial no contexto da imunização contra COVID-19 para a seleção adequada dos recursos necessários. Trata-se de estudo ecológico de caráter transversal baseado em uma abordagem espaço-temporal utilizando dados secundários, em Unidades Básicas de Saúde do Brasil. Foram adotados quatro passos analíticos para atribuir um volume de população por unidade básica, aplicando algoritmos de inteligência artificial a imagens de satélite. Em paralelo, as condições de acesso à internet móvel e o mapeamento de tendências espaço-temporais de casos graves de COVID-19 foram utilizados para caracterizar cada município do país. Cerca de 18% da população idosa brasileira está a mais de 4 quilômetros de distância de uma sala de vacina. No total, 4.790 municípios apresentaram tendência de agudização de casos de Síndrome Respiratória Aguda Grave. As regiões Norte e Nordeste apresentaram o maior número de Unidades Básicas de Saúde com mais de 5 quilômetros de distância de antenas de celular. O Plano nacional de vacinação requer o uso de estratégias inovadoras para contornar os desafios do país. O uso de metodologias baseadas em inteligência artificial espacial pode contribuir para melhoria do planejamento das ações de resposta à COVID-19.


Subject(s)
COVID-19 Vaccines , COVID-19 , Aged , Artificial Intelligence , Brazil , Cities , Cross-Sectional Studies , Humans , Intelligence , SARS-CoV-2 , Vaccination
3.
Cien Saude Colet ; 26(8): 3265-3276, 2021 Aug.
Article in Portuguese | MEDLINE | ID: covidwho-20239424

ABSTRACT

In this study, the perception of Brazilians regarding COVID-19 in 12 cities in the country was analyzed. Issues about the severity and dangers of the disease, sources of information and reliability, checking information, attitudes, precautions, and priorities for coping and trusting relationships in science were addressed. This study was carried out in the context of broader research on how Brazilians perceive the Oswaldo Cruz Foundation (Fiocruz). The survey was applied between May 18 and June 10, 2020, with 1,643 residents over 16 years of age in Brazilian cities where Fiocruz has a technical unit or office. The results reveal that the majority of the interviewees appreciate the seriousness of the pandemic, the importance of being properly informed, considers the measures indicated by health authorities important and trusts scientists and scientific institutions as sources of information. With the sense of urgency and experience of uncertainties about the present and the future, the need for strengthening of trust in institutions is present.


Neste estudo, analisamos a percepção de brasileiros e brasileiras sobre a COVID-19 em 12 cidades do país. Foram abordadas questões sobre a gravidade e os perigos da doença, fontes de informações e confiabilidade, checagem de informações, atitudes, precauções e prioridades para o enfrentamento e relações de confiança na ciência. Este estudo foi realizado no contexto de uma pesquisa mais ampla sobre como brasileiros e brasileiras veem a Fundação Oswaldo Cruz (Fiocruz). A survey foi aplicada no período de 18 de maio e 10 de junho de 2020 com 1.643 moradores com mais de 16 anos nas cidades brasileiras em que a Fiocruz possui unidade ou escritório técnico. Os resultados revelam que boa parte dos entrevistados reconhece a gravidade da pandemia, a importância de se informar corretamente, considera as medidas indicadas por autoridades de saúde válidas e confia em cientistas e instituições científicas como fontes de informação. Com o senso de urgência e a potencialização e vivência das incertezas acerca do presente e do futuro, o fortalecimento da confiança nas instituições se faz presente.


Subject(s)
COVID-19 , Pandemics , Attitude , Cities , Humans , Perception , Reproducibility of Results , SARS-CoV-2
4.
Cien Saude Colet ; 26(8): 2937-2947, 2021 Aug.
Article in Portuguese, English | MEDLINE | ID: covidwho-20232909

ABSTRACT

Routine immunization during pandemics can be harmed. This study estimated the influenza vaccination coverage in older adults during the COVID-19 through the EPICOVID-19, a population-based study conducted in 133 cities from the 26 Brazilian states and Federal District. We selected 25 census tracts per city, with probability proportional to the tract's size, ten households by census tract, and one random individual interviewed. A total of 8,265 older adults (≥60 years old) were interviewed and asked whether they had been vaccinated against flu in 2020. Vaccination coverage was 82.3% (95% CI: 80.1-84.2) with no difference by gender, age, and region; higher vaccination coverage was observed among the wealthiest (84.7% versus 80.1% in the poorest) and among the more educated (87.3% versus 83.2% less educated); lower coverage among indigenous (56.9% versus > 80% among other ethnic groups). A positive association was identified with the number of comorbidities among men but not among women. Most of the population was vaccinated (97.5%) in the public health system. The private network was chosen mainly in the South by the wealthiest and more educated. Vaccination coverage was seven percentage points lower than the government target (90%), and inequalities should be reversed in future campaigns.


Imunizações de rotina durante pandemias podem ser prejudicadas. Este estudo estimou a cobertura vacinal para influenza em idosos durante a COVID-19 através do EPICOVID-19, inquérito populacional realizado em 133 cidades sentinelas dos 26 estados brasileiros e Distrito Federal. Selecionou-se 25 setores censitários por cidade, amostragem proporcional ao tamanho, dez domicílios por setor e uma pessoa por domicílio, aleatoriamente. O quantitativo de 8.265 idosos (≥ 60 anos) foram entrevistados e responderam se haviam sido vacinados contra gripe em 2020. A cobertura foi 82,3% (IC95% 80,1; 84,2), sem diferenças por sexo, idade ou região. Maiores coberturas ocorreram nos mais ricos (84,7% versus 80,1% nos mais pobres) e nos mais escolarizados (87,3% versus 83,2% nos menos escolarizados). Menor cobertura nos indígenas (56,9% versus coberturas superiores a 80% nos demais grupos étnicos). Houve associação positiva com número de comorbidades entre homens, mas não entre mulheres. A maioria vacinou-se na rede pública (97,5%), sendo a rede privada mais utilizada na região Sul, pelos mais escolarizados e mais ricos. Conclui-se que a cobertura vacinal ficou sete pontos percentuais abaixo da meta governamental (90%), e que desigualdades devem ser revertidas em futuras campanhas.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Aged , Cities , Female , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Male , Middle Aged , Pandemics/prevention & control , SARS-CoV-2 , Vaccination
5.
Cien Saude Colet ; 27(1): 49-56, 2022 Jan.
Article in Portuguese, English | MEDLINE | ID: covidwho-20232369

ABSTRACT

The images of cities before, during and after the COVID-19 pandemic represent a contemporary challenge. During this period, thinking about being a person, being there and living in an ableist city/society brings to light the loss of rights and the demands of population segments, particularly in the face of architectural, communicational, attitudinal, sensory and sociocultural barriers. To thematize about experiencing the different types of daily inaccessibility in the cities come into contact with and raise discussions about the ethical-aesthetic level of the existential territories of people with disabilities and mental suffering. To what extent do urban planners maintain concepts that support invisibility constructs, which reflect segregations generated by macropolitics? Would they be imagining the cities without thinking about the people who inhabit them? The present essay collaborates with the debate on the need for actions aimed at overcoming capacitism. Based on critical science theories and the concept of the health subject's right, the "topic landscape" is explored with a view to implementing accessible and inclusive public policies.


As imagens das cidades antes, durante e depois da pandemia de COVID-19 representam um desafio contemporâneo. Nesse período, pensar sobre o ser, o estar e o habitar em uma cidade/sociedade capacitista traz à tona a perda de direitos e as demandas de segmentos populacionais particularmente diante das barreiras arquitetônicas, comunicacionais, atitudinais, sensoriais e socioculturais. Tematizar sobre o viver as diferentes inacessibilidades cotidianas nas cidades tangenciam e suscitam discussões no plano ético-estético dos territórios existenciais das pessoas com deficiência e sofrimento psíquico. Em que medida, urbanistas mantém conceitos que sustentam constructos de invisibilidade, que refletem segregações geradas pela macropolítica? Estariam pensando as cidades sem pensar nas pessoas que nelas habitam? O ensaio colabora com o debate sobre a necessidade de ações que visam superar o capacitismo. Partindo de teorias das ciências críticas e da noção de direito do sujeito sanitário, sobrevoa-se a "paisagem do tema" com vistas à efetivação de políticas públicas acessíveis e inclusivas.


Subject(s)
COVID-19 , Disabled Persons , Cities , Humans , Pandemics , SARS-CoV-2
6.
Int J Environ Res Public Health ; 20(10)2023 05 16.
Article in English | MEDLINE | ID: covidwho-20239732

ABSTRACT

Cities, as places of social interactions and human relationships, face new challenges, problems, and threats, which are sources of stress for residents. An additional cause of stress in recent years has been the COVID-19 pandemic; it was urban dwellers who were most exposed to the virus and most affected by it. Chronic stress has led to the serious erosion of physical health and psychophysical well-being among urban dwellers, and so there is a need to seek new solutions in terms of building the resilience of cities and their residents to stress. This study aims to verify the hypothesis that greenery reduced the level of stress among urban dwellers during the pandemic. The verification of this hypothesis was achieved based on a literature analysis and the results of geo-questionnaire studies conducted involving 651 residents of Poznan-among the largest of Polish cities, where the share of green areas in the spatial structure is more than 30%. According to the analysis, the interviewees experienced above-average stress levels that went up during the pandemic, and the source was not so much the virus but the restrictions imposed. Green areas and outdoor activities helped in reducing this stress (being surrounded by and looking at greenery, garden work, or plant cultivation). Residents perceive a post-pandemic city as one that is more green, in which priority is given to unmanaged green areas. It has also been pointed out that a response to the reported need for urban re-construction towards stress resilience may be a biophilic city.


Subject(s)
COVID-19 , Pandemics , Humans , Cities/epidemiology , COVID-19/epidemiology , Plants , Gardens
7.
Environ Sci Pollut Res Int ; 30(33): 81019-81037, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-20238648

ABSTRACT

As COVID-19 has swept across the world, the escalating number of confirmed and suspected cases overwhelmed the admission capacity of the designated hospitals. Faced with such a grim situation, governments made a quick decision to build emergency medical facilities to address the outbreak. However, the emergency medical facilities faced a huge risk of epidemic spread and improper site could lead to serious secondary transmission. Using the disaster prevention and risk avoidance function of urban green space can solve the problem of selecting the location of emergency medical facilities to a certain extent, with country parks having a high degree of compatibility with the latter. Based on the location requirements of emergency medical facilities, using Analytic Hierarchy Process and Delphi method, through analyzing the type of country parks, effective risk avoidance area, spatial fragmentation, distance from water sources, wind direction, and distance from the city, quantification of 8 impact factors such as hydrogeology and traffic duration was conducted to comprehensively compare 30 country parks in Guangzhou. The results showed that the overall quality of country parks approximated a normal distribution, with Lianma Forest Country Park having the highest comprehensive score and the most balanced distribution of scores for various impact factors. Considering safety, expandability, rehabilitation, convenience, pollution prevention, and fecal isolation, it is a preferred destination for emergency medical facility construction.


Subject(s)
COVID-19 , Public Health , Humans , Parks, Recreational , Emergencies , Cities , China , Public Facilities
8.
BMC Public Health ; 23(1): 1112, 2023 Jun 09.
Article in English | MEDLINE | ID: covidwho-20237824

ABSTRACT

BACKGROUND: COVID-19 mass vaccination is the only hopeful savior to curb the pandemic. Vaccine distribution to achieve herd immunity is hindered by hesitance and negative attitude of the public against COVID-19 vaccination. This study aims to evaluate the vaccine hesitancy and attitudes in major cities in Pakistan as well as their determinants. METHODS: A cross-sectional telephonic survey was conducted in June 2021 in major cities of Pakistan including Karachi, Lahore, Islamabad, Peshawar, and Gilgit, from unvaccinated urban population aged 18 years or older. Random Digit Dialing through multi-stage stratified random sampling was used to ensure representation of each target city and socio-economic classes. Questionnaire collected information on socio-demographics, COVID-19-related experiences, risk perception of infection, and receptivity of COVID-19 vaccination. Multivariate logistic regression analyses were performed to identify key determinants of vaccine hesitancy and acceptance. RESULTS: The prevalence of vaccinated population in this survey was 15%. Of the 2270 respondents, 65% respondents were willing to vaccinate, while only 19% were registered for vaccination. Factors significantly associated with vaccine willingness were older age (aOR: 6.48, 95% CI: 1.94-21.58), tertiary education (aOR: 2.02, 95% CI: 1.36, 3.01), being employed (aOR: 1.34, 95% CI: 1.01, 1.78), perceived risk of COVID-19 (aOR: 4.38, 95% CI: 2.70, 7.12), and higher compliance with standard operating procedures (aOR: 1.72, 95% CI: 1.26, 2.35). The most common vaccine hesitancy reasons were 'no need' (n = 284, 36%) and concerns with 'vaccine safety and side effects' (n = 251, 31%), while most reported vaccine motivation reasons were 'health safety' (n = 1029, 70%) and 'to end the pandemic' (n = 357, 24%). CONCLUSIONS: Although our study found 35% hesitancy rate of COVID-19 vaccine, there were noticeable demographic differences that suggest tailored communication strategy to address concerns held by most hesitant subpopulation. Use of mobile vaccination facilities particularly for less mobile and disadvantaged, and implementation and evaluation of social mobilization strategy should be considered to increase overall COVID-19 vaccination acceptance and coverage.


Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , Attitude , Cities , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Pakistan/epidemiology , Vaccination , Adolescent , Adult
9.
BMC Infect Dis ; 23(1): 394, 2023 Jun 12.
Article in English | MEDLINE | ID: covidwho-20237535

ABSTRACT

BACKGROUND: Early data on COVID-19 (based primarily on PCR testing) indicated a low burden in Sub-Saharan Africa. To better understand this, this study aimed to estimate the incidence rate and identify predictors of SARS-CoV-2 seroconversion in the two largest cities of Burkina Faso. This study is part of the EmulCOVID-19 project (ANRS-COV13). METHODS: Our study utilized the WHO Unity protocol for cohort sero-epidemiological studies of COVID-19 in general population. We conducted random sampling stratified by age group and sex. Individuals aged 10 years and older in the cities of Ouagadougou and Bobo-Dioulasso, Burkina Faso were included and surveyed at 4 time points, each 21 days apart, from March 3 to May 15, 2021. WANTAI SARS-CoV-2 Ab ELISA serological tests were used to detect total antibodies (IgM, IgG) in serum. Predictors were investigated using Cox proportional hazards regression. RESULTS: We analyzed the data from 1399 participants (1051 in Ouagadougou, 348 in Bobo-Dioulasso) who were SARS-CoV-2 seronegative at baseline and had at least one follow-up visit. The incidence rate of SARS-CoV-2 seroconversion was 14.3 cases [95%CI 13.3-15.4] per 100 person-weeks. The incidence rate was almost three times higher in Ouagadougou than in Bobo-Dioulasso (Incidence rate ratio: IRR = 2.7 [2.2-3.2], p < 0.001). The highest incidence rate was reported among women aged 19-59 years in Ouagadougou (22.8 cases [19.6-26.4] per 100 person-weeks) and the lowest among participants aged 60 years and over in Bobo-Dioulasso, 6.3 cases [4.6-8.6] per 100 person-weeks. Multivariable analysis showed that participants aged 19 years and older were almost twice as likely to seroconvert during the study period compared with those aged 10 to 18 years (Hazard ratio: HR = 1.7 [1.3-2.3], p < 0.001). Those aged 10-18 years exhibited more asymptomatic forms than those aged 19 years and older, among those who achieved seroconversion (72.9% vs. 40.4%, p < 0.001). CONCLUSION: The spread of COVID-19 is more rapid in adults and in large cities. Strategies to control this pandemic in Burkina Faso, must take this into account. Adults living in large cities should be the priority targets for vaccination efforts against COVID-19.


Subject(s)
COVID-19 , Adult , Humans , Female , Middle Aged , Aged , SARS-CoV-2 , Burkina Faso , Cities , Incidence , Prospective Studies
10.
Front Public Health ; 11: 1029385, 2023.
Article in English | MEDLINE | ID: covidwho-20236976

ABSTRACT

Rapid urbanization has gradually strengthened the spatial links between cities, which greatly aggravates the possibility of the spread of an epidemic. Traditional methods lack the early and accurate detection of epidemics. This study took the Hubei province as the study area and used Tencent's location big data to study the spread of COVID-19. Using ArcGIS as a platform, the urban relation intensity, urban centrality, overlay analysis, and correlation analysis were used to measure and analyze the population mobility data of 17 cities in Hubei province. The results showed that there was high similarity in the spatial distribution of urban relation intensity, urban centrality, and the number of infected people, all indicating the spatial distribution characteristics of "one large and two small" distributions with Wuhan as the core and Huanggang and Xiaogan as the two wings. The urban centrality of Wuhan was four times higher than that of Huanggang and Xiaogan, and the urban relation intensity of Wuhan with Huanggang and Xiaogan was also the second highest in the Hubei province. Meanwhile, in the analysis of the number of infected persons, it was found that the number of infected persons in Wuhan was approximately two times that of these two cities. Through correlation analysis of the urban relation intensity, urban centrality, and the number of infected people, it was found that there was an extremely significant positive correlation among the urban relation intensity, urban centrality, and the number of infected people, with an R2 of 0.976 and 0.938, respectively. Based on Tencent's location big data, this study conducted the epidemic spread research for "epidemic spatial risk classification and prevention and control level selection" to make up for the shortcomings in epidemic risk analysis and judgment. This could provide a reference for city managers to effectively coordinate existing resources, formulate policy, and control the epidemic.


Subject(s)
COVID-19 , Epidemics , Animals , Humans , Big Data , COVID-19/epidemiology , Disease Outbreaks , Cities
11.
Int J Soc Psychiatry ; 69(4): 928-941, 2023 06.
Article in English | MEDLINE | ID: covidwho-20236102

ABSTRACT

BACKGROUND: Internationally, hospital-based short-stay crisis units have been introduced to provide a safe space for stabilisation and further assessment for those in psychiatric crisis. The units typically aim to reduce inpatient admissions and psychiatric presentations to emergency departments. AIMS: To assess changes to service use following a service user's first visit to a unit, characterise the population accessing these units and examine equality of access to the units. METHODS: A prospective cohort study design (ISCTRN registered; 53431343) compared service use for the 9 months preceding and following a first visit to a short-stay crisis unit at three cities and one rural area in England. Included individuals first visited a unit in the 6 months between 01/September/2020 and 28/February/2021. RESULTS: The prospective cohort included 1189 individuals aged 36 years on average, significantly younger (by 5-13 years) than the population of local service users (<.001). Seventy percent were White British and most were without a psychiatric diagnosis (55%-82% across sites). The emergency department provided the largest single source of referrals to the unit (42%), followed by the Crisis and Home Treatment Team (20%). The use of most mental health services, including all types of admission and community mental health services was increased post discharge. Social-distancing measures due to the COVID-19 pandemic were in place for slightly over 50% of the follow-up period. Comparison to a pre-COVID cohort of 934 individuals suggested that the pandemic had no effect on the majority of service use variables. CONCLUSIONS: Short-stay crisis units are typically accessed by a young population, including those who previously were unknown to mental health services, who proceed to access a broader range of mental health services following discharge.


Subject(s)
COVID-19 , Emergency Services, Psychiatric , Mental Disorders , Humans , Prospective Studies , Cohort Studies , Aftercare , Cities , Pandemics , Patient Discharge , COVID-19/epidemiology , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Disorders/psychology , England/epidemiology , Referral and Consultation
12.
BMC Public Health ; 23(1): 935, 2023 05 24.
Article in English | MEDLINE | ID: covidwho-20244505

ABSTRACT

BACKGROUND: The COVID-19 pandemic was a "wake up" call for public health agencies. Often, these agencies are ill-prepared to communicate with target audiences clearly and effectively for community-level activations and safety operations. The obstacle is a lack of data-driven approaches to obtaining insights from local community stakeholders. Thus, this study suggests a focus on listening at local levels given the abundance of geo-marked data and presents a methodological solution to extracting consumer insights from unstructured text data for health communication. METHODS: This study demonstrates how to combine human and Natural Language Processing (NLP) machine analyses to reliably extract meaningful consumer insights from tweets about COVID and the vaccine. This case study employed Latent Dirichlet Allocation (LDA) topic modeling, Bidirectional Encoder Representations from Transformers (BERT) emotion analysis, and human textual analysis and examined 180,128 tweets scraped by Twitter Application Programming Interface's (API) keyword function from January 2020 to June 2021. The samples came from four medium-sized American cities with larger populations of people of color. RESULTS: The NLP method discovered four topic trends: "COVID Vaccines," "Politics," "Mitigation Measures," and "Community/Local Issues," and emotion changes over time. The human textual analysis profiled the discussions in the selected four markets to add some depth to our understanding of the uniqueness of the different challenges experienced. CONCLUSIONS: This study ultimately demonstrates that our method used here could efficiently reduce a large amount of community feedback (e.g., tweets, social media data) by NLP and ensure contextualization and richness with human interpretation. Recommendations on communicating vaccination are offered based on the findings: (1) the strategic objective should be empowering the public; (2) the message should have local relevance; and, (3) communication needs to be timely.


Subject(s)
COVID-19 , Health Communication , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Cities , Natural Language Processing , Pandemics/prevention & control , Public Health
13.
Environ Monit Assess ; 195(7): 822, 2023 Jun 09.
Article in English | MEDLINE | ID: covidwho-20244205

ABSTRACT

Land surface temperature (LST) is an important variable in urban microclimate research. At the end of 2019, the emergence of Covid-19 pandemic has changed the world in a manner that forced many countries to impose restrictions in human activities. As a measure to prevent the expansion of Covid-19 infections, most of the major cities have entered a prolonged lockdown period and reduction in human activities between the early 2020 and the late 2021. These restrictions were strict in most of the cities in Southeast Asia, particularly in Vietnam. The present study investigated the variations in LST and NDVI observed in three rapidly growing urban areas, namely Da Nang, Hue and Vinh, in Vietnam using Landsat-8 imagery acquired between 2017 and 2022. There has been a slight reduction in LST in the study sites, particularly in Da Nang City, during the lockdown period but not as high as observed in recently conducted studies from big metropolitan cities, including in Vietnam. It is also observed that LST estimated from built-up areas and other impervious surfaces remained relatively stable during the study period which is similar to the results from recent studies.


Subject(s)
COVID-19 , Urbanization , Humans , Cities , Temperature , Hot Temperature , Vietnam/epidemiology , Pandemics , Environmental Monitoring/methods , COVID-19/epidemiology , Communicable Disease Control
14.
Sci Total Environ ; 892: 164496, 2023 Sep 20.
Article in English | MEDLINE | ID: covidwho-2327808

ABSTRACT

COVID-19 has notably impacted the world economy and human activities. However, the strict urban lockdown policies implemented in various countries appear to have positively affected pollution and the thermal environment. In this study, Moderate Resolution Imaging Spectroradiometer (MODIS) land surface temperature (LST) and aerosol optical depth (AOD) data were selected, combined with Sentinel-5P images and meteorological elements, to analyze the changes and associations among air pollution, LST, and urban heat islands (UHIs) in three urban agglomerations in mainland China during the COVID-19 lockdown. The results showed that during the COVID-19 lockdown period (February 2020), the levels of the AOD and atmospheric pollutants (fine particles (PM2.5), NO2, and CO) significantly decreased. Among them, PM2.5 and NO2 decreased the most in all urban agglomerations, by >14 %. Notably, the continued improvement in air pollution attributed to China's strict control policies could lead to overestimation of the enhanced air quality during the lockdown. The surface temperature in all three urban agglomerations increased by >1 °C during the lockdown, which was mainly due to climate factors, but we also showed that the lockdown constrained positive LST anomalies. The decrease in the nighttime urban heat island intensity (UHIInight) in the three urban agglomerations was greater than that in the daytime quantity by >25 %. The reduction in surface UHIs at night was mainly due to the reduced human activities and air pollutant emissions. Although strict restrictions on human activities positively affected air pollution and UHIs, these changes were quickly reverted when lockdown policies were relaxed. Moreover, small-scale lockdowns contributed little to environmental improvement. Our results have implications for assessing the environmental benefits of city-scale lockdowns.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Humans , COVID-19/epidemiology , Cities , Hot Temperature , Temperature , East Asian People , Nitrogen Dioxide , Environmental Monitoring , Communicable Disease Control , Respiratory Aerosols and Droplets , Air Pollution/analysis , Air Pollutants/analysis , Particulate Matter/analysis
15.
Sci Total Environ ; 891: 164519, 2023 Sep 15.
Article in English | MEDLINE | ID: covidwho-2327777

ABSTRACT

Wastewater-based epidemiology (WBE) is a rapid and cost-effective method that can detect SARS-CoV-2 genomic components in wastewater and can provide an early warning for possible COVID-19 outbreaks up to one or two weeks in advance. However, the quantitative relationship between the intensity of the epidemic and the possible progression of the pandemic is still unclear, necessitating further research. This study investigates the use of WBE to rapidly monitor the SARS-CoV-2 virus from five municipal wastewater treatment plants in Latvia and forecast cumulative COVID-19 cases two weeks in advance. For this purpose, a real-time quantitative PCR approach was used to monitor the SARS-CoV-2 nucleocapsid 1 (N1), nucleocapsid 2 (N2), and E genes in municipal wastewater. The RNA signals in the wastewater were compared to the reported COVID-19 cases, and the strain prevalence data of the SARS-CoV-2 virus were identified by targeted sequencing of receptor binding domain (RBD) and furin cleavage site (FCS) regions employing next-generation sequencing technology. The model methodology for a linear model and a random forest was designed and carried out to ascertain the correlation between the cumulative cases, strain prevalence data, and RNA concentration in the wastewater to predict the COVID-19 outbreak and its scale. Additionally, the factors that impact the model prediction accuracy for COVID-19 were investigated and compared between linear and random forest models. The results of cross-validated model metrics showed that the random forest model is more effective in predicting the cumulative COVID-19 cases two weeks in advance when strain prevalence data are included. The results from this research help inform WBE and public health recommendations by providing valuable insights into the impact of environmental exposures on health outcomes.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , SARS-CoV-2 , Latvia/epidemiology , Wastewater , Cities/epidemiology , Prevalence , Random Forest
16.
Cad Saude Publica ; 39(4): e00119022, 2023.
Article in English, Portuguese | MEDLINE | ID: covidwho-2327772

ABSTRACT

This study aimed to develop a prioritization index to speed up the achievement of national health targets proposed in the 2030 Agenda. This is an ecological study that addressed the Health Regions in Brazil. The index incorporated 25 indicators with analytical proximity to the official indicators of the 2030 Agenda whose data are available from public municipal sources for the period of 2015-2019. According to our study, the index was a powerful method to support health management decisions. The results showed the most vulnerable territories are located in the North Region of the country, and therefore, these are priority areas for resource allocation. The analysis of subindices highlighted local health bottlenecks, reinforcing the need for municipalities in each region to set their own priorities while making decisions for health resource allocation. By indicating Health Regions and priority themes for more investments, this investigation shows paths to support the implementation of the 2030 Agenda, from the local to the national level, in addition to providing elements that can be used by policy makers to minimize the effects of social inequalities on health, prioritizing territories with worse indices.


O objetivo deste artigo é desenvolver um índice de priorização para aceleração do cumprimento das metas nacionais de saúde propostas pela Agenda 2030. Trata-se de estudo ecológico que abordou as Regiões de Saúde do Brasil. O índice incorporou 25 indicadores com proximidade analítica aos indicadores oficiais da Agenda 2030, para os quais existem dados de fontes públicas no nível municipal para o período de 2015 a 2019. O índice apresentou-se como potente método para apoiar a decisão da gestão em saúde. Os resultados permitiram identificar que a Região Norte do país apresenta os territórios mais vulneráveis e, portanto, prioritários para a alocação de recursos. Além disso, a análise dos subíndices permitiu destacar os gargalos locais de saúde, reforçando a necessidade de os municípios de cada região estabelecerem suas próprias prioridades na decisão de alocação dos recursos da saúde. Ao indicar as Regiões de Saúde e os temas prioritários para maiores investimentos, esta investigação aponta caminhos que podem apoiar a implementação da Agenda 2030 do nível local ao nacional, além de fornecer elementos por meio dos quais os formuladores de políticas podem minimizar os efeitos das iniquidades sociais sobre a saúde, priorizando os territórios com piores índices.


El objetivo fue desarrollar un índice de priorización para acelerar el cumplimiento de las metas nacionales de salud propuestas por la Agenda 2030. Se trata de un estudio ecológico que abordó las Regiones de Salud de Brasil. El índice incorporó 25 indicadores con proximidad analítica a los indicadores oficiales de la Agenda 2030 para los cuales existen datos de fuentes públicas a nivel municipal para el período 2015-2019. El índice se presentó como potente método para apoyar la decisión de la gestión en salud. Los resultados permitieron identificar que la Región Norte del país cuenta con los territorios más vulnerables y, por tanto, áreas prioritarias para la asignación de recursos. Además, el análisis de los subíndices permitió resaltar cuellos de botella locales en salud, reforzando la necesidad de que los municipios de cada región establezcan sus propias prioridades en la decisión de asignación de recursos en salud. Al indicar las Regiones de Salud y los temas prioritarios para mayores inversiones, esta investigación apunta caminos que pueden apoyar la implementación de la Agenda 2030 desde el nivel local al nacional, además de proporcionar elementos a través de los cuales los formuladores de políticas pueden minimizar los efectos de las inequidades sociales sobre la salud, priorizando los territorios con peores índices.


Subject(s)
Sustainable Development , Humans , Brazil , Cities , Socioeconomic Factors
17.
Cien Saude Colet ; 28(5): 1399-1412, 2023 May.
Article in Portuguese, English | MEDLINE | ID: covidwho-2323116

ABSTRACT

The community health agents (CHAs) comprised the workforce at the forefront of health systems in the fight against COVID-19. The study identified the structural conditions for organizing and characterizing the work of CHAs in three municipalities of northeastern Brazil during the pandemic period. A qualitative study of multiple cases was carried out. Twenty-eight subjects were interviewed, including community agents and municipal managers. Data production assessed the interviews with document analysis. The operational categories that emerged from the data analysis were: structural conditions and characteristics of the activities. The results of this study disclosed the scarcity of the structural conditions in the health units, which during the pandemic made improvised adaptations of the internal spaces. As for the work characteristics, actions permeated by bureaucratic aspects of an administrative nature were evidenced in the health units, resulting in the elimination of their binding function of territorial articulation and community mobilization. Thus, changes in their work can be seen as signs of the fragility of the health system and, especially, of primary health care.


Os agentes comunitários de saúde (ACS) compuseram uma força de trabalho na linha de frente dos sistemas de saúde no combate a COVID-19. O trabalho identificou as condições estruturais para organização e caracterização do trabalho dos ACS em três municípios do Nordeste brasileiro no período pandêmico. Realizou-se um estudo qualitativo de casos múltiplos. Foram entrevistados 28 sujeitos entre agentes comunitários e gestores municipais. A produção dos dados cotejou as entrevistas com a análise documental. As categorias operacionais que emergiram da análise dos dados foram: condições estruturais e características das atividades. Os resultados deste estudo revelaram escassez nas condições estruturais das unidades de saúde, que durante a pandemia passou por adaptações improvisadas em seus espaços internos. Quanto às características do trabalho, evidenciaram-se ações permeadas por aspectos burocráticos de cunho administrativo no interior das unidades de saúde, acarretando o esvaziamento de sua função vincular de articulação territorial e mobilização comunitária. Assim, as alterações em seu trabalho podem ser vistas como sinalizadores da fragilização do sistema de saúde e, especialmente, da atenção primária à saúde.


Subject(s)
COVID-19 , Humans , Pandemics , Public Health , Brazil/epidemiology , Cities
18.
Cien Saude Colet ; 28(5): 1325-1339, 2023 May.
Article in Portuguese, English | MEDLINE | ID: covidwho-2325633

ABSTRACT

The aim of this study was to analyze the organization and development of primary health care and surveillance, including normative frameworks and the implementation of local health actions. Qualitative descriptive multiple-case study involving three municipalities in the state of Bahia. We conducted 75 interviews and a document analysis. The results were categorized into the following two dimensions: approach to the organization of the pandemic response; and development of care and surveillance actions at local level. Municipality 1 was found to have a well-defined concept of the integration of health and surveillance with a view to organizing team work processes. However, the municipality did not strengthen the technical capacity of health districts to support surveillance actions. In M2 and M3, delays in defining PHC as the entry point for the health system and the prioritization of a central telemonitoring service run by the municipal health surveillance department compounded the fragmentation of actions and meant that PHC services played only a limited role in the pandemic response. Clear policy and technical guidelines and adequate structural conditions are vital to ensure the effective reorganization of work processes and foster the development of permanent arrangements that strengthen intersectoral collaboration.


O estudo objetivou analisar a organização e o desenvolvimento das ações de vigilância e atenção na APS, desde o arcabouço normativo até a execução das ações sanitárias nos territórios de abrangência das equipes de saúde. Estudo exploratório, analítico-descritivo, de natureza qualitativa, de casos múltiplos em três municípios-sede de região de saúde na Bahia. Foram feitas 75 entrevistas e análise documental. Os resultados consideraram a lógica de organização tecnológica e o desenvolvimento das ações de atenção e vigilância em saúde pelas equipes no nível local. No caso do M1, constatou-se uma concepção bem definida sobre a integração das ações, com vistas à organização do processo de trabalho das equipes. Contudo, não houve aumento da capacidade técnica dos distritos sanitários para apoiar as ações de vigilância junto às equipes. Em M2 e M3, a demora na definição da APS como porta de entrada e a priorização de serviço central de telemonitoramento realizado pela vigilância municipal reforçou a fragmentação das ações, revelando um baixo protagonismo da APS nas respostas. Diretrizes políticas e técnicas e condições estruturais mostraram-se fundamentais para a reorganização do trabalho, de modo a fomentar arranjos permanentes que promovam condições e incentivem a colaboração intersetorial.


Subject(s)
COVID-19 , Humans , Cities , Brazil/epidemiology , Health Policy , Primary Health Care
20.
Injury ; 54(7): 110766, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-2319409

ABSTRACT

BACKGROUND: The COVID-19 pandemic has significant impacts on the US socioeconomic structure. Gun violence is a major public health issue and the effects on this area have not been well-elucidated. The objective of this study was to determine the impacts of the pandemic on mass shootings in six major United States cities with historically high rates of gun violence. METHODS: Mass shooting data were extracted from an open-source database, Gun Violence Archive. Mass shooting was defined as four or more people shot at a single event. Data from six cities with the highest incidence of mass shootings were analyzed in 2019 versus 2020 (Baltimore, Chicago, Detroit, New Orleans, Philadelphia, and St. Louis). Geographic data were examined to assess changes in each city's mass shooting geographic distribution over time. Quantitative changes were assessed using the Area Deprivation Index (ADI), and qualitative data were assessed using ArcGIS. RESULTS: In 2020, the overall percentage of mass shootings increased by 46.7% though there was no change in the distribution of these events when assessed quantitatively (no change in average ADI) nor qualitatively (using ArcGIS). In the six cities analyzed, the total proportion of mass shooting events was unchanged during the pandemic (21.8% vs 20.6%, p = 0.64). Chicago, the US city with the highest incidence of mass shootings, did not experience a significant change in 2020 (n = 34/91, 37.3% vs. n = 53/126, 42.1%, p = 0.57). Baltimore had a significant decrease in mass shooting events (n = 18/91, 19.8% vs. 10/126, 7.9%, p = 0.01). The other four cities had no significant change in the number of mass shootings (p>0.05). CONCLUSION: This study is the first to use ArcGIS technology to describe the patterns of mass shooting in six major US cities during the COVID-19 pandemic. The number of mass shootings in six US cities remained largely unchanged which suggests that changes in mass shootings is likely occurring in smaller cities. Future studies should focus on the changing patterns of homicides in at-risk communities and other possible social influences.


Subject(s)
COVID-19 , Firearms , Wounds, Gunshot , Humans , United States/epidemiology , Wounds, Gunshot/epidemiology , Pandemics , Cities/epidemiology , COVID-19/epidemiology
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