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2.
J Med Internet Res ; 23(2): e24767, 2021 02 22.
Article in English | MEDLINE | ID: covidwho-1575466

ABSTRACT

BACKGROUND: Online medical records are being used to organize processes in clinical and outpatient settings and to forge doctor-patient communication techniques that build mutual understanding and trust. OBJECTIVE: We aimed to understand the reasons why patients tend to avoid using online medical records and to compare the perceptions that patients have of online medical records based on demographics and cancer diagnosis. METHODS: We used data from the Health Information National Trends Survey Cycle 3, a nationally representative survey, and assessed outcomes using descriptive statistics and chi-square tests. The patients (N=4328) included in the analysis had experienced an outpatient visit within the previous 12 months and had answered the online behavior question regarding their use of online medical records. RESULTS: Patients who were nonusers of online medical records consisted of 58.36% of the sample (2526/4328). The highest nonuser rates were for patients who were Hispanic (460/683, 67.35%), patients who were non-Hispanic Black (434/653, 66.46%), and patients who were older than 65 years (968/1520, 63.6%). Patients older than 65 years were less likely to use online medical records (odds ratio [OR] 1.51, 95% CI 1.24-1.84, P<.001). Patients who were White were more likely to use online medical records than patients who were Black (OR 1.71, 95% CI 1.43-2.05, P<.001) or Hispanic (OR 1.65, 95% CI 1.37-1.98, P<.001). Patients who were diagnosed with cancer were more likely to use online medical records compared to patients with no cancer (OR 1.31, 95% CI 1.11-1.55, 95% CI 1.11-1.55, P=.001). Among nonusers, older patients (≥65 years old) preferred speaking directly to their health care providers (OR 1.76, 95% CI 1.35-2.31, P<.001), were more concerned about privacy issues caused by online medical records (OR 1.79, 95% CI 1.22-2.66, P<.001), and felt uncomfortable using the online medical record systems (OR 10.55, 95% CI 6.06-19.89, P<.001) compared to those aged 18-34 years. Patients who were Black or Hispanic were more concerned about privacy issues (OR 1.42, 1.09-1.84, P=.007). CONCLUSIONS: Studies should consider social factors such as gender, race/ethnicity, and age when monitoring trends in eHealth use to ensure that eHealth use does not induce greater health status and health care disparities between people with different backgrounds and demographic characteristics.


Subject(s)
Electronic Health Records/standards , Health Information Exchange/standards , Surveys and Questionnaires/standards , Adolescent , Adult , Aged , Data Analysis , Female , History, 21st Century , Humans , Internet Use , Male , Middle Aged , Physician-Patient Relations , Telemedicine/statistics & numerical data , Young Adult
5.
Parasit Vectors ; 14(1): 282, 2021 May 26.
Article in English | MEDLINE | ID: covidwho-1523322

ABSTRACT

Trichinellosis is a foodborne disease caused by several Trichinella species around the world. In Chile, the domestic cycle was fairly well-studied in previous decades, but has been neglected in recent years. The aims of this study were to analyze, geographically, the incidence of trichinellosis in Chile to assess the relative risk and to analyze the incidence rate fluctuation in the last decades. Using temporal data spanning 1964-2019, as well as geographical data from 2010 to 2019, the time series of cases was analyzed with ARIMA models to explore trends and periodicity. The Dickey-Fuller test was used to study trends, and the Portmanteau test was used to study white noise in the model residuals. The Besag-York-Mollie (BYM) model was used to create Bayesian maps of the level of risk relative to that expected by the overall population. The association of the relative risk with the number of farmed swine was assessed with Spearman's correlation. The number of annual cases varied between 5 and 220 (mean: 65.13); the annual rate of reported cases varied between 0.03 and 1.9 cases per 105 inhabitants (mean: 0.53). The cases of trichinellosis in Chile showed a downward trend that has become more evident since the 1980s. No periodicities were detected via the autocorrelation function. Communes (the smallest geographical administrative subdivision) with high incidence rates and high relative risk were mostly observed in the Araucanía region. The relative risk of the commune was significantly associated with the number of farmed pigs and boar (Sus scrofa Linnaeus, 1758). The results allowed us to state that trichinellosis is not a (re)emerging disease in Chile, but the severe economic poverty rate of the Mapuche Indigenous peoples and the high number of backyard and free-ranging pigs seem to be associated with the high risk of trichinellosis in the Araucanía region.


Subject(s)
Swine Diseases/epidemiology , Trichinellosis/epidemiology , Animals , Bayes Theorem , Chile/epidemiology , Disease Outbreaks , Geographic Mapping , History, 20th Century , History, 21st Century , Incidence , Risk Assessment , Swine , Trichinella , Trichinellosis/history
6.
Lancet ; 398(10313): 1837-1850, 2021 11 13.
Article in English | MEDLINE | ID: covidwho-1510434

ABSTRACT

Type 1 diabetes is on the rise globally; however, the burden of mortality remains disproportionate in low-income and middle-income countries (LMICs). As 2021 marks 100 years since the discovery of insulin, we revisit progress, global burden of type 1 diabetes trends, and understanding of the pathogenesis and management practices related to the disease. Despite much progress, inequities in access and availability of insulin formulations persist and are reflected in differences in survival and morbidity patterns related to the disease. Some of these inequities have also been exacerbated by health-system challenges during the COVID-19 pandemic. There is a clear opportunity to improve access to insulin and related essential technologies for improved management of type 1 diabetes in LMICs, especially as a part of universal health coverage. These improvements will require concerted action and investments in human resources, community engagement, and education for the timely diagnosis and management of type 1 diabetes, as well as adequate health-care financing. Further research in LMICs, especially those in Africa, is needed to improve our understanding of the burden, risk factors, and implementation strategies for managing type 1 diabetes.


Subject(s)
Developing Countries , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/pathology , Diabetes Mellitus, Type 1/therapy , Global Burden of Disease/trends , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Adolescent , Child , Child, Preschool , Disease Management , History, 20th Century , History, 21st Century , Humans , Hypoglycemic Agents/economics , Hypoglycemic Agents/history , Insulin/economics , Insulin/history , Life Expectancy , Universal Health Insurance
9.
Mol Biol Cell ; 32(22): ae2, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1500972

ABSTRACT

If this was not happening in the midst of the COVID-19 pandemic, I imagine that I would be speaking these words instead of writing them on my laptop. Even so, I am so jazzed for this opportunity! No word or phrase describes what I am feeling in this moment in receiving the 2021 American Society for Cell Biology Prize for Excellence in Inclusivity. It is certainly an honor to be recognized in this way. I am grateful to the Howard Hughes Medical Institute for awarding me additional resources to keep on keeping on. My approach to finding the connection between people and their science certainly could use the monetary support. Resources open doors. At the same time that I am grateful for the attention, I am not exactly sure what to do with the spotlight. Importantly, there are a host of other folks out there also doing amazing things who have never been recognized. Let's work to ensure that their contributions are supported, appreciated, and recognized. Instead of focusing the spotlight on me, I would rather redirect it to recognize my foundational influences. I also hope to encourage the need for institutional approaches beyond celebrating individual accomplishment.


Subject(s)
Awards and Prizes , Cultural Diversity , Social Change , Academies and Institutes , History, 21st Century , Humans , Social Environment
11.
Nat Rev Clin Oncol ; 18(11): 675, 2021 11.
Article in English | MEDLINE | ID: covidwho-1488032
13.
Neuron ; 109(19): 3022-3024, 2021 10 06.
Article in English | MEDLINE | ID: covidwho-1482840

ABSTRACT

In this Neuron Q&A, Xiang Yu talks about the stress and anxiety brought to the lab by the pandemic, the new opportunities for teaching and scientific conferences it created, the value of the individual, and the social responsibility of science for humanity and society to shape a brighter future.


Subject(s)
Neurosciences/trends , Beijing , COVID-19 , China , History, 21st Century , Pandemics , Research Support as Topic
17.
Kidney Blood Press Res ; 46(5): 639-646, 2021.
Article in English | MEDLINE | ID: covidwho-1476898

ABSTRACT

BACKGROUND: It is just over a century since the 1918 flu pandemic, sometimes referred to as the "mother" of pandemics. This brief retrospective of the 1918 pandemic is taken from the viewpoint of the current SARS-CoV-2/COVID-19 pandemic and is based on a short lecture given during the 2021 Virtual Congress of the ERA-EDTA. SUMMARY: This review summarizes and highlights some of the earlier pandemic's salient features, some parallels with today, and some potential learnings, bearing in mind that the flu pandemic occurred over 100 years ago at a time of major turmoil during the climax to WWl, and with limited medical expertise and knowledge, research facilities, or well-structured and resourced healthcare services. While there is little or no information on renal complications at the time, or an effective treatment, some observations in relation to COVID-19 and vaccination are included. Key Messages: Lessons are difficult to draw from 1918 other than the importance and value of non-pharmaceutical measures to limit viral transmission. While the economic impact of the 1918 pandemic was significant, as it is now with COVID-19, subsequent economic analysis has shown that protecting public health and preserving economic activity are not mutually exclusive. Both H1N1 and SARS-CoV-2 viruses are neurotropic and may cause chronically debilitating neurological diseases, including conditions such as encephalitis lethargica (still debated) and myalgic encephalomyelitis (chronic fatigue syndrome), respectively. Although coronavirus and influenza viral infections have some similarities, they are certainly not the same, as we are realising, and future infectious pandemics may still surprise us, but being "forewarned is forearmed."


Subject(s)
COVID-19 , Influenza Pandemic, 1918-1919/history , Influenza, Human/transmission , Pandemics , COVID-19/complications , COVID-19/economics , History, 20th Century , History, 21st Century , Humans , Influenza A Virus, H1N1 Subtype , Influenza Pandemic, 1918-1919/economics
19.
Nat Commun ; 12(1): 6009, 2021 10 14.
Article in English | MEDLINE | ID: covidwho-1469968

ABSTRACT

By October 2021, 230 million SARS-CoV-2 diagnoses have been reported. Yet, a considerable proportion of cases remains undetected. Here, we propose GInPipe, a method that rapidly reconstructs SARS-CoV-2 incidence profiles solely from publicly available, time-stamped viral genomes. We validate GInPipe against simulated outbreaks and elaborate phylodynamic analyses. Using available sequence data, we reconstruct incidence histories for Denmark, Scotland, Switzerland, and Victoria (Australia) and demonstrate, how to use the method to investigate the effects of changing testing policies on case ascertainment. Specifically, we find that under-reporting was highest during summer 2020 in Europe, coinciding with more liberal testing policies at times of low testing capacities. Due to the increased use of real-time sequencing, it is envisaged that GInPipe can complement established surveillance tools to monitor the SARS-CoV-2 pandemic. In post-pandemic times, when diagnostic efforts are decreasing, GInPipe may facilitate the detection of hidden infection dynamics.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Genome, Viral , SARS-CoV-2/genetics , COVID-19/history , Europe/epidemiology , History, 21st Century , Humans , Incidence , Pandemics , Phylogeny , SARS-CoV-2/classification , SARS-CoV-2/isolation & purification , Scotland , Switzerland , Victoria
20.
Disaster Med Public Health Prep ; 14(6): e15-e17, 2020 12.
Article in English | MEDLINE | ID: covidwho-1461907
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