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1.
Sci Rep ; 12(1): 328, 2022 01 10.
Article in English | MEDLINE | ID: covidwho-1616999

ABSTRACT

Emerging infectious diseases (EIDs), including the latest COVID-19 pandemic, have emerged and raised global public health crises in recent decades. Without existing protective immunity, an EID may spread rapidly and cause mass casualties in a very short time. Therefore, it is imperative to identify cases with risk of disease progression for the optimized allocation of medical resources in case medical facilities are overwhelmed with a flood of patients. This study has aimed to cope with this challenge from the aspect of preventive medicine by exploiting machine learning technologies. The study has been based on 83,227 hospital admissions with influenza-like illness and we analysed the risk effects of 19 comorbidities along with age and gender for severe illness or mortality risk. The experimental results revealed that the decision rules derived from the machine learning based prediction models can provide valuable guidelines for the healthcare policy makers to develop an effective vaccination strategy. Furthermore, in case the healthcare facilities are overwhelmed by patients with EID, which frequently occurred in the recent COVID-19 pandemic, the frontline physicians can incorporate the proposed prediction models to triage patients suffering minor symptoms without laboratory tests, which may become scarce during an EID disaster. In conclusion, our study has demonstrated an effective approach to exploit machine learning technologies to cope with the challenges faced during the outbreak of an EID.


Subject(s)
COVID-19/epidemiology , Communicable Diseases, Emerging/epidemiology , Hospitalization/statistics & numerical data , Machine Learning , Preventive Medicine/statistics & numerical data , Public Health/statistics & numerical data , COVID-19/prevention & control , COVID-19/virology , Communicable Diseases, Emerging/prevention & control , Hospital Mortality , Humans , International Classification of Diseases , Logistic Models , Models, Theoretical , Pandemics/prevention & control , Preventive Medicine/methods , Public Health/methods , Risk Factors , SARS-CoV-2/physiology , Severity of Illness Index
4.
Am J Nurs ; 121(8): 16, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1546036
5.
JAMA Netw Open ; 4(11): e2131455, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1520138

ABSTRACT

Importance: This randomized clinical trial examines the feasibility and acceptability of a decision-making tool for increasing patient interest in individualized recommendations for preventive care services. Objective: To pilot a tool to help patients compare life expectancy gains from evidence-based preventive services. Design, Setting, and Participants: This randomized clinical trial examined patient and physician responses to a pilot decision tool incorporating personalized risk factors at 3 US primary care clinics between 2017 and 2020. Eligible patients were between ages 45 to 70 years with 2 or more high-risk factors. Patients were followed-up after 1 year. Interventions: The gain in life expectancy associated with guideline adherence to each recommended preventive service was estimated. Personalized estimates incorporating risk factors in electronic health records were displayed in a physician-distributed visual aid. During development, physicians discussed individualized results with patients using shared decision-making (SDM). During the trial, patients were randomized to receive individualized recommendations or usual care (nonmasked, parallel, 1:1 ratio). Main Outcomes and Measures: Primary outcome was patient interest in individualized recommendations, assessed by survey. Secondary outcomes were use of SDM, decisional comfort, readiness to change, and preventive services received within 1 year. Results: The study enrolled 104 patients (31 development, 39 intervention, 34 control), of whom 101 were included in analysis (mean [SD] age, 56.5 [5.3] years; 73 [72.3%] women; 80 [79.2%] Black patients) and 20 physicians. Intervention patients found the tool helpful and wanted to use it again, rating it a median 9 of 10 (IQR, 8-10) and 10 of 10 (8-10), respectively. Compared with the control group, intervention patients more often correctly identified the service least likely (18 [46%] vs 0; P = .03) to improve their life expectancy. A greater number of patients also identified the service most likely to improve their life expectancy (26 [69%] vs 10 [30%]; P = .07), although this result was not statistically significant. Intervention patients reported greater mean [SD] improvement in SDM (4.7 [6.9] points) and near-term readiness to change (13.8 points for top-3-ranked recommendations). Point estimates indicated that patients in the intervention group experienced greater, although non-statistically significant, reductions in percentage of body weight (-2.96%; 95% CI, -8.18% to 2.28%), systolic blood pressure (-6.42 mm Hg; 95% CI, -16.12 to 3.27 mm Hg), hemoglobin A1c (-0.68%; 95% CI, -1.82% to 0.45%), 10-year atherosclerotic cardiovascular disease risk score (-1.20%; 95% CI, -3.65% to 1.26%), and low-density lipoprotein cholesterol (-8.46 mg/dL; 95% CI, -26.63 to 9.70 mg/dL) than the control group. Nineteen of 20 physicians wanted to continue using the decision tool in the future. Conclusions and Relevance: In this clinical trial, an individualized preventive care decision support tool improved patient understanding of primary prevention and demonstrated promise for improved shared decision-making and preventive care utilization. Trial Registration: ClinicalTrials.gov Identifier: NCT03023813.


Subject(s)
Decision Making , Decision Support Techniques , Physician-Patient Relations , Preventive Medicine/methods , Aged , Attitude of Health Personnel , Evidence-Based Medicine , Female , Guideline Adherence , Humans , Life Expectancy , Male , Middle Aged , Physicians/psychology , Pilot Projects
6.
Ocul Immunol Inflamm ; 29(6): 1225-1233, 2021 Aug 18.
Article in English | MEDLINE | ID: covidwho-1467232

ABSTRACT

The novel pandemic coronavirus disease 2019 (COVID-19) leading to health and economic problems worldwide is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although COVID-19 mainly occurs as a lower respiratory tract infection, there is multiorgan involvement in infected patients. The disease is transmitted from person to person through air droplets or contact with contaminated surfaces. SARS-CoV-2 leads to this systemic involvement by attaching to angiotensin-converting enzyme 2 (ACE2) receptors located on several human cells. Since SARS-CoV-2 RNA has been found in tears of infected patients, ocular surface may allow the virus to transmit to nasopharynx via the nasolacrimal duct. This narrative review aims to sum up all segmental ocular complications, ocular adverse effects of COVID-19 treatment, and preventive measures suggested to minimize the SARS-CoV-2 transmission between patients and ophthalmologists by reviewing currently available literature.


Subject(s)
COVID-19/diagnosis , Eye Infections, Viral/diagnosis , SARS-CoV-2 , Tears/virology , COVID-19/prevention & control , COVID-19/virology , COVID-19 Nucleic Acid Testing , Conjunctivitis, Viral/diagnosis , Conjunctivitis, Viral/prevention & control , Conjunctivitis, Viral/virology , Encephalitis, Viral/diagnosis , Encephalitis, Viral/prevention & control , Encephalitis, Viral/virology , Eye Infections, Viral/prevention & control , Eye Infections, Viral/virology , Humans , Preventive Medicine/methods , Retinal Diseases/diagnosis , Retinal Diseases/prevention & control , Retinal Diseases/virology , SARS-CoV-2/pathogenicity
8.
PLoS One ; 16(8): e0255704, 2021.
Article in English | MEDLINE | ID: covidwho-1365423

ABSTRACT

BACKGROUND: Governments commonly fund research with specific applications in mind. Such mechanisms may facilitate 'research translation' but funders may employ strategies that can also undermine the integrity of both science and government. We estimated the prevalence and investigated correlates of funder efforts to suppress health behaviour intervention trial findings. METHODS: Our sampling frame was lead or corresponding authors of papers (published 2007-2017) included in a Cochrane review, reporting findings from trials of interventions to improve nutrition, physical activity, sexual health, smoking, and substance use. Suppression events were based on a previous survey of public health academics. Participants answered questions concerning seven suppression events in their efforts to report the trial, e.g., [I was…] "asked to suppress certain findings as they were viewed as being unfavourable." We also examined the association between information on study funder, geographical location, targeted health behaviour, country democracy rating and age of publication with reported suppression. FINDINGS: We received responses from 104 authors (50%) of 208 eligible trials, from North America (34%), Europe (33%), Oceania (17%), and other countries (16%). Eighteen percent reported at least one of the seven suppression events relating to the trial in question. The most commonly reported suppression event was funder(s) expressing reluctance to publish because they considered the results 'unfavourable' (9% reported). We found no strong associations with the subject of research, funding source, democracy, region, or year of publication. CONCLUSIONS: One in five researchers in this global sample reported being pressured to delay, alter, or not publish the findings of health behaviour intervention trials. Regulation of funder and university practices, establishing study registries, and compulsory disclosure of funding conditions in scientific journals, are needed to protect the integrity of public-good research.


Subject(s)
Financial Management/trends , Health Behavior , Randomized Controlled Trials as Topic , Research Design , Research Personnel/economics , /economics , Alcoholism/prevention & control , Diet, Healthy , Europe , Exercise , Government Programs/economics , Humans , North America , Preventive Medicine/methods , Sexual Health , Surveys and Questionnaires , Tobacco Use/prevention & control
11.
Am J Prev Med ; 61(1): 1-2, 2021 07.
Article in English | MEDLINE | ID: covidwho-1271555
12.
Int Urol Nephrol ; 54(3): 601-608, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1290162

ABSTRACT

OBJECTIVES: This study investigated the psychological status of patients and staff, and the implementation of preventative measures in hemodialysis centers in Guangdong province, China, during the 2019 novel coronavirus disease (COVID-19) pandemic. METHODS: An electronic questionnaire survey was carried out anonymously between March 28 and April 3, 2020. All of the 516 hemodialysis centers registered in Guangdong province were invited to participate in the survey. The questionnaires were designed to investigate the psychological status of hemodialysis patients and general staff members (doctors, nurses, technicians, and other staff), and to address the implementation of preventative measures for administrators (directors or head nurses) of the hemodialysis centers. RESULTS: A total of 1782 patients, 3400 staff, and 420 administrators voluntarily participated in this survey. Patients living in rural areas reported a higher incidence of severe anxiety compared to those living in other areas (in rural areas, towns, and cities, the incidence rate was 17.0%, 9.0%, and 8.9%, respectively, P < 0.001). Medical staff were less likely to worry about being infected than non-medical staff (13.1% vs 30.3%, respectively, P < 0.001). With respect to the implementation of preventative measures, hemodialysis centers in general hospitals outperformed stand-alone blood purification centers, while tertiary hospitals outperformed hospitals of other levels. However, restrictions regarding the admission of non-resident patients were lower in tertiary hospitals than in other hospitals. In this situation, only one patient imported from Hubei province was diagnosed with COVID-19. CONCLUSIONS: COVID-19 did not significantly affect the psychological status of most patients and medical staff members. Due to the implementation of comprehensive preventative measures, there were no cluster outbreaks of COVID-19 in hemodialysis centers. This provincial-level survey may provide referential guidance for other countries and regions that are experiencing a similar pandemic.


Subject(s)
Attitude of Health Personnel , COVID-19 , Infection Control/organization & administration , Kidney Failure, Chronic , Preventive Medicine , Renal Dialysis , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Female , Humans , Incidence , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/psychology , Kidney Failure, Chronic/therapy , Male , Middle Aged , Organizational Innovation , Preventive Medicine/methods , Preventive Medicine/organization & administration , Psychology , Renal Dialysis/methods , Renal Dialysis/trends , SARS-CoV-2 , Surveys and Questionnaires
13.
PLoS One ; 16(6): e0253446, 2021.
Article in English | MEDLINE | ID: covidwho-1278197

ABSTRACT

BACKGROUND: COVID-19 is a novel respiratory disease associated with severe morbidity and high mortality in the elderly population and people with comorbidities. Studies have suggested that pregnant women are more susceptible to COVID-19 compared to non-pregnant women. However, it's unclear whether pregnant women in Ghana are knowledgeable about COVID-19 and practice preventive measures against it. This study sought to assess the knowledge and preventive practices towards COVID-19 among pregnant women seeking antenatal services in Northern Ghana. METHODS: A cross-sectional study was conducted using a structured questionnaire in the Nabdam district in Ghana. A total of 527 pregnant women were randomly sampled from health facilities offering antenatal care services in the district. Multivariable logistic regression analysis was used to assess the association between the predictors and outcome variables. RESULTS: The prevalence of adequate knowledge and good COVID-19 preventive practices were 85.6%, (95% CI: 82.57, 88.59) and 46.6%, (95% CI: 42.41, 50.95) respectively. Having at least a primary education, residing in an urban area, and receiving COVID-19 education at a health facility were positively associated with adequate knowledge on COVID-19. Factors positively associated with good COVID-19 preventive practices were older age, having at least a primary education, pregnant women with a chronic disease, and living in an urban area. Multiparity was negatively associated with good COVID-19 preventive practices. CONCLUSION: Although majority of women had adequate knowledge of COVID-19, less than half of them were engaged in good COVID-19 preventive practices. Education of pregnant women on COVID-19 preventive practices should be intensified at health facilities while improving upon the water, sanitation and hygiene need particularly in rural communities.


Subject(s)
COVID-19/prevention & control , Health Knowledge, Attitudes, Practice , Pregnant Women , Prenatal Care/statistics & numerical data , Preventive Medicine/statistics & numerical data , SARS-CoV-2/isolation & purification , Adult , COVID-19/epidemiology , COVID-19/virology , Cross-Sectional Studies , Educational Status , Female , Ghana/epidemiology , Humans , Logistic Models , Multivariate Analysis , Pandemics/prevention & control , Pregnancy , Prenatal Care/methods , Preventive Medicine/methods , Rural Population/statistics & numerical data , SARS-CoV-2/physiology , Surveys and Questionnaires , Young Adult
14.
Aust N Z J Public Health ; 45(4): 344-347, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1221531

ABSTRACT

OBJECTIVE: We report a survey in regional Queensland to understand the reasons for suboptimal uptake of the COVIDSafe app. METHODS: A short five-minute electronic survey disseminated to healthcare professionals, mining groups and school communities in the Central Queensland region. Free text responses and their topics were modelled using natural language processing and a latent Dirichlet model. RESULTS: We received a total of 723 responses; of these, 69% had downloaded the app and 31% had not. The respondents' reasons for not downloading the app were grouped under four topics: lack of perceived risk of COVID-19/lack of perceived need and privacy issues; phone-related issues; tracking and misuse of data; and trust, security and credibility. Among the 472 people who downloaded the app and provided text amenable to text mining, the two topics most commonly listed were: to assist with contact tracing; and to return to normal. CONCLUSIONS: This survey of a regional population found that lack of perceived need, concerns around privacy and technical difficulties were the major barriers to users downloading the application. Implications for public health: Health promotion campaigns aimed at increasing the uptake of the COVIDSafe app should focus on promoting how the app will assist with contact tracing to help return to 'normal'. Additionally, health promotors should address the app's impacts on privacy, people's lack of perceived need for the app and technical barriers.


Subject(s)
Attitude to Computers , COVID-19/prevention & control , Confidentiality/psychology , Data Accuracy , Mobile Applications/statistics & numerical data , Preventive Medicine/statistics & numerical data , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Queensland , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires
16.
OMICS ; 25(4): 234-241, 2021 04.
Article in English | MEDLINE | ID: covidwho-1165314

ABSTRACT

A key lesson emerging from COVID-19 is that pandemic proofing planetary health against future ecological crises calls for systems science and preventive medicine innovations. With greater proximity of the human and animal natural habitats in the 21st century, it is also noteworthy that zoonotic infections such as COVID-19 that jump from animals to humans are increasingly plausible in the coming decades. In this context, glycomics technologies and the third alphabet of life, the sugar code, offer veritable prospects to move omics systems science from discovery to diverse applications of relevance to global public health and preventive medicine. In this expert review, we discuss the science of glycomics, its importance in vaccine development, and the recent progress toward discoveries on the sugar code that can help prevent future infectious outbreaks that are looming on the horizon in the 21st century. Glycomics offers veritable prospects to boost planetary health, not to mention the global scientific capacity for vaccine innovation against novel and existing infectious agents.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/epidemiology , Glycomics/organization & administration , Pandemics/prevention & control , SARS-CoV-2/pathogenicity , Zoonoses/epidemiology , Animals , COVID-19/immunology , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Vaccines/biosynthesis , Ecosystem , Global Health/economics , Global Health/trends , Humans , International Cooperation , Mass Vaccination/methods , Preventive Medicine/methods , SARS-CoV-2/drug effects , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/immunology , Vaccines, Synthetic/administration & dosage , Vaccines, Synthetic/biosynthesis , Zoonoses/immunology , Zoonoses/prevention & control , Zoonoses/transmission
17.
J Public Health Manag Pract ; 27(Suppl 3): S123-S128, 2021.
Article in English | MEDLINE | ID: covidwho-1160248

ABSTRACT

The 2020 SARS-CoV-2 pandemic created a unique opportunity for Public Health/General Preventive Medicine (PH/GPM) and Occupational and Environmental Medicine (OM) residents to contribute to pandemic public health response activities. We surveyed all 18 Health Resources and Services Administration (HRSA)-funded PH/GPM and OM residency program directors to evaluate program and resident involvement in pandemic response activities from January 1 through June 30, 2020. Of 116 residents, 110 (95%) participated at some level in the response activities including screening/testing, contact tracing, surveillance, data analysis, incident command, provider support, reopening, direct patient care, education, and risk communication. Residents' response activities were in multiple settings, such as state, local, and federal health agencies; hospital systems; long-term care facilities; academic centers; local businesses and labor unions; Federally Qualified Health Centers; homeless shelters; and clinics. Residents' participation was facilitated by their training in public health, epidemiology, the care of patients and populations, and emergency preparedness. Programs should continue to promote these experiences and key roles that PH/GPM and OM residents can play, as this leadership is a necessity for the successful navigation of future major public health events. As the pandemic continues, evaluation of residents' experiences will help guide longer-term changes to program curriculum and partnerships. Many trainees' contributions and expertise met both educational and service goals and therefore should be integrated into ongoing pandemic response work in PH/GPM and OM programs.


Subject(s)
COVID-19/prevention & control , Internship and Residency/methods , Preventive Medicine/education , COVID-19/diagnosis , COVID-19/therapy , Humans , Internship and Residency/statistics & numerical data , Surveys and Questionnaires , United States , United States Health Resources and Services Administration/organization & administration
18.
J Public Health Manag Pract ; 27(Suppl 3): S139-S145, 2021.
Article in English | MEDLINE | ID: covidwho-1159788

ABSTRACT

CONTEXT: Preventive medicine residents must train in population medicine (including analytics and population health) and clinical preventive medicine (including screening, behavioral counseling, and chemoprophylaxis). Yet, opportunities to perform both functions concurrently for the same population are scarce. Residents must also master the art of preventive medicine, but they often lack an established community of practice that provides a continuous forum to do so. This project explored Population Health Rounds as a novel vehicle to optimize preventive medicine residency training. PROGRAM DESCRIPTION: Modeled after traditional medical rounds, Population Health Rounds consist of a 1-hour weekly meeting engaging preventive medicine residents and supervising attendings at Stony Brook Medicine in both population medicine and clinical preventive medicine concurrently, including patient case discussions and targeted population health analytics. EVALUATION AND RESULTS: Because of the pandemic, the rounds have predominantly focused on COVID-19 and its effects on the hospital employee population. In addition to providing direct patient care to COVID-19-positive and exposed employees, residents have analyzed data on this population and made recommendations to hospital leadership based on COVID-19's institutional epidemiology, including incidence, prevalence, and predictive factors. A formative qualitative survey of resident perceptions offers insights on the value and learning outcomes of this new model. DISCUSSION AND CONCLUSION: Factors that may impact the implementation, sustainability, and feasibility of this model are discussed. The preventive medicine residency program is commissioned to address gaps in clinical preventive services for the patient-centered medical home tied to the sponsoring institution's family medicine practice. Additional plans are underway to expand the rounds to other clinical contexts, such as lifestyle medicine in the occupational setting, and for targeted populations, such as the underserved. Replication of the Population Health Rounds model is recommended to determine its effectiveness.


Subject(s)
Internship and Residency/methods , Population Health , Preventive Medicine/education , Teaching Rounds/methods , Humans , New York
19.
J Res Health Sci ; 21(1): e00509, 2021 Feb 14.
Article in English | MEDLINE | ID: covidwho-1159060

ABSTRACT

BACKGROUND: Hospital staffs are at high risk of Novel Coronavirus (2019-nCoV preventive behaviors play a peculiar role in the reduction of the incidence and mortality of this infection. Therefore, the present study aimed to assess the prevention behaviors of COVID-19 among health staff based on the Extended Parallel Model (EPPM) in western Iran. STUDY DESIGN: It was a cross-sectional study. . METHODS: The present study was performed in the west of Iran in April 2020. In total, 1,664 cases were enrolled in this study via multi-stage sampling. The data were collected using a questionnaire, including the demographic characteristics of participants and EPPM constructs. All analyses were conducted in Stata software (version 14) at a 5% significant level. RESULTS: As evidenced by the obtained results,  1,523 (91.53%), 1,226 (73.68%), 1,526 (91.71%), 893 (53.67%), and 862 (51.86%) of health staff wear gloves, use masks, avoid contact with others, maintain a good distance from other people, and wash their hands frequently with water and soap, respectively. In terms of using gloves and avoiding contacts with others, participants with high perceived threat had higher odds of observing health behaviors (OR= 3.14, 95% CI: 2.08, 4.73; P<0.001) and (OR= 3.1, 95% CI: 2.04, 4.69; P<0.001), respectively. In all categories of EPPM, the participants with high efficacy had higher odds of exhibiting health behaviors, compared to those with low efficacy (P<0.001). CONCLUSION: The results of the present study demonstrated that  health workers are expected to be at the highest level of threat and efficiency. Moreover, the findings emphasized the effectiveness of the recommended strategies in the prevention of COVID-19 disease.


Subject(s)
Attitude of Health Personnel , COVID-19/prevention & control , COVID-19/psychology , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Preventive Medicine/methods , Preventive Medicine/statistics & numerical data , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Iran/epidemiology , Male , Middle Aged , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
20.
J Res Health Sci ; 21(1): e00505, 2021 Mar 07.
Article in English | MEDLINE | ID: covidwho-1158971

ABSTRACT

BACKGROUND: Since the beginning of the coronavirus disease 2019 (COVID-19) epidemic in Iran, the control and management of the epidemic were headed by the National Headquarter for the Control of COVID-19 Epidemic through setting up different scientific committees, including the COVID-19 National Epidemiology Committee. The present study reviews the missions, structures, achievements, and challenges of the Epidemiology Committee. STUDY DESIGN: A rapid review . METHODS: All relevant reports, documents, guidelines, published literature, and surveillance data related to the establishment, visions, missions, roles, activities, and outputs of the COVID-19 Epidemiology Committee were critically reviewed in this study. RESULTS: The efforts of the committee's working groups may have impacted improvements in data registration/usage, provincial data quality at provincial levels, and perception of the epidemic situation in the provinces. The committees have also played role in informing the policies in different stages of the epidemic through routine or problem-based data/evidence analyses, epidemic investigations, and mathematical modeling. CONCLUSION: The structure and experience gained by the committee can be used in similar situations within and outside the country. To further improve the impacts of our activities, it is essential to have effective interaction, collaboration, and data flow between the committee and a broad range of organizations within and outside the Ministry of Health and Medical Education.


Subject(s)
COVID-19/epidemiology , Epidemics/prevention & control , Epidemics/statistics & numerical data , Organizational Objectives , Preventive Medicine/organization & administration , Preventive Medicine/statistics & numerical data , Adult , Aged , Aged, 80 and over , Female , Humans , Iran/epidemiology , Male , Middle Aged
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