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1.
JAMA Cardiol ; 7(2): 231-232, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-2172192
2.
Sex Health ; 19(4): 319-328, 2022 08.
Article in English | MEDLINE | ID: covidwho-2050708

ABSTRACT

Sexually transmitted infections (STIs) affect hundreds of millions of people globally. The resulting impact on quality of life and the economy for health systems is huge. Specialist sexual health services (SHS) play a key role in the provision of primary prevention interventions targeted against STIs. We conducted a narrative review to explore the role of SHSs in delivering primary prevention interventions for STIs. Established interventions include education and awareness building, condom promotion, and the provision of vaccines. Nascent interventions such as the use of antibiotics as pre- and post-exposure prophylaxis are not currently recommended, but have already been adopted by some key population groups. The shift to delivering SHS through digital health technologies may help to reduce barriers to access for some individuals, but creates challenges for the delivery of primary prevention and may inadvertently increase health inequities. Intervention development will need to consider carefully these shifting models of service delivery so that existing primary prevention options are not side-lined and that new interventions reach those who can benefit most.


Subject(s)
Health Services/classification , Sexually Transmitted Diseases/prevention & control , Condoms , HIV Infections/epidemiology , HIV Infections/prevention & control , Health Services/trends , Humans , Primary Prevention , Quality of Life , Sexually Transmitted Diseases/epidemiology
3.
Int J Environ Res Public Health ; 19(16)2022 08 17.
Article in English | MEDLINE | ID: covidwho-2023661

ABSTRACT

Environmental factors including household crowding and inadequate washing facilities underpin recurrent streptococcal infections in childhood that cause acute rheumatic fever (ARF) and subsequent rheumatic heart disease (RHD). No community-based 'primordial'-level interventions to reduce streptococcal infection and ARF rates have been reported from Australia previously. We conducted a study at three Australian Aboriginal communities aiming to reduce infections including skin sores and sore throats, usually caused by Group A Streptococci, and ARF. Data were collected for primary care diagnoses consistent with likely or potential streptococcal infection, relating to ARF or RHD or related to environmental living conditions. Rates of these diagnoses during a one-year Baseline Phase were compared with a three-year Activity Phase. Participants were children or adults receiving penicillin prophylaxis for ARF. Aboriginal community members were trained and employed to share knowledge about ARF prevention, support reporting and repairs of faulty health-hardware including showers and provide healthcare navigation for families focusing on skin sores, sore throat and ARF. We hypothesized that infection-related diagnoses would increase through greater recognition, then decrease. We enrolled 29 participants and their families. Overall infection-related diagnosis rates increased from Baseline (mean rate per-person-year 1.69 [95% CI 1.10-2.28]) to Year One (2.12 [95% CI 1.17-3.07]) then decreased (Year Three: 0.72 [95% CI 0.29-1.15]) but this was not statistically significant (p = 0.064). Annual numbers of first-known ARF decreased, but numbers were small: there were six cases of first-known ARF during Baseline, then five, 1, 0 over the next three years respectively. There was a relationship between household occupancy and numbers (p = 0.018), but not rates (p = 0.447) of infections. This first Australian ARF primordial prevention study provides a feasible model with encouraging findings.


Subject(s)
Pharyngitis , Rheumatic Fever , Rheumatic Heart Disease , Streptococcal Infections , Adult , Australia/epidemiology , Child , Crowding , Family Characteristics , Humans , Native Hawaiian or Other Pacific Islander , Primary Prevention , Rheumatic Fever/epidemiology , Rheumatic Fever/prevention & control , Rheumatic Heart Disease/epidemiology , Rheumatic Heart Disease/prevention & control , Streptococcal Infections/complications
4.
BMC Pregnancy Childbirth ; 21(1): 577, 2021 Aug 22.
Article in English | MEDLINE | ID: covidwho-1910281

ABSTRACT

BACKGROUND: The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. METHODS: We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women's hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. RESULTS: We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. CONCLUSIONS: In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.


Subject(s)
COVID-19/epidemiology , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome/epidemiology , Social Isolation/psychology , Female , Humans , Infant, Newborn , Iran/epidemiology , Pregnancy , Primary Prevention/methods , Severity of Illness Index
5.
BMC Pregnancy Childbirth ; 21(1): 574, 2021 Aug 21.
Article in English | MEDLINE | ID: covidwho-1910280

ABSTRACT

SARS-Cov-2 (Severe Acute Respiratory Coronavirus 2) infection confers a non-negligible risk for younger pregnant women with diabetes, which is still less well investigated. This topic was recently addressed by a systematic scoping review in BMC Pregnancy and Childbirth, aiming to summarize the complex interaction between SARS-Cov-2 infection, pregnancy and diabetes. This commentary will summarize and discuss the main findings of this article and its implications for future research.


Subject(s)
COVID-19/epidemiology , Infectious Disease Transmission, Vertical/prevention & control , Maternal Health/statistics & numerical data , Pregnancy Complications, Infectious/epidemiology , Pregnancy in Diabetics/epidemiology , Prenatal Care/methods , Female , Humans , Infant, Newborn , Pregnancy , Primary Prevention/methods
6.
BMC Pregnancy Childbirth ; 21(1): 573, 2021 Aug 21.
Article in English | MEDLINE | ID: covidwho-1910279

ABSTRACT

BACKGROUND: Currently, we suffer from an increasing diabetes pandemic and on the other hand from the SARS-CoV-2 pandemic. Already at the beginning of the SARS-CoV-2 pandemic, it was quickly assumed that certain groups are at increased risk to suffer from a severe course of COVID-19. There are serious concerns regarding potential adverse effects on maternal, fetal, and neonatal outcomes. Diabetic pregnancies clearly need special care, but clinical implications as well as the complex interplay of diabetes and SARS-CoV-2 are currently unknown. We summarized the evidence on SARS-CoV-2 in diabetic pregnancies, including the identification of novel potential pathophysiological mechanisms and interactions as well as clinical outcomes and features, screening, and management approaches. METHODS: We carried out a systematic scoping review in MEDLINE (PubMed), EMBASE, CINAHL, Cochrane Library, and Web of Science Core Collection in September 2020. RESULTS: We found that the prognosis of pregnant women with diabetes mellitus and COVID-19 may be associated with potential underlying mechanisms such as a simplified viral uptake by ACE2, a higher basal value of pro-inflammatory cytokines, being hypoxemic as well as platelet activation, embolism, and preeclampsia. In the context of "trans-generational programming" and COVID-19, life-long consequences may be "programmed" during gestation by pro-inflammation, hypoxia, over- or under-expression of transporters and enzymes, and epigenetic modifications based on changes in the intra-uterine milieu. COVID-19 may cause new onset diabetes mellitus, and that vertical transmission from mother to baby might be possible. CONCLUSIONS: Given the challenges in clinical management, the complex interplay between COVID-19 and diabetic pregnancies, evidence-based recommendations are urgently needed. Digital medicine is a future-oriented and effective approach in the context of clinical diabetes management. We anticipate our review to be a starting point to understand and analyze mechanisms and epidemiology to most effectively treat women with SARS-COV-2 and diabetes in pregnancy.


Subject(s)
COVID-19/epidemiology , Infectious Disease Transmission, Vertical/prevention & control , Maternal Health/statistics & numerical data , Pregnancy Complications, Infectious/epidemiology , Pregnancy in Diabetics/epidemiology , Prenatal Care/methods , Female , Humans , Infant, Newborn , Pregnancy , Primary Prevention/methods
7.
Am J Orthopsychiatry ; 92(5): 616-621, 2022.
Article in English | MEDLINE | ID: covidwho-1908109

ABSTRACT

Child trafficking is one of the most egregious violations of children's rights and well-being. In 2014, the Global Alliance for Behavioral Health and Social Justice formed a task force to focus on the issue. After completing two comprehensive reviews and consultations with experts in the field, the task force identified the need for a coherent framework, which conceptualized the primary prevention of child trafficking, which includes children vulnerable to being trafficked and becoming traffickers. This article describes the process undertaken to develop the primary prevention framework, an innovative, aspirational plan for communities to be absent of trafficking. It describes the framework in detail, including the theories that underlie it and the principles that guide it. The framework's flexibility is evident in its application to such worldwide challenges as racism, inequities, and a pandemic. Although the full consequences of the impact of the COVID-19 pandemic on children are not yet known, this article describes certain trends, which have been identified and discusses critical lessons for applying a dynamic framework, as global disruptors will continue. The article ends with examples of how the framework could be implemented by all stakeholders in the community, to address the primary prevention of child trafficking in both the physical and the virtual world. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
COVID-19 , Human Trafficking , COVID-19/prevention & control , Child , Human Trafficking/prevention & control , Humans , Pandemics , Primary Prevention , Social Justice
8.
J Am Heart Assoc ; 11(12): e023357, 2022 Jun 21.
Article in English | MEDLINE | ID: covidwho-1891999

ABSTRACT

Background There is little evidence on the relationship between statin use and the risk of hospitalization attributable to COVID-19. Methods and Results The French National Healthcare Data System database was used to conduct a matched-cohort study. For each adult aged ≥40 years receiving statins for the primary prevention of cardiovascular diseases, one nonuser was randomly selected and matched for year of birth, sex, residence area, and comorbidities. The association between statin use and hospitalization for COVID-19 was examined using conditional Cox proportional hazards models, adjusted for baseline characteristics, comorbidities, and long-term medications. Its association with in-hospital death from COVID-19 was also explored. All participants were followed up from February 15, 2020, to June 15, 2020. The matching procedure generated 2 058 249 adults in the statin group and 2 058 249 in the control group, composed of 46.6% of men with a mean age of 68.7 years. Statin users had a 16% lower risk of hospitalization for COVID-19 than nonusers (adjusted hazard ratio [HR], 0.84; 95% CI, 0.81-0.88). All types of statins were significantly associated with a lower risk of hospitalization, with the adjusted HR ranging from 0.75 for fluvastatin to 0.89 for atorvastatin. Low- and moderate-intensity statins also showed a lower risk compared with nonusers (HR, 0.78 [95% CI, 0.71-0.86] and HR, 0.84 [95% CI, 0.80-0.89], respectively), whereas high-intensity statins did not (HR, 1.01; 95% CI, 0.86-1.18). We found similar results with in-hospital death from COVID-19. Conclusions Our findings support that the use of statins for primary prevention is associated with lower risks of hospitalization for COVID-19 and of in-hospital death from COVID-19.


Subject(s)
COVID-19 , Cardiovascular Diseases , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Adult , Aged , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/prevention & control , Cohort Studies , Hospital Mortality , Hospitalization , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Male , Primary Prevention , Retrospective Studies
9.
Cochrane Database Syst Rev ; 1: CD013320, 2022 01 05.
Article in English | MEDLINE | ID: covidwho-1838125

ABSTRACT

BACKGROUND: High intake of added sugar have been suggested to impact the risk for cardiovascular disease (CVD). Knowledge on the subject can contribute to preventing CVD. OBJECTIVES: To assess the effects of a high versus low-added sugar consumption for primary prevention of CVD in the general population. SEARCH METHODS: We searched Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, Embase, Conference Proceedings Citation Index-Science (CPCI-S) on 2 July 2021. We also conducted a search of ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) Search Portal for ongoing or unpublished trials. The search was performed together with reference checking, citation searching and contact with study authors to identify additional studies. We imposed no restriction on language of publication or publication status. SELECTION CRITERIA: We included randomised controlled trials (RCTs), including cross-over trials, that compared different levels of added sugar intake. Exclusion criteria were: participants aged below 18 years; diabetes mellitus (type 1 and 2); and previous CVD. Primary outcomes were incident cardiovascular events (coronary, carotid, cerebral and peripheral arterial disease) and all-cause mortality. Secondary outcomes were changes in systolic and diastolic blood pressure, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, fasting plasma glucose and adverse events (gastrointestinal symptoms and impaired dental health). DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. MAIN RESULTS: We included 21 RCTs (1110 participants completing the interventions) examining the effects of different levels of added sugar intake with a mean duration of 14 weeks. The study participants were generally described as healthy and the mean age ranged from 22 to 57 years. No studies reported on cardiovascular events or all-cause mortality. There was minimal effect of low intake of added sugar on total cholesterol levels (MD 0.11, 95% CI 0.01 to 0.21; I² = 0%; 16 studies; 763 participants; low certainty of evidence) and triglycerides (MD 0.10, 95% CI 0.03 to 0.17; I² = 3%; 14 studies; 725 participants) but no evidence of effect on LDL-cholesterol and HDL-cholesterol. There was minimal effect on diastolic blood pressure (MD 1.52, 95% CI 0.67 to 2.37; I² = 0%; 13 studies; 873 participants) and on systolic blood pressure (MD 1.44, 95% 0.08 to 2.80; I² = 27%, 14 studies; 873 participants; low certainty of evidence), but no evidence of effect on fasting plasma glucose. Only one study reported on dental health, with no events. No other trials reported adverse events (impaired dental health or gastrointestinal symptoms). All results were judged as low-quality evidence according to GRADE. The risk of bias was generally unclear, five studies were classified at an overall low risk of bias (low risk in at least four domains, not including other bias). AUTHORS' CONCLUSIONS: No trials investigating the effect of added sugar on cardiovascular events or all-cause mortality were identified in our searches. Evidence is uncertain whether low intake of added sugar has an effect on risk factors for CVD; the effect was small and the clinical relevance is, therefore, uncertain. Practical ways to achieve reductions in dietary added sugar includes following current dietary recommendations. Future trials should have longer follow-up time and report on all-cause mortality and cardiovascular events in order to clarify the effect of added sugar on these outcomes. Future trials should also aim for more direct interventions and preferably be more independent of industry funding.


Subject(s)
Cardiovascular Diseases , Adult , Aged , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/prevention & control , Cholesterol , Dietary Sugars/adverse effects , Humans , Middle Aged , Primary Prevention , Sugars , Young Adult
10.
PLoS One ; 17(3): e0264237, 2022.
Article in English | MEDLINE | ID: covidwho-1724847

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) causes more than five million deaths worldwide. Pregnant women are at high risk for infection due to the physiologic change in the immune and cardiopulmonary system and also it increases the risk of severe disease, intensive care unit admission, and receive mechanical ventilation when compared with non-pregnant women. It is associated with adverse maternal and neonatal outcomes. So pregnant women need to have adhered to preventive measures to prevent COVID-19 related consequences. Therefore, this study aimed to assess adherence toCOVID-19 preventive practice and associated factors among pregnant women in Gondar city, northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted from July 1st to 30th, 2021, in Gondar city. A cluster sampling technique was employed to select 678 pregnant women. Data were collected using a pre-tested, face-to-face interviewer-administered questionnaire. Data were entered into EPI DATA version 4.6 and exported to SPSS version 25 for analysis. Both bivariable and multivariable logistic regression analysis was fitted to identify associated factors. Adjusted odds ratio with a 95% confidence interval was used to report the association between covariates and the outcome variable. RESULTS: The prevalence of good adherence to COVID-19 preventive practice was 44.8% (95% CI: 41.3, 48.7). Maternal age (≤24 years) [AOR = 2.89, 95% CI: 1.37, 6.10], maternal education (secondary school) [AOR = 2.95, 95% CI: 1.58, 5.53] and (college and above) [AOR = 4.57,95% CI: 2.42, 8.62], having ANC follow up [AOR = 2.95, 95% CI: 1.35, 6.46] and adequate knowledge towards COVID-19 [AOR = 1.70, 95% CI: 1.20, 2.41] were significantly associated with good adherence to COVID-19 preventive practice. CONCLUSION: In this study, adherence towards COVID-19 preventive practice in pregnant women is low. Hence, it is important to strengthen women's awareness about COVID-19 through different media and health education. In addition, empowering women to attain ANC and special consideration should be given to women who had no formal education.


Subject(s)
COVID-19/prevention & control , Patient Compliance/statistics & numerical data , Primary Prevention/statistics & numerical data , Adult , Cities , Community-Based Participatory Research , Cross-Sectional Studies , Educational Status , Ethiopia/epidemiology , Female , Health Knowledge, Attitudes, Practice , Humans , Maternal Age , Pregnancy , Primary Prevention/education , Socioeconomic Factors , Surveys and Questionnaires , Young Adult
11.
Int J Mol Sci ; 23(3)2022 Feb 06.
Article in English | MEDLINE | ID: covidwho-1674673

ABSTRACT

The SARS-CoV-2 pandemic caused a massive health and societal crisis, although the fast development of effective vaccines reduced some of the impact. To prepare for future respiratory virus pandemics, a pan-viral prophylaxis could be used to control the initial virus outbreak in the period prior to vaccine approval. The liposomal vaccine adjuvant CAF®09b contains the TLR3 agonist polyinosinic:polycytidylic acid, which induces a type I interferon (IFN-I) response and an antiviral state in the affected tissues. When testing CAF09b liposomes as a potential pan-viral prophylaxis, we observed that intranasal administration of CAF09b liposomes to mice resulted in an influx of innate immune cells into the nose and lungs and upregulation of IFN-I-related gene expression. When CAF09b liposomes were administered prior to challenge with mouse-adapted influenza A/Puerto Rico/8/1934 virus, it protected from severe disease, although the virus was still detectable in the lungs. However, when CAF09b liposomes were administered after influenza challenge, the mice had a similar disease course to controls. In conclusion, CAF09b may be a suitable candidate as a pan-viral prophylactic treatment for epidemic viruses, but must be administered prior to virus exposure to be effective.


Subject(s)
/therapeutic use , Influenza Vaccines/therapeutic use , Influenza, Human/prevention & control , Orthomyxoviridae Infections/prevention & control , /methods , Adjuvants, Immunologic/administration & dosage , Adjuvants, Immunologic/therapeutic use , /chemistry , Administration, Intranasal , Animals , COVID-19/prevention & control , COVID-19 Vaccines/chemical synthesis , COVID-19 Vaccines/therapeutic use , Cells, Cultured , Chick Embryo , Gene Expression Regulation/drug effects , Humans , Influenza Vaccines/administration & dosage , Influenza Vaccines/chemistry , Influenza Vaccines/pharmacology , Interferon Type I/genetics , Liposomes/chemistry , Mice , Mice, Inbred BALB C , Mice, Inbred C57BL , Primary Prevention/methods , SARS-CoV-2/immunology
12.
Nat Commun ; 13(1): 554, 2022 01 27.
Article in English | MEDLINE | ID: covidwho-1655581

ABSTRACT

We aim to identify those measures that effectively control the spread of SARS-CoV-2 in Austrian schools. Using cluster tracing data we calibrate an agent-based epidemiological model and consider situations where the B1.617.2 (delta) virus strain is dominant and parts of the population are vaccinated to quantify the impact of non-pharmaceutical interventions (NPIs) such as room ventilation, reduction of class size, wearing of masks during lessons, vaccinations, and school entry testing by SARS-CoV2-antigen tests. In the data we find that 40% of all clusters involved no more than two cases, and 3% of the clusters only had more than 20 cases. The model shows that combinations of NPIs together with vaccinations are necessary to allow for a controlled opening of schools under sustained community transmission of the SARS-CoV-2 delta variant. For plausible vaccination rates, primary (secondary) schools require a combination of at least two (three) of the above NPIs.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Primary Prevention/methods , Vaccination/statistics & numerical data , Adolescent , Austria/epidemiology , COVID-19/epidemiology , COVID-19 Vaccines/immunology , Child , Contact Tracing , Disease Hotspot , Humans , Masks , Quarantine , SARS-CoV-2 , Schools/statistics & numerical data , Ventilation
13.
PLoS Negl Trop Dis ; 16(1): e0010048, 2022 01.
Article in English | MEDLINE | ID: covidwho-1606114

ABSTRACT

BACKGROUND: The first community transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant of concern (VOC) in Guangzhou, China occurred between May and June 2021. Herein, we describe the epidemiological characteristics of this outbreak and evaluate the implemented containment measures against this outbreak. METHODOLOGY/PRINCIPAL FINDINGS: Guangzhou Center for Disease Control and Prevention provided the data on SARS-CoV-2 infections reported between 21 May and 24 June 2021. We estimated the incubation period distribution by fitting a gamma distribution to the data, while the serial interval distribution was estimated by fitting a normal distribution. The instantaneous effective reproductive number (Rt) was estimated to reflect the transmissibility of SARS-CoV-2. Clinical severity was compared for cases with different vaccination statuses using an ordinal regression model after controlling for age. Of the reported local cases, 7/153 (4.6%) were asymptomatic. The median incubation period was 6.02 (95% confidence interval [CI]: 5.42-6.71) days and the means of serial intervals decreased from 5.19 (95% CI: 4.29-6.11) to 3.78 (95% CI: 2.74-4.81) days. The incubation period increased with age (P<0.001). A hierarchical prevention and control strategy against COVID-19 was implemented in Guangzhou, with Rt decreasing from 6.83 (95% credible interval [CrI]: 3.98-10.44) for the 7-day time window ending on 27 May 2021 to below 1 for the time window ending on 8 June and thereafter. Individuals with partial or full vaccination schedules with BBIBP-CorV or CoronaVac accounted for 15.3% of the COVID-19 cases. Clinical symptoms were milder in partially or fully vaccinated cases than in unvaccinated cases (odds ratio [OR] = 0.26 [95% CI: 0.07-0.94]). CONCLUSIONS/SIGNIFICANCE: The hierarchical prevention and control strategy against COVID-19 in Guangzhou was timely and effective. Authorised inactivated vaccines are likely to contribute to reducing the probability of developing severe disease. Our findings have important implications for the containment of COVID-19.


Subject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control/methods , SARS-CoV-2/isolation & purification , Adult , Aged , Basic Reproduction Number , COVID-19/transmission , China/epidemiology , Female , Humans , Male , Middle Aged , Primary Prevention/methods , Severity of Illness Index , Vaccination/statistics & numerical data , Young Adult
16.
J Med Virol ; 93(12): 6496-6505, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1544293

ABSTRACT

The COVID-19 epidemic is not only a medical issue but also a sophisticated social problem. We propose a network dynamics model of epidemic transmission introducing a heterogeneous control factor. The proposed model applied the classical susceptible- exposed-infectious-recovered model to the network based on effective distance and was modified by introducing a heterogeneous control factor with temporal and spatial characteristics. International aviation data were approximately used to estimate the flux fraction matrix, and the effective distance was calculated. Through parameter estimation and simulation, the theoretical values of the modified model fit well with practical values. By adjusting the parameters and observing the change of the results, we found that the modified model is more in line with the actual needs and has higher credibility in the comprehensive analysis. The assessment shows that the number of confirmed cases worldwide will reach about 20 million optimistically. In severe cases, the peak value will exceed 80 million, and the late stage of the epidemic shows a long tail shape, lasting more than one and a half years. The effective way to control the global epidemic is to strengthen international cooperation and to impose international travel restrictions and other measures.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Communicable Disease Control/methods , Primary Prevention/methods , Computer Simulation , Humans , Physical Distancing , Quarantine , SARS-CoV-2
17.
BMC Public Health ; 21(1): 1742, 2021 09 25.
Article in English | MEDLINE | ID: covidwho-1496156

ABSTRACT

BACKGROUND: Substance use among young people is a significant public health concern, particularly in Scotland. Primary prevention activities are essential in delaying young people's substance use and reducing the harms associated with use. However, such prevention activities are generally lacking. The Icelandic Model (IM) has received increasing attention and has been associated with improvements in substance use in Iceland since the 1990s. There is interest in implementing the IM in Scotland but concerns regarding transferability. This research study aimed to address a gap in the evidence base by providing insight into stakeholders' views of the IM in Dundee and more widely in Scotland. METHODS: Qualitative data were collected via semi-structured telephone interviews with 16 stakeholders. Data were analysed using Framework Analysis in NVivo, informed by the Consolidated Framework for Implementation Research. RESULTS: Participants were keen for more prevention activities to be delivered in Scotland and were generally supportive of the IM, given the high rates of substance use and related harm. A range of positive factors were identified, including the evidence base, the multi-component nature of the IM, and availability of current services that could be embedded into delivery. Several barriers were noted, relating to funding, the franchise model, support and buy-in and cultural differences. CONCLUSIONS: Our findings provide insight into the views of a range of stakeholders regarding the potential implementation of the IM in Scotland, and perceived barriers and facilitators. There is a desire for primary prevention activities in Scotland, driven by concerns about high rates of substance use and related harms, and a general lack of effective and evidence based prevention activities across the country. Several key barriers would need to be addressed in order for implementation to be successful, and participants were clear that initial piloting is required. Future research and evaluation is required to examine its potential and the outcomes of the approach in Scotland.


Subject(s)
COVID-19 , Substance-Related Disorders , Adolescent , Humans , Iceland , Primary Prevention , Qualitative Research , Scotland , Substance-Related Disorders/epidemiology , Substance-Related Disorders/prevention & control
18.
Future Oncol ; 17(32): 4233-4235, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1484983

ABSTRACT

The COVID-19 pandemic has modified the management of urothelial carcinoma (UC). Eighteen months after the onset of the pandemic, a scoping narrative review was able to state that radical cystectomy for UC should not be delayed beyond 10 weeks when neoadjuvant chemotherapy (NAC) was administered and 12 weeks when it was not. NAC should be considered when imminent chemotherapy cannot be performed. Early cystectomy should not be delayed when indicated for patients with high-risk non-MIBC. Patients with non-MIBC should still receive their induction doses of intravesical instillations. Diagnostic cystoscopy should not be deferred in symptomatic patients. Surgical management of upper tract urothelial carcinoma (UTUC) allows for a wider deferral interval.


Subject(s)
Cystectomy , Cystoscopy , Time-to-Treatment , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/surgery , COVID-19/prevention & control , Humans , Primary Prevention/methods , SARS-CoV-2 , Urinary Bladder/pathology , Urinary Bladder Neoplasms/pathology , Urothelium/pathology
19.
Syst Rev ; 9(1): 63, 2020 03 24.
Article in English | MEDLINE | ID: covidwho-1455998

ABSTRACT

BACKGROUND: A large proportion of the burden of disease is preventable, yet investment in health promotion and disease prevention programmes remains a small share of the total health budget in many countries. The perception that there is paucity of evidence on the cost-effectiveness of public health programmes is seen as a barrier to policy change. The aim of this scoping review is to conduct a census of economic evaluations in primary prevention in order to identify and map the existing evidence. METHODS: This review is an update of a prior census and will include full economic evaluations of primary prevention programmes conducted in a community-based setting that were published between 2014 and 2019. The search of electronic databases (MEDLINE and Embase, and NHS-EED for 2014) will be supplemented by a search for grey literature in OpenGrey and a search of the reference lists of reviews of economic evaluations identified in our searches. Retrieved citations will be imported into Covidence® and independently screened in a two-stage process by two reviewers (abstracts and full papers). Any disagreements on the eligibility of a citation will be resolved by discussion with a third reviewer. Included studies will then be categorised by one independent reviewer according to a four-part typology covering the type of health promotion intervention, the risk factor being tackled, the setting in which the intervention took place and the population most affected by the intervention. New to this version of the census, we will also document whether or not the intervention sets out specifically to address inequalities in health. DISCUSSION: This review will produce an annotated bibliography of all economic evaluations plus a report summarising the current scope and content of the economic evidence (highlighting where it is plentiful and where it is lacking) and describing any changes in the type of economic evidence available for the various categories of disease prevention programmes since the last census. This will allow us to identify where future evaluative efforts should be focused to enhance the economic evidence base regarding primary prevention interventions. SYSTEMATIC REVIEW REGISTRATION: Registration is being sought concurrently.


Subject(s)
Censuses , Primary Prevention , Cost-Benefit Analysis , Delivery of Health Care , Health Promotion , Review Literature as Topic
20.
J Korean Med Sci ; 36(38): e274, 2021 Oct 04.
Article in English | MEDLINE | ID: covidwho-1450798

ABSTRACT

Applying work restrictions for asymptomatic healthcare personnel (HCP) with potential exposure to coronavirus disease 2019 (COVID-19) is recommended to prevent transmission from potentially contagious HCP to patients and other HCP. However, it can lead to understaffing, which threatens the safety of both patients and HCP. We evaluated 203 COVID-19 exposure events at a single tertiary hospital from January 2020 to June 2021. A total of 2,365 HCP were potentially exposed, and work restrictions were imposed on 320 HCP, leading to the loss of 3,311 working days. However, only one of the work-restricted HCP was confirmed with COVID-19. During the study period, the work restriction measures might be taken excessively compared to their benefit, so establishing more effective standards for work restriction is required.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Health Personnel , Occupational Exposure/prevention & control , Occupational Health , Primary Prevention/methods , Humans , Republic of Korea , Retrospective Studies , SARS-CoV-2 , Workplace
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