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1.
Bull. W.H.O. (Print) ; 100(5): 315-328, 2022-5-01.
Article | WHOLIS, WHOIRIS | ID: covidwho-1834234

Subject(s)
Research
3.
Thorax ; 77(5): 511-513, 2022 May.
Article in English | MEDLINE | ID: covidwho-1788989

ABSTRACT

Obstructive sleep apnoea (OSA) is associated with significant comorbidity, preventable accidents and reduced quality of life. Little is known about the research priorities of patients with OSA, family members and clinicians. A James Lind Alliance research priority setting partnership was conducted. An initial survey (690 respondents who generated 1110 questions), a prioritisation survey (250 respondents), and a final workshop were used to identify the top 10 research priorities. Consensus was achieved on the top-ranked research priorities. Our results will inform the efforts of funders, researchers and policy-makers to align directly with stakeholder priorities related to OSA.


Subject(s)
Biomedical Research , Sleep Apnea, Obstructive , Health Priorities , Humans , Quality of Life , Research , Research Personnel , Sleep Apnea, Obstructive/therapy
4.
BMJ Open ; 12(4): e059312, 2022 Apr 13.
Article in English | MEDLINE | ID: covidwho-1788967

ABSTRACT

OBJECTIVE: To identify and prioritise the research needed to help Nepali agencies develop an improved road safety system. DESIGN: Delphi study. SETTING: Nepal. PARTICIPANTS: Stakeholders from government institutions, academia, engineering, healthcare and civil society were interviewed to identify knowledge gaps and research questions. Participants then completed two rounds of ranking and a workshop. RESULTS: A total of 93 participants took part in interviews and two rounds of ranking. Participants were grouped with others sharing expertise relating to each of the five WHO 'pillars' of road safety: (1) road safety management; (2) safer roads; (3) safer vehicles; (4) safer road users and (5) effective postcrash response. Interviews yielded 1019 research suggestions across the five pillars. Two rounds of ranking within expert groups yielded consensus on the important questions for each pillar. A workshop involving all participants then led to the selection of 6 questions considered the most urgent: (1) How can implementing agencies be made more accountable? (2) How should different types of roads, and roads in different geographical locations, be designed to make them safer for all road users? (3) What vehicle fitness factors lead to road traffic crashes? (4) How can the driver licensing system be improved to ensure safer drivers? (5) What factors lead to public vehicle crashes and how can they be addressed? and (6) What factors affect emergency response services getting to the patient and then getting them to the right hospital in the best possible time? CONCLUSIONS: The application of the Delphi approach is useful to enable participants representing a range of institutions and expertise to contribute to the identification of road safety research priorities. Outcomes from this study provide Nepali researchers with a greater understanding of the necessary focus for future road safety research.


Subject(s)
Automobile Driving , Accidents, Traffic/prevention & control , Delphi Technique , Humans , Licensure , Nepal , Research , Safety
5.
Pediatr Infect Dis J ; 41(5): 424-426, 2022 05 01.
Article in English | MEDLINE | ID: covidwho-1788550

ABSTRACT

Accurately determining the risk of long COVID is challenging. Existing studies in children and adolescents have considerable limitations and distinguishing long-term SARS-CoV-2 infection-associated symptoms from pandemic-related symptoms is difficult. Over half of individuals in this age group, irrespective of COVID-19, report physical and psychologic symptoms, highlighting the impact of the pandemic. More robust data is needed to inform policy decisions.


Subject(s)
COVID-19 , Adolescent , COVID-19/complications , Child , Humans , Pandemics , Research , SARS-CoV-2
6.
J Prev Med Public Health ; 55(2): 144-152, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1786149

ABSTRACT

OBJECTIVES: This study aimed to identify the social and policy determinants of coronavirus disease 2019 (COVID-19) infection across 23 countries. METHODS: COVID-19 indicators (incidence, mortality, and fatality) for each country were calculated by direct and indirect standardization. Multivariable regression analyses were used to identify the social and policy determinants of COVID-19 infection. RESULTS: A higher number of doctors per population was related to lower incidence, mortality, and fatality rates of COVID-19 in 23 countries (ß=-0.672, -0.445, and -0.564, respectively). The number of nurses/midwives per population was associated with lower mortality and fatality rates of COVID-19 in 23 countries (ß=-0.215 and -0.372, respectively). Strengthening of policy restriction indicators, such as restrictions of public gatherings, was related to lower COVID-19 incidence (ß=-0.423). A national Bacillus Calmette-Guérin vaccination policy conducted among special groups or in the past was associated with a higher incidence of COVID-19 in 23 countries (ß=0.341). The proportion of the elderly population (aged over 70 years) was related to higher mortality and fatality rates (ß=0.209 and 0.350, respectively), and income support was associated with mortality and fatality rates (ß=-0.362 and -0.449, respectively). CONCLUSIONS: These findings do not imply causality because this was a country-based correlation study. However, COVID-19 transmission can be influenced by social and policy determinants such as integrated health systems and policy responses to COVID-19. Various social and policy determinants should be considered when planning responses to COVID-19.


Subject(s)
COVID-19 , Aged , COVID-19/epidemiology , Humans , Incidence , Policy , Regression Analysis , Research
7.
Nature ; 604(7904): 36-39, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1783955

Subject(s)
Research
8.
Health Res Policy Syst ; 20(1): 25, 2022 Mar 02.
Article in English | MEDLINE | ID: covidwho-1779650

ABSTRACT

BACKGROUND: In the present COVID-19 crisis, one of the greatest challenges for research funding at both the international and national level is selecting the best research topic to achieve efficiency and equity in health research and to address the knowledge gap urgently raised due to the event. Despite international recommendations, countries should consider their context-specific situation and define local research priorities. We aimed to exercise a priority-setting activity to identify the knowledge gaps and suggest research priorities in response to the COVID-19 epidemic in Iran. METHODS: First, we tried to identify the contextual knowledge gaps based on an online survey, performing key informant interviews (i.e. health professionals, policy-makers and managers) and media analysis. We also performed a literature review and considered international research priorities for COVID-19. Subsequently, we prepared a list of research questions and challenges to respond to the COVID-19 crisis in Iran using a systems approach. Then we mapped approved COVID-19 research projects in the country to research questions. Finally, we compared the identified research questions (not challenges) with the prioritized research from international organizations and then prioritized them for Iran. RESULTS: We found risk factors and epidemiological dissemination patterns of the virus and its consequences in an epidemiology domain, implementation of clinical and hygiene in a clinical management domain, genetic studies for targeting prevention and treatment in a candidate treatment and vaccine research and development (R&D) knowledge domain, examination of the manifestations of ethics in society instead of ethics in research in an ethics domain, "care, access and health system" and "public health and participation in response to public health and clinical research" as two sub-domains of a social sciences domain, and finally, no new questions in either the virology, transmission, diagnosis or animal and environmental domain. CONCLUSIONS: In the event of global health crises like COVID-19, prioritization of research questions can be done globally, but some of the research priorities are context-specific and may vary by regional needs. To better manage research resources, researchers must respond to the challenges faced in each country based on its political, economic, social and cultural characteristics, and to make evidence-informed decisions, global knowledge gaps must be customized in each country.


Subject(s)
COVID-19 , Epidemics , Epidemics/prevention & control , Health Priorities , Humans , Iran , Research , SARS-CoV-2
9.
J Prim Care Community Health ; 13: 21501319221087870, 2022.
Article in English | MEDLINE | ID: covidwho-1767019

ABSTRACT

Misinformation about health topics is a public health issue. We are bombarded with information from many sources, across many digital means of communication, affecting the ways in which we are born, grow, work, live, and age. This makes information environments a social determinant of health (SDoH), but one not currently adequately addressed by clinical or public health practitioners. Since health systems are already screening for social determinants of health, existing mechanisms can additionally screen for unhealthy information environments. Then, for those patients who screen positive, we can apply best practices learned from initiatives addressing vaccine hesitancy: providing a non-judgmental environment in which to discuss health beliefs, using motivational interviewing techniques to gage patient perspectives and readiness for change, and taking a harm-reduction approach in recognizing that behavior change evolves over time. Displacing misinformation is a process, not an event. As such, we need to address the underlying psychological and sociological reasons that people maintain unscientific beliefs as we would hope to do with any other SDoH. Furthermore, as information environments are the product of both individual choices and structural factors, clinicians should approach patients immersed in unhealthy information environments without blame or ostracism, much as we would approach any patient adversely impacted by social determinants of health.


Subject(s)
Communication , Government Programs , Humans , Mass Screening , Public Health , Research
11.
J Glob Health ; 12: 05007, 2022.
Article in English | MEDLINE | ID: covidwho-1771701

ABSTRACT

Background: Pneumonia remains the leading cause of infectious deaths in children under-five globally. We update the research priorities for childhood pneumonia in the context of the COVID-19 pandemic and explore whether previous priorities have been addressed. Methods: We conducted an eDelphi study from November 2019 to June 2021. Experts were invited to take part, targeting balance by: gender, profession, and high (HIC) and low- and middle-income countries (LMIC). We followed a three-stage approach: 1. Collating questions, using a list published in 2011 and adding newly posed topics; 2. Narrowing down, through participant scoring on importance and whether they had been answered; 3. Ranking of retained topics. Topics were categorized into: prevent and protect, diagnosis, treatment and cross-cutting. Results: Overall 379 experts were identified, and 108 took part. We started with 83 topics, and 81 further general and 40 COVID-19 specific topics were proposed. In the final ranking 101 topics were retained, and the highest ranked was to "explore interventions to prevent neonatal pneumonia". Among the top 20 topics, epidemiological research and intervention evaluation was commonly prioritized, followed by the operational and implementation research. Two COVID-19 related questions were ranked within the top 20. There were clear differences in priorities between HIC and LMIC respondents, and academics vs non-academics. Conclusions: Operational research on health system capacities, and evaluating optimized delivery of existing treatments, diagnostics and case management approaches are needed. This list should act as a catalyst for collaborative research, especially to meet the top priority in preventing neonatal pneumonia, and encourage multi-disciplinary partnerships.


Subject(s)
COVID-19 , Child , Health Priorities , Humans , Infant, Newborn , Pandemics , Poverty , Research , SARS-CoV-2
12.
BMJ Glob Health ; 7(3)2022 03.
Article in English | MEDLINE | ID: covidwho-1769906

ABSTRACT

In January 2021, Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, warned that the world was 'on the brink of a catastrophic moral failure [that] will be paid with lives and livelihoods in the world's poorest countries'. We are now past the brink. Many high-income countries have vaccinated their populations (which, in some cases, includes third and even fourth doses) and are loosening public health and social measures, while low-income and middle-income countries are struggling to secure enough supply of vaccines to administer first doses. While injustices abound in the deployment and allocation of COVID-19 vaccines, therapies and diagnostics, an area that has hitherto received inadequate ethical scrutiny concerns the upstream structures and mechanisms that govern and facilitate the research and development (R&D) associated with these novel therapies, vaccines and diagnostics. Much can be learnt by looking to past experiences with the rapid deployment of R&D in the context of public health emergencies. Yet, much of the 'learning' from past epidemics and outbreaks has largely focused on technical or technological innovations and overlooked the essential role of important normative developments; namely, the importance of fostering multiple levels of trust, strong and fair governance, and broad research collaborations. In this paper, we argue that normative lessons pertaining to the conduct of R&D during the 2014-2016 Ebola epidemic in West Africa provide important insights for how R&D ought to proceed to combat the current COVID-19 pandemic and future infectious disease threats.


Subject(s)
COVID-19 , Public Health , COVID-19/epidemiology , COVID-19 Vaccines , Emergencies , Humans , Pandemics , Research , Trust
13.
Cancer J ; 28(2): 118-120, 2022.
Article in English | MEDLINE | ID: covidwho-1764714

ABSTRACT

ABSTRACT: The COVID-19 (coronavirus disease 2019) pandemic has worldwide implications on health care, especially in our most vulnerable population: cancer patients. Flexibility and adaptation are needed to continue clinical research and for clinical trial development. At the Intramural Research Program, National Cancer Institute, swift changes have been implemented to protect our patients while maintaining the scientific integrity of our cancer clinical trials. Many lessons have been learned including incorporation of telehealth into clinical trials, partnerships with the oncology community at both academic institutions and community practices, focusing on diversity and inclusion to improve scientific innovation, and strengthened relationships with regulatory agencies and institutional review boards. These changes will enhance the clinical trials we conduct well beyond the pandemic.


Subject(s)
COVID-19 , Neoplasms , Humans , National Cancer Institute (U.S.) , Neoplasms/epidemiology , Neoplasms/therapy , Pandemics , Research , United States/epidemiology
14.
Nat Commun ; 13(1): 1589, 2022 03 24.
Article in English | MEDLINE | ID: covidwho-1764177

ABSTRACT

Progressive respiratory failure and hyperinflammatory response is the primary cause of death in the coronavirus disease 2019 (COVID-19) pandemic. Despite mounting evidence of disruption of the hypothalamus-pituitary-adrenal axis in COVID-19, relatively little is known about the tropism of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to adrenal glands and associated changes. Here we demonstrate adrenal viral tropism and replication in COVID-19 patients. Adrenal glands showed inflammation accompanied by inflammatory cell death. Histopathologic analysis revealed widespread microthrombosis and severe adrenal injury. In addition, activation of the glycerophospholipid metabolism and reduction of cortisone intensities were characteristic for COVID-19 specimens. In conclusion, our autopsy series suggests that SARS-CoV-2 facilitates the induction of adrenalitis. Given the central role of adrenal glands in immunoregulation and taking into account the significant adrenal injury observed, monitoring of developing adrenal insufficiency might be essential in acute SARS-CoV-2 infection and during recovery.


Subject(s)
COVID-19 , Autopsy , Humans , Research , SARS-CoV-2 , Tropism
15.
Lancet Oncol ; 23(4): 531-539, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1764043

ABSTRACT

BACKGROUND: Similarly to several other upper-middle-income countries, there is a major shortfall in radiotherapy services for the treatment of cancer in Brazil. In this study, we developed the linear accelerator (LINAC) shortage index to assess the LINAC shortage and support the prioritisation of new LINAC distribution in Brazil. METHODS: This cross-sectional, population-based study used data from the National Cancer Institute 2020 Cancer estimates, the Ministry of Health 2019 radiotherapy census, the Minister of Health radiotherapy expansion programme progress reports, and the Fundação Oncocentro de São Paulo public database of the Cancer Hospital Registry of the State of São Paulo to calculate the LINAC shortage index. Data collected were number of new cancer cases in Brazil, number of LINACs per region and state, number of cancer cases treated with radiotherapy, patient state of residence, and radiotherapy treatment centre and location. National, regional, and state-level data were collected for analysis. LINAC numbers, cancer incidence, geographical distribution, and radiotherapy needs were estimated. A LINAC shortage index was calculated as a relative measure of LINAC demand compared with supply based on number of new cancer cases, number of patients requiring radiotherapy, and the number of LINCAS in the region or state. We then built a prioritisation framework using the LINAC shortage index, cancer incidence, and geographical factors. Finally, using patient-level public cancer registry data from the Fundação Oncocentro de São Paulo and Google maps, we estimated the geospatial distance travelled by patients with cancer from their state of residence to radiotherapy treatment in São Paulo from 2005-14. Non-parametric statistics were used for analysis. FINDINGS: Data were collected between Feb 2 and Dec 31, 2021. In 2020, there were 625 370 new cancer cases in Brazil and 252 LINAC machines. The number of LINACs was inadequate in all Brazilian regions, with a national LINAC shortage index of 221 (ie, 121% less than the required radiotherapy capacity). The LINAC shortage index was higher in the midwest (326), north (313), and northeast (237) regions, than the southeast (210) and south (192) regions. Four states (Tocantins, Acre, Amapá, and Roraima) in the north region were ranked first on the prioritisation rank due to no availability of LINACs. There was an association between LINAC shortage index and the number of patients who travelled to receive radiotherapy (p<0·0001). Patients living in the midwest (793 km), north (2835 km), and northeast (2415 km) regions travelled significantly longer average distances to receive radiotherapy treatment in São Paulo than patients living in the southeast or south regions (p=0·032). The reduced number of LINACs in these regions was associated with longer distance travelled (p=0·032). INTERPRETATION: There is substantial discordance between distribution of cancer cases and LINAC availability in Brazil. We developed a tool using the LINACs shortage index to help prioritise the development of radiotherapy infrastructure across Brazil; this approach might also be useful in other health systems. FUNDING: None.


Subject(s)
Radiation Oncology , Brazil/epidemiology , Cross-Sectional Studies , Humans , Particle Accelerators , Research
17.
PLoS One ; 17(3): e0264265, 2022.
Article in English | MEDLINE | ID: covidwho-1759946

ABSTRACT

The gender gap is a well-known problem in academia and, despite its gradual narrowing, recent estimations indicate that it will persist for decades. Short-term descriptive studies suggest that this gap may have actually worsened during the months of confinement following the start of the COVID-19 pandemic in 2020. In this work, we evaluate the impact of the COVID-19 lockdown on female and male academics' research productivity using preprint drop-off data. We examine a total of 307,902 unique research articles deposited in 5 major preprint repositories during the period between January and May each year from 2017 to 2020. We find that the proportion of female authors in online repositories steadily increased over time; however, the trend reversed during the confinement and gender parity worsened in two respects. First, the proportion of male authors in preprints increased significantly during lockdown. Second, the proportion of male authors in COVID-19-related articles was significantly higher than that of women. Overall, our results imply that the gender gap in academia suffered an approximately 1-year setback during the strict lockdown months of 2020, and COVID-related research areas suffered an additional 1.5-year setback.


Subject(s)
Authorship , COVID-19/epidemiology , Publications/statistics & numerical data , Quarantine , COVID-19/prevention & control , Female , Humans , Male , Research/statistics & numerical data , Sex Factors , Time Factors
18.
Acad Pediatr ; 22(1): 17-18, 2022.
Article in English | MEDLINE | ID: covidwho-1757004
19.
Thromb Haemost ; 122(1): 1-4, 2022 01.
Article in English | MEDLINE | ID: covidwho-1751806
20.
Mol Biol Cell ; 32(22): ae3, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1752057

ABSTRACT

I am honored to receive the E. E. Just Award. I applaud ASCB's commitment to recognizing the contributions of researchers from historically excluded racial and ethnic groups and appreciate my inclusion on a long list of accomplished peers. I also thank Barney Graham, who not only had a profound impact on my own career, but has a deep commitment to advancing unrepresented groups in the sciences. Finally, I thank my parents, for encouraging me to use my scholarship to excite change, for reminding me that anything is possible, and for advising me with tenderness along the way. As I recently went through a career transition, I found myself returning to much of my father's sage advice. In this essay, I discuss one important piece of advice that I received from my father in hopes that it will help others navigate their own career choices.


Subject(s)
Career Choice , Research , Academic Success , Awards and Prizes , COVID-19 , Fathers , Female , Humans , Male , Minority Groups , Parents
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