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1.
Turk J Med Sci ; 51(5): 2243-2247, 2021 10 21.
Article in English | MEDLINE | ID: covidwho-1566689

ABSTRACT

Introduction: COVID-19 pandemic created concerns among patients receiving immunosuppressive therapy. Frequency of COVID-19 and impact of lockdown on treatment compliance in patients with vasculitis are largely unknown. Patients and method: Patients with ANCA-associated and large vessel vasculitis that have been followed-up in our clinic were contacted by phone and a questionnaire containing home isolation status, treatment adherence and history of COVID -19 between March 1st and June 30th, 2020 was applied. Results: The survey was applied to 103 patients (F/M: 59/44, mean age: 53.2±12.5). Thirty-three (32%) patients didn?t attend at least one appointment; 98(95.1%) noted that they spent 3 months in home isolation. Five patients (4.8%) received immunosuppressives irregularly and 3(2.9%) developed symptoms due to undertreatment. Four (3.9%) patients admitted to hospital with a suspicion of COVID-19, but none of them had positive PCR or suggestive findings by imaging. COVID-19 diagnosed in a patient with granulomatosis with polyangiitis during hospitalization for disease flare and she died despite treatment. Discussion: Frequency of COVID-19 was low in patients with vasculitis in our single center cohort. Although outpatient appointments were postponed in one-third of our patients, high compliance with treatment and isolation rules ensured patients with vasculitis overcome this period with minimal morbidity and mortality.


Subject(s)
COVID-19 , Medication Adherence/statistics & numerical data , Systemic Vasculitis/drug therapy , Adult , Aged , COVID-19/complications , Female , Health Surveys , Humans , Middle Aged , Quarantine , Systemic Vasculitis/complications , Time Factors , Turkey
2.
World Dev ; 137: 105168, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1500330

ABSTRACT

This research note sheds light on the first three months of the COVID-19 outbreak in South Africa, where the virus has spread faster than anywhere else in the region. At the same time, South Africa has been recognized globally for its swift and efficient early response. We consider the impact of this response on different segments of the population, looking at changes in mobility by province to highlight variation in the willingness and ability of different subsets of the population to comply with lockdown orders. Using anonymized mobile phone data, we show that South Africans in all provinces reduced their mobility substantially in response to the government's lockdown orders. Statistical regression analysis shows that such mobility reductions are significantly and negatively associated with COVID-19 growth rates two weeks later. These findings add an important perspective to the emerging literature on the efficacy of shelter-in-place orders, which to date is dominated by studies of the United States. We show that people were particularly willing and able to act in the provinces hit hardest by the pandemic in its initial stages. At the same time, compliance with lockdown orders presented a greater challenge among rural populations and others with more precarious livelihoods. By reflecting on South Africa's inequality profile and results of a recent survey, we demonstrate how the country's response may deepen preexisting divides. This cautionary tale is relevant beyond South Africa, as much of the continent - and the world - grapples with similar tradeoffs. Along with measures to contain the spread of disease, governments and other development focused organizations should seriously consider how to offset the costs faced by already marginalized populations.

3.
Viruses ; 13(3)2021 03 16.
Article in English | MEDLINE | ID: covidwho-1457709

ABSTRACT

BACKGROUND: Efficacy for cervical cancer prevention of opportunistic HPV vaccination in post-pubertal girls is lower than in 11-year-olds. METHODS: Women born between 1986 and 1992 vaccinated at 15-25 years of age (at least one dose of 4-valent HPV vaccine) and screened at 24-27 years of age were included. Frequency of opportunistic vaccination, overall and by birth cohort, was calculated; screening outcomes were compared between vaccinated and unvaccinated women. RESULTS: Overall, 4718 (4.9%) HPV-vaccinated, and 91,512 unvaccinated, women were studied. The frequency of vaccination increased by birth cohort, ranging between 1.8% and 9.8%; age at vaccination decreased progressively by birth cohort (p < 0.0001). Participation in screening was 60.8% among vaccinated, and 56.6% among unvaccinated, women (p < 0.0001). Detection rates (DR) for high-grade lesions were lower in vaccinated women (2.11‰ vs. 3.85‰ in unvaccinated, for CIN3+, p = 0.24; 0.0‰ vs. 0.22‰ for cancer). The DR of CIN3+ increased with age at vaccination, scoring respectively 0.0‰, 0.83‰, and 4.68‰ for women vaccinated when they were 15-16, 17-20, and 21-25 years old (p = 0.17). CONCLUSIONS: In comparison to unvaccinated women, higher compliance with cervical cancer screening invitation and lower CIN3+ DR among vaccinated women was observed. Age at vaccination was inversely correlated to vaccination efficacy.


Subject(s)
Papillomavirus Infections/prevention & control , Papillomavirus Vaccines/administration & dosage , Uterine Cervical Neoplasms/prevention & control , Adolescent , Adult , Early Detection of Cancer , Female , Humans , Italy/epidemiology , Mass Screening , Retrospective Studies , Young Adult
4.
Adv Radiat Oncol ; 6(6): 100725, 2021.
Article in English | MEDLINE | ID: covidwho-1432710

ABSTRACT

Purpose: To report real-world compliance to radiation in gynecologic cancers during the complete lockdown phase of COVID-19 pandemic. Methods and Materials: From March 23, 2020, until June 30, 2020, complete lockdown was imposed in India. During this period there was restructuring of cancer care and radiation oncology department due to operational policies prevalent in the institution, and the care for gynecological cancer was based on the evolving international recommendations. Institutional review board approval was obtained to audit patterns of care during the complete lockdown phase. Descriptive variables were used to report on patient characteristics, compliance, delays, toxicity, and observed deviations in recommended care. Results: During the lockdown period spanning 100 days, treatment of 270 and telephonic follow-up of 1103 patients with gynecological cancer was undertaken. Of 270 new patients, due to travel restrictions, 90 patients were referred to the facilities in vicinity of their residence. Of the remaining 180 patients, 138 were planned for complete treatment at our institution and 42 were referred to our center for brachytherapy. Of 138 patients, only 106 (76%) completed the planned external radiation. Twenty-four (26%) patients completed full course of concurrent chemotherapy, 11 (12%) received chemotherapy dose reduction, and 57 (62%) received no concurrent chemotherapy. Treatment delay of up to 3 weeks was noted in 8.6% patients due to COVID-19 infection. No grade 4 to 5 acute sequelae were observed. No excess adverse effects were observed in high-risk population. Low rate of symptom burden was observed among 1103 patients on telephonic follow-up. With 100 (9.6%) patients reporting symptoms, among these, 54% (54 of 100) had complete resolution of symptoms within 4 weeks of teleconsultation, and 10% had disease progression. Conclusions: Low compliance with planned treatment was observed for radiation and concurrent chemotherapy due to lockdown and fear of contracting COVID-19 and will likely lead to increased risk of cancer-related mortality. Rapid restructuring of care is needed to prevent the same as COVID-19 pandemic further evolves.

5.
Infect Control Hosp Epidemiol ; : 1-7, 2021 May 03.
Article in English | MEDLINE | ID: covidwho-1428665

ABSTRACT

OBJECTIVE: Prior studies of universal masking have not measured face-mask compliance. We performed a quality improvement study to monitor and improve face-mask compliance among healthcare personnel (HCP) during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN: Mixed-methods study. SETTING: Tertiary-care center in West Haven, Connecticut. PATIENTS: HCP including physicians, nurses, and ancillary staff. METHODS: Face-mask compliance was measured through direct observations during a 4-week baseline period after universal masking was mandated. Frontline and management HCP completed semistructured interviews from which a multimodal intervention was developed. Direct observations were repeated during a 14-week period following implementation of the multimodal intervention. Differences between units were evaluated with χ2 testing using the Bonferroni correction. Face-mask compliance between baseline and intervention periods was compared using time-series regression. RESULTS: Among 1,561 observations during the baseline period, median weekly face-mask compliance was 82.2% (range, 80.8%-84.4%). Semistructured interviews were performed with 16 HCP. Qualitative analysis informed the development of a multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership. Among 2,651 observations during the intervention period, median weekly face-mask compliance was 92.6% (range, 84.6%-97.9%). There was no difference in weekly face-mask compliance between COVID-19 and non-COVID-19 units. The multimodal intervention was associated with an increase in face-mask compliance (ß = 0.023; P = .002). CONCLUSIONS: Face-mask compliance remained suboptimal among HCP despite a facility-wide mandate for universal masking. A multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership was effective in increasing face-mask compliance among HCP.

6.
J Appl Behav Anal ; 54(2): 582-599, 2021 04.
Article in English | MEDLINE | ID: covidwho-1384186

ABSTRACT

The current study taught 6 children with autism spectrum disorder (ASD) to increase passive compliance of wearing a facemask across sequentially increasing durations of time. A changing-criterion design embedded within a nonconcurrent multiple baseline design was used to evaluate the effectiveness of a resetting differential reinforcement of other behavior (DRO) without escape extinction procedure on passive compliance. Terminal probe sessions determined DRO fading intervals. Results showed that 2 participants acquired mastery level passive compliance (30 min) without fading during the initial baseline sessions. The remaining 4 participants acquired mastery level passive compliance following fading intervals within the DRO intervention. Participants' passive compliance generalized across 2 novel settings. This study replicates previous studies and extends empirical support for the use of DRO without escape extinction interventions for increasing passive compliance with medical devices in children with ASD.


Subject(s)
Autism Spectrum Disorder/psychology , Masks , Patient Compliance/psychology , Adolescent , COVID-19/prevention & control , Child , Child, Preschool , Female , Humans , Male
7.
Front Psychol ; 11: 603440, 2020.
Article in English | MEDLINE | ID: covidwho-1389239

ABSTRACT

These days many gyms and fitness centers are closed to reduce transmission of the SARS-CoV-2 virus in society. The gym is an environment rich in microorganisms, and careful hygiene is a necessity to keep infections at bay. Exercise centers strive for better hygiene compliance among their members. This effort has become essential in light of the current pandemic. Several experimental studies show that others' physical presence, or the "illusion" of being watched, may alter behavior. This article reports on a natural field experiment testing one specific social nudge intended to increase gym members' hygienic behavior. The study was conducted before the SARS-COV-2 pandemic. A picture of "observing eyes" was attached to paper dispensers and cleanser spray bottles at two different gyms in Norway. A reversal design, also called an ABA design, with and without the nudge's presence, was used to investigate the impact on gym members' hygienic behavior. A follow-up study was conducted in one of the centers to investigate whether the nudge stimuli would function over time. The study included 254 individual choice situations during nine observation sessions conducted over 9 weeks. The results from both centers provide evidence of a strong effect of the nudge. However, the effect decreased during the follow-up study. These findings support previous research indicating that human behavior is influenced by the presence of implicit observation cues - in this case - observing eyes. However, insights into the long-term effect of implicit observation cues are still needed since the salience of the stimuli faded over time.

8.
Int Arch Occup Environ Health ; 94(6): 1239-1247, 2021 08.
Article in English | MEDLINE | ID: covidwho-1317552

ABSTRACT

OBJECTIVE: The aim of the study is to identify the relationship between the fear of COVID-19 and the preventive measures of healthcare workers and service sector employees during the covid-19 pandemic. METHODS: The present study is a descriptive type of research. The study's sample group consisted of 735 people and included healthcare workers (n = 426) and service sector employees (n = 309). In this study, sociodemographic characteristics, employment in the healthcare or service sector, having a relative with COVID-19, losing any relative due to COVID-19 and taking preventive measures were taken as independent variables. The dependent variable was the score from the Fear of COVID-19 Scale (FCV-19S). RESULTS: The FCV-19S median value was 14 for the service sector and 17 for the healthcare sector. While no difference was found between occupational groups and the FCV-19S score in the service sector, there was a significant correlation between occupational groups and the FCV-19S score in the healthcare sector. The FCV-19S median value of midwives was 21, and it was higher than those of other occupational groups were. The mean FCV-19S scores of those who thought they had COVID-19 symptoms due to stress or panic were higher among the healthcare workers. CONCLUSION: The healthcare workers need more support in fear management than those engaged in service sector employees, and it is recommended that raising the awareness of service sector employees in terms of compliance with preventive measures should be prioritized.


Subject(s)
COVID-19/psychology , Fear , Pandemics , Adolescent , Adult , Female , Health Personnel/psychology , Humans , Male , Middle Aged , Occupations , Surveys and Questionnaires , Workforce , Young Adult
9.
J Thromb Haemost ; 18(7): 1752-1755, 2020 07.
Article in English | MEDLINE | ID: covidwho-1317980

ABSTRACT

A prothrombotic coagulopathy is commonly found in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS). A unique feature of COVID-19 respiratory failure is a relatively preserved lung compliance and high Alveolar-arterial oxygen gradient, with pathology reports consistently demonstrating diffuse pulmonary microthrombi on autopsy, all consistent with a vascular occlusive etiology of respiratory failure rather than the more classic findings of low-compliance in ARDS. The COVID-19 pandemic is overwhelming the world's medical care capacity with unprecedented needs for mechanical ventilators and high rates of mortality once patients progress to needing mechanical ventilation, and in many environments including in parts of the United States the medical capacity is being exhausted. Fibrinolytic therapy has previously been used in a Phase 1 clinical trial that led to reduced mortality and marked improvements in oxygenation. Here we report a series of three patients with severe COVID-19 respiratory failure who were treated with tissue plasminogen activator. All three patients had a temporally related improvement in their respiratory status, with one of them being a durable response.


Subject(s)
Betacoronavirus/pathogenicity , Blood Coagulation Disorders/drug therapy , Coronavirus Infections/drug therapy , Fibrinolysis/drug effects , Fibrinolytic Agents/administration & dosage , Pneumonia, Viral/drug therapy , Thrombolytic Therapy , Tissue Plasminogen Activator/administration & dosage , Aged , Blood Coagulation Disorders/blood , Blood Coagulation Disorders/diagnosis , Blood Coagulation Disorders/virology , COVID-19 , Coronavirus Infections/blood , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Fatal Outcome , Female , Fibrinolytic Agents/adverse effects , Host-Pathogen Interactions , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Recovery of Function , SARS-CoV-2 , Thrombolytic Therapy/adverse effects , Tissue Plasminogen Activator/adverse effects , Treatment Outcome
10.
Int J Clin Pract ; 75(10): e14492, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1297677

ABSTRACT

OBJECTIVES: Isolation precautions are very important for emergency personnel faced with this high risk. This is cross-sectional study carried out to determine the compliance of emergency healthcare personnel with isolation precautions during the COVID-19 pandemic. METHODS: The study was carried out in the Emergency Services department of Erzurum Atatürk University and Erzurum Regional Training and Research Hospital from May 2020 to June 2020. The study population comprised 184 healthcare professionals working in emergency services, and the sample comprised 138 healthcare professionals who agreed to participate in the study. Data were collected using the "Healthcare Professionals Sociodemographic Form" and the "Compliance with Isolation Precautions Scale". Percentage distribution, t test, variance analysis (ANOVA), Mann-Whitney U test and Kruskal-Wallis test were used to analyse the data. Permission to conduct the study was obtained from the ethics committee and the Ministry of Health. RESULTS: Of the participants, 58.7% were male, 37.7% had worked for 1-5 years, 31.2% were nurses and the mean age was 30.78 ± 7.17. Of the participants, 86.2% wanted to receive training on isolation precautions, 87% knew the type of isolation practiced, 81.2% were able to identify suspected patients and 84.1% knew suspected patients were put into isolation. The emergency healthcare personnel's mean score on the isolation precautions compliance scale was determined as 67.63 ± 4.64. CONCLUSION: It was concluded that the emergency healthcare personnel had high levels of knowledge about the COVID-19 pandemic; however, they had an average level of compliance with isolation precautions.


Subject(s)
COVID-19 , Pandemics , Adult , Cross-Sectional Studies , Health Personnel , Humans , Male , Patient Compliance , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
11.
PLoS One ; 16(6): e0252670, 2021.
Article in English | MEDLINE | ID: covidwho-1278176

ABSTRACT

In March of 2020, the United States was confronted with a major public health crisis caused by the coronavirus disease (COVID-19). This study aimed to identify what factors influence adherence to recently implemented public health measures such as mask-wearing and social distancing, trust of scientific organizations like the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) on information pertaining to the pandemic, and level of perceived risk. Data were collected from June 30, 2020 to July 22, 2020 on 951 adult residents of the United States using an online survey through Microsoft Forms. Multiple linear regression was used to identify the strongest predictors for compliance to pandemic-related health measures, trust in the scientific community, and perceived risk. Results showed that the strongest predictor of all variables of interest was degree of policy liberalism. Additionally, participants who consumed more conservative news media conformed less to the pandemic health guidelines and had less trust in the scientific community. Degree of policy liberalism was found to have a significant moderating effect on the relationship between gender and conformity to pandemic-related health behaviors. These findings have concerning implications that factors like degree of policy liberalism and source of news are more influential in predicting adherence to life-saving health measures than established risk factors like pre-existing health conditions.


Subject(s)
COVID-19/prevention & control , Health Behavior , Mass Media/statistics & numerical data , Policy , SARS-CoV-2/isolation & purification , Trust , Adult , Aged , COVID-19/epidemiology , COVID-19/virology , Centers for Disease Control and Prevention, U.S. , Female , Humans , Male , Middle Aged , Pandemics , Politics , Public Health/methods , Public Health/statistics & numerical data , SARS-CoV-2/physiology , Surveys and Questionnaires/statistics & numerical data , United States , Young Adult
12.
Am J Infect Control ; 49(6): 733-739, 2021 06.
Article in English | MEDLINE | ID: covidwho-1269211

ABSTRACT

BACKGROUND: Evidence-based practices to increase hand hygiene compliance (HHC) among health care workers are warranted. We aimed to investigate the effect of a multimodal strategy on HHC. METHODS: During this 14-month prospective, observational study, an automated monitoring system was implemented in a 29-bed surgical ward. Hand hygiene opportunities and alcohol-based hand rubbing events were measured in patient and working rooms (medication, utility, storerooms, toilets). We compared baseline HHC of health care workers across periods with light-guided nudging from sensors on dispensers and data-driven performance feedback (multimodal strategy) using the Student's t test. RESULTS: The doctors (n = 10) significantly increased their HHC in patient rooms (16% vs 42%, P< .0001) and working rooms (24% vs 78%, P= .0006) when using the multimodal strategy. The nurses (n = 26) also increased their HHC significantly from baseline in both patient rooms (27% vs 43%, P = .0005) and working rooms (39% vs 64%, P< .0001). The nurses (n = 9), who subsequently received individual performance feedback, further increased HHC, compared with the period when they received group performance feedback (patient rooms: 43% vs 55%, P< .0001 and working rooms: 64% vs 80%, P< .0001). CONCLUSIONS: HHC of doctors and nurses can be significantly improved with light-guided nudging and data-driven performance feedback using an automated hand hygiene system.


Subject(s)
Cross Infection , Hand Hygiene , Nurses , Cross Infection/prevention & control , Feedback , Guideline Adherence , Hand Disinfection , Humans , Prospective Studies
13.
Cytokine ; 148: 155618, 2021 12.
Article in English | MEDLINE | ID: covidwho-1260707

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an acute respiratory disease; approximately 5% of patients developing severe COVID-19. It is known that cytokine release is associated with disease severity, but the relationship between the different clinical phenotypes and inflammatory endotypes is not well understood. OBJECTIVE: This study investigated the association between inflammatory biomarker-based endotypes and severe COVID-19 phenotypes. METHODS: Interleukin (IL) -6, C-reactive protein (CRP), C-X-C motif chemokine (CXCL) 9, IL-18, C-C motif chemokine (CCL) 3, CCL17, IL-10, and vascular endothelial growth factor (VEGF) were measured in 57 COVID-19 patients, and their association with clinical characteristics was examined using a cluster analysis. RESULTS: Significantly higher blood levels of the eight inflammatory markers were noted in patients who developed acute respiratory distress syndrome (ARDS) than in those who did not develop ARDS (non-ARDS). Using a cluster analysis, the patient groups were classified into four clusters, of which two had patients with high IL-6 and CRP levels. In the cluster with high levels of Type 1 (T1) inflammatory markers such as CXCL9 and IL-18, 85% of the patients had ARDS, 65% of the patients developed acute kidney injury (AKI), and 78% of the patients developed pulmonary fibrosis. CONCLUSIONS: In the cluster with high levels of T1 inflammatory markers, the patients frequently suffered from tissue damage, manifested as ARDS and AKI. Our findings identified distinct T1 inflammatory endotypes of COVID-19 and suggest the importance of controlling inflammation by monitoring T1 biomarkers and treating accordingly to limit the severity of the disease.


Subject(s)
COVID-19/complications , COVID-19/physiopathology , Inflammation/pathology , Pulmonary Fibrosis/complications , Pulmonary Fibrosis/physiopathology , Aged , Biomarkers/blood , COVID-19/blood , COVID-19/virology , Cluster Analysis , Disease Progression , Female , Humans , Inflammation/blood , Inflammation/complications , Lung Compliance , Male , Middle Aged , Pulmonary Fibrosis/blood , Respiratory Distress Syndrome/blood , Respiratory Distress Syndrome/complications , SARS-CoV-2/physiology
14.
JMIR Mhealth Uhealth ; 9(6): e16304, 2021 06 08.
Article in English | MEDLINE | ID: covidwho-1261323

ABSTRACT

BACKGROUND: Parkinson disease (PD) is a common, multifaceted neurodegenerative disorder profoundly impacting patients' autonomy and quality of life. Assessment in real-life conditions of subjective symptoms and objective metrics of mobility and nonmotor symptoms such as sleep disturbance is strongly advocated. This information would critically guide the adaptation of antiparkinsonian medications and nonpharmacological interventions. Moreover, since the spread of the COVID-19 pandemic, health care practices are being reshaped toward a more home-based care. New technologies could play a pivotal role in this new approach to clinical care. Nevertheless, devices and information technology tools might be unhandy for PD patients, thus dramatically limiting their widespread employment. OBJECTIVE: The goals of the research were development and usability evaluation of an application, SleepFit, for ecological momentary assessment of objective and subjective clinical metrics at PD patients' homes, and as a remote tool for researchers to monitor patients and integrate and manage data. METHODS: An iterative and user-centric strategy was employed for the development of SleepFit. The core structure of SleepFit consists of (1) an electronic finger-tapping test; (2) motor, sleepiness, and emotional subjective scales; and (3) a sleep diary. Applicable design, ergonomic, and navigation principles have been applied while tailoring the application to the specific patient population. Three progressively enhanced versions of the application (alpha, v1.0, v2.0) were tested by a total of 56 patients with PD who were asked to perform multiple home assessments 4 times per day for 2 weeks. Patient compliance was calculated as the proportion of completed tasks out of the total number of expected tasks. Satisfaction on the latest version (v2.0) was evaluated as potential willingness to use SleepFit again after the end of the study. RESULTS: From alpha to v1.0, SleepFit was improved in graphics, ergonomics, and navigation, with automated flows guiding the patients in performing tasks throughout the 24 hours, and real-time data collection and consultation were made possible thanks to a remote web portal. In v2.0, the kiosk-mode feature restricts the use of the tablet to the SleepFit application only, thus preventing users from accidentally exiting the application. A total of 52 (4 dropouts) patients were included in the analyses. Overall compliance (all versions) was 88.89% (5707/6420). SleepFit was progressively enhanced and compliance increased from 87.86% (2070/2356) to 89.92% (2899/3224; P=.04). Among the patients who used v2.0, 96% (25/26) declared they would use SleepFit again. CONCLUSIONS: SleepFit can be considered a state-of-the-art home-based system that increases compliance in PD patients, ensures high-quality data collection, and works as a handy tool for remote monitoring and data management in clinical research. Thanks to its user-friendliness and modular structure, it could be employed in other clinical studies with minimum adaptation efforts. TRIAL REGISTRATION: ClinicalTrials.gov NCT02723396; https://clinicaltrials.gov/ct2/show/NCT02723396.


Subject(s)
COVID-19 , Parkinson Disease , Data Collection , Humans , Pandemics , Parkinson Disease/drug therapy , Quality of Life , SARS-CoV-2
15.
Proc Natl Acad Sci U S A ; 118(25)2021 06 22.
Article in English | MEDLINE | ID: covidwho-1260986

ABSTRACT

What is an effective vaccination policy to end the COVID-19 pandemic? We address this question in a model of the dynamics of policy effectiveness drawing upon the results of a large panel survey implemented in Germany during the first and second waves of the pandemic. We observe increased opposition to vaccinations were they to be legally required. In contrast, for voluntary vaccinations, there was higher and undiminished support. We find that public distrust undermines vaccine acceptance, and is associated with a belief that the vaccine is ineffective and, if enforced, compromises individual freedom. We model how the willingness to be vaccinated may vary over time in response to the fraction of the population already vaccinated and whether vaccination has occurred voluntarily or not. A negative effect of enforcement on vaccine acceptance (of the magnitude observed in our panel or even considerably smaller) could result in a large increase in the numbers that would have to be vaccinated unwillingly in order to reach a herd-immunity target. Costly errors may be avoided if policy makers understand that citizens' preferences are not fixed but will be affected both by the crowding-out effect of enforcement and by conformism. Our findings have broad policy applicability beyond COVID-19 to cases in which voluntary citizen compliance is essential because state capacities are limited and because effectiveness may depend on the ways that the policies themselves alter citizens' beliefs and preferences.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/immunology , Crowding , Social Conformity , Social Norms , Vaccination , Health Policy , Humans , Models, Immunological , Motivation
16.
PLoS One ; 16(6): e0252835, 2021.
Article in English | MEDLINE | ID: covidwho-1259250

ABSTRACT

IMPORTANCE: Knowledge and attitude influence compliance and individuals' practices. The risk and protective factors associated with high compliance to these preventive measures are critical to enhancing pandemic preparedness. OBJECTIVE: This survey aims to assess differences in mental health, knowledge, attitudes, and practices (KAP) of preventive measures for COVID-19 amongst healthcare professionals (HCP) and non-healthcare professionals. DESIGN: Multi-national cross-sectional study was carried out using electronic surveys between May-June 2020. SETTING: Multi-national survey was distributed across 36 countries through social media, word-of-mouth, and electronic mail. PARTICIPANTS: Participants ≥21 years working in healthcare and non-healthcare related professions. MAIN OUTCOME: Risk factors determining the difference in KAP towards personal hygiene and social distancing measures during COVID-19 amongst HCP and non-HCP. RESULTS: HCP were significantly more knowledgeable on personal hygiene (AdjOR 1.45, 95% CI -1.14 to 1.83) and social distancing (AdjOR 1.31, 95% CI -1.06 to 1.61) compared to non-HCP. They were more likely to have a positive attitude towards personal hygiene and 1.5 times more willing to participate in the contact tracing app. There was high compliance towards personal hygiene and social distancing measures amongst HCP. HCP with high compliance were 1.8 times more likely to flourish and more likely to have a high sense of emotional (AdjOR 1.94, 95% CI (1.44 to 2.61), social (AdjOR 2.07, 95% CI -1.55 to 2.78), and psychological (AdjOR 2.13, 95% CI (1.59-2.85) well-being. CONCLUSION AND RELEVANCE: While healthcare professionals were more knowledgeable, had more positive attitudes, their higher sense of total well-being was seen to be more critical to enhance compliance. Therefore, focusing on the well-being of the general population would help to enhance their compliance towards the preventive measures for COVID-19.


Subject(s)
COVID-19/epidemiology , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Pandemics/prevention & control , Patient Compliance , Adult , Cross-Sectional Studies , Female , Global Health , Humans , Male , Middle Aged , Risk Factors , Surveys and Questionnaires
17.
Antimicrob Resist Infect Control ; 10(1): 86, 2021 06 03.
Article in English | MEDLINE | ID: covidwho-1259217

ABSTRACT

BACKGROUND: Knowledge of infection prevention and control (IPC) procedures among healthcare workers (HCWs) is crucial for effective IPC. Compliance with IPC measures has critical implications for HCWs safety, patient protection and the care environment. AIMS: To discuss the body of available literature regarding HCWs' knowledge of IPC and highlight potential factors that may influence compliance to IPC precautions. DESIGN: A systematic review. A protocol was developed based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis [PRISMA] statement. DATA SOURCES: Electronic databases (PubMed, CINAHL, Embase, Proquest, Wiley online library, Medline, and Nature) were searched from 1 January 2006 to 31 January 2021 in the English language using the following keywords alone or in combination: knowledge, awareness, healthcare workers, infection, compliance, comply, control, prevention, factors. 3417 papers were identified and 30 papers were included in the review. RESULTS: Overall, the level of HCW knowledge of IPC appears to be adequate, good, and/or high concerning standard precautions, hand hygiene, and care pertaining to urinary catheters. Acceptable levels of knowledge were also detected in regards to IPC measures for specific diseases including TB, MRSA, MERS-CoV, COVID-19 and Ebola. However, gaps were identified in several HCWs' knowledge concerning occupational vaccinations, the modes of transmission of infectious diseases, and the risk of infection from needle stick and sharps injuries. Several factors for noncompliance surrounding IPC guidelines are discussed, as are recommendations for improving adherence to those guidelines. CONCLUSION: Embracing a multifaceted approach towards improving IPC-intervention strategies is highly suggested. The goal being to improve compliance among HCWs with IPC measures is necessary.


Subject(s)
COVID-19/prevention & control , Health Personnel , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , COVID-19/transmission , Cross Infection/prevention & control , Databases, Factual , Guideline Adherence , Health Knowledge, Attitudes, Practice , Humans , SARS-CoV-2/isolation & purification
19.
Psychosom Med ; 83(4): 363-367, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1254938

ABSTRACT

OBJECTIVE: The US Centers for Disease Control and Prevention recommended behavioral measures to slow the spread of COVID-19, such as social distancing and wearing masks. Although many individuals comply with these recommendations, compliance has been far from universal. Identifying predictors of compliance is crucial for improving health behavior messaging and thereby reducing disease spread and fatalities. METHODS: We report preregistered analyses from a longitudinal study that investigated personality predictors of compliance with behavioral recommendations in diverse US adults across five waves from March to August 2020 (n = 596) and cross-sectionally in August 2020 (n = 405). RESULTS: Agreeableness-characterized by compassion-was the most consistent predictor of compliance, above and beyond other traits, and sociodemographic predictors (sample A, ß = 0.25; sample B, ß = 0.12). The effect of agreeableness was robust across two diverse samples and sensitivity analyses. In addition, openness, conscientiousness, and extraversion were also associated with greater compliance, but effects were less consistent across sensitivity analyses and were smaller in sample A. CONCLUSIONS: Individuals who are less agreeable are at higher risk for noncompliance with behavioral mandates, suggesting that health messaging can be meaningfully improved with approaches that address these individuals in particular. These findings highlight the strong theoretical and practical utility of testing long-standing psychological theories during real-world crises.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control , Health Behavior , Models, Psychological , Personality , Adult , COVID-19/psychology , Empathy , Female , Humans , Longitudinal Studies , Male , Masks/statistics & numerical data , Personality Tests , Physical Distancing , United States
20.
Curr Psychol ; : 1-11, 2021 May 26.
Article in English | MEDLINE | ID: covidwho-1252235

ABSTRACT

The COVID -19 pandemic represents a global health crisis, so adherence to government guidelines and public health advice is critical in reducing transmission rates. Despite this, it has been reported that a minority of people do not comply with the governmental guidelines. When considering the reasons why some people do not comply with preventive measures, previous studies have shown that beliefs in COVID-19 conspiracy theories negatively predict responsible pandemic-related behaviour. This, in turn, could seriously undermine success in combating the pandemic. Our aim was, therefore, to further investigate the relationship between conspiracy beliefs and adherence to official COVID-19 medical guidelines by including mediating roles of beliefs in pseudoscientific information and trust in government officials. A total of 1882 adults from Croatia provided sociodemographic information and completed several scales related to COVID-19 conspiracy beliefs, beliefs in pseudoscientific information, trust in government officials, and adherence to official COVID-19 guidelines. A multiple mediation analysis revealed a direct negative effect of COVID-19 conspiracy beliefs on compliance with the preventive measures. In addition, conspiracy beliefs were indirectly related to compliance via trust in government officials. The present study builds upon emerging research showing that conspiracy beliefs may have significant social consequences and pose a potential risk to public health. Practical implications of these findings are discussed further. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-021-01898-y.

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