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1.
BMC Public Health ; 21(1): 654, 2021 04 06.
Artículo en Inglés | MEDLINE | ID: covidwho-1169959

RESUMEN

BACKGROUND: The COVID-19 pandemic has prompted a lockdown in many countries to control the exponential spread of the SARS-CoV-2 virus, hereby reducing the time-varying basic reproduction number (Rt) to below one. Governments are looking for evidence to balance the demand of their citizens to ease some of the restriction, against the fear of a new peak in infections. In this study, we wanted to quantify the relative contribution of mobility restrictions, and that of behavioral changes that occurred already before the lockdowns, on the reduction of transmission during lockdowns in Western countries in early 2020. METHODS: Incidence data of cases and deaths from the first wave of infections for 35 Western countries (32 European, plus Israel, USA and Canada) were analyzed using epidemiological compartment models in a Bayesian framework. Mobility data was used to estimate the timing of changes associated with a lockdown, and was correlated with estimated reductions of Rt. RESULTS: Across all countries, the initial median estimate for Rt was 3.6 (95% IQR 2.4-5.2), and it was reduced to 0.78 (95% IQR 0.58-1.01) during lockdown. 48% (18-65%) of the reduction occurred already in the week before lockdown, with lockdown itself causing the remaining drop in transmission. A lower Rt during lockdown was independently associated with an increased time spent at home (0.21 per 10% more time, p < 0.007), and decreased mobility related to retail and recreation (0.07 per 10% less mobility, p < 0.008). CONCLUSIONS: In a Western population unaware of the risk, SARS-CoV-2 can be highly contagious with a reproduction number R0 > 5. Our results are consistent with evidence that recreational activities (including restaurant and bar visits) enable super-spreading events. Exiting from lockdown therefore requires continued physical distancing and tight control on this kind of activities.


Asunto(s)
Comercio , Cuarentena , Recreación , Teorema de Bayes , /prevención & control , Canadá/epidemiología , Comercio/estadística & datos numéricos , Europa (Continente)/epidemiología , Humanos , Israel/epidemiología , Cuarentena/psicología , Recreación/psicología , Estados Unidos/epidemiología
2.
CMAJ Open ; 9(2): E324-E330, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1168152

RESUMEN

BACKGROUND: Virtual care for patients with coronavirus disease 2019 (COVID-19) allows providers to monitor COVID-19-positive patients with variable trajectories while reducing the risk of transmission to others and ensuring health care capacity in acute care facilities. The objective of this descriptive analysis was to assess the initial adoption, feasibility and safety of a family medicine-led remote monitoring program, COVIDCare@Home, to manage the care of patients with COVID-19 in the community. METHODS: COVIDCare@Home is a multifaceted, interprofessional team-based remote monitoring program developed at an ambulatory academic centre, the Women's College Hospital in Toronto. A descriptive analysis of the first cohort of patients admitted from Apr. 8 to May 11, 2020, was conducted. Lessons from the implementation of the program are described, focusing on measure of adoption (number of visits per patient total, with a physician or with a nurse; length of follow-up), feasibility (received an oximeter or thermometer; consultation with general internal medicine, social work or mental health, pharmacy or acute ambulatory care unit) and safety (hospitalizations, mortality and emergency department visits). RESULTS: The COVIDCare@Home program cared for a first cohort of 97 patients (median age 41 yr, 67% female) with 415 recorded virtual visits. Patients had a median time from positive testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to first appointment of 3 (interquartile range [IQR] 2-4) days, with a median virtual follow-up time of 8 (IQR 5-10) days. A total of 4 (4%) had an emergency department visit, with no patients requiring hospitalization and no deaths; 16 (16%) of patients required support with mental and social health needs. INTERPRETATION: A family medicine-led, team-based remote monitoring program can safely manage the care of outpatients diagnosed with COVID-19. Virtual care approaches, particularly those that support patients with more complex health and social needs, may be an important part of ongoing health system efforts to manage subsequent waves of COVID-19 and other diseases.


Asunto(s)
Atención Ambulatoria/tendencias , Medicina Familiar y Comunitaria , Grupo de Atención al Paciente/organización & administración , Telemedicina/métodos , Adulto , /terapia , /métodos , Canadá/epidemiología , Atención Integral de Salud , Transmisión de Enfermedad Infecciosa/prevención & control , Salud de la Familia , Medicina Familiar y Comunitaria/métodos , Medicina Familiar y Comunitaria/organización & administración , Estudios de Factibilidad , Femenino , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Apoyo Social
3.
Front Public Health ; 9: 628479, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1154263

RESUMEN

Background: COVID-19 has caused a global public health emergency. Government mitigation strategies included a series of behavior-based prevention policies that had a likely impact on the spread of other contagious respiratory illnesses, such as seasonal influenza. Our aim was to explore how 2019-2020 influenza tracked onto COVID-19 pandemic and its mitigation methods. Materials and Methods: We linked the WHO FluNet database and COVID-19 confirmed cases (Johns Hopkins University) for four countries across the northern (Canada, the United States) and southern hemispheres (Australia, Brazil) for the period 2016-2020. Graphical presentations of longitudinal data were provided. Results: There was a notable reduction in influenza cases for the 2019-2020 season. Northern hemisphere countries experienced a quicker ending to the 2019-2020 seasonal influenza cases (shortened by 4-7 weeks) and virtually no 2020 fall influenza season. Countries from the southern hemisphere experienced drastically low levels of seasonal influenza, with consistent trends that were approaching zero cases after the introduction of COVID-19 measures. Conclusions: It is likely that the COVID-19 mitigation measures played a notable role in the marked decrease in influenza, with little to no influenza activity in both the northern and southern hemispheres. In spite of this reduction in influenza cases, there was still community spread of COVID-19, highlighting the contagiousness of SARS-CoV-2 compared to influenza. These results, together with the higher mortality rate from SARS-CoV-2 compared to influenza, highlight that COVID-19 is a far greater health threat than influenza.


Asunto(s)
/epidemiología , Gripe Humana/epidemiología , Gripe Humana/fisiopatología , Internacionalidad , Pandemias/estadística & datos numéricos , Evaluación de Síntomas/estadística & datos numéricos , Australia/epidemiología , Brasil/epidemiología , Canadá/epidemiología , Femenino , Humanos , Masculino , Salud Pública/estadística & datos numéricos , Estados Unidos/epidemiología
4.
Can J Nurs Res ; 53(1): 5-15, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: covidwho-1136160

RESUMEN

BACKGROUND: The severity of the COVID-19 health crisis has placed acute care nurses in dire work environments in which they have had to deal with uncertainty, loss, and death on a constant basis. It is necessary to gain a better understanding of nurses' experiences to develop interventions supportive of their emotional well-being. PURPOSE: The purpose of this study is to explore how nurses are emotionally affected working in COVID-19 acute care hospital environments. The research question is: What is the emotional experience of nurses working in COVID-19 acute care hospital environments? METHODS: We employed a narrative methodology that focused on participants' stories. Twenty registered nurses, who worked in six hospitals in the Greater Toronto Area in Canada, participated in interviews. A narrative analysis was conducted with a focus on content and form of stories. RESULTS: We identified three themes about working in COVID-19 acute care hospital environments: the emotional experience, the agency of emotions, and how emotions shape nursing and practice. CONCLUSION: In moving forth with pandemic preparations, healthcare leaders and governments need to make sure that a nurse's sacrifice is not all-encompassing. Supporting nurses' emotional well-being and resilience is necessary to counterbalance the loss and trauma nurses go through.


Asunto(s)
/enfermería , Enfermería de Cuidados Críticos , Emociones , Personal de Enfermería en Hospital/psicología , /epidemiología , Canadá/epidemiología , Hospitales , Humanos , Investigación Cualitativa
5.
Healthc Policy ; 16(3): 6-15, 2021 02.
Artículo en Inglés | MEDLINE | ID: covidwho-1134498

RESUMEN

In 2020, the COVID-19 pandemic unexpectedly upended everyone's life, from sudden mass unemployment to family separations. In spite of this upheaval, health systems and services research carried on. Often, these efforts supported public health efforts to slow the spread of the virus.


Asunto(s)
/prevención & control , Prestación de Atención de Salud/economía , Prestación de Atención de Salud/organización & administración , Investigación sobre Servicios de Salud/economía , Investigación sobre Servicios de Salud/organización & administración , /epidemiología , Canadá/epidemiología , Costos y Análisis de Costo , Humanos
6.
Healthc Policy ; 16(3): 16-25, 2021 02.
Artículo en Inglés | MEDLINE | ID: covidwho-1134497

RESUMEN

Canada's provinces are without a publicly funded psychotherapy program for common mental disorders despite evidence that psychological services help reduce the length and number of depressive episodes, symptoms of post-traumatic stress and associated negative outcomes (hospitalizations and suicide attempts). Studies also show that including psychological services as part of the service package offered under the public health plan for those without access pays for itself. We posit that a publicly funded psychotherapy program in Canada, including digitized self-guided psychotherapy platforms for common mental disorders, will lead to improved population health useful in the COVID-19 context and beyond.


Asunto(s)
Práctica Clínica Basada en la Evidencia/economía , Financiación Gubernamental , Trastornos Mentales/terapia , Psicoterapia/economía , /epidemiología , Canadá/epidemiología , Humanos
7.
BMJ Open ; 11(3): e046177, 2021 03 09.
Artículo en Inglés | MEDLINE | ID: covidwho-1125301

RESUMEN

OBJECTIVE: The main objectives of this study were to synthesise and compare pandemic preparedness strategies issued by the federal and provincial/territorial (P/T) governments in Canada and to assess whether COVID-19 public health (PH) measures were tailored towards priority populations, as defined by relevant social determinants of health. METHODS: This scoping review searched federal and P/T websites on daily COVID-19 pandemic preparedness strategies between 30 January and 30 April 2020. The PROGRESS-Plus equity-lens framework was used to define priority populations. All definitions, policies and guidelines of PH strategies implemented by the federal and P/T governments to reduce risk of SARS-CoV-2 transmission were included. PH measures were classified using a modified Public Health Agency of Canada Framework for Canadian Pandemic Influenza Preparedness. RESULTS: A total of 722 COVID-19 PH measures were issued during the study period. Of these, home quarantine (voluntary) (n=13.0%; 94/722) and retail/commerce restrictions (10.9%; n=79/722) were the most common measures introduced. Many of the PH orders, including physical distancing, cancellation of mass gatherings, school closures or retail/commerce restrictions began to be introduced after 11 March 2020. Lifting of some of the PH orders in phases to reopen the economy began in April 2020 (6.5%; n=47/722). The majority (68%, n=491/722) of COVID-19 PH announcements were deemed mandatory, while 32% (n=231/722) were recommendations. Several PH measures (28.0%, n=202/722) targeted a variety of groups at risk of socially produced health inequalities, such as age, religion, occupation and migration status. CONCLUSIONS: Most PH measures centred on limiting contact between people who were not from the same household. PH measures were evolutionary in nature, reflecting new evidence that emerged throughout the pandemic. Although ~30% of all implemented COVID-19 PH measures were tailored towards priority groups, there were still unintended consequences on these populations.


Asunto(s)
/prevención & control , Control de Enfermedades Transmisibles/métodos , Pandemias , Canadá/epidemiología , Aglomeración , Humanos , Pandemias/prevención & control , Cuarentena
8.
CMAJ Open ; 9(1): E181-E188, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1124785

RESUMEN

BACKGROUND: Clinical data on patients admitted to hospital with coronavirus disease 2019 (COVID-19) provide clinicians and public health officials with information to guide practice and policy. The aims of this study were to describe patients with COVID-19 admitted to hospital and intensive care, and to investigate predictors of outcome to characterize severe acute respiratory infection. METHODS: This observational cohort study used Canadian data from 32 selected hospitals included in a global multisite cohort between Jan. 24 and July 7, 2020. Adult and pediatric patients with a confirmed diagnosis of COVID-19 who received care in an intensive care unit (ICU) and a sampling of up to the first 60 patients receiving care on hospital wards were included. We performed descriptive analyses of characteristics, interventions and outcomes. The primary analyses examined in-hospital mortality, with secondary analyses of the length of hospital and ICU stay. RESULTS: Between January and July 2020, among 811 patients admitted to hospital with a diagnosis of COVID-19, the median age was 64 (interquartile range [IQR] 53-75) years, 495 (61.0%) were men, 46 (5.7%) were health care workers, 9 (1.1%) were pregnant, 26 (3.2%) were younger than 18 years and 9 (1.1%) were younger than 5 years. The median time from symptom onset to hospital admission was 7 (IQR 3-10) days. The most common symptoms on admission were fever, shortness of breath, cough and malaise. Diabetes, hypertension and cardiac, kidney and respiratory disease were the most common comorbidities. Among all patients, 328 received care in an ICU, admitted a median of 0 (IQR 0-1) days after hospital admission. Critically ill patients received treatment with invasive mechanical ventilation (88.8%), renal replacement therapy (14.9%) and extracorporeal membrane oxygenation (4.0%); 26.2% died. Among those receiving mechanical ventilation, 31.2% died. Age was an influential predictor of mortality (odds ratio per additional year of life 1.06, 95% confidence interval 1.03-1.09). INTERPRETATION: Patients admitted to hospital with COVID-19 commonly had fever, respiratory symptoms and comorbid conditions. Increasing age was associated with the development of critical illness and death; however, most critically ill patients in Canada, including those requiring mechanical ventilation, survived and were discharged from hospital.


Asunto(s)
/epidemiología , Cuidados Críticos , Hospitalización , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , /terapia , Canadá/epidemiología , Comorbilidad , Enfermedad Crítica , Manejo de la Enfermedad , Progresión de la Enfermedad , Femenino , Humanos , Incidencia , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Mortalidad , Pandemias , Embarazo , Vigilancia en Salud Pública , Índice de Severidad de la Enfermedad , Adulto Joven
11.
PLoS One ; 16(3): e0247799, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1117486

RESUMEN

COVID-19 has greatly affected public health and world economy. In this study, we analyzed 129 full-length genomes of SARS-CoV-2 viruses of a Canadian population during early phase of the pandemic. Phylogenetic analysis revealed three major paths of transmission of SARS-CoV-2 viruses into Canada. Twenty-one substitutions that have frequencies greater than 3% of viral population were identified. Analysis of these substitutions indicated that P1427I (ORF1b), Y1464C (ORF1b), and Q57H (ORF3a) might affect functions of the corresponding SARS-CoV-2 encoded proteins. Additionally, we found the evidence of positive selection on the ORF3a and codon 614 of Spike protein, suggesting the viral components responsible for host entry and activation of inflammation response were targeted by host immune responses. The study showed genomic variation and evolution of SARS-CoV-2 in a Canadian population. These information may help develop preventive strategies and be used for further study of SARS-CoV-2 pathogenesis and therapeutics development.


Asunto(s)
/virología , Genoma Viral , /genética , /epidemiología , Canadá/epidemiología , Evolución Molecular , Variación Genética , Humanos , Filogenia , Glicoproteína de la Espiga del Coronavirus/genética , Proteínas Virales/genética
12.
CMAJ Open ; 9(1): E142-E148, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1115548

RESUMEN

BACKGROUND: After nonelective (i.e., semiurgent, urgent and emergent) surgeries, patients discharged from hospitals are at risk of readmissions, emergency department visits or death. During the coronavirus disease 2019 (COVID-19) pandemic, we are undertaking the Post Discharge after Surgery Virtual Care with Remote Automated Monitoring Technology (PVC-RAM) trial to determine if virtual care with remote automated monitoring (RAM) compared with standard care will increase the number of days adult patients remain alive at home after being discharged following nonelective surgery. METHODS: We are conducting a randomized controlled trial in which 900 adults who are being discharged after nonelective surgery from 8 Canadian hospitals are randomly assigned to receive virtual care with RAM or standard care. Outcome adjudicators are masked to group allocations. Patients in the experimental group learn how to use the study's tablet computer and RAM technology, which will measure their vital signs. For 30 days, patients take daily biophysical measurements and complete a recovery survey. Patients interact with nurses via the cellular modem-enabled tablet, who escalate care to preassigned and available physicians if RAM measurements exceed predetermined thresholds, patients report symptoms, a medication error is identified or the nurses have concerns they cannot resolve. The primary outcome is number of days alive at home during the 30 days after randomization. INTERPRETATION: This trial will inform management of patients after discharge following surgery in the COVID-19 pandemic and offer insights for management of patients who undergo nonelective surgery in a nonpandemic setting. Knowledge dissemination will be supported through an online multimedia resource centre, policy briefs, presentations, peer-reviewed journal publications and media engagement. TRIAL REGISTRATION: ClinicalTrials.gov, no. NCT04344665.


Asunto(s)
Cuidados Posteriores/tendencias , Monitoreo Ambulatorio/métodos , Alta del Paciente/normas , Consulta Remota/instrumentación , Adulto , /epidemiología , Canadá/epidemiología , Computadoras de Mano/provisión & distribución , Humanos , Persona de Mediana Edad , Periodo Posoperatorio , Interfaz Usuario-Computador
13.
J Med Internet Res ; 23(3): e24883, 2021 03 11.
Artículo en Inglés | MEDLINE | ID: covidwho-1112561

RESUMEN

BACKGROUND: Effective communication during a health crisis can ease public concerns and promote the adoption of important risk-mitigating behaviors. Public health agencies and leaders have served as the primary communicators of information related to COVID-19, and a key part of their public outreach has taken place on social media platforms. OBJECTIVE: This study examined the content and engagement of COVID-19 tweets authored by Canadian public health agencies and decision makers. We propose ways for public health accounts to adjust their tweeting practices during public health crises to improve risk communication and maximize engagement. METHODS: We retrieved data from tweets by Canadian public health agencies and decision makers from January 1, 2020, to June 30, 2020. The Twitter accounts were categorized as belonging to either a public health agency, regional or local health department, provincial health authority, medical health officer, or minister of health. We analyzed trends in COVID-19 tweet engagement and conducted a content analysis on a stratified random sample of 485 tweets to examine the message functions and risk communication strategies used by each account type. RESULTS: We analyzed 32,737 tweets authored by 118 Canadian public health Twitter accounts, of which 6982 tweets were related to COVID-19. Medical health officers authored the largest percentage of COVID-19-related tweets (n=1337, 35%) relative to their total number of tweets and averaged the highest number of retweets per COVID-19 tweet (112 retweets per tweet). Public health agencies had the highest frequency of daily tweets about COVID-19 throughout the study period. Compared to tweets containing media and user mentions, hashtags and URLs were used in tweets more frequently by all account types, appearing in 69% (n=4798 tweets) and 68% (n=4781 tweets) of COVID-19-related tweets, respectively. Tweets containing hashtags also received the highest average retweets (47 retweets per tweet). Our content analysis revealed that of the three tweet message functions analyzed (information, action, community), tweets providing information were the most commonly used across most account types, constituting 39% (n=181) of all tweets; however, tweets promoting actions from users received higher than average retweets (55 retweets per tweet). When examining tweets that received one or more retweet (n=359), the difference between mean retweets across the message functions was statistically significant (P<.001). The risk communication strategies that we examined were not widely used by any account type, appearing in only 262 out of 485 tweets. However, when these strategies were used, these tweets received more retweets compared to tweets that did not use any risk communication strategies (P<.001) (61 retweets versus 13 retweets on average). CONCLUSIONS: Public health agencies and decision makers should examine what messaging best meets the needs of their Twitter audiences to maximize sharing of their communications. Public health accounts that do not currently employ risk communication strategies in their tweets may be missing an important opportunity to engage with users about the mitigation of health risks related to COVID-19.


Asunto(s)
/epidemiología , Toma de Decisiones/ética , Salud Pública , Medios de Comunicación Sociales/tendencias , Canadá/epidemiología , Humanos , /aislamiento & purificación
15.
Can J Public Health ; 112(2): 179-182, 2021 04.
Artículo en Inglés | MEDLINE | ID: covidwho-1089266
16.
PLoS One ; 16(2): e0246317, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1088754

RESUMEN

This study reports a comprehensive empirical investigation of the nature and correlates of anti-mask attitudes during the COVID-19 pandemic. Accumulating evidence underscores the importance of facemasks, as worn by the general public, in limiting the spread of infection. Accordingly, mask wearing has become increasingly mandatory in public places such as stores and on public transit. Although the public has been generally adherent to mask wearing, a small but vocal group of individuals refuse to wear masks. Anti-mask protest rallies have occurred in many places throughout the world, sometimes erupting violently. Few empirical studies have examined the relationship between anti-mask attitudes and mask non-adherence and little is known about how such attitudes relate to one another or other factors (e.g., non-adherence to social distancing, anti-vaccination attitudes). To investigate these issues, the present study surveyed 2,078 adults from the US and Canada. Consistent with other surveys, we found that most (84%) people wore masks because of COVID-19. The 16% who did not wear masks scored higher on most measures of negative attitudes towards masks. Network analyses indicated that negative attitudes about masks formed an intercorrelated network, with the central nodes in the network being (a) beliefs that masks are ineffective in preventing COVID-19, and (b) psychological reactance (PR; i.e., an aversion to being forced to wear masks). These central nodes served as links, connecting the network of anti-masks attitudes to negative attitudes toward SARSCoV2 vaccination, beliefs that the threat of COVID-19 has been exaggerated, disregard for social distancing, and political conservatism. Findings regarding PR are important because, theoretically, PR is likely to strengthen other anti-masks attitudes (e.g., beliefs that masks are ineffective) because people with strong PR react with anger and counter-arguments when their beliefs are challenged, thereby leading to a strengthening of their anti-mask beliefs. Implications for improving mask adherence are discussed.


Asunto(s)
Actitud Frente a la Salud , /transmisión , Máscaras/virología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , /prevención & control , Canadá/epidemiología , Transmisión de Enfermedad Infecciosa/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Adulto Joven
17.
Soc Sci Med ; 275: 113774, 2021 04.
Artículo en Inglés | MEDLINE | ID: covidwho-1085477

RESUMEN

This study examines whether economic hardship during the COVID-19 pandemic is deleteriously associated with psychological distress and self-rated health. A social causation perspective suggests that exposure to economic hardship will harm well-being, but a social selection perspective suggests that the appearance of health effects of hardship during the pandemic are attributable to the increased risk of exposure to hardship associated with poor well-being at the start of the pandemic. We also propose a third perspective, economic selection, which suggests that economic hardship prior to the pandemic negatively affects health and increases risk of exposure to hardship during the pandemic; consequently, an association between health and economic hardship during the pandemic may be spurious, and entirely due to pre-existing levels of hardship. To test these competing perspectives, we use a longitudinal study based in Canada that began in late March of 2020 and followed respondents monthly in April, May, and June. Baseline psychological distress and self-rated health, as well as economic hardship prior to the pandemic, independently predict the accumulation of monthly periods of hardship from April to June. The accumulation of periods of hardship from April to June is deleteriously associated with psychological distress and self-rated health in June. Controls for prior economic hardship and baseline health weaken the association between accumulation of periods of hardship and psychological distress, while also eliminating the association between accumulation of hardship and self-rated health. These findings favor a social causation perspective for psychological distress and a social selection perspective for self-rated health, with less evidence found in support of economic selection. This study took place during the first months of the COVID-19 pandemic, though, and associations with self-rated health may have become more evident as hardship further wore on individual well-being over a longer period of time.


Asunto(s)
Economía , Pandemias , Condiciones Sociales , Estrés Psicológico , Canadá/epidemiología , Humanos , Estudios Longitudinales , Estrés Psicológico/epidemiología
18.
Front Public Health ; 8: 620748, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-1082023

RESUMEN

The aim of this study was to test how youth and young adult e-cigarette users responded to the COVID-19 pandemic. The 2020 Youth and Young Adult Vaping Survey (N = 1,308) included 540 (44.7%) participants that reported differences in their vaping behaviors since the onset of the pandemic. Gender was the only relevant covariate that yielded a significant effect and/or interaction through a multivariate test. A two-way multivariate analysis of variance was used to test the effect of pandemic onset (pre- vs. during-pandemic), gender (males vs. females), and their interaction on vaping behaviors (days of vaping per week, episodes of vaping per day, and puffs per vaping episode). Respondents reported fewer days of vaping per week, episodes of vaping per day, and puffs per vaping episode during-pandemic than pre-pandemic [F (3,533) = 52.81, p < 0.001, η p 2 = 0.229]. The multivariate effect of gender on the three vaping outcomes was not statistically significant [F (3, 533) = 2.14, p = 0.095, η p 2 = 0.012], though the interaction between pandemic onset and gender was [F (3, 533) = 2.86, p = 0.036, η p 2 = 0.016]. Males reported fewer episodes of vaping per day [t (262) = 7.40, p < 0.001, 95% CI: 5.19-8.97] and puffs per vaping episode [t (263) = 3.23, p = 0.001, 95% CI:0.292-1.20] during-pandemic than pre-pandemic. Females reported fewer vaping episodes per day during-pandemic than pre-pandemic [t (273) = 5.14, p < 0.001, 95% CI: 2.76-6.18]. Further, females reported more frequent puffs per vaping episode in comparison to males during-pandemic [t (538) = -2.38, p = 0.017, 95% CI: -2.09-0.200]. The COVID-19 pandemic presents an opportunity to reduce vaping through health promotion messaging. Since females take more puffs per vaping episode overall, they may benefit the most from greater vaping cessation supports.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Vapeo/epidemiología , Adolescente , Análisis de Varianza , /mortalidad , Canadá/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Análisis Multivariante , Factores de Riesgo , Factores Sexuales , Encuestas y Cuestionarios , Adulto Joven
19.
Cell Rep ; 34(9): 108790, 2021 03 02.
Artículo en Inglés | MEDLINE | ID: covidwho-1077816

RESUMEN

Characterization of the humoral response to SARS-CoV-2, the etiological agent of COVID-19, is essential to help control the infection. The neutralization activity of plasma from patients with COVID-19 decreases rapidly during the first weeks after recovery. However, the specific role of each immunoglobulin isotype in the overall neutralizing capacity is still not well understood. In this study, we select plasma from a cohort of convalescent patients with COVID-19 and selectively deplete immunoglobulin A, M, or G before testing the remaining neutralizing capacity of the depleted plasma. We find that depletion of immunoglobulin M is associated with the most substantial loss of virus neutralization, followed by immunoglobulin G. This observation may help design efficient antibody-based COVID-19 therapies and may also explain the increased susceptibility to SARS-CoV-2 of autoimmune patients receiving therapies that impair the production of immunoglobulin M (IgM).


Asunto(s)
/terapia , Inmunoglobulina M/inmunología , Inmunoglobulina M/uso terapéutico , /inmunología , Adulto , Anciano , Anticuerpos Neutralizantes/inmunología , Anticuerpos Antivirales/inmunología , /inmunología , Canadá/epidemiología , Estudios de Cohortes , Femenino , Humanos , Inmunidad Humoral/inmunología , Inmunización Pasiva/métodos , Inmunoglobulina A/inmunología , Inmunoglobulina G/inmunología , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Glicoproteína de la Espiga del Coronavirus/inmunología , Adulto Joven
20.
PLoS One ; 16(2): e0246405, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1076267

RESUMEN

The aim of this study was to examine aspects of children's health literacy; the information sources they were accessing, their information preferences, their perceived understanding of and their reported information needs in relation to COVID-19. An online survey for children aged 7-12 years of age and parent/caregivers from the UK, Sweden, Brazil, Spain, Canada and Australia was conducted between 6th of April and the 1st of June 2020. The surveys included demographic questions and both closed and open questions focussing on access to and understanding of COVID-19 information. Descriptive statistics and qualitative content analysis procedures were conducted. The findings show that parents are the main source of information for children during the pandemic in most countries (89%, n = 347), except in Sweden where school was the main source of information. However, in many cases parents chose to shield, filter or adapt their child's access to information about COVID-19, especially in relation to the death rates within each country. Despite this, children in this study reported knowing that COVID-19 was deadly and spreads quickly. This paper argues for a community rather than individual approach to addressing children's health literacy needs during a pandemic.


Asunto(s)
/mortalidad , Alfabetización en Salud/estadística & datos numéricos , Australia/epidemiología , Brasil/epidemiología , /transmisión , Canadá/epidemiología , Niño , Salud del Niño , Estudios Transversales , Femenino , Humanos , Masculino , Sistemas en Línea , Pandemias/estadística & datos numéricos , España/epidemiología , Encuestas y Cuestionarios , Suecia/epidemiología , Reino Unido/epidemiología
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