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Hart T, Westerheim I, van Welzenis T, Semler O, Raggio C, Rauch F, Dadzie R, Prince S, Wekre LL. The IMPACT Survey: the economic impact of osteogenesis imperfecta in adults. Orphanet J Rare Dis 2024; 19:222. [PMID: 38831282 PMCID: PMC11149192 DOI: 10.1186/s13023-024-03218-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/15/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The IMPACT survey aimed to elucidate the humanistic, clinical and economic burden of osteogenesis imperfecta (OI) on individuals with OI, their families, caregivers and wider society. Research methodology, demographics and initial insights from the survey have been previously reported. The cost of illness (healthcare resource use, productivity loss, out-of-pocket spending) and drivers of the economic impact of OI are reported here. METHODS IMPACT was an international mixed-methods online survey in eight languages (fielded July-September 2021) targeting adults (aged ≥ 18 years) or adolescents (aged ≥ 12-17 years) with OI, caregivers with or without OI and other close relatives. Survey domains included demographics, socioeconomic factors, clinical characteristics, treatment patterns, quality of life and health economics. The health economic domain for adults, which included questions on healthcare resource use, productivity loss and out-of-pocket spending, was summarised. Regression and pairwise analyses were conducted to identify independent drivers and associations with respondent characteristics. RESULTS Overall, 1,440 adults with OI responded to the survey. Respondents were mostly female (70%) and from Europe (63%) with a median age of 43 years. Within a 12-month period, adults with OI reported visiting a wide range of healthcare professionals. Two-thirds (66%) of adults visited a hospital, and one-third (33%) visited the emergency department. The mean total number of diagnostic tests undergone by adults within these 12 months was 8.0. Adults had undergone a mean total of 11.8 surgeries up to the time point of the survey. The proportions of adults using queried consumables or services over 12 months ranged from 18-82%, depending on the type of consumable or service. Most adults (58%) were in paid employment, of which nearly one-third (29%) reported missing a workday. Of the queried expenses, the mean total out-of-pocket spending in 4 weeks was €191. Respondent characteristics such as female sex, more severe self-reported OI and the experience of fractures were often associated with increased economic burden. CONCLUSION IMPACT provides novel insights into the substantial cost of illness associated with OI on individuals, healthcare systems and society at large. Future analyses will provide insights into country-specific economic impact, humanistic impact and the healthcare journey of individuals with OI.
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Affiliation(s)
- Tracy Hart
- Osteogenesis Imperfecta Foundation, Gaithersburg, MD, USA
| | | | | | - Oliver Semler
- Faculty of Medicine and University Hospital Cologne, Department of Paediatrics, University of Cologne, Cologne, Germany
| | | | | | - Ruby Dadzie
- Wickenstones Ltd, Abingdon, Oxfordshire, UK.
| | | | - Lena Lande Wekre
- TRS National Resource Center for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesodden, Norway
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Zhang T, Liu H, Lu Y, Wang Q, Loh YC, Li Z. IMPACT OF CLIMATE CHANGE ON COASTAL ECOSYSTEM AND OUTDOOR ACTIVITIES: A COMPARATIVE ANALYSIS AMONG FOUR LARGEST COASTLINE COVERING COUNTRIES. ENVIRONMENTAL RESEARCH 2024; 250:118405. [PMID: 38365060 DOI: 10.1016/j.envres.2024.118405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/25/2024] [Accepted: 02/01/2024] [Indexed: 02/18/2024]
Abstract
Climate change and coastal ecosystems have become challenging subjects for world sustainability. Humans, animals, and other ocean habitats are primarily affected by the harmful changes in climate. Coastal ecosystems support biodiversity and a wide range of species that serve as habitats for many commercially important fish species and enhance human activities in coastal areas. By engaging in coastal outdoor activities, individuals can experience numerous physical and mental health benefits, foster environmental awareness. This study provided valuable insights into the importance of coastal outdoor activities and their potential to improve our quality of life. This study undertook a challenging subject where we graphically and econometrically analyze the relationship and linkages among coastal indicators with other climate-concerning factors. The study comprises the ordinary regression and comparative analysis among the four largest coastline countries in the world. The study took a sample from Canada, Indonesia, Norway, and the Russian Federation from 1990 to 2022. The data is selected on a convenient basis. Results declared that each country has its unique challenges and opportunities in mitigating adverse climate change and retaining a sustainable coastal ecosystem. The study surprisingly revealed that climate change insignificantly affects the coastal ecosystem in Indonesia and the Russian Federation while it inversely affects the coastal ecosystem in Canada and Norway, showed that climate change on average declines coastal production by 0.0041922 and 0.0261104 in Canada and Norway respectively. The detailed review is given in the results section; however, the pooling analysis proved that at the aggregate level, a one percent increase in climate change caused a 0.02266-tonne decline in coastal ecosystems in the four largest coastline nations. There is a need for policies tend to increase CAP activities by implementing practical marine protected areas. Furthermore, scientific research and monitoring will be beneficial in restoring coastal sustainability.
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Affiliation(s)
- Tiejun Zhang
- Institute of Physical Education, Henan University of Economics and Law, Zheng zhou 450067, Henan, China.
| | - Huarong Liu
- School of Physical Education, China University of Geosciences, Wuhan, Hubei Province, China.
| | - Yi Lu
- Sports Teaching and Research Section, Wuhan University of Communication, Wuhan 430205, China.
| | - Qinglei Wang
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Yean Chun Loh
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Minden, Penang, Malaysia; School of Chemical Sciences, Universiti Sains Malaysia, 11800, Minden, Penang, Malaysia.
| | - Zeyun Li
- Geography Section, School of Humanities, Universiti Sains Malaysia, Penang, Malaysia.
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Buonanno M, Kleiman NJ, Welch D, Hashmi R, Shuryak I, Brenner DJ. 222 nm far-UVC light markedly reduces the level of infectious airborne virus in an occupied room. Sci Rep 2024; 14:6722. [PMID: 38509265 PMCID: PMC10954628 DOI: 10.1038/s41598-024-57441-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 03/18/2024] [Indexed: 03/22/2024] Open
Abstract
An emerging intervention for control of airborne-mediated pandemics and epidemics is whole-room far-UVC (200-235 nm). Laboratory studies have shown that 222-nm light inactivates airborne pathogens, potentially without harm to exposed occupants. While encouraging results have been reported in benchtop studies and in room-sized bioaerosol chambers, there is a need for quantitative studies of airborne pathogen reduction in occupied rooms. We quantified far-UVC mediated reduction of aerosolized murine norovirus (MNV) in an occupied mouse-cage cleaning room within an animal-care facility. Benchtop studies suggest that MNV is a conservative surrogate for airborne viruses such as influenza and coronavirus. Using four 222-nm fixtures installed in the ceiling, and staying well within current recommended regulatory limits, far-UVC reduced airborne infectious MNV by 99.8% (95% CI: 98.2-99.9%). Similar to previous room-sized bioaerosol chamber studies on far-UVC efficacy, these results suggest that aerosolized virus susceptibility is significantly higher in room-scale tests than in bench-scale laboratory studies. That said, as opposed to controlled laboratory studies, uncertainties in this study related to airflow patterns, virus residence time, and dose to the collected virus introduce uncertainty into the inactivation estimates. This study is the first to directly demonstrate far-UVC anti-microbial efficacy against airborne pathogens in an occupied indoor location.
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Affiliation(s)
- Manuela Buonanno
- Center for Radiological Research, Columbia University Irving Medical Center, 630 West 168th St., New York, NY, 10032, USA.
| | - Norman J Kleiman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
| | - David Welch
- Center for Radiological Research, Columbia University Irving Medical Center, 630 West 168th St., New York, NY, 10032, USA
| | - Raabia Hashmi
- Center for Radiological Research, Columbia University Irving Medical Center, 630 West 168th St., New York, NY, 10032, USA
| | - Igor Shuryak
- Center for Radiological Research, Columbia University Irving Medical Center, 630 West 168th St., New York, NY, 10032, USA
| | - David J Brenner
- Center for Radiological Research, Columbia University Irving Medical Center, 630 West 168th St., New York, NY, 10032, USA.
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Kuroda M, Shaw AV, Campagna CD. The experiences of community health workers when communicating with refugees about COVID-19 vaccines in Syracuse, NY: A qualitative study. Heliyon 2024; 10:e26136. [PMID: 38434037 PMCID: PMC10906162 DOI: 10.1016/j.heliyon.2024.e26136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 03/05/2024] Open
Abstract
Background Refugees are among the most health-vulnerable members of society. Despite the importance of vaccination to mitigate the risks associated with COVID-19 infection, ensuring adequate access and uptake of the COVID-19 vaccine remains a pressing concern for refugee populations. Research has suggested that community-oriented approaches and open communication with trusted individuals are essential to address this challenge. Vaccine outreach efforts were performed in Syracuse, NY, by Community Health Workers (CHWs) as trusted refugee community members. This study explored CHWs' experiences during vaccine outreach and perceptions about COVID-19 vaccine hesitancy and acceptance among refugees, including barriers and facilitators to vaccination. Methods A qualitative study was performed using thematic analysis following six semi-structured interviews with CHWs. Results Four main themes supported by 16 sub-themes were extracted. CHWs described the (1) diverse beliefs and attitudes of refugees by ethnic group, with most having low vaccine acceptance at first. (2) Barriers included contextual barriers, lack of awareness, misinformation, and withdrawal when forced from vaccine mandates. However, CHWs also identified numerous (3) facilitators to vaccination, including the internal processing and eventual vaccine acceptance, supported by external messaging by CHWs and time. Culturally sensitive intervention strategies occurred through (4) CHW team efforts and their provision of reliable information to refugee clients, with openness and over time. The team efforts of CHWs significantly contributed to refugee acceptance and uptake of the COVID-19 vaccine. Conclusions This study revealed how the refugee population changed their belief towards the COVID-19 vaccine through trust, time, and reliable information provided by CHWs and describes culturally sensitive strategies for vaccine uptake by refugees. CHWs' reflection on COVID-19 vaccine hesitancy and acceptance among refugees during outreach efforts is an essential perspective when implementing future public health interventions.
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Affiliation(s)
- Moe Kuroda
- Norton College of Medicine, MPH Program, SUNY Upstate Medical University, Syracuse, NY, USA
- Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of General Medicine, Toyama University Hospital, Toyama, Japan
| | - Andrea V. Shaw
- Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Christina D. Campagna
- Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of Public Health & Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
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Hurtado DA, Greenspan SA, Alley L, Hammer LB, Furnari M, Lenhart A. Safety Responsiveness and Psychological Distress Among Health Care Workers During COVID-19 (2020-2022) in the Pacific Northwest. Am J Public Health 2024; 114:204-212. [PMID: 38354349 PMCID: PMC10916732 DOI: 10.2105/ajph.2024.307582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 02/16/2024]
Abstract
Objectives. The COVID-19 pandemic imposed unprecedented safety challenges on health care facilities. This study examined whether health care workers who deemed a better safety response to the pandemic by their units or employers experienced lower psychological distress. Methods. Patient care workers at a health care system in the Pacific Northwest were surveyed every 6 to 8 months from May 2020 to May 2022 (n = 3468). Psychological distress was measured with the Well-being Index (range: -2 to 7 points). Safety response was scored on the basis of participants' ratings (on a 1-5 scale) of equipment sufficiency and responsiveness to safety concerns by their health care system and unit. Results. Adjusted multilevel regressions showed an inverse association between safety responsiveness and psychological distress at the individual level (b = -0.54; 95% confidence interval [CI] = -0.67, -0.41) and the unit level (b = -0.73; 95% CI = -1.46, -0.01). The cross-level interaction was also statistically significant (b = -0.46; 95% CI = -0.87, -0.05). Conclusions. Health care workers who deemed a better response to safety challenges reported lower psychological distress. This study highlights the need for continued efforts to ensure adequate safety resources. (Am J Public Health. 2024;114(S2):S204-S212. https://doi.org/10.2105/AJPH.2024.307582).
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Affiliation(s)
- David A Hurtado
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Samuel A Greenspan
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Lindsey Alley
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Leslie B Hammer
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Megan Furnari
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
| | - Abigail Lenhart
- The authors are with Oregon Health & Science University, Portland. David A. Hurtado, Samuel A. Greenspan, Leslie B. Hammer, and Lindsey Alley are with the Oregon Institute of Occupational Health Sciences. Megan Furnari is with the Division of Neonatology, School of Medicine. Abigail Lenhart is with the Division of General Internal Medicine and Geriatrics
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Nash D, Srivastava A, Shen Y, Penrose K, Kulkarni SG, Zimba R, You W, Berry A, Mirzayi C, Maroko A, Parcesepe AM, Grov C, Robertson MM. Seroincidence of SARS-CoV-2 infection prior to and during the rollout of vaccines in a community-based prospective cohort of U.S. adults. Sci Rep 2024; 14:644. [PMID: 38182731 PMCID: PMC10770061 DOI: 10.1038/s41598-023-51029-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/29/2023] [Indexed: 01/07/2024] Open
Abstract
This study used repeat serologic testing to estimate infection rates and risk factors in two overlapping cohorts of SARS-CoV-2 N protein seronegative U.S. adults. One mostly unvaccinated sub-cohort was tracked from April 2020 to March 2021 (pre-vaccine/wild-type era, n = 3421), and the other, mostly vaccinated cohort, from March 2021 to June 2022 (vaccine/variant era, n = 2735). Vaccine uptake was 0.53% and 91.3% in the pre-vaccine and vaccine/variant cohorts, respectively. Corresponding seroconversion rates were 9.6 and 25.7 per 100 person-years. In both cohorts, sociodemographic and epidemiologic risk factors for infection were similar, though new risk factors emerged in the vaccine/variant era, such as having a child in the household. Despite higher incidence rates in the vaccine/variant cohort, vaccine boosters, masking, and social distancing were associated with substantially reduced infection risk, even through major variant surges.
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Affiliation(s)
- Denis Nash
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA.
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA.
- CUNY Graduate School of Public Health and Health Policy, 55 W. 125th St., 6th Floor, New York, NY, 10027, USA.
| | - Avantika Srivastava
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
| | - Yanhan Shen
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
| | - Kate Penrose
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
| | - Sarah G Kulkarni
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
| | - Rebecca Zimba
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
| | - William You
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
| | - Amanda Berry
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
| | - Chloe Mirzayi
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
| | - Andrew Maroko
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
- Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
| | - Angela M Parcesepe
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
- Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christian Grov
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
| | - McKaylee M Robertson
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA
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7
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Zhao X, Kadono M, Kranzler EC, Pavisic I, Miles S, Maher M, Strausser L, Cai X, Hoffman L. Message Fatigue and COVID-19 Vaccine Booster Uptake in the United States. JOURNAL OF HEALTH COMMUNICATION 2024; 29:61-71. [PMID: 37962284 DOI: 10.1080/10810730.2023.2282036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Dissemination of public health information plays an essential role in communicable disease control and prevention. However, widespread and repeated messaging could become counterproductive if it leads to avoidance and disengagement due to message fatigue. Americans have been inundated with accurate and inaccurate COVID-19 information from myriad sources since the start of the pandemic. Using the health belief model (HBM) as a guiding framework, this study examines COVID-19-related message fatigue among adults in the United States who have gotten at least one dose of a COVID-19 vaccine and the association between message fatigue and COVID-19 booster uptake and intentions. A special survey module of The COVID States Project was fielded between August and September 2022 (n = 16,546). Results showed moderately high levels of message fatigue among vaccinated individuals. Message fatigue was negatively associated with the likelihood of having gotten a COVID-19 booster and intentions to do so among those who had not yet received a booster, above and beyond variance explained by the HBM constructs. These findings underscore the importance of monitoring and mitigating COVID-19-related message fatigue in encouraging the public to stay up to date with COVID-19 vaccination.
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Affiliation(s)
- Xiaoquan Zhao
- Department of Communication, George Mason University, Fairfax, Virginia, USA
| | - Mika Kadono
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia, USA
| | - Elissa C Kranzler
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia, USA
| | - Ivica Pavisic
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia, USA
| | - Stephanie Miles
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia, USA
| | - Marcus Maher
- Advanced Analytics, Fors Marsh, Arlington, Virginia, USA
| | - Lindsey Strausser
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia, USA
| | - Xiaomei Cai
- Department of Communication, George Mason University, Fairfax, Virginia, USA
| | - Leah Hoffman
- Communication Campaign Research & Evaluation, Fors Marsh, Arlington, Virginia, USA
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Quenzer FC, Coyne CJ, Ferran K, Williams A, Lafree AT, Kajitani S, Mathen G, Villegas V, Kajitani KM, Tomaszewski C, Brodine S. ICU Admission Risk Factors for Latinx COVID-19 Patients at a U.S.-Mexico Border Hospital. J Racial Ethn Health Disparities 2023; 10:3039-3050. [PMID: 36478268 PMCID: PMC9735002 DOI: 10.1007/s40615-022-01478-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Few studies have examined the impact of coronavirus disease 2019 (COVID-19) on the primarily Latinx community along the U.S.-Mexico border. This study explores the socioeconomic impacts which contribute to strong predictors of severe COVID-19 complications such as intensive care unit (ICU) hospitalization in a primarily Latinx/Hispanic U.S.-Mexico border hospital. METHODS A retrospective, observational study of 156 patients (≥ 18 years) Latinx/Hispanic patients who were admitted for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at a U.S.-Mexico border hospital from April 10, 2020, to May 30, 2020. Descriptive statistics of sex, age, body mass index (BMI), and comorbidities (coronary artery disease, hypertension, diabetes, cancer/lymphoma, current use of immunosuppressive drug therapy, chronic kidney disease/dialysis, or chronic respiratory disease). Multivariate regression models were produced from the most significant variables and factors for ICU admission. RESULTS Of the 156 hospitalized Latinx patients, 63.5% were male, 84.6% had respiratory failure, and 45% were admitted to the ICU. The average age was 67.2 (± 12.2). Those with body mass index (BMI) ≥ 25 had a higher frequency of ICU admission. Males had a 4.4 (95% CI 1.58, 12.308) odds of ICU admission (p = 0.0047). Those who developed acute kidney injury (AKI) and BMI 25-29.9 were strong predictors of ICU admission (p < 0.001 and p = 0.0020, respectively). Those with at least one reported comorbidity had 1.98 increased odds (95% CI 1.313, 2.99) of an ICU admission. CONCLUSION Findings show that age, AKI, and male sex were the strongest predictors of COVID-19 ICU admissions in the primarily Latinx population at the U.S.-Mexico border. These predictors are also likely driven by socioeconomic inequalities which are most apparent in border hospitals.
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Affiliation(s)
- Faith C Quenzer
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA.
- Department of Emergency Medicine, Temecula Valley Hospital, Temecula, CA, USA.
| | - Christopher J Coyne
- Department of Emergency Medicine, University of California San Diego Health, San Diego, CA, USA
| | - Karen Ferran
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA
| | - Ashley Williams
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA
| | - Andrew T Lafree
- Department of Emergency Medicine, University of California San Diego Health, San Diego, CA, USA
- Department of Emergency Medicine, El Centro Regional Medical Center, El Centro, CA, USA
| | - Sten Kajitani
- Department of Emergency Medicine, University of California San Diego Health, San Diego, CA, USA
- Department of Emergency Medicine, El Centro Regional Medical Center, El Centro, CA, USA
| | - George Mathen
- Department of Emergency Medicine, University of California San Diego Health, San Diego, CA, USA
- Department of Emergency Medicine, El Centro Regional Medical Center, El Centro, CA, USA
| | - Vanessa Villegas
- Department of Emergency Medicine, El Centro Regional Medical Center, El Centro, CA, USA
| | - Kari M Kajitani
- Department of Emergency Medicine, University of California San Diego Health, San Diego, CA, USA
- Department of Emergency Medicine, El Centro Regional Medical Center, El Centro, CA, USA
| | - Christian Tomaszewski
- Department of Emergency Medicine, University of California San Diego Health, San Diego, CA, USA
- Department of Emergency Medicine, El Centro Regional Medical Center, El Centro, CA, USA
| | - Stephanie Brodine
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA
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Rusk R, Hodge J. Impact of nasal photodisinfection on SARS-CoV-2 infection in an industrial workplace. PUBLIC HEALTH IN PRACTICE 2023; 6:100393. [PMID: 37309366 PMCID: PMC10229198 DOI: 10.1016/j.puhip.2023.100393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/25/2023] [Accepted: 05/02/2023] [Indexed: 06/14/2023] Open
Abstract
Objectives We aimed to evaluate a quality improvement initiative designed to control SARS-CoV-2 (COVID) using the large-scale deployment of antimicrobial photodisinfection therapy (aPDT) for nasal decolonization in a Canadian industrial workplace (a food processing plant). Study design Using a retrospective chart review of treatment questionnaires, linked to COVID laboratory testing results, a quality improvement assessment was analyzed to determine treatment effectiveness and safety. Methods This voluntary aPDT intervention involved the administration of a light-sensitive liquid to the nose followed by nonthermal red-light irradiation on a weekly basis. Employees in food processing industries are at increased risk for COVID infection due to the nature of their work environments. In an effort to mitigate the transmission and consequences of the disease among such workers and the community at large, aPDT was added to a well-established bundle of pre-existing pandemic safety measures (e.g., mask-wearing, testing, contact tracing, workplace-engineered barriers, increased paid sick leave). Results From December 2020 to May 2021, we found high interest in and compliance with aPDT treatment, along with a statistically significant lower PCR test positivity rate in the study population in comparison to the case rates for the local Canadian province. Treatment safety monitoring and outcomes of the aPDT program demonstrated no serious adverse events. Conclusions This study suggests nasal photodisinfection provides safe and effective COVID viral suppression when deployed across the majority of workers in an industrial workplace setting.
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Affiliation(s)
- Richard Rusk
- Department of Emergency Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Judy Hodge
- Katrime Integrated Health, Winnipeg, Manitoba, Canada
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10
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Johnson KE, Pasco R, Woody S, Lachmann M, Johnson-Leon M, Bhavnani D, Klima J, Paltiel AD, Fox SJ, Meyers LA. Optimizing COVID-19 testing strategies on college campuses: Evaluation of the health and economic costs. PLoS Comput Biol 2023; 19:e1011715. [PMID: 38134223 PMCID: PMC10773932 DOI: 10.1371/journal.pcbi.1011715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/08/2024] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
Colleges and universities in the US struggled to provide safe in-person education throughout the COVID-19 pandemic. Testing coupled with isolation is a nimble intervention strategy that can be tailored to mitigate the changing health and economic risks associated with SARS-CoV-2. We developed a decision-support tool to aid in the design of university-based screening strategies using a mathematical model of SARS-CoV-2 transmission. Applying this framework to a large public university reopening in the fall of 2021 with a 60% student vaccination rate, we find that the optimal strategy, in terms of health and economic costs, is twice weekly antigen testing of all students. This strategy provides a 95% guarantee that, throughout the fall semester, case counts would not exceed twice the CDC's original high transmission threshold of 100 cases per 100k persons over 7 days. As the virus and our medical armament continue to evolve, testing will remain a flexible tool for managing risks and keeping campuses open. We have implemented this model as an online tool to facilitate the design of testing strategies that adjust for COVID-19 conditions as well as campus-specific populations, resources, and priorities.
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Affiliation(s)
- Kaitlyn E. Johnson
- Department of Integrative Biology, The University of Texas at Austin, Austin, Texas, United States of America
- The Pandemic Prevention Institute, The Rockefeller Foundation, New York, New York, United States of America
| | - Remy Pasco
- Department of Integrative Biology, The University of Texas at Austin, Austin, Texas, United States of America
| | - Spencer Woody
- Department of Integrative Biology, The University of Texas at Austin, Austin, Texas, United States of America
| | - Michael Lachmann
- Santa Fe Institute, Santa Fe, New Mexico, United States of America
| | - Maureen Johnson-Leon
- Department of Integrative Biology, The University of Texas at Austin, Austin, Texas, United States of America
| | - Darlene Bhavnani
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, United States of America
| | - Jessica Klima
- Office of the Vice President for Research, The University of Texas at Austin, Austin, Texas, United States of America
| | - A. David Paltiel
- Public Health Modeling Unit, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Spencer J. Fox
- Department of Integrative Biology, The University of Texas at Austin, Austin, Texas, United States of America
- Department of Epidemiology & Biostatistics, The University of Georgia, Athens, Georgia, United States of America
| | - Lauren Ancel Meyers
- Department of Integrative Biology, The University of Texas at Austin, Austin, Texas, United States of America
- Santa Fe Institute, Santa Fe, New Mexico, United States of America
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11
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Li H, Huang J, Lian X, Zhao Y, Yan W, Zhang L, Li L. Impact of human mobility on the epidemic spread during holidays. Infect Dis Model 2023; 8:1108-1116. [PMID: 37859862 PMCID: PMC10582379 DOI: 10.1016/j.idm.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/24/2023] [Accepted: 10/03/2023] [Indexed: 10/21/2023] Open
Abstract
COVID-19 has posed formidable challenges as a significant global health crisis. Its complexity stems from factors like viral contagiousness, population density, social behaviors, governmental regulations, and environmental conditions, with interpersonal interactions and large-scale activities being particularly pivotal. To unravel these complexities, we used a modified SEIR epidemiological model to simulate various outbreak scenarios during the holiday season, incorporating both inter-regional and intra-regional human mobility effects into the parameterization scheme. In addition, evaluation metrics were used to evaluate the accuracy of the model simulation by comparing the congruence between simulated results and recorded confirmed cases. The findings suggested that intra-city mobility led to an average surge of 57.35% in confirmed cases of China, while inter-city mobility contributed to an average increase of 15.18%. In the simulation for Tianjin, China, a one-week delay in human mobility attenuated the peak number of cases by 34.47% and postponed the peak time by 6 days. The simulation for the United States revealed that human mobility played a more pronounced part in the outbreak, with a notable disparity in peak cases when mobility was considered. This study highlights that while inter-regional mobility acted as a trigger for the epidemic spread, the diffusion effect of intra-regional mobility was primarily responsible for the outbreak. We have a better understanding on how human mobility and infectious disease epidemics interact, and provide empirical evidence that could contribute to disease prevention and control measures.
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Affiliation(s)
- Han Li
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
- College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Jianping Huang
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
- College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Xinbo Lian
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
- College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Yingjie Zhao
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
- College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Wei Yan
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
- College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Li Zhang
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
- College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Licheng Li
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, 730000, China
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12
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Galipeau Y, Xavier A, Dyks A, Cooper C, Langlois MA. Continuous false positive results by SARS-CoV-2 rapid antigen testing: a case report. Front Public Health 2023; 11:1240308. [PMID: 38026284 PMCID: PMC10657208 DOI: 10.3389/fpubh.2023.1240308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/29/2023] [Indexed: 12/01/2023] Open
Abstract
Efficient and rapid identification of active SARS-CoV-2 infections has been key to monitoring and mitigating the spread of the virus. The implementation of nucleic acid testing (e.g., RT-PCR) was broadly adopted by most public health organizations at the national and community levels across the globe, which was followed by more accessible means of home testing including lateral flow immunochromatographic assay (LFA), also known as a rapid antigen test. Here we report the case of an adult female who repeatedly and consecutively tested positive by RAT (BTNX inc). This sustained false positive was not linked with an active SARS-CoV-2 infection, which was ruled out by RT-PCR and serological analyses. SARS-CoV-2 serology revealed no detectable levels of antibodies against the nucleocapsid suggesting no recent prior infection by SARS-CoV-2. This continuous false positive was limited to BTNX testing devices. This case report aims to describe that such continuous false positives can occur and describes alternative testing approaches that can be performed to confirm RAT results. In addition, broader awareness of such occurrences is warranted in the healthcare and public health community to avoid unnecessary negative impacts on individual's day to day life.
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Affiliation(s)
- Yannick Galipeau
- Department of Biochemistry, Microbiology & Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Abishek Xavier
- Department of Biochemistry, Microbiology & Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Aaron Dyks
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Curtis Cooper
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Marc-André Langlois
- Department of Biochemistry, Microbiology & Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa Centre for Infection, Immunity and Inflammation (CI3), Ottawa, ON, Canada
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13
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Agrawal V, Cantor J, Sood N, Whaley C. The impact of COVID-19 shelter-in-place policy responses on excess mortality. HEALTH ECONOMICS 2023; 32:2499-2515. [PMID: 37464737 DOI: 10.1002/hec.4737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 05/24/2023] [Accepted: 06/25/2023] [Indexed: 07/20/2023]
Abstract
As a way of slowing COVID-19 transmission, many countries and U.S. states implemented shelter-in-place (SIP) policies. However, the effects of SIP policies on public health are a priori ambiguous. Using an event study approach and data from 43 countries and all U.S. states, we measure changes in excess deaths following the implementation of COVID-19 shelter-in-place (SIP) policies. We do not find that countries or U.S. states that implemented SIP policies earlier had lower excess deaths. We do not observe differences in excess deaths before and after the implementation of SIP policies, even when accounting for pre-SIP COVID-19 death rates.
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Affiliation(s)
- Virat Agrawal
- University of Southern California, Los Angeles, California, USA
| | | | - Neeraj Sood
- University of Southern California, Los Angeles, California, USA
- National Bureau for Economic Research, Cambridge, Massachusetts, USA
| | - Christopher Whaley
- RAND Corporation, Santa Monica, California, USA
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA
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14
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Ryan RE, Silke C, Parkhill A, Virgona A, Merner B, Hurley S, Walsh L, de Moel-Mandel C, Schonfeld L, Edwards AG, Kaufman J, Cooper A, Chung RKY, Solo K, Hellard M, Di Tanna GL, Pedrana A, Saich F, Hill S. Communication to promote and support physical distancing for COVID-19 prevention and control. Cochrane Database Syst Rev 2023; 10:CD015144. [PMID: 37811673 PMCID: PMC10561351 DOI: 10.1002/14651858.cd015144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
BACKGROUND This review is an update of a rapid review undertaken in 2020 to identify relevant, feasible and effective communication approaches to promote acceptance, uptake and adherence to physical distancing measures for COVID-19 prevention and control. The rapid review was published when little was known about transmission, treatment or future vaccination, and when physical distancing measures (isolation, quarantine, contact tracing, crowd avoidance, work and school measures) were the cornerstone of public health responses globally. This updated review includes more recent evidence to extend what we know about effective pandemic public health communication. This includes considerations of changes needed over time to maintain responsiveness to pandemic transmission waves, the (in)equities and variable needs of groups within communities due to the pandemic, and highlights again the critical role of effective communication as integral to the public health response. OBJECTIVES To update the evidence on the question 'What are relevant, feasible and effective communication approaches to promote acceptance, uptake and adherence to physical distancing measures for COVID-19 prevention and control?', our primary focus was communication approaches to promote and support acceptance, uptake and adherence to physical distancing. SECONDARY OBJECTIVE to explore and identify key elements of effective communication for physical distancing measures for different (diverse) populations and groups. SEARCH METHODS We searched MEDLINE, Embase and Cochrane Library databases from inception, with searches for this update including the period 1 January 2020 to 18 August 2021. Systematic review and study repositories and grey literature sources were searched in August 2021 and guidelines identified for the eCOVID19 Recommendations Map were screened (November 2021). SELECTION CRITERIA Guidelines or reviews focusing on communication (information, education, reminders, facilitating decision-making, skills acquisition, supporting behaviour change, support, involvement in decision-making) related to physical distancing measures for prevention and/or control of COVID-19 or selected other diseases (sudden acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, Ebola virus disease (EVD) or tuberculosis (TB)) were included. New evidence was added to guidelines, reviews and primary studies included in the 2020 review. DATA COLLECTION AND ANALYSIS Methods were based on the original rapid review, using methods developed by McMaster University and informed by Cochrane rapid review guidance. Screening, data extraction, quality assessment and synthesis were conducted by one author and checked by a second author. Synthesis of results was conducted using modified framework analysis, with themes from the original review used as an initial framework. MAIN RESULTS This review update includes 68 studies, with 17 guidelines and 20 reviews added to the original 31 studies. Synthesis identified six major themes, which can be used to inform policy and decision-making related to planning and implementing communication about a public health emergency and measures to protect the community. Theme 1: Strengthening public trust and countering misinformation: essential foundations for effective public health communication Recognising the key role of public trust is essential. Working to build and maintain trust over time underpins the success of public health communications and, therefore, the effectiveness of public health prevention measures. Theme 2: Two-way communication: involving communities to improve the dissemination, accessibility and acceptability of information Two-way communication (engagement) with the public is needed over the course of a public health emergency: at first, recognition of a health threat (despite uncertainties), and regularly as public health measures are introduced or adjusted. Engagement needs to be embedded at all stages of the response and inform tailoring of communications and implementation of public health measures over time. Theme 3: Development of and preparation for public communication: target audience, equity and tailoring Communication and information must be tailored to reach all groups within populations, and explicitly consider existing inequities and the needs of disadvantaged groups, including those who are underserved, vulnerable, from diverse cultural or language groups, or who have lower educational attainment. Awareness that implementing public health measures may magnify existing or emerging inequities is also needed in response planning, enactment and adjustment over time. Theme 4: Public communication features: content, timing and duration, delivery Public communication needs to be based on clear, consistent, actionable and timely (up-to-date) information about preventive measures, including the benefits (whether for individual, social groupings or wider society), harms (likewise) and rationale for use, and include information about supports available to help follow recommended measures. Communication needs to occur through multiple channels and/or formats to build public trust and reach more of the community. Theme 5: Supporting behaviour change at individual and population levels Supporting implementation of public health measures with practical supports and services (e.g. essential supplies, financial support) is critical. Information about available supports must be widely disseminated and well understood. Supports and communication related to them require flexibility and tailoring to explicitly consider community needs, including those of vulnerable groups. Proactively monitoring and countering stigma related to preventive measures (e.g. quarantine) is also necessary to support adherence. Theme 6: Fostering and sustaining receptiveness and responsiveness to public health communication Efforts to foster and sustain public receptiveness and responsiveness to public health communication are needed throughout a public health emergency. Trust, acceptance and behaviours change over time, and communication needs to be adaptive and responsive to these changing needs. Ongoing community engagement efforts should inform communication and public health response measures. AUTHORS' CONCLUSIONS Implications for practice Evidence highlights the critical role of communication throughout a public health emergency. Like any intervention, communication can be done well or poorly, but the consequences of poor communication during a pandemic may mean the difference between life and death. The approaches to effective communication identified in this review can be used by policymakers and decision-makers, working closely with communication teams, to plan, implement and adjust public communications over the course of a public health emergency like the COVID-19 pandemic. Implications for research Despite massive growth in research during the COVID-19 period, gaps in the evidence persist and require high-quality, meaningful research. This includes investigating the experiences of people at heightened COVID-19 risk, and identifying barriers to implementing public communication and protective health measures particular to lower- and middle-income countries, and how to overcome these.
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Affiliation(s)
- Rebecca E Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Charlotte Silke
- UNESCO Child & Family Research Centre, School of Political Science & Sociology, University of Galway, Galway, Ireland
| | - Anne Parkhill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Ariane Virgona
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Shauna Hurley
- Cochrane Australia, School of Public Health & Preventive Medicine, Melbourne, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
- Department of Nursing and Allied Health, Swinburne University of Technology, Hawthorn, Australia
- Burnet Institute, Melbourne, Australia
| | | | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Adrian Gk Edwards
- Wales COVID-19 Evidence Centre, Cardiff University, 8th floor Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN , UK
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, 8th floor Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN, UK
| | - Jessica Kaufman
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
- Vaccine Uptake Group, Murdoch Children's Research Institute , The Royal Children's Hospital, Parkville, Australia
| | - Alison Cooper
- Wales COVID-19 Evidence Centre, Cardiff University, 8th floor Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN , UK
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, 8th floor Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN, UK
| | | | - Karla Solo
- GRADE McMaster & Cochrane Canada, Health Research Methods, Evidence & Impact, McMaster University , Hamilton, Ontario , Canada
| | | | - Gian Luca Di Tanna
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Lugano, Switzerland
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | | | | | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Nash D, Srivastava A, Shen J, Penrose K, Kulkarni SG, Zimba R, You W, Berry A, Mirzayi C, Maroko A, Parcesepe AM, Grov C, Robertson MM. Seroincidence of SARS-CoV-2 infection prior to and during the rollout of vaccines in a community-based prospective cohort of U.S. adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.29.23296142. [PMID: 37873066 PMCID: PMC10593054 DOI: 10.1101/2023.09.29.23296142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Background Infectious disease surveillance systems, which largely rely on diagnosed cases, underestimate the true incidence of SARS-CoV-2 infection, due to under-ascertainment and underreporting. We used repeat serologic testing to measure N-protein seroconversion in a well-characterized cohort of U.S. adults with no serologic evidence of SARS-CoV-2 infection to estimate the incidence of SARS-CoV-2 infection and characterize risk factors, with comparisons before and after the start of the SARS-CoV-2 vaccine and variant eras. Methods We assessed the incidence rate of infection and risk factors in two sub-groups (cohorts) that were SARS-CoV-2 N-protein seronegative at the start of each follow-up period: 1) the pre-vaccine/wild-type era cohort (n=3,421), followed from April to November 2020; and 2) the vaccine/variant era cohort (n=2,735), followed from November 2020 to June 2022. Both cohorts underwent repeat serologic testing with an assay for antibodies to the SARS-CoV-2 N protein (Bio-Rad Platelia SARS-CoV-2 total Ab). We estimated crude incidence and sociodemographic/epidemiologic risk factors in both cohorts. We used multivariate Poisson models to compare the risk of SARS-CoV-2 infection in the pre-vaccine/wild-type era cohort (referent group) to that in the vaccine/variant era cohort, within strata of vaccination status and epidemiologic risk factors (essential worker status, child in the household, case in the household, social distancing). Findings In the pre-vaccine/wild-type era cohort, only 18 of the 3,421 participants (0.53%) had ≥1 vaccine dose by the end of follow-up, compared with 2,497/2,735 (91.3%) in the vaccine/variant era cohort. We observed 323 and 815 seroconversions in the pre-vaccine/wild-type era and the vaccine/variant era and cohorts, respectively, with corresponding incidence rates of 9.6 (95% CI: 8.3-11.5) and 25.7 (95% CI: 24.2-27.3) per 100 person-years. Associations of sociodemographic and epidemiologic risk factors with SARS-CoV-2 incidence were largely similar in the pre-vaccine/wild-type and vaccine/variant era cohorts. However, some new epidemiologic risk factors emerged in the vaccine/variant era cohort, including having a child in the household, and never wearing a mask while using public transit. Adjusted incidence rate ratios (aIRR), with the entire pre-vaccine/wild-type era cohort as the referent group, showed markedly higher incidence in the vaccine/variant era cohort, but with more vaccine doses associated with lower incidence: aIRRun/undervaccinated=5.3 (95% CI: 4.2-6.7); aIRRprimary series only=5.1 (95% CI: 4.2-7.3); aIRRboosted once=2.5 (95% CI: 2.1-3.0), and aIRRboosted twice=1.65 (95% CI: 1.3-2.1). These associations were essentially unchanged in risk factor-stratified models. Interpretation In SARS-CoV-2 N protein seronegative individuals, large increases in incidence and newly emerging epidemiologic risk factors in the vaccine/variant era likely resulted from multiple co-occurring factors, including policy changes, behavior changes, surges in transmission, and changes in SARS-CoV-2 variant properties. While SARS-CoV-2 incidence increased markedly in most groups in the vaccine/variant era, being up to date on vaccines and the use of non-pharmaceutical interventions (NPIs), such as masking and social distancing, remained reliable strategies to mitigate the risk of SARS-CoV-2 infection, even through major surges due to immune evasive variants. Repeat serologic testing in cohort studies is a useful and complementary strategy to characterize SARS-CoV-2 incidence and risk factors.
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Affiliation(s)
- Denis Nash
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY); New York, New York, USA
| | - Avantika Srivastava
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY); New York, New York, USA
| | - Jenny Shen
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY); New York, New York, USA
| | - Kate Penrose
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
| | - Sarah Gorrell Kulkarni
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
| | - Rebecca Zimba
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY); New York, New York, USA
| | - William You
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
| | - Amanda Berry
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
| | - Chloe Mirzayi
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY); New York, New York, USA
| | - Andrew Maroko
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
- Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, City University of New York (CUNY); New York, New York, USA
| | - Angela M. Parcesepe
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
- Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Christian Grov
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York (CUNY); New York, New York, USA
| | - McKaylee M. Robertson
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY); New York, New York, USA
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16
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Blaak J, Grabmann S, Simon I, Callaghan T, Staib P. Five dimensions of cleansing: A holistic view on the facets and importance of skin cleansing. Int J Cosmet Sci 2023; 45:557-571. [PMID: 37367943 DOI: 10.1111/ics.12879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/19/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
Cleansing is an important human ritual practised for hygiene, well-being and relaxation over centuries. As part of body care it is often taken for granted, yet its relevance cannot be underestimated. Although cleansing the skin may seem trivial to some, it is accepted, that this fundamental function of skin cleansing products is highly complex, diverse and crucial for a variety of reasons in the personal, public, healthcare and dermatological settings. Employing a comprehensive and strategic approach in viewing cleansing and its rituals, supports innovation, understanding and development. Apart from being a fundamental function, as far as we know, there is no comprehensive presentation of skin cleansing with all its effects besides 'removing dirt'. To our knowledge, comprehensive analyses on the multi-dimensional facets of skin cleansing are either rare or not published. Against this background, we examine the importance of cleansing in terms of function, relevance and concepts. First, the key functions and efficacies of skin cleansing were investigated by literature research. Based on this survey, the functions were analysed, sorted and merged and a novel approach to skin cleansing 'dimensions' was developed. Herewith, we took into consideration the evolution of skin cleansing in terms of concept evolution, complexity and testing methods for cleansing products and their claims. Several multi-dimensional functions of skin cleansing were identified and then established into five skin cleansing dimensions, namely: hygienic and medical importance; socio-cultural and interpersonal relevance; mood, emotion and well-being; cosmetic and aesthetic function; corneobiological interactions. It became obvious, that these five dimensions with their corresponding 11 sub-dimensions, are influenced by each other throughout history by culture and society, technical progress, scientific knowledge and consumer trends. This article presents the enormous complexity of skin cleansing. Skin cleansing has evolved from basic care up to a highly complex and diverse cosmetic product category in terms of technology, efficacy and usage routine(s). In view of future challenges, such as the effects of climate and associated lifestyle changes, the development of skin cleansing will remain an exciting and important topic and thus will finally, again, further increase the complexity of skin cleansing itself.
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Affiliation(s)
- Jürgen Blaak
- Research & Development and Regulatory Affairs, Kneipp GmbH, Würzburg, Germany
| | - Svenja Grabmann
- Research & Development and Regulatory Affairs, Kneipp GmbH, Würzburg, Germany
| | - Isabel Simon
- Research & Development and Regulatory Affairs, Kneipp GmbH, Würzburg, Germany
| | | | - Peter Staib
- Research & Development and Regulatory Affairs, Kneipp GmbH, Würzburg, Germany
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17
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Johnson KF, Hood KB, Moreno O, Fuentes L, Williams CD, Vassileva J, Amstadter AB, Dick DM. COVID-19-Induced Inequalities and Mental Health: Testing the Moderating Roles of Self-rated Health and Race/Ethnicity. J Racial Ethn Health Disparities 2023; 10:2093-2103. [PMID: 36018451 PMCID: PMC9415252 DOI: 10.1007/s40615-022-01389-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 06/20/2022] [Accepted: 08/05/2022] [Indexed: 11/05/2022]
Abstract
This study examines the relationship among COVID-19-induced social, economic, and educational inequalities on mental health (i.e., anxiety and depression). This study also examines if levels of self-rated health (SRH) moderate the relationship (i.e., COVID-induced inequalities [CII] and mental health), as well as examines the racial/ethnic group differences among 567 young adults in the mid-Atlantic region. Using a moderation model, results indicate that CII were significantly related to depression (b = .221, t(554) = 4.59, p = .000) and anxiety (b = .140, t(555) = 3.23, p = .001). SRH and race/ethnicity also moderated both relationships. At above-average SRH (i.e., moderator), higher CII were also significantly related to lower anxiety (Asian young adults only) and lower depression (Asian and White young adults only). Overall, SRH and race/ethnicity are important factors in the mental health impact of COVID-19 on young adults.
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Affiliation(s)
- Kaprea F Johnson
- Department of Educational Studies, The Ohio State University, Columbus, OH, USA
| | - Kristina B Hood
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA.
| | - Oswaldo Moreno
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
| | - Lisa Fuentes
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
| | - Chelsea Derlan Williams
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
| | - Jasmin Vassileva
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Ananda B Amstadter
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Danielle M Dick
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
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18
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Salmani B, Hasani J, Zanjani Z, Gholami-Fesharaki M. Two Years after the Beginning of COVID-19: Comparing Families Who Had or Did not Have Patients with COVID-19 on Health Beliefs and Obsessive-Compulsive Symptoms. IRANIAN JOURNAL OF PSYCHIATRY 2023; 18:429-442. [PMID: 37881416 PMCID: PMC10593991 DOI: 10.18502/ijps.v18i4.13630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/15/2022] [Accepted: 01/30/2023] [Indexed: 10/27/2023]
Abstract
Objective: This study aimed to compare health beliefs and obsessive-compulsive symptoms (OCS) in families with (FIM+) or without an infected member (FIM-) two years after the beginning of COVID-19. Additionally, this research intended to predict a decrease in OCS from baseline (T1) to 40 days later (T2) based on health beliefs. Method : In a longitudinal survey, 227 participants in two groups, including FIM+ (n = 98; M = 30.44; SD = 5.39) and FIM- (n = 129; M = 29.24; SD = 4.93), were selected through purposive sampling. They responded to measurements consisting of demographic characteristics, the Obsessive-Compulsive Inventory-Revised (OCI-R), Patient Health Questionnaire (PHQ-9), Impact of Event Scale-Revised (IES-R), and COVID-19 Health Belief Questionnaire (COVID-19-HBQ) at the final assessment phase (T2). To investigate differences between the two groups and predict OCS changes from T1 to T2, data were analyzed using Chi-squared, t-tests, U-Mann-Whitney, Kruskal-Wallis, Pearson correlations, and linear regression analyses. Results: At T1, FIM+ demonstrated significantly greater OCS, health beliefs, posttraumatic stress symptoms (PTS), and depressive symptoms than FIM-. Furthermore, FIM+ showed a decrease in OCS from T1 to T2 after its infected member recovered from COVID-19 (P < 0.001). A decrease in OCS was correlated with a decrease in perceived susceptibility, severity, and barriers. Lack of a vulnerable family member, lower educational attainment, and being a primary caregiver were associated with a greater decrease in OCS. Changes in perceived severity and self-efficacy accounted for 17% of variation in OCS. Conclusion: Even two years after the onset of the pandemic, COVID-19 not only impacts the life of patients with COVID-19 but family members who care for such patients respond to the disease by engaging in excessive health behaviors in the form of OCS.
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Affiliation(s)
- Behzad Salmani
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
| | - Jafar Hasani
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
| | - Zahra Zanjani
- Department of Clinical Psychology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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19
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Jones RM, Snead R, Sarwer DB, Ibrahim JK. Mask Adherence and the Relationship Between Masking and Weather-Related Metrics. J Community Health 2023; 48:761-768. [PMID: 37097507 PMCID: PMC10126535 DOI: 10.1007/s10900-023-01219-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2023] [Indexed: 04/26/2023]
Abstract
Little is known about adherence to COVID-19 masking mandates on college campuses or the relationship between weather-related variables and masking. This study aimed to (1) observe students' adherence to on-campus mask mandates and (2) estimate the effect of weather on mask-wearing. Temple University partnered in the Centers for Disease Control and Prevention's observational Mask Adherence Surveillance at Colleges and Universities Project. February-April 2021, weekly observations were completed at 12 on-campus locations to capture whether individuals wore masks, wore them correctly, and the type of mask worn. Fashion and university masks also were recorded. Weekly average temperature, humidity, and precipitation were calculated. Descriptive statistics were calculated for masking adherence overall, over time, and by location. Statistical significance was assessed between correct mask use and mask type and the linear relationships between weekly weather metrics and mask use. Overall, 3508 individuals were observed with 89.6% wearing masks. Of those, 89.4% correctly wore masks. Cloth (58.7%) and surgical masks (35.3%) were most commonly observed and 21.3% wore fashion masks. N95/KN95 masks were correctly worn in 98.3% of observations and surgical and cloth masks were correctly worn ~ 90% of the time. Weekly adherence varied over time and by campus location. Significant inverse linear relationships existed between weekly temperature (r = - 0.72; p < 0.05) and humidity (r = - 0.63; p ≤ 0.05) and masking. Mask adherence and correct use was high. Temperature and humidity inversely affected adherence. Adherence varied by on-campus location, which suggests the locations (e.g., academic buildings, recreational center) and possibly the characteristics of individuals who frequent certain areas impacted adherence.
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Affiliation(s)
- Resa M Jones
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, 1301 Cecil B. Moore Ave. Ritter Annex, 9thFloor, Philadelphia, PA, 19122, USA.
- Fox Chase Cancer Center, Temple University Health, Philadelphia, PA, USA.
| | - Ryan Snead
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, 1301 Cecil B. Moore Ave. Ritter Annex, 9thFloor, Philadelphia, PA, 19122, USA
| | - David B Sarwer
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Jennifer K Ibrahim
- Department of Health Services, Administration, and Policy, College of Public Health, Temple University, Philadelphia, PA, USA
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20
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Van Rensburg D, Adams AK, Perez G, Bishop S, Warne T, Hassell L, Quigley T, Garza L, Dupuis V, Drain PK, Whiting Sorrell A, Ko LK. Factors influencing COVID-19 testing among Native Americans and Latinos in two rural agricultural communities: a qualitative study. Front Public Health 2023; 11:1220052. [PMID: 37790722 PMCID: PMC10543655 DOI: 10.3389/fpubh.2023.1220052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/25/2023] [Indexed: 10/05/2023] Open
Abstract
Objective To examine factors influencing decisions to test for COVID-19 among Native Americans on the Flathead Reservation in Montana and the Latino community in the Yakima Valley of Washington state. Methods We conducted 30 key informant interviews with community leaders and six focus groups with community members to examine factors impacting decisions to test for COVID-19 during the second year of the COVID-19 pandemic from May 2021 to June 2021. Results Three major themes that impacted testing for COVID-19 were identified: (1) Social factors, including the influence of families and friends and employment practices; (2) health factors, including testing procedures, home-based testing, and health communication; and (3) contextual factors, including distrust for government and medical communities and the impact on cultural practices and celebrations. Conclusions Social, health, and contextual factors influence the decision to test for COVID-19. Understanding the community's perception is critical for successful implementation of preventive strategies.
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Affiliation(s)
- Dillon Van Rensburg
- Institute of Translational Health Sciences, University of Washington, Seattle, WA, United States
| | - Alexandra K. Adams
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, United States
| | - Georgina Perez
- Institute of Translational Health Sciences, University of Washington, Seattle, WA, United States
| | - Sonia Bishop
- Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Teresa Warne
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, United States
| | - Laurie Hassell
- Institute of Translational Health Sciences, University of Washington, Seattle, WA, United States
| | - Thomas Quigley
- Collaborative Data Services, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Lorenzo Garza
- Family and Community Engagement, Sunnyside School District, Sunnyside, WA, United States
| | - Virgil Dupuis
- Extension Office, Salish Kootenai College, Pablo, MT, United States
| | - Paul K. Drain
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Anna Whiting Sorrell
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, United States
| | - Linda K. Ko
- Health Systems and Population Health, University of Washington, Seattle, WA, United States
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21
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Smith MAJHJ, Earl J, Dawson L. The Ethics of Personal Behaviors for Preventing Infectious Diseases in a Post-COVID-19 Pandemic World. Public Health Rep 2023; 138:822-828. [PMID: 37476927 PMCID: PMC10363674 DOI: 10.1177/00333549231184931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Affiliation(s)
- MAJ Hunter Jackson Smith
- Global Emerging Infections Surveillance Branch, Armed Forces Health Surveillance Division, US Department of Defense, Silver Spring, MD, USA
- Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, USA
| | - Jake Earl
- Research Ethics and Integrity Team, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Liza Dawson
- Research Ethics and Integrity Team, Walter Reed Army Institute of Research, Silver Spring, MD, USA
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22
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Lin Y, Cheng L, Wang Q, Xu W. Effects of Medical Masks on Voice Assessment During the COVID-19 Pandemic. J Voice 2023; 37:802.e25-802.e29. [PMID: 34116888 DOI: 10.1016/j.jvoice.2021.04.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Voice assessment is of great significance to the evaluation of voice quality. Our study aims to explore the effects of medical masks on healthy people in acoustic, aerodynamic and formant parameters during the COVID-19 pandemic. In addition, we also attempted to verify the differences between different sexes and ages. METHODS Fifty-three healthy participants (25 males and 28 females) were involved in our study. The acoustic parameters, including fundamental frequency (F0), sound pressure level (SPL), percentage of jitter (%), percentage of shimmer (%), noise to harmonic ratio (NHR) and cepstral peak prominence (CPP), aerodynamic parameter (maximum phonation time, MPT) and formant parameters (formant frequency, F1, F2, F3) without and with wearing medical masks were included. We further investigated the potential differences in the impact on different sexes and ages (≤45 years old and >45 years old). RESULTS While wearing medical masks, the SPL significantly increased (71.22±4.25 dB, 72.42±3.96 dB, P = 0.021). Jitter and shimmer significantly decreased (jitter 1.19±0.83, 0.87±0.67 P = 0.005; shimmer 4.49±2.20, 3.66±2.02 P = 0.002), as did F3 (2855±323.34 Hz, 2781.89±353.42 Hz P = 0.004). F0, MPT, F1 and F2 showed increasing trends without statistical significance, and NHR as well as CPP showed little change without and with wearing medical masks. There were no significant differences seen between males and females. Regarding to age, a significant difference in MPT was seen (>45-year-old 16.15±6.98 s, 15.38±7.02 s; ≤45-year-old 20.26±6.47 s, 21.44±6.98 s, P = 0.032). CONCLUSION Healthy participants showed a significantly higher SPL, a smaller perturbation and an evident decrease in F3 after wearing medical masks. These changes may result from the adjustment of the vocal tract and the filtration function of medical masks, leading to the stability of voices we recorded being overstated. The impacts of medical masks on sex were not evident, while the MPT in the >45-year-old group was influenced more than that in the ≤45-year-old group.
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Affiliation(s)
- Yuhong Lin
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Liyu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qingcui Wang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wen Xu
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
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23
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Boulos DNK, Hassan AM. Using the Health Belief Model to assess COVID-19 perceptions and behaviours among a group of Egyptian adults: a cross-sectional study. BMC Public Health 2023; 23:1624. [PMID: 37626356 PMCID: PMC10464151 DOI: 10.1186/s12889-023-16513-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND It is crucial to study the public's perceptions and behaviour during a pandemic as this will be the driving force for practicing recommended precautions. The current study aimed to identify perceptions of a group of Egyptian adults to COVID-19 using the Health Belief Model (HBM), to measure self-reported practice of preventive behaviours and to identify influencing factors. METHODS Cross sectional study was used, including Egyptian adults aged 18 + years. A structured anonymous online questionnaire was used including: a demographic section, the modified MERS- CoV Health Belief Model scale after addition of questions related to COVID-19 and questions on preventive behaviours to COVID-19. RESULTS Of the 532 study participants, 28.6% were males, age ranges (18 to 74 years). There was a statistically significant positive correlation between total practice score and all COVID-19 Health Belief Model constructs total scores except for perceived barriers score showing negative correlation (P value < 0.05). Linear regression analysis showed that older age, male gender and living inside Cairo were associated with lower practice score (P value < 0.01). CONCLUSIONS Increased perceived susceptibility, perceived benefits, cues to action and perceived self-efficacy scores were associated with higher practice score in the current study. Additionally, results revealed that social media and websites can play an important role in shaping risk perception in the community. Stressing risk perception and efficacy beliefs prevention message can drive people to practice preventive behaviors.
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Affiliation(s)
- Dina N K Boulos
- Department of Public Health, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
- Department of Public Health and Community Medicine, School of Medicine, Newgiza University, Giza, Egypt.
| | - Azza Mohammed Hassan
- Department of Public Health, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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24
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Wu Y, Shi A, Chen L, Su D. Differential COVID-19 preventive behaviors among Asian subgroups in the United States. Expert Rev Respir Med 2023; 17:1049-1059. [PMID: 38018378 DOI: 10.1080/17476348.2023.2289527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/27/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Given the observed within-Asian disparity in COVID-19 incidence, we aimed to explore the differential preventive behaviors among Asian subgroups in the United States. METHODS Based on data from the Asian subsample (N = 982) of the 2020 Health, Ethnicity, and Pandemic survey, we estimated the weighted proportion of noncompliance with Centers for Disease Control and Prevention (CDC) guidelines on preventive behaviors and COVID-19 testing by Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Other Asian). We examined these subgroup differences after adjusting for demographic factors and state-level clustering. RESULTS Filipinos demonstrated the lowest rate of noncompliance for mask-wearing, social distancing, and handwashing. As compared with the Filipinos, our logistic models showed that the Chinese and the 'other Asians' subgroup had significantly higher risk of noncompliance with mask-wearing, while the Japanese, the Vietnamese, and other Asians were significantly more likely to report noncompliance with social distancing. CONCLUSIONS The significant variation of preventive behavior across Asian subgroups signals the necessity of data disaggregation when it comes to understanding the health behavior of Asian Americans, which is critical for future pandemic preparedness. The excess behavioral risk among certain Asian subgroups (especially those 'other Asians') warrants further investigation and interventions about the driving forces behind these disparities.
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Affiliation(s)
- YuJing Wu
- Department of Internal Medicine, Hangzhou Red Cross Hospital, Hangzhou, China
| | - Ahan Shi
- Independent researcher, Daniel High School Central, South Carolina, USA
| | - Laite Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Dejun Su
- Department of Health Promotion, University of Nebraska Medical Center, Nebraska, NE, USA
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25
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Losier A, Gupta G, Caldararo M, Dela Cruz CS. The Impact of Coronavirus Disease 2019 on Viral, Bacterial, and Fungal Respiratory Infections. Clin Chest Med 2023; 44:407-423. [PMID: 37085229 PMCID: PMC9968485 DOI: 10.1016/j.ccm.2022.11.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Although coronavirus disease 2019 (COVID-19) remains an ongoing threat, concerns regarding other respiratory infections remain. Throughout the COVID-19 pandemic various epidemiologic trends have been observed in other respiratory viruses including a reduction in influenza and respiratory syncytial virus infections following onset of the COVID-19 pandemic. Observations suggest that infections with other respiratory viruses were reduced with social distancing, mask wearing, eye protection, and hand hygiene practices. Coinfections with COVID-19 exist not only with other respiratory viruses but also with bacterial pneumonias and other nosocomial and opportunistic infections. Coinfections have been associated with increased severity of illness and other adverse outcomes.
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Affiliation(s)
- Ashley Losier
- Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT 06511, USA.
| | - Gayatri Gupta
- Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Mario Caldararo
- Veteran's Affairs Connecticut Healthcare System, West Haven, CT 06516, USA
| | - Charles S Dela Cruz
- Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT 06511, USA
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26
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Pizza L, Ronfard S, Coley JD, Kelemen D. Why we should care about moral foundations when preparing for the next pandemic: Insights from Canada, the UK and the US. PLoS One 2023; 18:e0285549. [PMID: 37172059 PMCID: PMC10180656 DOI: 10.1371/journal.pone.0285549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/26/2023] [Indexed: 05/14/2023] Open
Abstract
Health behaviors that do not effectively prevent disease can negatively impact psychological wellbeing and potentially drain motivations to engage in more effective behavior, potentially creating higher health risk. Despite this, studies linking "moral foundations" (i.e., concerns about harm, fairness, purity, authority, ingroup, and/or liberty) to health behaviors have generally been limited to a narrow range of behaviors, specifically effective ones. We therefore explored the degree to which moral foundations predicted a wider range of not only effective but ineffective (overreactive) preventative behaviors during the COVID-19 pandemic. In Study 1, participants from Canada, the United Kingdom, and the United States reported their engagement in these preventative behaviors and completed a COVID-specific adaptation of the Moral Foundations Questionnaire during the pandemic peak. While differences occurred across countries, authority considerations consistently predicted increased engagement in both effective preventative behaviors but also ineffective overreactions, even when controlling for political ideology. By contrast, purity and liberty considerations reduced intentions to engage in effective behaviors like vaccination but had no effect on ineffective behaviors. Study 2 revealed that the influence of moral foundations on U.S participants' behavior remained stable 5-months later, after the pandemic peak. These findings demonstrate that the impact of moral foundations on preventative behaviors is similar across a range of western democracies, and that recommendations by authorities can have unexpected consequences in terms of promoting ineffective-and potentially damaging-overreactive behaviors. The findings underscore the importance of moral concerns for the design of health interventions that selectively promote effective preventative behavior.
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Affiliation(s)
- Lizette Pizza
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, United States of America
| | - Samuel Ronfard
- Department of Psychology, University of Toronto at Mississauga, Mississauga, Ontario, Canada
| | - John D. Coley
- Department of Psychology, Northeastern University, Boston, Massachusetts, United States of America
- Department of Marine & Environmental Sciences, Northeastern University, Boston, Massachusetts, United States of America
| | - Deborah Kelemen
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, United States of America
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27
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Wong SC, Chan VWM, Yuen LLH, AuYeung CHY, Leung JOY, Li CK, Kwok MOT, So SYC, Chen JHK, Chiu KHY, Tam AR, Hung IFN, Kai-Wang To K, Lo JYC, Yuen KY, Cheng VCC. Infection of healthcare workers despite a high vaccination rate during the fifth wave of COVID-19 due to Omicron variant in Hong Kong. Infect Prev Pract 2023; 5:100261. [PMID: 36465098 PMCID: PMC9705264 DOI: 10.1016/j.infpip.2022.100261] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/15/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022] Open
Abstract
Background No nosocomial infection was recorded in our healthcare workers (HCWs) during the early phase of the coronavirus disease 2019 (COVID-19) pandemic. With the emergence of the Omicron variant of increased transmissibility, infection in HCWs occurred as expected. We aimed to study the epidemiology of infection in HCWs and to describe the infection control measures during the outbreak of the Omicron variant. Methods With daily rapid antigen testing and molecular confirmation test for COVID-19, infected HCWs were interviewed by infection control nurses (ICNs) to investigate the potential source of infection. The epidemiology of COVID-19 in Hong Kong served as reference. Results During the fifth wave of COVID-19 (31 December 2021 to 31 May 2022), 1,200,068 cases were reported (incidence 95 times higher than in preceding waves in Hong Kong; 162,103 vs 1,707 per million population respectively, P<0.001). The proportion of infected HCWs was significantly higher than that of the general population (24.9%, 1,607/6,452 vs 16.2%, 1,200,068/7,403,100 respectively; P<0.01). The proportion of infected non-clinical staff was significantly higher than that of clinical staff (31.8%, 536/1,687 vs 22.5%, 1,071/4,765 respectively; P<0.001). Of 82.8% (1,330/1,607) infected HCWs interviewed by ICNs, 99.5% (1,324/1,330) had been fully vaccinated; 49.5% (659/1,330) had no identifiable source; 40.7% (541/1,330) were probably infected from household members; 9.8% (130/1,330) had possible exposure to confirmed patients or HCWs, but no lapse in infection control measures or inappropriate use of personal protective equipment was recalled. Conclusion Omicron variant is highly transmissible such that breakthrough infection occurred despite high level of vaccination.
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Affiliation(s)
- Shuk-Ching Wong
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Veronica Wing-Man Chan
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Lithia Lai-Ha Yuen
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Christine Ho-Yan AuYeung
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Jessica Oi-Yan Leung
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Chi-Kuen Li
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Monica Oi-Tung Kwok
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Simon Yung-Chun So
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Jonathan Hon-Kwan Chen
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Kelvin Hei-Yeung Chiu
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Anthony Raymond Tam
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ivan Fan-Ngai Hung
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kelvin Kai-Wang To
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Janice Yee-Chi Lo
- Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Kwok-Yung Yuen
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Vincent Chi-Chung Cheng
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China,Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China,Corresponding author. Address: Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China. Tel.: +852 22552351, Fax: +852 23523698
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28
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Preas E, Carroll RA, Van Den Elzen G, Halbur M, Harper M. Evaluating the Use of Video Modeling With Voiceover Instructions to Train Therapists to Deliver Caregiver Training Through Telehealth. Behav Modif 2023; 47:402-431. [PMID: 35850543 DOI: 10.1177/01454455221111988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Caregiver training is an important component of behavioral intervention; however, many barriers exist for in-person training. Alternatively, behavioral therapists may use telehealth as a service delivery method. To effectively train caregivers through telehealth, therapists should receive explicit training, but there has been limited research on effective methods for teaching this skill. The purpose of the current study was to evaluate video modeling with voice-over instruction (VMVO) to train therapists to implement 11 component skills of caregiver training through telehealth to teach confederate caregivers to implement a guided compliance procedure. We measured the therapist's implementation of the component skills during a scripted role-play before and after video-model training within a multiple baseline design across participants. We also conducted maintenance and generalization probes to a novel skill. All seven therapists learned the skill, but three therapists required a feedback component in addition to the VMVO. The results suggest that VMVO may be an efficient and effective method for training therapists to conduct caregiver training via telehealth. Furthermore, results indicate that component skill analyses may be valuable to monitor skills that require remediation.
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Affiliation(s)
- Elizabeth Preas
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, USA
| | - Regina A Carroll
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, USA
| | | | - Mary Halbur
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, USA
| | - Megan Harper
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, USA
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Irvin R, Venkataramani M, Galiatsatos P, Hitchcock JD, Hemphill N, Dearey M, Bigelow BF, Cooper LA, Molello NE, O'Conor KJ, Page KR, Golden SH. A Path Forward: COVID-19 Vaccine Equity Community Education and Outreach Initiative. Health Secur 2023; 21:85-94. [PMID: 36791317 PMCID: PMC10079247 DOI: 10.1089/hs.2022.0096] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/28/2022] [Accepted: 11/29/2022] [Indexed: 02/17/2023] Open
Abstract
COVID-19 vaccines offer hope to end the COVID-19 pandemic. In this article, we document key lessons learned as we continue to confront COVID-19 variants and work to adapt our vaccine outreach strategies to best serve our community. In the fall of 2020, the Office of Diversity, Inclusion and Health Equity at Johns Hopkins Medicine, in collaboration with the Office of Government and Community Affairs for Johns Hopkins University and Medicine, established the COVID-19 Vaccine Equity Community Education and Outreach Initiative in partnership with faith and community leaders, local and state government representatives, and community-based organizations. Working with community and government partnerships established before COVID-19 enabled our team to quickly build infrastructure focused on COVID-19 vaccine education and equity. These partnerships resulted in the development and implementation of web-based educational content, major culturally adapted media campaigns (reaching more than 200,000 individuals), community and faith education outreach, youth-focused initiatives, and equity-focused mobile vaccine clinics. The community mobile vaccine clinics vaccinated over 3,000 people in the first 3 months. Of these, 90% identified as persons of color who have been disproportionately impacted during the COVID-19 pandemic. Academic-government-community partnerships are vital to ensure health equity. Community partnerships, education events, and open dialogues were conducted between the community and medical faculty. Using nontraditional multicultural media venues enabled us to reach many community members and facilitated informed decisionmaking. Additionally, an equitable COVID-19 vaccine policy requires attention to vaccine access as well as access to sound educational information. Our initiative has been thoughtful about using various types of vaccination sites, mobile vaccine units, and flexible hours of operation.
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Affiliation(s)
- Risha Irvin
- Risha Irvin, MD, MPH, is Associate Vice Chair for Diversity, Equity, and Inclusion, Department of Medicine; and Associate Professor, Division of Infectious Diseases; Johns Hopkins University School of Medicine, Baltimore, MD
| | - Maya Venkataramani
- Maya Venkataramani, MD, MPH, is an Assistant Professor, Division of General Internal Medicine of Medicine and Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Panagis Galiatsatos
- Panagis Galiatsatos, MD, MHS, is Co-Director, Medicine for the Greater Good, and an Assistant Professor, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jeanne D. Hitchcock
- Jeanne D. Hitchcock, JD, is Special Advisor to the Vice President for Local Government, Community, and Corporate Affairs; Johns Hopkins Local Government and Community Affairs, Johns Hopkins University and Medicine, Baltimore, MD
| | - Nondie Hemphill
- Nondie Hemphill, JD, is Associate Director, Johns Hopkins Local Government and Community Affairs, Johns Hopkins University and Medicine, Baltimore, MD
| | - Margaret Dearey
- Margaret Dearey, MHS, is a Research Program Coordinator, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Benjamin F. Bigelow
- Benjamin F. Bigelow is Director, COVID-19 Mobile Vaccine Team, Johns Hopkins Health System, Baltimore, MD
| | - Lisa A. Cooper
- Lisa A. Cooper, MD, MPH, is a Bloomberg Distinguished Professor, Equity in Health and Healthcare, Department of Health, Behavior, and Society; Director, Johns Hopkins Center for Health Equity; and Director, Johns Hopkins Urban Health Institute; all at the Johns Hopkins Bloomberg School of Public Health. She is also the James F. Fries Professor of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nancy Edwards Molello
- Nancy Edwards Molello, MSB, is Program Director, Operations and Strategic Initiatives, Johns Hopkins Center for Health Equity, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Katie J. O'Conor
- Katie J O'Conor, MD, is Faculty and Chief Diversity Officer, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kathleen R. Page
- Kathleen R. Page, MD, is an Associate Professor, Division of Infectious Diseases, and Co-Director, Center for Salud/Health and Opportunities for Latinos, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sherita H. Golden
- Sherita H. Golden, MD, MHS, is Vice President and Chief Diversity Officer, Johns Hopkins Medicine; and Hugh P. McCormick Family Professor of Endocrinology and Metabolism, Johns Hopkins Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD
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Wu N, Joyal-Desmarais K, Ribeiro PAB, Vieira AM, Stojanovic J, Sanuade C, Yip D, Bacon SL. Long-term effectiveness of COVID-19 vaccines against infections, hospitalisations, and mortality in adults: findings from a rapid living systematic evidence synthesis and meta-analysis up to December, 2022. THE LANCET. RESPIRATORY MEDICINE 2023; 11:439-452. [PMID: 36780914 PMCID: PMC9917454 DOI: 10.1016/s2213-2600(23)00015-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Synthesising evidence on the long-term vaccine effectiveness of COVID-19 vaccines (BNT162b2 [Pfizer-BioNTech], mRNA-1273 [Moderna], ChAdOx1 nCoV-19 [AZD1222; Oxford-AstraZeneca], and Ad26.COV2.S [Janssen]) against infections, hospitalisations, and mortality is crucial to making evidence-based pandemic policy decisions. METHODS In this rapid living systematic evidence synthesis and meta-analysis, we searched EMBASE and the US National Institutes of Health's iSearch COVID-19 Portfolio, supplemented by manual searches of COVID-19-specific sources, until Dec 1, 2022, for studies that reported vaccine effectiveness immediately and at least 112 days after a primary vaccine series or at least 84 days after a booster dose. Single reviewers assessed titles, abstracts, and full-text articles, and extracted data, with a second reviewer verifying included studies. The primary outcomes were vaccine effectiveness against SARS-CoV-2 infections, hospitalisations, and mortality, which were assessed using three-level meta-analytic models. This study is registered with the National Collaborating Centre for Methods and Tools, review 473. FINDINGS We screened 16 696 records at the title and abstract level, appraised 832 (5·0%) full texts, and initially included 73 (0·4%) studies. Of these, we excluded five (7%) studies because of critical risk of bias, leaving 68 (93%) studies that were extracted for analysis. For infections caused by any SARS-CoV-2 strain, vaccine effectiveness for the primary series reduced from 83% (95% CI 80-86) at baseline (14-42 days) to 62% (53-69) by 112-139 days. Vaccine effectiveness at baseline was 92% (88-94) for hospitalisations and 91% (85-95) for mortality, and reduced to 79% (65-87) at 224-251 days for hospitalisations and 86% (73-93) at 168-195 days for mortality. Estimated vaccine effectiveness was lower for the omicron variant for infections, hospitalisations, and mortality at baseline compared with that of other variants, but subsequent reductions occurred at a similar rate across variants. For booster doses, which covered mostly omicron studies, vaccine effectiveness at baseline was 70% (56-80) against infections and 89% (82-93) against hospitalisations, and reduced to 43% (14-62) against infections and 71% (51-83) against hospitalisations at 112 days or later. Not enough studies were available to report on booster vaccine effectiveness against mortality. INTERPRETATION Our analyses indicate that vaccine effectiveness generally decreases over time against SARS-CoV-2 infections, hospitalisations, and mortality. The baseline vaccine effectiveness levels for the omicron variant were notably lower than for other variants. Therefore, other preventive measures (eg, face-mask wearing and physical distancing) might be necessary to manage the pandemic in the long term. FUNDING Canadian Institutes of Health Research and the Public Health Agency of Canada.
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Affiliation(s)
- Nana Wu
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Keven Joyal-Desmarais
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Paula A B Ribeiro
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Ariany Marques Vieira
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Jovana Stojanovic
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
| | - Comfort Sanuade
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Doro Yip
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Simon L Bacon
- META Group, Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, Canada.
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31
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Aboulatta L, Kowalec K, Leong C, Delaney JA, Falk J, Alessi-Severini S, Chateau D, Tan Q, Kearns K, Raimondi C, Vaccaro C, Lavu A, Haidar L, Peymani P, Eltonsy S. Preterm birth and stillbirth rates associated with socioeconomic disparities during COVID-19 pandemic: a population-based cross-sectional study. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001686. [PMID: 36806202 PMCID: PMC9943698 DOI: 10.1136/bmjpo-2022-001686] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/07/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Conflicting evidence exists on the impact of the COVID-19 pandemic restrictions on preterm birth (PTB) and stillbirth rates. We aimed to evaluate changes in PTB and stillbirth rates before and during the pandemic period and assess the potential effect modification of socioeconomic status (SES). METHODS Using the linked administrative health databases from Manitoba, Canada, we conducted a cross-sectional study among all pregnant women, comparing 3.5 years pre-pandemic (1 October 2016 to 29 February 2020) to the first year of the pandemic (1 March 2020 to 31 March 2021). We used generalised linear models to assess the quarterly rates of PTB (<37 weeks) and stillbirths. We calculated the predicted trends based on pre-pandemic period data. Finally, we evaluated the PTB and stillbirth rates among lower and higher SES pregnant women (average annual household income) using subgroup analysis and interaction models. RESULTS We examined 70 931 pregnancies in Manitoba during the study period. The risk of PTB increased by 7.7% (95%CI 1.01 to 1.13) and stillbirths by 33% (95% CI 1.08 to 1.64) during the pandemic period. Following COVID-19 restrictions implemented in March 2020, there were increases in the quarterly rates of both PTB (immediate increase (β2)=1.37; p=0.0247) and stillbirths (immediate increase (β2)=0.12; p=0.4434). Among the lower income groups, the pandemic restrictions resulted in an immediate relative increase in PTB and stillbirth rates by 20.12% (immediate increase (β2)=3.17; p=0.0057) and 27.19% (immediate increase (β2)=0.48; p=0.0852). However, over the pandemic, the overall PTB rate significantly decreased as a rebound effect by 0.85% per quarter (p=0.0004), whereas the overall stillbirth rate did not decrease significantly (slope decrease (β3) =-0.01; p=0.8296) compared with the pre-pandemic period. The quarterly rates during the pandemic among the higher income group decreased by 0.39% (p=0.1296) for PTB and increased by 0.07% (p=0.1565) for stillbirth. We observed an effect modification by SES for PTB rates (p=0.047). CONCLUSION While the onset of COVID-19 pandemic restrictions was not associated with significant effects on stillbirth rates, we observed an immediate and rebound effect on PTB rates. The impact of COVID-19 on preterm birth was dependent on SES, with higher influence on families with lower SES. Further studies are needed to detect future trend changes during pandemic waves after 2021 and assess potential underlying mechanisms.
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Affiliation(s)
- Laila Aboulatta
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kaarina Kowalec
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christine Leong
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Psychiatry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Joseph A Delaney
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Jamie Falk
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Silvia Alessi-Severini
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Dan Chateau
- College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Qier Tan
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Katherine Kearns
- Department of Family Medicine, College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christina Raimondi
- Department of Family Medicine, College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christine Vaccaro
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alekhya Lavu
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lara Haidar
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Payam Peymani
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sherif Eltonsy
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada .,Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
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Abulsoud AI, El-Husseiny HM, El-Husseiny AA, El-Mahdy HA, Ismail A, Elkhawaga SY, Khidr EG, Fathi D, Mady EA, Najda A, Algahtani M, Theyab A, Alsharif KF, Albrakati A, Bayram R, Abdel-Daim MM, Doghish AS. Mutations in SARS-CoV-2: Insights on structure, variants, vaccines, and biomedical interventions. Biomed Pharmacother 2023; 157:113977. [PMID: 36370519 PMCID: PMC9637516 DOI: 10.1016/j.biopha.2022.113977] [Citation(s) in RCA: 67] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 10/29/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
COVID-19 is a worldwide pandemic caused by SARS-coronavirus-2 (SARS-CoV-2). Less than a year after the emergence of the Covid-19 pandemic, many vaccines have arrived on the market with innovative technologies in the field of vaccinology. Based on the use of messenger RNA (mRNA) encoding the Spike SARS-Cov-2 protein or on the use of recombinant adenovirus vectors enabling the gene encoding the Spike protein to be introduced into our cells, these strategies make it possible to envisage the vaccination in a new light with tools that are more scalable than the vaccine strategies used so far. Faced with the appearance of new variants, which will gradually take precedence over the strain at the origin of the pandemic, these new strategies will allow a much faster update of vaccines to fight against these new variants, some of which may escape neutralization by vaccine antibodies. However, only a vaccination policy based on rapid and massive vaccination of the population but requiring a supply of sufficient doses could make it possible to combat the emergence of these variants. Indeed, the greater the number of infected individuals, the faster the virus multiplies, with an increased risk of the emergence of variants in these RNA viruses. This review will discuss SARS-CoV-2 pathophysiology and evolution approaches in altered transmission platforms and emphasize the different mutations and how they influence the virus characteristics. Also, this article summarizes the common vaccines and the implication of the mutations and genetic variety of SARS-CoV-2 on the COVID-19 biomedical arbitrations.
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Affiliation(s)
- Ahmed I Abulsoud
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City 11231, Cairo, Egypt; Department of Biochemistry and Biotechnology, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Hussein M El-Husseiny
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai Cho, Fuchu-shi, Tokyo 183-8509, Japan; Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh, Elqaliobiya 13736, Egypt.
| | - Ahmed A El-Husseiny
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City 11231, Cairo, Egypt; Department of Biochemistry, Faculty of Pharmacy, Egyptian Russian University, Badr City 11829, Cairo, Egypt
| | - Hesham A El-Mahdy
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City 11231, Cairo, Egypt
| | - Ahmed Ismail
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City 11231, Cairo, Egypt
| | - Samy Y Elkhawaga
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City 11231, Cairo, Egypt
| | - Emad Gamil Khidr
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City 11231, Cairo, Egypt
| | - Doaa Fathi
- Department of Biochemistry and Biotechnology, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Eman A Mady
- Laboratory of Veterinary Physiology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai Cho, Fuchu-shi, Tokyo 183-8509, Japan; Department of Animal Hygiene, Behavior and Management, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh, Elqaliobiya 13736, Egypt
| | - Agnieszka Najda
- Department of Vegetable Crops and Medicinal Plants University of Life Sciences, Lublin 50A Doświadczalna Street, 20-280, Lublin, Poland.
| | - Mohammad Algahtani
- Department of Laboratory & Blood Bank, Security Forces Hospital, P.O. Box 14799, Mecca 21955, Saudi Arabia
| | - Abdulrahman Theyab
- Department of Laboratory & Blood Bank, Security Forces Hospital, P.O. Box 14799, Mecca 21955, Saudi Arabia; College of Medicine, Al-Faisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia
| | - Khalaf F Alsharif
- Department of Clinical Laboratory sciences, College of Applied medical sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Ashraf Albrakati
- Department of Human Anatomy, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Roula Bayram
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, P.O. Box 6231, Jeddah 21442, Saudi Arabia
| | - Mohamed M Abdel-Daim
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, P.O. Box 6231, Jeddah 21442, Saudi Arabia; Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ahmed S Doghish
- Department of Biochemistry, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt.
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Mori T, Nagata T, Ikegami K, Hino A, Tateishi S, Tsuji M, Matsuda S, Fujino Y, Mori K, Ando H, Eguchi H, Muramatsu K, Mafune K, Okawara M, Kuwamura M, Matsugaki R, Ishimaru T, Igarashi Y. Effect of COVID-19 infection related experiences on social behaviors when a state of emergency is declared: a cohort study. BMC Public Health 2022; 22:2445. [PMID: 36577963 PMCID: PMC9795144 DOI: 10.1186/s12889-022-14864-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Restricting the movement of the public to gathering places and limiting close physical contact are effective measures against COVID-19 infection. In Japan, states of emergency have been declared in specific prefectures to reduce public movement and control COVID-19 transmission. We investigated how COVID-19 infection related experiences including people with a history of infection, people with a history of close contact, and people whose acquaintances have been infected, affected self-restraint from social behaviors during the second state of emergency in Japan. METHODS A prospective cohort study was conducted among workers aged 20-65 years using data from an internet survey. The baseline survey was conducted on December 22-25, 2020, and a follow-up survey was on February 18-19, 2021. There were 19,051 participants who completed both surveys and were included in the final analysis. We identified eight social behaviors: (1) eating out (4 people or fewer); (2) eating out (5 people or more); (3) gathering with friends and colleagues; (4) day trip; (5) overnight trip (excluding visiting home); (6) visiting home; (7) shopping for daily necessities; and (8) shopping for other than daily necessities. We set self-restraint regarding each social behavior after the second state of emergency was declared in January 2021 as the dependent variable, and COVID-19 infection related experiences as independent variables. Odds ratios were estimated using multilevel logistic regression analyses nested in the prefecture of residence. RESULTS Significant differences by COVID-19 infection related experiences were identified: compared to people without COVID-19 related experiences, people with a history of COVID-19 were less likely self-restraint from most social behaviors. People whose acquaintance had been diagnosed with COVID-19 were significantly more likely to refrain from most social behaviors. There was no significant difference in any social behaviors for people with a history of close contact only. CONCLUSION To maximize the effect of a state of emergency, health authorities should disseminate information for each person in the target population, taking into account potential differences related to the infection related experiences.
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Affiliation(s)
- Takahiro Mori
- grid.271052.30000 0004 0374 5913Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Tomohisa Nagata
- grid.271052.30000 0004 0374 5913Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Kazunori Ikegami
- grid.271052.30000 0004 0374 5913Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Ayako Hino
- grid.271052.30000 0004 0374 5913Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu , Fukuoka 807-8555 Japan
| | - Seiichiro Tateishi
- grid.271052.30000 0004 0374 5913Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu , Fukuoka 807-8555 Japan
| | - Mayumi Tsuji
- grid.271052.30000 0004 0374 5913Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Shinya Matsuda
- grid.271052.30000 0004 0374 5913Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Yoshihisa Fujino
- grid.271052.30000 0004 0374 5913Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
| | - Koji Mori
- grid.271052.30000 0004 0374 5913Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka 807-8555 Japan
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Engdaw GT, Worede EA, Destaw Bitew B. The Practice of Post-vaccination COVID-19 Prevention Strategy Among Healthcare Professionals in Felege Hiwot Referral Hospital, Northwest Ethiopia. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221146892. [PMID: 36601521 PMCID: PMC9805928 DOI: 10.1177/11786302221146892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) is an acute respiratory illness first discovered and identified in China. Countries are taking precautions to prevent COVID-19 in accordance with WHO guidelines. OBJECTIVE The objective of this study was to assess the practice of the COVID-19 prevention strategy post-vaccination and associated factors among health care professionals in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia, in 2021. METHODS An institutional-based cross-sectional study was carried out at Felege Hiwot Referral Hospital, Bahir Dar. Data were entered into Epi-Info software, version 7.1, and exported to SPSS, version 23, for analysis. Descriptive statistics were used to describe the socio-demographic characteristics of the respondents. The crude odds ratio (COR) and the adjusted odds ratio (AOR) with 95% CI were calculated to determine the coefficient of the COVID-19 prevention strategy. RESULTS In this study, 68.7% (95% CI: 63.7, 73.8) of health care professionals had good practice of the COVID-19 prevention strategy post-vaccination. Sex (AOR: 1.76; 95% CI: 1.08, 2.89), marital status (AOR: 1.75; 95% CI: 1.09, 2.93), and good attitude toward vaccination (AOR: 3.24; 95% CI: 2.13, 5.48) were significantly associated with the practice of COVID-19 prevention strategies post vaccination. CONCLUSIONS The practices of COVID-19 preventive strategies post-vaccination were good among healthcare professionals. Good attitude toward vaccination, sex (male), marital status (married) were factors determining the occurrences of COVID-19 preventive strategies post-vaccination.
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Affiliation(s)
- Garedew Tadege Engdaw
- Garedew Tadege Engdaw, Department of
Environmental and Occupational Health and Safety, Institute of Public Health,
College of Medicine and Health Sciences, University of Gondar, Gondar, 196,
Ethiopia. Emails: ;
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Xie Z, Tan Y, Yan Y, Gu X, Chen H, Huang Q, Wang Z, Gu J, Huang J. Concerns about and stimuli of COVID-19 vaccination hesitancy among diverse occupational groups in metropolitan areas of China: a cross-sectional study. BMJ Open 2022; 12:e062032. [PMID: 36549746 PMCID: PMC9772125 DOI: 10.1136/bmjopen-2022-062032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES In this study, we aimed to identify concerns and stimuli regarding COVID-19 vaccination acceptance and to compare the findings by occupation. METHODS We conducted a cross-sectional study of individuals vaccinated against COVID-19 between 1 April and 30 June 2021 in four metropolitan areas of China. A total of 20 863 participants completed questionnaires, 20 767 of which were eligible for analysis. We used ordered logistic regression to assess the association of vaccination concerns and stimuli with vaccination hesitancy according to occupation. RESULTS Farmers were mainly concerned about the quality of vaccines (adjusted OR (aOR): 3.18, 95% CI (CI): 1.83 to 5.54). Among civil servants, media publicity reduced hesitancy (aOR: 0.44, 95% CI: 0.21 to 0.92). Among medical staff, concerns about a short duration of protective effects increased hesitancy (aOR: 8.31, 95% CI: 2.03 to 33.99). For most occupations, concerns about side effects, poor protective effects and health status increased hesitancy. In contrast, protecting oneself and protecting others acted as a stimulus to decrease hesitancy. Interestingly, 'people around me have been vaccinated' was associated with higher vaccination hesitancy among farmers (aOR: 2.19, 95% CI: 1.20 to 4.00). CONCLUSION The association of vaccination concerns and stimuli with vaccination hesitancy varied by occupation. The characteristics and concerns of specific target audiences should be considered when designing informational campaigns to promote vaccination against COVID-19.
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Affiliation(s)
- Zhilan Xie
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yinliang Tan
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuge Yan
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoqing Gu
- Xidu Community Health Service Center of Fengxian District, Shanghai, China
| | - Haiying Chen
- Xidu Community Health Service Center of Fengxian District, Shanghai, China
| | - Qian Huang
- Weifang Community Health Service Center of Pudong New District, Shanghai, China
| | - Zhaoxin Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Gu
- Department of General Practition, Zhongshan Hospital Fudan University, Shanghai, China
- International Medical Center, Zhong Shan Hospital, Shanghai, China
| | - Jiaoling Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Ren B, Hwang WT. Modeling post-holiday surge in COVID-19 cases in Pennsylvania counties. PLoS One 2022; 17:e0279371. [PMID: 36534663 PMCID: PMC9762594 DOI: 10.1371/journal.pone.0279371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
COVID-19 arrived in the United States in early 2020, with cases quickly being reported in many states including Pennsylvania. Many statistical models have been proposed to understand the trends of the COVID-19 pandemic and factors associated with increasing cases. While Poisson regression is a natural choice to model case counts, this approach fails to account for correlation due to spatial locations. Being a contagious disease and often spreading through community infections, the number of COVID-19 cases are inevitably spatially correlated as locations neighboring counties with a high COVID-19 case count are more likely to have a high case count. In this analysis, we combine generalized estimating equations (GEEs) for Poisson regression, a popular method for analyzing correlated data, with a semivariogram to model daily COVID-19 case counts in 67 Pennsylvania counties between March 20, 2020 to January 23, 2021 in order to study infection dynamics during the beginning of the pandemic. We use a semivariogram that describes the spatial correlation as a function of the distance between two counties as the working correlation. We further incorporate a zero-inflated model in our spatial GEE to accommodate excess zeros in reported cases due to logistical challenges associated with disease monitoring. By modeling time-varying holiday covariates, we estimated the effect of holiday timing on case count. Our analysis showed that the incidence rate ratio was significantly greater than one, 6-8 days after a holiday suggesting a surge in COVID-19 cases approximately one week after a holiday.
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Affiliation(s)
- Benny Ren
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - Wei-Ting Hwang
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Akowuah KA, Akuffo RA, Boateng AT, Asigbee TW, Bonney JHK, Lamptey H, Adusei-Poku MA, Obodai E, Asante IA, Adjei S, Aboagye JO, Adu-Amankwah S, Partey FD, Kyei GB, Ampofo WK, Odoom JK, Bonney EY. SARS-CoV-2 infections among asymptomatic individuals contributed to COVID-19 cases: A cross-sectional study among prospective air travelers from Ghana. Front Public Health 2022; 10:1035763. [PMID: 36589973 PMCID: PMC9795010 DOI: 10.3389/fpubh.2022.1035763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/11/2022] [Indexed: 12/15/2022] Open
Abstract
Background The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by asymptomatic individuals has been reported since the early stages of the coronavirus disease 2019 (COVID-19) outbreak in various parts of the world. However, there are limited data regarding SARS-CoV-2 among asymptomatic individuals in Ghana. The aim of the study was to use test data of prospective travelers from Ghana as a proxy to estimate the contribution of asymptomatic cases to the spread of COVID-19. Methods The study analyzed the SARS-CoV-2 PCR test data of clients whose purpose for testing was classified as "Travel" at the COVID-19 walk-in test center of the Noguchi Memorial Institute for Medical Research (NMIMR) from July 2020 to July 2021. These individuals requesting tests for travel generally had no clinical symptoms of COVID-19 at the time of testing. Data were processed and analyzed using Microsoft Excel office 16 and STATA version 16. Descriptive statistics were used to summarize data on test and demographic characteristics. Results Out of 42,997 samples tested at the center within that period, 28,384 (66.0%) were classified as "Travel" tests. Of these, 1,900 (6.7%) tested positive for SARS-CoV-2. The majority (64.8%) of the "Travel" tests were requested by men. The men recorded a SARS-CoV-2 positivity of 6.9% compared to the 6.4% observed among women. Test requests for SARS-CoV-2 were received from all regions of Ghana, with a majority (83.3%) received from the Greater Accra Region. Although the Eastern region recorded the highest SARS-CoV-2 positivity rate of 8.35%, the Greater Accra region contributed 81% to the total number of SARS-CoV-2 positive cases detected within the period of study. Conclusion Our study found substantial SARS-CoV-2 positivity among asymptomatic individuals who, without the requirement for a negative SARS-CoV-2 result for travel, would have no reason to test. These asymptomatic SARS-CoV-2-infected individuals could have traveled to other countries and unintentionally spread the virus. Our findings call for enhanced tracing and testing of asymptomatic contacts of individuals who tested positive for SARS-CoV-2.
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Affiliation(s)
- Kwasi A. Akowuah
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Richard A. Akuffo
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana,Medical and Scientific Research Centre, University of Ghana Medical Centre, Accra, Ghana
| | - Anthony T. Boateng
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Theodore W. Asigbee
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Joseph H. K. Bonney
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Helena Lamptey
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Mildred A. Adusei-Poku
- Department of Medical Microbiology, School of Medicine, University of Ghana, Accra, Ghana
| | - Evangeline Obodai
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ivy A. Asante
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Samuel Adjei
- Department of Animal Experimentation, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - James O. Aboagye
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana,Medical and Scientific Research Centre, University of Ghana Medical Centre, Accra, Ghana
| | - Susan Adu-Amankwah
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Frederica D. Partey
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - George B. Kyei
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana,Medical and Scientific Research Centre, University of Ghana Medical Centre, Accra, Ghana
| | - William K. Ampofo
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - John K. Odoom
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Evelyn Y. Bonney
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana,*Correspondence: Evelyn Y. Bonney
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Social cognitive predictors of vaccination status, uptake and mitigation behaviors in the Canadian COVID-19 Experiences survey. Vaccine 2022:S0264-410X(22)01526-2. [PMID: 36528446 PMCID: PMC9742224 DOI: 10.1016/j.vaccine.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 12/14/2022]
Abstract
Emerging infectious diseases like COVID-19 will remain a concern for the foreseeable future, and determinants of vaccination and other mitigation behaviors are therefore critical to understand. Using data from the first two waves of the Canadian COVID-19 Experiences Survey (CCES; N = 1,958; 66.56 % female), we examined social cognitive predictors of vaccination status, transition to acceptance and mitigation behaviors in a population-representative sample. Findings indicated that all social cognitive variables were strong predictors of mitigation behavior performance at each wave, particularly among unvaccinated individuals. Among those who were vaccine hesitant at baseline, most social cognitive variables predicted transition to fully vaccinated status at follow-up. After controlling for demographic factors and geographic region, greater odds of transitioning from unvaccinated at CCES Wave 1 to fully vaccinated at CCES Wave 2 was predicted most strongly by a perception that one's valued peers were taking up the vaccine (e.g., dynamic norms (OR = 2.13 (CI: 1.54,2.93)), perceived effectiveness of the vaccine (OR = 3.71 (CI: 2.43,5.66)), favorable attitudes toward the vaccine (OR = 2.80 (CI: 1.99,3.95)), greater perceived severity of COVID-19 (OR = 2.02 (CI: 1.42,2.86)), and stronger behavioral intention to become vaccinated (OR = 2.99 (CI: 2.16,4.14)). As a group, social cognitive variables improved prediction of COVID-19 mitigation behaviors (masking, distancing, hand hygiene) by a factor of 5 compared to demographic factors, and improved prediction of vaccination status by a factor of nearly 20. Social cognitive processes appear to be important leverage points for health communications to encourage COVID-19 vaccination and other mitigation behaviors, particularly among initially hesitant members of the general population.
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Dunphy C, Joo H, Sapiano MRP, Howard-Williams M, McCord R, Sunshine G, Kao SY, Guy GP, Weber R, Gakh M, Ekwueme DU. The Association Between State-Issued Mask Mandates and County COVID-19 Hospitalization Rates. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:712-719. [PMID: 36194816 PMCID: PMC9560902 DOI: 10.1097/phh.0000000000001602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
CONTEXT Mask mandates are one form of nonpharmaceutical intervention that has been utilized to combat the spread of SARS-CoV2, the virus that causes COVID-19. OBJECTIVE This study examines the association between state-issued mask mandates and changes in county-level and hospital referral region (HRR)-level COVID-19 hospitalizations across the United States. DESIGN Difference-in-difference and event study models were estimated to examine the association between state-issued mask mandates and COVID-19 hospitalization outcomes. PARTICIPANTS All analyses were conducted with US county-level data. INTERVENTIONS State-issued mask mandates. County-level data on the mandates were collected from executive orders identified on state government Web sites from April 1, 2020, to December 31, 2020. MAIN OUTCOME MEASURES Daily county-level (and HRR-level) estimates of inpatient beds occupied by patients with confirmed or suspected COVID-19 were collected by the US Department of Health and Human Services. RESULTS The state issuing of mask mandates was associated with an average of 3.6 fewer daily COVID-19 hospitalizations per 100 000 people (P < .05) and a 1.2-percentage-point decrease in the percentage of county beds occupied with COVID-19 patients (P < .05) within 70 days of taking effect. Event study results suggest that this association increased the longer mask mandates were in effect. In addition, the results were robust to analyses conducted at the HRR level. CONCLUSIONS This study demonstrated that state-issued mask mandates were associated with reduction in COVID-19 hospitalizations across the United States during the earlier portion of the pandemic. As new variants of the virus cause spikes in COVID-19 cases, reimposing mask mandates in indoor and congested public areas, as part of a layered approach to community mitigation, may reduce the spread of COVID-19 and lessen the burden on our health care system.
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Affiliation(s)
- Christopher Dunphy
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Heesoo Joo
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Mathew R. P. Sapiano
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Mara Howard-Williams
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Russell McCord
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Gregory Sunshine
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Szu-Yu Kao
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Gery P. Guy
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Regen Weber
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Maxim Gakh
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Donatus U. Ekwueme
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
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Karunathilake RP, Hewage S, Vidanapathirana G, Kumara A, Ranasinghe P, Noordeen F, Gawarammana I, Ratnatunga CN. Pre-vaccination RT-PCR negative contacts in workplace settings show high, SARS COV-2 neutralizing antibody levels. BMC Public Health 2022; 22:1961. [PMID: 36284261 PMCID: PMC9593990 DOI: 10.1186/s12889-022-14381-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Asymptomatic SARS-CoV-2 infection occurring in RT-PCR negative individuals represent a poorly characterized cohort with important infection control connotations. While household and community-based studies have evaluated seroprevalence of antibody and transmission dynamics in this group, workplace-based data is currently unavailable. Methods A cohort study was carried out in July 2021, during and immediately following the peak of the 3rd wave of COVID-19 in Sri Lanka, prior to mass vaccination. A total of 92 unvaccinated individuals between the ages of 17–65 years were purposively sampled from an office and two factory settings. The selected cohort that had been exposed to RT-PCR positive cases in the workplace was tested RT-PCR negative. Serological samples collected six weeks post exposure were tested for anti-SARS-CoV-2 neutralizing antibody. Results The seroprevalence for SARS-CoV-2 specific neutralizing antibodies in the overall cohort was 63.04% (58/92). Seroprevalences in the office setting, factory setting 1 and factory setting 2 were 69.2% (9/13), 55.7% (34/61) and 83.33% (15/18), respectively. Primary risk factor associated with seropositivity was face to face contact with no mask for > 15 min (p < 0.024, Odds Ratio (OR); 5.58, 95%CI;1.292– 25.65). Individuals with workspace exposure had significantly higher levels of neutralizing antibodies than those who did not (percentage neutralization in assay 63.3% (SD:21)vs 45.7% (SD:20), p = 0.0042), as did individuals who engaged socially without protective measures (62.4 (SD:21.6)% vs 49.7 (SD:21)%, p = 0.026). Conclusion There was a high seroprevalence for SARS-CoV-2 specific neutralizing antibodies among RT-PCR negative contacts in workplace settings in Sri Lanka. Higher levels of transmission of SARS-CoV-2 infection than estimated based on RT-PCR positive contact data indicate need for targeted infection control measures in these settings during future outbreaks. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14381-5.
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Affiliation(s)
- Ridma P Karunathilake
- grid.11139.3b0000 0000 9816 8637Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400 Sri Lanka
| | - Sameera Hewage
- Office of the Regional Director of Health Services, Kandy, Sri Lanka
| | - Gihani Vidanapathirana
- grid.11139.3b0000 0000 9816 8637Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400 Sri Lanka ,grid.11139.3b0000 0000 9816 8637Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Peradeniya, Kandy, Sri Lanka
| | - Athula Kumara
- grid.11139.3b0000 0000 9816 8637Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400 Sri Lanka
| | | | - Faseeha Noordeen
- grid.11139.3b0000 0000 9816 8637Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400 Sri Lanka
| | - Indika Gawarammana
- grid.11139.3b0000 0000 9816 8637Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400 Sri Lanka
| | - Champa N Ratnatunga
- grid.11139.3b0000 0000 9816 8637Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400 Sri Lanka
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Molassiotis A, Xie YJ, Leung AYM, Ho GWK, Li Y, Leung PHM, Wang HL, Chen CXR, Tong DWK, Siu JYM, Lau JTF. A Community-Based Participatory Research Approach to Developing and Testing Social and Behavioural Interventions to Reduce the Spread of SARS-CoV-2: A Protocol for the ' COPAR for COVID' Programme of Research with Five Interconnected Studies in the Hong Kong Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13392. [PMID: 36293972 PMCID: PMC9603243 DOI: 10.3390/ijerph192013392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND While a number of population preventive measures for COVID-19 exist that help to decrease the spread of the virus in the community, there are still many areas in preventative efforts that need improvement or refinement, particularly as new strains of the virus develop. Some of the key issues currently include incorrect and/or inconsistent use of face masks, low acceptance of early screening or vaccination for COVID-19, vaccine hesitance, and misinformation. This is particularly the case in some vulnerable populations, such as older people with chronic illnesses, ethnic minorities who may not speak the mainstream language well and children. The current protocol introduces a large programme of research through five interrelated studies that all focus on social and behavioural interventions to improve different aspects of community-related preventative indicators. Hence, the specific objectives of the overall programme are to (1) increase early testing for COVID-19 and promote the uptake of COVID-19 vaccines in the community (Study 1); (2) increase COVID-19-related health literacy and vaccine literacy and promote improved preventative measures in minority ethnic groups, chronically ill populations and caregivers (Study 2); (3) strengthen the public's motivation to stay at home and avoid nonessential high-risk activities (Study 3); (4) decrease COVID-19 vaccine hesitancy (Study 4); and (5) enhance the adherence to COVID-19-related hygiene practices and the uptake of early testing in school children (Study 5). METHODS We will utilise a community-based participatory research (CBPR) approach in the proposed studies. All studies will incorporate an intervention development phase in conjunction with key community stakeholders, a feasibility study and an execution stage. A variety of self-reported and objective-based measures will be used to assess various outcomes, based on the focus of each study, in both the short- and long-term, including, for example, the 8-item self-reported eHealth Literacy Scale (eHEAL) and objective measures such as vaccine uptake. DISCUSSION Theory-driven interventions will address each study's focus (e.g., social distancing, promotion of vaccine uptake, eHealth education, preventive measures and early detection). Improvements are expected to be seen in the outcomes of vulnerable and high-risk groups. Decreased infection rates are expected due to improved preventative behaviours and increased vaccine uptake. Long-term sustainability of the approach will be achieved through the CBPR model. The publication of this protocol can assist not only in sharing a large-scale and complex community-based design, but will also allow all to learn from this, so that we will have better insight in the future whether sharing of study designs can elicit timely research initiatives.
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Affiliation(s)
- Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Health and Social Care Research Centre, University of Derby, Derby DE22 1GB, UK
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Angela Y. M. Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Grace W. K. Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Polly Hang-Mei Leung
- Department of Health Technology & Informatics, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Hua Li Wang
- Department of Family Medicine and Primary Healthcare, Hong Kong West Cluster, Hospital Authority, Hong Kong SAR, China
| | | | | | - Judy Yuen-man Siu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Joseph T. F. Lau
- Centre for Health Behaviours Research, Jockey Club School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Hudson A, Hall PA, Hitchman SC, Meng G, Fong GT. Cognitive predictors of COVID-19 mitigation behaviors in vaccinated and unvaccinated general population members. Vaccine 2022:S0264-410X(22)01242-7. [PMID: 36253218 PMCID: PMC9556944 DOI: 10.1016/j.vaccine.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/19/2022] [Accepted: 10/05/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Given the long-term threat posed by COVID-19, predictors of mitigation behaviors are critical to identify. Prior studies have found that cognitive factors are associated with some COVID-19 mitigation behaviors, but few studies employ representative samples and no prior studies have examined cognitive predictors of vaccination status. The purpose of the present study was to examine associations between cognitive variables (executive function, delay discounting, and future orientation) and COVID-19 mitigation behaviors (mask wearing, social distancing, hand hygiene and vaccination) in a population representative sample. METHODS A population representative sample of 2,002 adults completed validated measures of delay discounting, future orientation, and executive function. Participants also reported frequency of mitigation behaviors, vaccination status, and demographics. RESULTS Future orientation was associated with more mask wearing (β = 0.160, 95 % CI [0.090, 0.220], p < 0.001), social distancing (β = 0.150, 95 % CI [0.070, 0.240], p < 0.001), hand hygiene behaviors (β = 0.090, 95 % CI [0.000, 0.190], p = 0.054), and a higher likelihood of being fully vaccinated (OR = 0.80, 95 % CI [0.670, 0.970], p = 0.020). Lower delay discounting predicted more consistent mask wearing (β = -0.060, 95 % CI[-0.120, -0.010], p = 0.032) and being fully vaccinated (OR = 1.28, 95 % CI [1.13, 1.44], p < 0.001), while more symptoms of executive dysfunction predicted less mask wearing (β = -0.240, 95 % CI [-0.320, -0.150] p < 0.001) and hand hygiene (β = -0.220, 95 % CI [-0.320, -0.130], p < 0.001), but not vaccination status (OR = 0.96, 95 % CI [0.80, 1.16], p = 0.690) or social distancing behaviors (β = -0.080, 95 % CI [-0.180, 0.020], p = 0.097). Overall, social distancing was the least well-predicted outcome from cognitive factors, while mask wearing was most well-predicted. Vaccination status was not a significant moderator of these effects of cognitive predictors on mitigation behaviors. CONCLUSIONS Cognitive variables predict significant variability in mitigation behaviors. regardless of vaccination status. In particular, thinking about the future and discounting it less may encourage more consistent implementation of mitigating behaviors.
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Affiliation(s)
- Anna Hudson
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada,Corresponding author
| | - Peter A. Hall
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada,Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada,Centre for Bioengineering and Biotechnology, University of Waterloo, Waterloo, Ontario, Canada
| | - Sara C. Hitchman
- Department of Communication and Media Research, University of Zurich, Zürich, Switzerland
| | - Gang Meng
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Geoffrey T. Fong
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada,Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada,Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Bhatia R, Sledge I, Baral S. Missing science: A scoping study of COVID-19 epidemiological data in the United States. PLoS One 2022; 17:e0248793. [PMID: 36223335 PMCID: PMC9555641 DOI: 10.1371/journal.pone.0248793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
Systematic approaches to epidemiologic data collection are critical for informing pandemic responses, providing information for the targeting and timing of mitigations, for judging the efficacy and efficiency of alternative response strategies, and for conducting real-world impact assessments. Here, we report on a scoping study to assess the completeness of epidemiological data available for COVID-19 pandemic management in the United States, enumerating authoritative US government estimates of parameters of infectious transmission, infection severity, and disease burden and characterizing the extent and scope of US public health affiliated epidemiological investigations published through November 2021. While we found authoritative estimates for most expected transmission and disease severity parameters, some were lacking, and others had significant uncertainties. Moreover, most transmission parameters were not validated domestically or re-assessed over the course of the pandemic. Publicly available disease surveillance measures did grow appreciably in scope and resolution over time; however, their resolution with regards to specific populations and exposure settings remained limited. We identified 283 published epidemiological reports authored by investigators affiliated with U.S. governmental public health entities. Most reported on descriptive studies. Published analytic studies did not appear to fully respond to knowledge gaps or to provide systematic evidence to support, evaluate or tailor community mitigation strategies. The existence of epidemiological data gaps 18 months after the declaration of the COVID-19 pandemic underscores the need for more timely standardization of data collection practices and for anticipatory research priorities and protocols for emerging infectious disease epidemics.
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Affiliation(s)
- Rajiv Bhatia
- Primary Care and Population Health, Stanford University, Stanford, CA, United States of America
- * E-mail:
| | | | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
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Conley TD, Piemonte JL, Shukla I, Mangla A, Mateti N, Tariq S. Monogamy as protection against COVID-19?: Non-monogamy stigma and risk (Mis)perception. ANALYSES OF SOCIAL ISSUES AND PUBLIC POLICY : ASAP 2022; 22:ASAP12325. [PMID: 36246084 PMCID: PMC9538616 DOI: 10.1111/asap.12325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 06/16/2023]
Abstract
COVID-19 public health messages largely communicated that Americans were "safer at home." Implicit in this advice are messages about protections ostensibly also offered by monogamy-that having more relationships is always more dangerous than having fewer relationships and that closer relationships are always safer-from a disease transmission perspective-than unfamiliar relationships. These heuristics may have led people to discount other COVID-19 dangers (such as spending more time with others of unknown infection status) and to ignore COVID-specific safety measures (such as mask-wearing, and ventilation). We conducted three studies in which we used experimental vignettes to assess people's perceptions of COVID-risky targets in monogamous relationships with a close, committed partner versus targets who were described as non-monogamous with casual partners but relatively COVID-safe. Participants perceived monogamous-but-COVID-riskier targets as more responsible and safer from COVID-19. Non-monogamy stigma seems to extend analogously to COVID-19 risk. Public health messages that fail to attend to the specifics and nuances of close relationships risk contributing to this stigma and ultimately undermining the goals of reducing the spread of infectious disease.
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Affiliation(s)
- Terri D. Conley
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | | | - Ishita Shukla
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Ananya Mangla
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Nainika Mateti
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Soha Tariq
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
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45
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Haddad MB, McLean JE, Feldman SS, Sizemore EE, Taylor MM. Innovative Approaches to COVID-19 Case Investigation and Contact Tracing. Public Health Rep 2022; 137:5S-10S. [PMID: 36113066 PMCID: PMC9483134 DOI: 10.1177/00333549221120454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Maryam B. Haddad
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jody E. McLean
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sue S. Feldman
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Erin E. Sizemore
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Melanie M. Taylor
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
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46
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Landry M, Vyas A, Nagaraj N, Sardon GA, Bornstein S, Latif H, Kucherlapaty P, McDonnell K, Castel A, Goldman L. Characteristics of student SARS-CoV-2 cases on an urban university campus: An Observational Study. Interact J Med Res 2022; 11:e39230. [PMID: 36037255 PMCID: PMC9472507 DOI: 10.2196/39230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Academic institutions are central hubs for young adults, laden with academic and social interactions, and communal living arrangements, heightening the risk of transmission of many communicable diseases, including COVID-19. Shortly after the start of the Fall 2020 academic year, institutions of higher learning were identified as hotspots for rises in COVID-19 incidence among young adults. OBJECTIVE This analysis aims to identify the characteristics of student SARS-CoV-2 cases, identify the extent to which the student population adhered to preventative strategies, and examine behaviors that would put them at higher risk of contracting or spreading COVID-19. METHODS This observational study comprises 1,175 university students at The George Washington University (GWU) in Washington, DC, with a confirmed COVID-19 diagnosis between August 3, 2020, and November 30, 2021. Case investigation and contact tracing tools were developed by the Campus COVID-19 Support Team and captured in REDCap. Trained case investigators were notified of a case and attempted to contact all cases within 24 hours of the case receiving their lab result. Associations between case characteristics and number of contacts were examined using Wilcoxon Rank Sum tests. Knowledge of exposure, behaviors since exposure, and student residence status, and fraternity and sorority life affiliation were examined using Chi-Square tests. RESULTS Positive student cases reported a median of three close contacts and 84.6% reported at least one symptom with a median of four COVID-19 symptoms. Congestion (53.4%), cough (45.1%), and headache (41.2%) were the most frequently reported symptoms. Thirty-six percent reported that they did not know how they were exposed to the virus. Among those aware of contact with a COVID-19 confirmed case, 55.1% reported the contact was a close friend or family member and 25.3% reported that it was someone with whom they lived. Athletes (vs. non-athletes), on-campus (vs. off-campus), and undergraduate (vs. graduate) students all reported a significantly higher number of contacts (P<.01). Students living on campus were more likely to report attending campus events in the two days prior to symptom onset or positive test result (P=.004). Students with fraternity/sorority affiliation were more likely to report attending campus events in the two days prior to symptom onset or positive test result (P<.001). CONCLUSIONS COVID-19 cases have not yet stabilized to a predictable state, but this study provides case characteristics and insights for how academic institutions might prepare to mitigate outbreaks on their campuses as the world plans for the transition from pandemic to endemic COVID-19. CLINICALTRIAL
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Affiliation(s)
- Megan Landry
- Office of the Dean, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 7th Floor, Washington, US
| | - Amita Vyas
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 3rd Floor, Washington, US
| | - Nitasha Nagaraj
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 3rd Floor, Washington, US
| | - Gary A Sardon
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, US
| | - Sydney Bornstein
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, US
| | - Hannah Latif
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 3rd Floor, Washington, US
| | - Padmini Kucherlapaty
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 3rd Floor, Washington, US
| | - Karen McDonnell
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 3rd Floor, Washington, US
| | - Amanda Castel
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, US
| | - Lynn Goldman
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, US.,Office of the Dean, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 7th Floor, Washington, US
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Germano C, Messina A, Tavella E, Vitale R, Avellis V, Barboni M, Attini R, Revelli A, Zola P, Manzoni P, Masturzo B. Fetal Brain Damage during Maternal COVID-19: Emerging Hypothesis, Mechanism, and Possible Mitigation through Maternal-Targeted Nutritional Supplementation. Nutrients 2022; 14:nu14163303. [PMID: 36014809 PMCID: PMC9414753 DOI: 10.3390/nu14163303] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022] Open
Abstract
The recent outbreak of the novel Coronavirus (SARS-CoV-2 or CoV-2) pandemic in 2019 and the risk of CoV-2 infection during pregnancy led the scientific community to investigate the potential negative effects of Coronavirus infection on pregnancy outcomes and fetal development. In particular, as CoV-2 neurotropism has been demonstrated in adults, recent studies suggested a possible risk of fetal brain damage and fetal brain development impairment, with consequent psychiatric manifestations in offspring of mothers affected by COronaVIrus Disease (COVID) during pregnancy. Through the understanding of CoV-2’s pathogenesis and the pathways responsible for cell damage, along with the available data about neurotropic virus attitudes, different strategies have been suggested to lower the risk of neurologic disease in newborns. In this regard, the role of nutrition in mitigating fetal damages related to oxidative stress and the inflammatory environment during viral infection has been investigated, and arginine, n3PUFA, vitamins B1 and B9, choline, and flavonoids were found to be promising in and out of pregnancy. The aim of this review is to provide an overview of the current knowledge on the mechanism of fetal brain damage and the impact of nutrition in reducing inflammation related to worse neurological outcomes in the context of CoV-2 infections during pregnancy.
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Affiliation(s)
- Chiara Germano
- Department of Maternal, Neonatal and Infant Medicine, University Hospital “Degli Infermi”, 13875 Ponderano, Italy
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
- Correspondence:
| | - Alessandro Messina
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Elena Tavella
- Sant’Anna Hospital, Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Raffaele Vitale
- Sant’Anna Hospital, Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Vincenzo Avellis
- Sant’Anna Hospital, Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Martina Barboni
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Rossella Attini
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Alberto Revelli
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Paolo Zola
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Paolo Manzoni
- Department of Maternal, Neonatal and Infant Medicine, University Hospital “Degli Infermi”, 13875 Ponderano, Italy
| | - Bianca Masturzo
- Department of Maternal, Neonatal and Infant Medicine, University Hospital “Degli Infermi”, 13875 Ponderano, Italy
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Gao Z, Wang S, Gu J, Gu C, Liu R. A community-level study on COVID-19 transmission and policy interventions in Wuhan, China. CITIES (LONDON, ENGLAND) 2022; 127:103745. [PMID: 35582597 PMCID: PMC9098919 DOI: 10.1016/j.cities.2022.103745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 04/28/2022] [Accepted: 05/08/2022] [Indexed: 05/14/2023]
Abstract
The specific factors and response strategies that affect COVID-19 transmission in local communities remain under-explored in the current literature due to a lack of data. Based on primary COVID-19 data collected at the community level in Wuhan, China, our study contributes a community-level investigation on COVID-19 transmission and response strategies by addressing two research questions: 1) What community factors are associated with viral transmission? and 2) What are the key mechanisms behind policy interventions towards controlling viral transmission within local communities? We conducted two sets of analyses to address these two questions-quantitative analyses of the relationship between community factors and viral transmission and qualitative analyses of policy interventions on community transmission. Our findings show that the viral spread in local communities is irrelevant to the built environment of a community and its socioeconomic position but is related to its demographic composition. Specifically, groups under the age of 18 play an important role in viral transmission. Moreover, a series of community shutdown management initiatives (e.g., group buying, delivering supplies, and self-reporting of health conditions) play an important role in curbing viral transmission at the local level that can be applied to other geographic contexts.
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Affiliation(s)
- Zhe Gao
- Hubei Provincial Key Laboratory for Geographical Process Analysis & Simulation, Central China Normal University, Wuhan, Hubei Province 430079, China
| | - Siqin Wang
- School of Earth and Environmental Sciences, University of Queensland, Brisbane 4067, Australia
| | - Jiang Gu
- Hubei Provincial Key Laboratory for Geographical Process Analysis & Simulation, Central China Normal University, Wuhan, Hubei Province 430079, China
| | - Chaolin Gu
- School of Architecture, Tsinghua University, Beijing 100084, China
| | - Regina Liu
- Department of Biology, Mercer University, Macon, GA, USA
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49
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Weerakoon SM, Henson-Garcia M, Valerio-Shewmaker MA, Messiah SE, Knell G. Contributions of Trustworthiness, Health Literacy, and Self-Efficacy in Communicating With COVID-19 Vaccine–Hesitant Audiences: Web-Based Survey Study. JMIR Form Res 2022; 6:e38076. [PMID: 35878123 PMCID: PMC9345324 DOI: 10.2196/38076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/27/2022] [Accepted: 07/13/2022] [Indexed: 11/20/2022] Open
Abstract
Background Large-scale health communication challenges during the COVID-19 pandemic, such as widespread misinformation and distrust in health care professionals, have influenced reluctance to take the COVID-19 vaccine, also known as vaccine hesitancy. Trust in health professionals, adequate health literacy, and high self-efficacy are key components of actively pursuing preventative and protective health care measures. These factors may be associated with intentions to seek and complete a COVID-19 vaccine dosing. Objective The objective of this analysis was to identify factors associated with COVID-19 vaccine hesitancy. Methods In February 2021, US adults (N=5872) responded to a web-based survey on COVID-19 vaccine hesitancy and components of health communication (trust in sources of health information, health literacy, and self-efficacy). Multivariable logistic regression models were used to explore associations between these factors and vaccine hesitancy while adjusting for key demographics. We hypothesized that low levels of trust, health literacy, and self-efficacy would be associated with increased vaccine hesitancy. Results The adjusted odds of vaccine hesitancy was greater among those who placed little to no trust in health professionals compared to those who held a lot of trust (adjusted odds ratio [AOR] 8.54, 95% CI 6.52-11.19). The odds of vaccine hesitancy was also greater among those who felt frustrated about finding health information compared to those who did not (AOR 2.10, 95% CI 1.62-2.70). Participants who had little to no confidence in receiving health advice or information had greater odds of vaccine hesitancy compared to those who had a lot of confidence (AOR 3.05, 95% CI 2.34-3.97). Conclusions This study underscores the importance of trust between health professionals and their patients, and a need for improving health literacy regarding vaccines. Perceptions of mistrust and low levels of health literacy were associated with high levels of vaccine hesitancy, providing empirical support of framing these factors as perceived barriers to vaccine uptake.
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Affiliation(s)
- Sitara M Weerakoon
- Center for Pediatric Population Health, School of Public Health and Children's Health System of Texas, University of Texas Health Science Center, Dallas Campus, Dallas, TX, United States
| | - Mike Henson-Garcia
- Center for Pediatric Population Health, School of Public Health and Children's Health System of Texas, University of Texas Health Science Center, Dallas Campus, Dallas, TX, United States
| | - Melissa A Valerio-Shewmaker
- Department of Health Promotion and Behavioral Science, School of Public Health, University of Texas Health Science Center, Brownsville Campus, Brownsville, TX, United States
| | - Sarah E Messiah
- Center for Pediatric Population Health, School of Public Health and Children's Health System of Texas, University of Texas Health Science Center, Dallas Campus, Dallas, TX, United States
| | - Gregory Knell
- Center for Pediatric Population Health, School of Public Health and Children's Health System of Texas, University of Texas Health Science Center, Dallas Campus, Dallas, TX, United States
- Children's Health Andrews Institute for Orthopaedics and Sports Medicine, Plano, TX, United States
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50
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Sunesson E, Sylwander C, Haglund E, Andersson MLE, Larsson I. Experiences of How Health and Lifestyle among Individuals with Knee Pain Have Been Influenced during the COVID-19 Pandemic, a HALLOA Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148255. [PMID: 35886110 PMCID: PMC9315972 DOI: 10.3390/ijerph19148255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has affected the health and lifestyles of both the general population and of vulnerable groups. Individuals with knee pain are recommended to lead an active lifestyle to relieve pain but find it difficult to maintain health and lifestyle compared to the general population due to the cause of chronic pain, impaired physical function, and a diminished quality of life. This study aimed to explore experiences of how health and lifestyle among individuals with knee pain have been influenced during the COVID-19 pandemic. Interviews (n = 19) were conducted in 2021 and analysed with qualitative content analysis. The results showed how individuals with knee pain adjusted their behaviour and revalued their life to maintain health and lifestyle during COVID-19. Adjusted behaviours emerged, such as spending more time at home, becoming digital, and spending more time outdoors, while revaluing life emerged as having a positive outlook on life and sharing responsibility. In conclusion, behaviour was adjusted, and life revalued to manage health and lifestyle during the pandemic. However, the findings are probably similar to the general population, i.e., individuals with knee pain live similar lives as the general population despite knee pain. The results may contribute to alternative ways of maintaining health and lifestyle in various vulnerable groups and may be applied in situations other than the pandemic.
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Affiliation(s)
- Evelina Sunesson
- Spenshult Research and Development Centre, SE-30274 Halmstad, Sweden; (E.S.); (C.S.); (E.H.); (M.L.E.A.)
| | - Charlotte Sylwander
- Spenshult Research and Development Centre, SE-30274 Halmstad, Sweden; (E.S.); (C.S.); (E.H.); (M.L.E.A.)
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Emma Haglund
- Spenshult Research and Development Centre, SE-30274 Halmstad, Sweden; (E.S.); (C.S.); (E.H.); (M.L.E.A.)
- Section of Rheumatology, Department of Clinical Sciences, Lund University, SE-22242 Lund, Sweden
- Department of Environmental and Biosciences, School of Business, Innovation and Sustainability, Halmstad University, SE-30118 Halmstad, Sweden
| | - Maria L. E. Andersson
- Spenshult Research and Development Centre, SE-30274 Halmstad, Sweden; (E.S.); (C.S.); (E.H.); (M.L.E.A.)
- Section of Rheumatology, Department of Clinical Sciences, Lund University, SE-22242 Lund, Sweden
| | - Ingrid Larsson
- Spenshult Research and Development Centre, SE-30274 Halmstad, Sweden; (E.S.); (C.S.); (E.H.); (M.L.E.A.)
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
- Section of Rheumatology, Department of Clinical Sciences, Lund University, SE-22242 Lund, Sweden
- Correspondence: ; Tel.: +46-72-977-3722
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