scholarly journals A retrospective study of a pre-travel consultation in the Lisbon Metropolitan Area, Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Galhano Lopes ◽  
M Bragança Pereira ◽  
M Machado Gil ◽  
S Duarte ◽  
A Moreira ◽  
...  
Keyword(s):  
Individual Characteristics ◽  
Yellow Fever Vaccine ◽  
Medical Community ◽  
Therapeutic Drug ◽  
Protective Measures ◽  
The Public ◽  
Related Risk ◽  
Medical Referral ◽  
The Impact

Abstract Background Travel from Portugal to other countries has increased in the past 5 years. A pre-travel health consultation is advised to all travellers to raise awareness and reduce travel-related risk. We describe the experience of a pre-travel consultation centre in the public health service. Methods A retrospective observational study about consultations in an international vaccination centre between 2014-2018. Variables included were: sex, age, destination, purpose, referral, and prescriptions. Descriptive analyses were performed for all variables. Results Between 2014 and 2018, there were 1,546 consultations. Regarding individual characteristics, 54% were female, and 80% had between 15 and 64 years of age. There was no referral in 66% of the consultations, followed by 16% from general practitioners in the Primary Care Centres Group. The leading destination was Africa (54%), in a downward trend (74% in 2015 and 32% in 2018) followed by Asia (18%) with an upward trend (12% to 28% in the same period). The primary purpose was tourism (83%), followed by work (9%). In total, 3,287 vaccines were prescribed with typhoid fever vaccine accounting for 26%, hepatitis A vaccine 22%, and yellow fever vaccine 15%. Mefloquine was the primary therapeutic drug prescribed for destinations with risk for malaria (41%). Regarding destinations with low risk for malaria, in 42% of the consultations, personal protective measures were the only recommendation. Conclusions Our data show that pre-travel consultations seem to be valued and actively asked for by travellers, but medical referral is still insufficient. Regarding health promotion and prevention of diseases, tracking trends in the most common destinations allows to optimize the information provided in the consultation, effectively capacitating the traveller to recognize and act on the most common travel-related health risks. In further studies, a post-travel follow-up should be carried out to determine the impact of the consultation. Key messages Pre-travel consultation is an actively sought-after service by the community, but awareness should be promoted in the medical community. Pre-travel consultation can have an important role in the health literacy of travellers.

scholarly journals A retrospective study of an International Vaccination Centre in the Lisbon Metropolitan Area

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Galhano Lopes ◽  
M Bragança Pereira ◽  
M Machado Gil ◽  
S Duarte ◽  
A Moreira ◽  
...  
Keyword(s):  
Cost Effective ◽  
Individual Characteristics ◽  
Yellow Fever Vaccine ◽  
African Countries ◽  
The Public ◽  
The Past ◽  
Related Risk ◽  
Vaccine Prophylaxis ◽  
Individual Profiles ◽  
Health Counselling

Abstract Background Vaccination is one of the most cost-effective disease prevention strategies. Trips from Portugal to other countries have increased in the past 5 years. Depending on the destination, certain vaccines are advised to travellers in order to reduce travel-related risk. We analyzed the data of an International Vaccination Centre (IVC) in the Public Health Unit of the Primary Care Centres Group (ACES) of Loures-Odivelas. Methods A retrospective observational study comprising data from an IVC database between 2014 and 2018. Variables included were sex, age, destination, purpose, referral, and prescriptions. Descriptive analyses were performed for all variables. Results Between 2014 and 2018, there was a total of 4,873 users. Regarding individual characteristics, 51% were female, 80% had between 15 and 64 years of age, and 51% were referred by general practitioners of the ACES. Africa was the leading destination (66% average for all years) with a downward trend (from 82% in 2014 to 47% in 2018) followed by South America (12%) with an upward trend (from 4% to 16% in the same period). The primary purpose of travelling was tourism (74%) followed by work (15%). A total of 7,323 vaccines were administered, with an annual increase from 1,250 administrations in 2014 to 1,862 in 2018. The yellow fever vaccine accounted for 36,9% of all administrations, followed by typhoid fever vaccine (32,3%) and hepatitis A vaccine (10,2%). Conclusions African countries are still the most common destination for Portuguese travellers, but changing trends might influence the vaccination strategies in the IVC. Information provided in the IVC can be optimized to suit individual profiles better. Key messages As travelling increases, the International Vaccination Centre has an essential role in the prevention of disease. Africa remains the most common destination, requiring pre-travel health counselling and vaccine prophylaxis.

scholarly journals Hepatitis B infection among Iraqi children: the impact of sanctions

2004 ◽  
Vol 10 (1-2) ◽  
pp. 6-11
Author(s):  
H. Y. M. Ali
Keyword(s):  
Hepatitis B ◽  
Vaccine Dose ◽  
United Nations Security Council ◽  
Enzyme Linked Immunosorbent Assay ◽  
The Public ◽  
Hbsag Carriers ◽  
Vaccine Availability ◽  
Vaccine Shortages ◽  
The Impact

Effect of sanctions on hepatitis B vaccine availability and occurrence of viral hepatitis B among Iraqi children was studied. Between June 2000 and June 2001, families of patients attending the Public Health Laboratory, Mosul, for hepatitis B follow-up were screened. Enzyme-linked immunosorbent assay was used to test for HBsAg, HBeAg and anti-HBe. We diagnosed 74 children born 1994-1998 as HBsAg carriers. For 62 of 74 cases, parents had consulted vaccine centres promptly:41 were not vaccinated and 21 had only one vaccine dose. HBeAg marker was positive for 9 [14.5%] and anti-HBe for 50 [80.7%]. Parental reluctance was the reason for non-vaccination for 12. Vaccine shortages during the birth years of cases were documented, even after implementation of United Nations Security Council Resolution 986

scholarly journals Synergetic measures needed to control infection waves and contain SARS-CoV-2 transmission

2021 ◽  
Author(s):  
Hang Su ◽  
Yafang Cheng ◽  
Ulrich Poeschl
Keyword(s):  
Basic Reproduction Number ◽  
Reproduction Number ◽  
Scientific Discourse ◽  
Protective Measure ◽  
Protective Measures ◽  
Vaccination Rates ◽  
The Public ◽  
Individual Measure ◽  
The Impact ◽  
Pharmaceutical Interventions

The public and scientific discourse on how to mitigate the COVID-19 pandemic is often focused on the impact of individual protective measures, in particular on immunization by vaccination. In view of changing virus variants and conditions, however, it seems not clear if vaccination or any other single protective measure alone may suffice to contain the transmission of SARS-CoV-2. Here, we investigate the effectiveness and synergies of vaccination and different non-pharmaceutical interventions such as universal masking (surgical, N95/FFP2), distancing & ventilation, contact reduction, and testing & isolation as a function of compliance in the population. We find that it would be difficult to contain SARS-CoV-2 transmission by any individual measure as currently available under realistic conditions. Instead, we show how multiple synergetic measures can be and have to be combined to decrease and keep the effective reproduction number (Re) below unity, even for virus variants with increased basic reproduction number (R0). We suggest that the presented approach and results can be used to design and communicate efficient strategies for mitigating the COVID-19 pandemic, depending on R0 as well as the efficacy and compliance achieved with each protective measure. At vaccination rates around 70%, the combination and synergies of universal masking, distancing & ventilation, and testing & isolation with moderate compliances around 30% appear well suited to keep Re below 1 and prevent or suppress infection waves. Higher compliance or additional measures like contact reductions (confinement/lockdown) are required to effectively and swiftly break intense waves of infection. For schools, we find that the transmission of SARS-CoV-2 can be contained by 2-3 tests per week combined with distancing & ventilation and masking.

scholarly journals Factors associated with headache and neck pain among telecommuters – a five days follow-up

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mariève Houle ◽  
Arianne Lessard ◽  
Émile Marineau-Bélanger ◽  
Arnaud Lardon ◽  
Andrée-Anne Marchand ◽  
...  
Keyword(s):  
Risk Factors ◽  
Neck Pain ◽  
Multivariate Regression ◽  
Associated Factors ◽  
Multivariate Regression Model ◽  
Work Related ◽  
Related Risk ◽  
The Impact ◽  
Headache And Neck Pain

Abstract Background The current sanitary crisis brought on by the COVID-19 recently forced a large proportion of workers to adopt telecommuting with limited time to plan transition. Given that several work-related risk factors are associated with headache and neck pain, it seems important to determine those associated with headache and neck pain in telecommuters. The main objective of this study was to identify which telecommuting and individual associated factors are related with headache and neck pain occurrence in telecommuters over a five days follow-up. The second objective was to evaluate the impact of wearing a headset on headache and neck pain intensity in telecommuters. Methods One hundred and sixty-two participants in telecommuting situation were recruited. Baseline assessment included sociodemographic data, headache and neck pain-related disability (6-item Headache Impact Test (HIT-6) and Neck Bournemouth Questionnaire (NBQ)), headache and neck pain frequency and intensity as well as questions about the wearing of a headset (headset wearing, headset type and headset wearing hours). A prospective data collection of headache, neck pain and headset wearing was conducted using daily e-mail over a 5-day follow-up. A stepwise multivariate regression model was performed to determine associated factors of headache or neck pain occurrence during the follow-up. A t-test was conducted to assess the impact of headset wearing on headache and neck pain intensity during the follow-up. Results Regarding headache, the stepwise multivariate regression model showed that the HIT-6 score was associated with future headache occurrence in telecommuters (OR (95% CI) = 1.094 (1.042–1.148); R2 = 0.094; p <  0.001). For neck pain, the stepwise multivariate regression showed that the NBQ score was related to future neck pain occurrence in telecommuters (OR (95% CI) = 1.182 (1.102–1.269); R2 = 0.182; p <  0.001). T-test showed no difference between participants that wore a headset and participant that did not wore a headset on mean headache (p = 0.94) and neck pain (p = 0.56) intensity during the five days follow-up. Conclusion Although several work-related risk factors are associated with headache and neck pain in workers, telecommuting did not present the same risks. Working set-up did not have a significant impact on headache and neck pain as headache-related disability was the only associated factor of future headache episodes and neck-pain related disability was the only associated factor of future neck pain episodes. Also, wearing a headset had no impact on headache and neck pain in telecommuters.

scholarly journals Impact of Individual and Neighborhood dimensions of Socioeconomic Status on the Prevalence of Mild Cognitive Impairment over Seven-Year Follow-Up

2019 ◽  
Author(s):  
Miguel Ángel Fernández-Blázquez ◽  
Bárbara Noriega-Ruiz ◽  
Marina Ávila-Villanueva ◽  
Meritxell Valentí-Soler ◽  
Belén Frades-Payo ◽  
...  
Keyword(s):  
Older Adults ◽  
Socioeconomic Status ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Low Socioeconomic Status ◽  
Social Inequalities ◽  
Housing Price ◽  
Individual Characteristics ◽  
The Impact

IMPORTANCE: There is strong evidence about the association between low socioeconomic status (SES) and higher risk of dementia. However, it has not been conveniently addressed so far the role of SES on the incidence of Mild Cognitive Impairment (MCI) which is considered a prodromal stage of latter dementia.OBJECTIVE: To examine the impact of individual and neighborhood dimensions of SES, as well as their interaction, on the risk of developing MCI in a sample of older adults that were followed-up for seven years.DESIGN, SETTING, AND PARTICIPANTS: Data from the Vallecas Project cohort, an ongoing community-based longitudinal study for early detection of cognitive impairment and dementia, were used to build two indices of SES namely individual and neighborhood, as well as a global SES as a combination of both, and to investigate their effects on MCI conversion by means of a multivariate-adjusted Cox proportional hazard model.MAIN OUTCOMES AND MEASURES: Based on data referred to as individual-level (one´s educational attainment, occupation, parent´s level of education) and neighborhood-level (district´s income, unemployment rate, housing price, percentage of people with no formal qualifications, with higher education, and with white-collar employs) different composite measures of SES were built and quartiles were considered for further analyses. MCI diagnoses were agreed between neurologists and neuropsychologists at consensus meetings.RESULTS: 1180 participants aged 70 years and older were enrolled in this study (mean age at baseline, 74.9 years; 63.5% females). Of these, 199 cases of MCI (16.9%) were diagnosed at any point of the follow-up. The individual and neighborhood dimensions of SES played different roles in the dynamics of the MCI occurrence through ageing. Most importantly, the risk of developing MCI was almost double for lower SES quartiles when compared to the highest one.CONCLUSIONS AND RELEVANCE: The incidence of MCI in older adults was related to both individual characteristics and socioeconomic context. Public health strategies should be holistic and focus not only on promoting the classical individual preventive measures, but also on reducing social inequalities as a means of fostering healthy ageing and reducing dementia burden.

scholarly journals Rural Healthcare Enterprises in the Vortex of COVID-19: The Impact of Public Policies on the Internal and External Environment

2021 ◽  
Vol 11 (3) ◽  
pp. 82
Author(s):  
Nikolaos Apostolopoulos ◽  
Sotiris Apostolopoulos ◽  
Ilias Makris ◽  
Stavros Stavroyiannis
Keyword(s):  
Public Policies ◽  
Bank Lending ◽  
Business Owners ◽  
Second Phase ◽  
Rural Healthcare ◽  
Local Authorities ◽  
Protective Measures ◽  
The Public ◽  
The Impact ◽  
External Environments

The public policies implemented in order to contain the spread of COVID-19 in the community have created issues both in the internal and the external environments of the Greek rural healthcare enterprises. This study aimed to investigate the full extent of the issues (internal and external) caused by the public policies. Regarding the external factors, we examined the state, the local authorities, the financial institutions, the social stakeholders and the citizens. Regarding the internal factors, we focused on turnover, liquidity, working conditions, internal changes related to patient care and the implementation of protective measures. A qualitative research was conducted among twelve rural healthcare business owners in the form of semi-structured interviews. The research was conducted in the fall of 2020 during the second phase of COVID-19. The research showed that these enterprises were severely impacted by the government’s public policies. Local authorities were not involved due to lack of competence. The business owners were unwilling to support their enterprises via bank lending. During the first phase of COVID-19, citizens postponed nonessential medical examinations, causing a reduction in these enterprises’ turnover. As a result, in the following periods, these enterprises faced liquidity problems. However, they developed social objectives and implemented protective measures for their employees and patients. The present study contributes to the mapping of the factors affecting the internal and external environments of rural healthcare enterprises along with the public policies developed in times of prolonged crisis. These kinds of data are crucial to the business world and government officials voting on social policies. One cannot rule out the possibility of a new financial or health crisis; the findings of this study can prove to be a useful tool in the process of decision making.

MO925VALVULAR HEART DISEASE EVOLUTION IN KIDNEY TRANSPLANT RECIPIENTS AND RELATED RISK FACTORS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Isabel Galceran ◽  
M Dolores Redondo Pachón ◽  
María José Pérez Sáez ◽  
Carlos Arias Cabrales ◽  
Carla Burballa Tarrega ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Graft Survival ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Disease Evolution ◽  
Related Risk ◽  
The Moment ◽  
The Impact

Abstract Background and Aims Cardiovascular diseases remains the leading cause of death in recipients of kidney transplantation (KT). Valvular heart disease (VHD) is not an exclusion criteria for KT, however it’s repercussion on KT follow-up has been less studied. Our objective was to analyse the impact of VHD in KT recipients and related risk factors of VHD progression (VHDp). Method Observational retrospective cohort study of all patients who underwent KT at Hospital del Mar (Barcelona, Spain) between January 1980 and December 2018. VHD was defined as presence of aortic stenosis (AS), aortic regurgitation, mitral stenosis, mitral regurgitation, tricuspid stenosis, tricuspid regurgitation or double valve injury of any degree diagnosed by echocardiography. We analysed the VHDp, defined as worsening of the initial valvular degree on heart ultrasound after KT, risk factors related with VHDp, recipients and graft survival. Results During the study period, 1422 patient underwent KT and 48 of them (3.4%) had VHD diagnosed prior to KT. In the median time of follow-up of 56.3 months (IQR25-75 17.7-119 month), 17 patients (35.4%) presented VHDp and 31 patients did not (64.6%). Figure 1 shows the primary outcome in the different types of VHD, AS was the valve with more VHDp after KT. Statistical evaluation revealed that recipients with VHDp had a higher body mass index (BMI) (27.4 ± 6.3 vs 24.3 ± 3.8 kg/m2, p=0.04) and worse PTH control (427.0 ± 309.3 vs 186.2 ± 140.6 pg/ml, p=0.02) at the moment of the KT. Also, patients with VHDp reached a worse nadir glomerular filtration rate (GFR) (44.1 ± 17.5 vs 56.0 ± 13.9 ml/min/1.73m2, p=0.01) during the follow-up, needed more time to reach their nadir GFR (4 [2-13] vs 1.2 [1.0-4.7] months, p&lt;0.001) and required more furosemide dose at that time (72.7 ± 21.7 vs 15.8 ± 5.6 mg/day, p=0.02). At the end of follow-up, 213 KT recipients had died, 16 with preKT-VHD (33.3% of all patients with VHD) and 197 without preKT-VHD (14.3% of all cases without VHD). There was a statistical significant association between preKT-VHD status and all-cause mortality after KT (log rank &lt; 0.001). However, there wasn’t statistical association between preKT-VHD status and death-censored graft survival (log rank = 0.2). Conclusion VHD has a significant impact on increased pos-KT mortality but it is not associated with graft survival. More than one third of recipients with preKT-VHD presented deterioration after KT. We found that increased preKT BMI and PTH, nadir GFR after KT, time to reach this nadir GFR and diuretic dose at that time are related with VHD progression.

scholarly journals PENYULUHAN KESEHATAN TENTANG HIPERTENSI DI WILAYAH RT 03 KELURAHAN MURNI

2019 ◽  
Vol 1 (3) ◽  
pp. 180
Author(s):  
Vevi Suryenti Putri ◽  
Maimaznah Maimaznah ◽  
Sumiyati Sumiyati ◽  
Yuliana Yuliana ◽  
Rica Meiliani
Keyword(s):  
Health Center ◽  
Healthy Lifestyle ◽  
The Elderly ◽  
Unhealthy Lifestyle ◽  
The Public ◽  
Low Fat Diet ◽  
Wide Range ◽  
The Impact ◽  
The Village

Hypertension is a disease that is more common because of unhealthy lifestyle, community RT 03 sub pure many suffer from hypertension because of lack of attention to the pattern of their lives, the public is less aware of the impact of hypertension so that even know they suffer from hypertension still doesn't change the style of life and rarely check the health.Based on the assessment done through interviews, observation and questionnaires showed problems in RT 03 sub Pure that cadres said the disease experienced by residents of RT 03 is hypertension, 63,63% of people of mature age and the elderly suffer from hypertension.Of counseling that we convey expected that citizens can implement a healthy lifestyle in everyday life as well as being able to control a wide range of health problems associated with a healthy lifestyle such as exercise regularly, low-fat diet, and do regular inspections. Follow-up plan of extension activities about hipetensi is coordinated with the health center to do counseling about hypertension by involving the cadres in the village pure and also coordinate with the health center to run the program health checks.

scholarly journals Methodological outlines for assessing the costs of cancer patients care

2021 ◽  
Vol 65 (2) ◽  
pp. 125-134
Author(s):  
Dmitry A. Andreev ◽  
Aleksander A. Zavyalov ◽  
Tatiana N. Ermolaeva
Keyword(s):  
Cost Analysis ◽  
Cancer Patients ◽  
Censored Data ◽  
Cost Estimation ◽  
Economic Assessment ◽  
Medical Community ◽  
The Public ◽  
Incidence Data ◽  
Morbidity Data

Introduction. The planning of funding in the public health system and specifically in cancer care remains a challenge for the medical community. Some issues of cancer cost analysis are still not entirely resolved. Aims. To review the options for analysis of direct cancer costs based on registered follow-up data. Methods. The targeting and consensus search methodology was applied to collect the relevant papers from PubMed, Cochrane, E-library (RSCI). Results and Discussion. The following options have been identified: 1) using incidence data; 2) using prevalence data; 3) system net and total costs approach; 4) phase approach; 5) cost estimation using censored data. The incidence costs are related to the time of diagnosis. The prevalence costs represent the costs over a fixed calendar period. The net costs can be calculated by subtracting the mean costs across non-cancer patients from the total mean costs across comparable cancer patients. Total costs are defined as the summated costs for cancer patients regardless of whether they are associated with cancer or not. Phase analysis is a variant of estimates based on morbidity data and includes identifying specific periods from the diagnosis when the costs significantly change. Cost estimation using censored data provides for the application of mathematical modeling methods. Conclusion. The availability of combined cost analysis methods makes it possible to obtain a comprehensive economic assessment for cancer treatment approaches.

scholarly journals The Situation Room: A Step by Step Procedure toward Pandemic Influenza Preparedness

2009 ◽  
Vol 3 (09) ◽  
pp. 649-653
Author(s):  
Miguel Angel Castro-Jiménez ◽  
Lina María Vera-Cala ◽  
Gloria Janneth Rey-Benito
Keyword(s):  
Public Health ◽  
Pandemic Influenza ◽  
Public Health Surveillance ◽  
Health Surveillance ◽  
The Public ◽  
Step Procedure ◽  
Level Of Economic Development ◽  
Health Event ◽  
The Impact

In the context of the public health surveillance, the situation room might be playing an interesting role as a strategy for early alert and follow-up of a specific public health event and its determinants. The implementation and proper functioning of an influenza situation room monitoring seasonal and pandemic influenza or any other public health event could help to mitigate the impact of the next pandemic on public health in any country regardless of its level of economic development. This paper is aimed to suggest some basic steps for implementing an Influenza Situation Room as a strategy of prevention of diseases with potential to cause human pandemics and its mitigation if it has already occurred.

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