scholarly journals HepCare Europe: a service innovation project. HepCheck: enhancing HCV identification and linkage to care for vulnerable populations through intensified outreach screening. A prospective multisite feasibility study

2019 ◽  
Vol 74 (Supplement_5) ◽  
pp. v39-v46 ◽  
Author(s):  
Suzanne Barror ◽  
Gordana Avramovic ◽  
Cristiana Oprea ◽  
Julian Surey ◽  
Alistair Story ◽  
...  
Keyword(s):  
High Risk ◽  
Liver Fibrosis ◽  
Vulnerable Populations ◽  
Large Scale ◽  
Linkage To Care ◽  
Total Sample ◽  
Models Of Care ◽  
Hcv Infection ◽  
Specialist Services ◽  
High Risk Populations

Abstract Objectives Hepatitis C is one of the main causes of chronic liver diseases worldwide. One of the major barriers to effecting EU- and WHO-mandated HCV elimination by 2030 is underdiagnosis. Community-based screening strategies have been identified as important components of HCV models of care. HepCheck Europe is a large-scale intensified screening initiative aimed at enhancing identification of HCV infection among vulnerable populations and linkage to care. Methods Research teams across four European countries were engaged in the study and rolled out screening to high-risk populations in community addiction, homeless and prison services. Screening was offered to 2822 individuals and included a self-administered questionnaire, HCV antibody and RNA testing, liver fibrosis assessment and referral to specialist services. Results There was a 74% (n=2079) uptake of screening. The majority (85.8%, n=1783) were male. In total 44.6% (n=927) of the sample reported ever injecting drugs, 38.4% (n=799) reported ever being homeless and 27.9% (n=581) were prisoners. In total 397 (19%) active HCV infections were identified and 136 (7% of total sample and 34% of identified active infections) were new cases. Of those identified with active HCV infection, 80% were linked to care, which included liver fibrosis assessment and referral to specialist services. Conclusions HepCheck’s screening and linkage to care is a clear strategy for reaching high-risk populations, including those at highest risk of transmission who are not accessing any type of care in the community. Elimination of HCV in the EU will only be achieved by such innovative, patient-centred approaches.

Outcome Monitoring in Preterm Populations

2008 ◽  
Vol 216 (3) ◽  
pp. 135-146 ◽  
Author(s):  
Samantha Johnson ◽  
Dieter Wolke ◽  
Neil Marlow
Keyword(s):  
High Risk ◽  
Large Scale ◽  
Learning Deficits ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Outcome Monitoring ◽  
High Risk Populations ◽  
Developmental Functioning

Routine neurodevelopmental follow-up is crucial in high-risk populations, such as those born very preterm. Even in the absence of severe neurosensory impairment, very preterm children are at risk for a range of long-term cognitive, motor, and learning deficits. Infant developmental assessments are typically carried out at 2 years of age for both clinical and research purposes, and they are crucial for outcome monitoring. We review psychometric tests of infant developmental functioning most widely used as outcome measures for very preterm infants and other high-risk populations. We also consider parent-based assessments and methodological issues pertaining to the use of these tools in large-scale research studies and in outcome monitoring in this population.

scholarly journals Screening, Linkage to Care and Treatment of Hepatitis C Infection in Primary Care Setting in the South of Italy

Life ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 359
Author(s):  
Anna Citarella ◽  
Simona Cammarota ◽  
Francesca F. Bernardi ◽  
Carmine Coppola ◽  
Maria D’Antò ◽  
...  
Keyword(s):  
Primary Care ◽  
Hepatitis C ◽  
High Risk ◽  
Care Setting ◽  
Primary Care Setting ◽  
Linkage To Care ◽  
Case Finding ◽  
Hcv Infection ◽  
Newly Diagnosed ◽  
Care And Treatment

Hepatitis C virus (HCV) infection remains a pressing public health issue. Our aim is to assess the linkage to care of patients with HCV diagnosis and to support the proactive case-finding of new HCV-infected patients in an Italian primary care setting. This was a retrospective cohort study of 44 general practitioners (GPs) who managed 63,955 inhabitants in the Campania region. Adults with already known HCV diagnosis or those with HCV high-risk profile at June 2019 were identified and reviewed by GPs to identify newly diagnosed of HCV and to assess the linkage to care and treatment for the HCV patients. Overall, 698 HCV patients were identified, 596 with already known HCV diagnosis and 102 identified by testing the high-risk group (2614 subjects). The 38.8% were already treated with direct-acting antivirals, 18.9% were referred to the specialist center and 42.3% were not sent to specialist care for treatment. Similar proportions were found for patients with an already known HCV diagnosis and those newly diagnosed. Given that the HCV infection is often silent, case-finding needs to be proactive and based on risk information. Our findings suggested that there needs to be greater outreach, awareness and education among GPs in order to enhance HCV testing, linkage to care and treatment.

scholarly journals Vitamin D Supplementation to Prevent COVID-19 Infections and Deaths—Accumulating Evidence from Epidemiological and Intervention Studies Calls for Immediate Action

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 411 ◽  
Author(s):  
Hermann Brenner
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Large Scale ◽  
Intervention Studies ◽  
Health Care Systems ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
World Population ◽  
High Risk Populations

The COVID-19 pandemic poses an unprecedented threat to human health, health care systems, public life, and economy around the globe. The repertoire of effective therapies for severe courses of the disease has remained limited. A large proportion of the world population suffers from vitamin D insufficiency or deficiency, with prevalence being particularly high among the COVID-19 high-risk populations. Vitamin D supplementation has been suggested as a potential option to prevent COVID-19 infections, severe courses, and deaths from the disease, but is not widely practiced. This article provides an up-to-date summary of recent epidemiological and intervention studies on a possible role of vitamin D supplementation for preventing severe COVID-19 cases and deaths. Despite limitations and remaining uncertainties, accumulating evidence strongly supports widespread vitamin D supplementation, in particular of high-risk populations, as well as high-dose supplementation of those infected. Given the dynamics of the COVID-19 pandemic, the benefit–risk ratio of such supplementation calls for immediate action even before results of ongoing large-scale randomized trials become available.

scholarly journals Cocooning is essential to relaxing social distancing

2020 ◽  
Author(s):  
Xutong Wang ◽  
Zhanwei Du ◽  
George Huang ◽  
Remy Pasco ◽  
Spencer Fox ◽  
...  
Keyword(s):  
High Risk ◽  
Vulnerable Populations ◽  
Social Distancing ◽  
Transmission Rates ◽  
High Risk Populations ◽  
Second Wave

As the first wave of COVID-19 recedes, policymakers are contemplating the relaxation of shelter-in-place orders. Using a model capturing high-risk populations and transmission rates estimated from hospitalization data, we find that postponing relaxation will only delay a second wave and cocooning vulnerable populations is needed to prevent overwhelming medical surges.

scholarly journals Epidemiologic profile of hepatitis C virus infection and genotype distribution in Burkina Faso: a systematic review with meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Serge Ouoba ◽  
Jean Claude Romaric Pingdwinde Ouedraogo ◽  
Moussa Lingani ◽  
Bunthen E ◽  
Md Razeen Ashraf Hussain ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
High Risk ◽  
General Population ◽  
Burkina Faso ◽  
Meta Analysis ◽  
Hcv Infection ◽  
Low Risk ◽  
Hcv Rna ◽  
High Risk Populations

Abstract Background Detailed characteristics of Hepatitis C virus (HCV) infection in Burkina Faso are scarce. The main aim of this study was to assess HCV seroprevalence in various settings and populations at risk in Burkina Faso between 1990 and 2020. Secondary objectives included the prevalence of HCV Ribonucleic acid (RNA) and the distribution of HCV genotypes. Methods A systematic database search, supplemented by a manual search, was conducted in PubMed, Web of Science, Scopus, and African Index Medicus. Studies reporting HCV seroprevalence data in low and high-risk populations in Burkina Faso were included, and a random-effects meta-analysis was applied. Risk of bias was assessed using the Joanna Briggs institute checklist. Results Low-risk populations were examined in 31 studies involving a total of 168,151 subjects, of whom 8330 were positive for HCV antibodies. Six studies included a total of 1484 high-risk persons, and 96 had antibodies to HCV. The pooled seroprevalence in low-risk populations was 3.72% (95% CI: 3.20–4.28) and 4.75% (95% CI: 1.79–8.94) in high-risk groups. A non-significant decreasing trend was observed over the study period. Seven studies tested HCV RNA in a total of 4759 individuals at low risk for HCV infection, and 81 were positive. The meta-analysis of HCV RNA yielded a pooled prevalence of 1.65% (95% CI: 0.74–2.89%) in low-risk populations, which is assumed to be indicative of HCV prevalence in the general population of Burkina Faso and suggests that about 301,174 people are active HCV carriers in the country. Genotypes 2 and 1 were the most frequent, with 60.3% and 25.0%, respectively. Conclusions HCV seroprevalence is intermediate in Burkina Faso and indicates the need to implement effective control strategies. There is a paucity of data at the national level and for rural and high-risk populations. General population screening and linkage to care are recommended, with special attention to rural and high-risk populations.

scholarly journals Making Sense of Genetic Information: The Promising Evolution of Clinical Stratification and Precision Oncology Using Machine Learning

Genes ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 722
Author(s):  
Mahaly Baptiste ◽  
Sarah Shireen Moinuddeen ◽  
Courtney Lace Soliz ◽  
Hashimul Ehsan ◽  
Gen Kaneko
Keyword(s):  
Machine Learning ◽  
High Risk ◽  
Genetic Information ◽  
Large Scale ◽  
Sequence Data ◽  
Precision Oncology ◽  
Nucleotide Polymorphisms ◽  
Making Sense ◽  
High Risk Populations ◽  
Systematic Identification

Precision medicine is a medical approach to administer patients with a tailored dose of treatment by taking into consideration a person’s variability in genes, environment, and lifestyles. The accumulation of omics big sequence data led to the development of various genetic databases on which clinical stratification of high-risk populations may be conducted. In addition, because cancers are generally caused by tumor-specific mutations, large-scale systematic identification of single nucleotide polymorphisms (SNPs) in various tumors has propelled significant progress of tailored treatments of tumors (i.e., precision oncology). Machine learning (ML), a subfield of artificial intelligence in which computers learn through experience, has a great potential to be used in precision oncology chiefly to help physicians make diagnostic decisions based on tumor images. A promising venue of ML in precision oncology is the integration of all available data from images to multi-omics big data for the holistic care of patients and high-risk healthy subjects. In this review, we provide a focused overview of precision oncology and ML with attention to breast cancer and glioma as well as the Bayesian networks that have the flexibility and the ability to work with incomplete information. We also introduce some state-of-the-art attempts to use and incorporate ML and genetic information in precision oncology.

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