scholarly journals Modelling the performance of isoniazid preventive therapy for reducing tuberculosis in HIV endemic settings: the effects of network structure

2011 ◽  
Vol 8 (63) ◽  
pp. 1510-1520 ◽  
Author(s):  
H. L. Mills ◽  
T. Cohen ◽  
C. Colijn
Keyword(s):  
Network Structure ◽  
Disease Transmission ◽  
Population Level ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
World Health ◽  
Individual Level ◽  
Health Organization ◽  
The Individual ◽  
The Impact

Individuals living with HIV experience a much higher risk of progression from latent M. tuberculosis infection to active tuberculosis (TB) disease relative to individuals with intact immune systems. A several-month daily course of a single drug during latent infection (i.e. isoniazid preventive therapy (IPT)) has proved in clinical trials to substantially reduce an HIV-infected individual's risk of TB disease. As a result of these findings and ongoing studies, the World Health Organization has produced strong guidelines for implementing IPT on a community-wide scale for individuals with HIV at risk of TB disease. To date, there has been limited use of IPT at a community-wide level. In this paper, we present a new co-network model for HIV and TB co-epidemics to address questions about how the population-level impact of community-wide IPT may differ from the individual-level impact of IPT offered to selected individuals. In particular, we examine how the effect of clustering of contacts within high-TB incidence communities may affect the rates of re-infection with TB and how this clustering modifies the expected population-level effects of IPT. We find that populations with clustering of respiratory contacts experience aggregation of TB cases and high numbers of re-infection events. While, encouragingly, the overall population-level effects of community-wide IPT appear to be sustained regardless of network structure, we find that in populations where these contacts are highly clustered, there is dramatic heterogeneity in the impact of IPT: in some sub-regions of these populations, TB is nearly eliminated, while in others, repeated re-infection almost completely undermines the effect of IPT. Our findings imply that as IPT programmes are brought to scale, we should expect local heterogeneity of effectiveness as a result of the complex patterns of disease transmission within communities.

Household and Population-Level Behavioural Changes Due to COVID-19 Pandemic: A Smart Thermostat Based Comparative Data Analysis

2021 ◽  
Vol 10 (1) ◽  
pp. 1-6
Author(s):  
Kirti Sundar Sahu ◽  
Arlene Oetomo ◽  
Niloofar Jalali ◽  
Plinio P. Morita
Keyword(s):  
Data Analysis ◽  
Population Level ◽  
World Health ◽  
Motion Sensors ◽  
Household Level ◽  
Work From Home ◽  
Significant Difference ◽  
Health Organization ◽  
Smart Thermostat ◽  
The Impact

The World Health Organization declared the coronavirus outbreak as a pandemic on March 11, 2020. To inhibit the spread of COVID-19, governments around the globe, including Canada, have implemented physical distancing and lockdown measures, including a work-from-home policy. Canada in 2020 has developed a 24-Hour Movement Guideline for all ages laying guidance on the ideal amount of physical activity, sedentary behaviour, and sleep (PASS) for an individual in a day. The purpose of this study was to investigate changes on the household and population-level in lifestyle behaviours (PASS) and time spent indoors at the household level, following the implementation of physical distancing protocols and stay-at-home guidelines. For this study, we used 2019 and 2020 data from ecobee, a Canadian smart Wi-Fi thermostat company, through the Donate Your Data (DYD) program. Using motion sensors data, we quantified the amount of sleep by using the absence of movement, and similarly, increased sensor activation to show a longer duration of household occupancy. The key findings of this study were; during the COVID-19 pandemic, overall household-level activity increased significantly compared to pre-pandemic times, there was no significant difference between household-level behaviours between weekdays and weekends during the pandemic, average sleep duration has not changed, but the pattern of sleep behaviour significantly changed, specifically, bedtime and wake up time delayed, indoor time spent has been increased and outdoor time significantly reduced. Our data analysis shows the feasibility of using big data to monitor the impact of the COVID-19 pandemic on the household and population-level behaviours and patterns of change.

Engaging older people in healthy and active lifestyles: a systematic review

2015 ◽  
Vol 36 (10) ◽  
pp. 2036-2060 ◽  
Author(s):  
JULIA MENICHETTI ◽  
PIETRO CIPRESSO ◽  
DARIO BUSSOLIN ◽  
GUENDALINA GRAFFIGNA
Keyword(s):  
Systematic Review ◽  
Health Promotion ◽  
World Health ◽  
Active Ageing ◽  
Individual Level ◽  
Active Lifestyles ◽  
Health Organization ◽  
The Individual ◽  
Health Promotion Interventions ◽  
Older Citizens

ABSTRACTIn 2002, the World Health Organization emphasised the concept of active ageing to manage and increase the last third of life. Although many efforts have been made to optimise treatment management, less attention has been paid to health promotion initiatives. To date, few shared guidelines exist that promote an active life in healthy older targets. To fill this gap, we conducted a systematic review to map health promotion interventions that targeted an active and healthy ageing among older citizens. Articles containing the key term active ageing and seven synonyms were searched for in the electronic databases. Because we were interested in actions aimed to promote healthier lifestyles, we connected the string with the term health. A total of 3,918 titles were retrieved and 20 articles were extracted. Twelve of the 20 studies used group interventions, five interventions targeted the individual level and three interventions targeted the community level. Interventions differed for the health focus of the programmes, which ranged from physical activity interventions to social participation or cognitive functioning. Most of the studies aimed to act on psychological components. The review suggests that different interventions promoted for active ageing are effective in improving specific healthy and active lifestyles; however, no studies were concerned directly with a holistic process of citizen health engagement to improve long-term outcomes.

scholarly journals Analyzing 24-Hour Blood Pressure Measurements with a Novel Cuffless Pulse Transit Time Device in Clinical Practice—Does the Software for Heartbeat Detection Matter?

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 361
Author(s):  
Leo Kilian ◽  
Philipp Krisai ◽  
Thenral Socrates ◽  
Christian Arranto ◽  
Otmar Pfister ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Transit Time ◽  
Pulse Transit Time ◽  
Population Level ◽  
Raw Data ◽  
Invasive Blood Pressure ◽  
Individual Level ◽  
Non Invasive ◽  
The Individual ◽  
The Impact

Background: The Somnotouch-Non-Invasive-Blood-Pressure (NIBP) device delivers raw data consisting of electrocardiography and photoplethysmography for estimating blood pressure (BP) over 24 h using pulse-transit-time. The study’s aim was to analyze the impact on 24-hour BP results when processing raw data by two different software solutions delivered with the device. Methods: We used data from 234 participants. The Somnotouch-NIBP measurements were analyzed using the Domino-light and Schiller software and compared. BP values differing >5 mmHg were regarded as relevant and explored for their impact on BP classification (normotension vs. hypertension). Results: Mean (±standard deviation) absolute systolic/diastolic differences for 24-hour mean BP were 1.5 (±1.7)/1.1 (±1.3) mm Hg. Besides awake systolic BP (p = 0.022), there were no statistically significant differences in systolic/diastolic 24-hour mean, awake, and asleep BP. Twenty four-hour mean BP agreement (number (%)) between the software solutions within 5, 10, and 15 mmHg were 222 (94.8%), 231 (98.7%), 234 (100%) for systolic and 228 (97.4%), 232 (99.1%), 233 (99.5%) for diastolic measurements, respectively. A BP difference of >5 mmHg was present in 24 (10.3%) participants leading to discordant classification in 4–17%. Conclusion: By comparing the two software solutions, differences in BP are negligible at the population level. However, at the individual level there are, in a minority of cases, differences that lead to different BP classifications, which can influence the therapeutic decision.

Review of Common Management Strategies for Fatigue in Multiple Sclerosis

1999 ◽  
Vol 1 (2) ◽  
pp. 23-31 ◽  
Author(s):  
A Chan
Keyword(s):  
Multiple Sclerosis ◽  
Management Strategies ◽  
Active Role ◽  
World Health ◽  
Common Symptom ◽  
Promotion Strategy ◽  
Fatigue Management ◽  
Health Organization ◽  
The Individual ◽  
The Impact

Abstract Fatigue is the most common symptom experienced by individuals with multiple sclerosis (MS), regardless of their disability level or the severity of the disease. The Fatigue Severity Scale and the Fatigue Impact Scale are standardized tools designed to measure the impact of fatigue on an individual's life. In addition to the use of medications, other fatigue management strategies include education, modification of activities and environment, compensation, and participation in physical exercises. Because the patient is required to take an active role in the implementation of these fatigue management strategies, his or her sense of control in disease management is enhanced, resulting in empowerment of the individual. According to the World Health Organization (WHO), empowerment is a health-promotion strategy for the individual and for populations. Therefore, having options and control in fatigue management is empowering and promotes health for individuals with MS.

scholarly journals Tuberculosis screening coverage and isoniazid preventive therapy among people living with HIV at Gambella Hospital, southwest Ethiopia: a retrospective study design

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110461
Author(s):  
Mecha Aboma ◽  
Nagasa Dida
Keyword(s):  
Retrospective Study ◽  
Complete Information ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
World Health ◽  
People Living With Hiv ◽  
African Countries ◽  
Tuberculosis Screening ◽  
Southwest Ethiopia ◽  
Health Organization

Objective We aimed to assess the coverage of tuberculosis screening and isoniazid preventive therapy (IPT) among people living with human immunodeficiency virus (PLHIV) at Gambella Hospital, southwest Ethiopia. Methods We conducted a 5-year retrospective study of PLHIV receiving care in an antiretroviral therapy clinic from 1 January 2011 to 30 December 2015. We reviewed a total of 900 medical records of patients with complete information. Result Of the total, 897 (99.7%) PLHIV were screened for tuberculosis, among which 77 (8.6%) were found to be positive for active tuberculosis. Among 820 (91.4%) individuals eligible for IPT, only 545 (66.5%) were provided IPT; 275 (33.5%) eligible PLHIV were not provided IPT. Male sex (adjusted odds ratio [AOR] 1.63) and ages 18–29 years (AOR 0.33) and 30–44 years (AOR 0.31) were significantly associated with the likelihood of tuberculosis infection. Conclusion The present study findings demonstrated that tuberculosis screening for PLHIV at Gambella Hospital was improved in comparison with reports from many African countries and other parts of Ethiopia. Despite this improvement, the implementation rate of IPT was below national and World Health Organization recommendations. Overall, tuberculosis diagnostic approaches and available preventive measures should be strengthened in the study area.

scholarly journals The Normative Underpinnings of Population-Level Alcohol Use: An Individual-Level Simulation Model

2020 ◽  
Vol 47 (2) ◽  
pp. 224-234
Author(s):  
Charlotte Probst ◽  
Tuong Manh Vu ◽  
Joshua M. Epstein ◽  
Alexandra E. Nielsen ◽  
Charlotte Buckley ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Social Norms ◽  
Drinking Behavior ◽  
Population Level ◽  
Drinking Patterns ◽  
Individual Level ◽  
Behavioral Rules ◽  
Level Model ◽  
The Individual ◽  
The Impact

Background. By defining what is “normal,” appropriate, expected, and unacceptable, social norms shape human behavior. However, the individual-level mechanisms through which social norms impact population-level trends in health-relevant behaviors are not well understood. Aims. To test the ability of social norms mechanisms to predict changes in population-level drinking patterns. Method. An individual-level model was developed to simulate dynamic normative mechanisms and behavioral rules underlying drinking behavior over time. The model encompassed descriptive and injunctive drinking norms and their impact on frequency and quantity of alcohol use. A microsynthesis initialized in 1979 was used as a demographically representative synthetic U.S. population. Three experiments were performed in order to test the modelled normative mechanisms. Results. Overall, the experiments showed limited influence of normative interventions on population-level alcohol use. An increase in the desire to drink led to the most meaningful changes in the population’s drinking behavior. The findings of the experiments underline the importance of autonomy, that is, the degree to which an individual is susceptible to normative influence. Conclusion. The model was able to predict theoretically plausible changes in drinking patterns at the population level through the impact of social mechanisms. Future applications of the model could be used to plan norms interventions pertaining to alcohol use as well as other health behaviors.

THE ACTIVIY OF INTERNATIONAL ORGANIZATIONS IN COVID-19 CRISIS MANAGEMENT

2021 ◽  
pp. 114-127
Author(s):  
Svetlana Cebotari ◽  
Keyword(s):  
Interpersonal Relationships ◽  
International Organizations ◽  
North Atlantic ◽  
World Health ◽  
The European Union ◽  
The North ◽  
Un Security Council ◽  
Health Organization ◽  
The Individual ◽  
The Impact

One of the most discussed issues in academia, but also in the discourse of polemologists, political scientists, economists and specialists in other fields is the issue regarding the impact of the COVID-19 virus on international security. Although all the attention of the international community has been focused on the emergence of the COVID-19 virus and its impact on the individual, societal, human and interpersonal relationships, it is worth paying attention to the involvement of international organizations in managing the COVID-19 crisis. This article aims to highlight the role and involvement of international organizations in managing the COVID-19 crisis. The involvement of the United Nations, specifically of the UN Security Council, in the management of issues related to the COVID-19 crisis will be examined. The activity of the World Health Organization, the European Union, the North Atlantic Alliance in the management of the COVID-19 pandemic will also be examined.

scholarly journals Modelling cause-of-death mortality and the impact of cause-elimination

2014 ◽  
Vol 9 (1) ◽  
pp. 167-186 ◽  
Author(s):  
Daniel H. Alai ◽  
Séverine Arnold (-Gaille) ◽  
Michael Sherris
Keyword(s):  
Cause Of Death ◽  
Residual Life ◽  
Population Level ◽  
World Health ◽  
Mortality Trends ◽  
Force Of Mortality ◽  
French Case ◽  
Competing Causes ◽  
Health Organization ◽  
The Impact

AbstractThe analysis of causal mortality provides rich insight into changes in mortality trends that are hidden in population-level data. Therefore, we develop and apply a multinomial logistic framework to model causal mortality. We use internationally classified cause-of-death categories and data obtained from the World Health Organization. Inherent dependence amongst the competing causes is accounted for in the framework, which also allows us to investigate the effects of improvements in, or the elimination of, cause-specific mortality. This has applications to scenario-based forecasting often used to assess the impact of changes in mortality. The multinomial model is shown to be more conservative than commonly used approaches based on the force of mortality. We use the model to demonstrate the impact of cause-elimination on aggregate mortality using residual life expectancy and apply the model to a French case study.

Dose-Response Study of Formaldehyde on Nasal Mucosa Swelling. A Study on Residents with Nasal Distress at Home

1994 ◽  
Vol 8 (3) ◽  
pp. 143-146 ◽  
Author(s):  
Jan E. Falk ◽  
Jan E. Juto ◽  
Göran Stridh ◽  
Gunnar Bylin
Keyword(s):  
Nasal Mucosa ◽  
World Health ◽  
Control Group ◽  
Great Effort ◽  
Indoor Climate ◽  
Sick Building ◽  
Health Organization ◽  
The Individual ◽  
Dose Response Study ◽  
The Impact

Despite great effort, it has been difficult to demonstrate in an objective way any impact of sick building environment on affected individuals. The aim of this study was to learn whether or not it is possible with rhinostereometry to register changes in the nasal mucosa swelling at exposure to formaldehyde in concentrations 0–0.174 mg/m3. Seven persons, non-allergic, otherwise healthy, and with a history of nasal distress in their homes, participated in the study. Six healthy persons, without nose problems, were controls. Each person was exposed to formaldehyde in different concentrations during two hours in a climate chamber. Increased swelling was recorded al the two highest concentrations (0.073 and 0.174 mg/m3) in the symptomatic group. The control group did not show any mucosal swelling. It was possible to demonstrate an increased mucosal swelling that must be attributed to exposure to formaldehyde. This was possible at formaldehyde concentrations close to the (0.125 mg/m3) upper limit for indoor climate recommended by the World Health Organization (WHO). The study model can be considered useful for further investigations of the impact on the individual from other airborne irritants connected to sick building environments.

Screening for active tuberculosis before isoniazid preventive therapy among HIV-infected West African adults

2017 ◽  
Vol 21 (12) ◽  
pp. 1237-1244 ◽  
Author(s):  
R. Moh ◽  
A. Badjé ◽  
J-B. N'takpé ◽  
G. M. Kouamé ◽  
D. Gabillard ◽  
...  
Keyword(s):  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
World Health ◽  
Open Label ◽  
Clinical Algorithm ◽  
Related Risk ◽  
Immunodeficiency Virus ◽  
Chest X Ray ◽  
Open Label Trial ◽  
Health Organization

SETTING: TEMPRANO was a multicentre, open-label trial in which human immunodeficiency virus (HIV) infected adults with high CD4 counts were randomised into early or deferred antiretroviral therapy (ART) arms with or without 6-month isoniazid preventive therapy (IPT) in a setting where the World Health Organization (WHO) recommends IPT in HIV-infected patients. Despite the WHO recommendation, IPT coverage remains low due to fear of the presence of undiagnosed active TB before prescribing IPT, and the related risk of drug resistance.OBJECTIVE: To report the frequency of undiagnosed TB in patients enrolled for IPT and describe the results of a 1-month buffer period to avoid prescribing IPT for active TB cases.DESIGN: Patients were screened using a clinical algorithm and chest X-ray at Day 0 and started on isoniazid at Month 1 if no sign/symptom suggestive of TB appeared between Day 0 and Month 1.RESULTS: Of 1030 patients randomised into IPT arms. 10% never started IPT at Month 1. Of these, 23 had active TB, including 16 with prevalent TB. Among the 927 patients who started IPT, 6 had active TB, including 1 with prevalent TB. Only 1 patient with active TB received IPT due to the 1-month buffer period between Day 0 and IPT initiation.CONCLUSION: In this study, 1.6% of adults considered free of active TB based on clinical screening at pre-inclusion actually had active TB.

Sign in / Sign up

Export Citation Format

Share Document