scholarly journals Optimal strategies for quarantine stopping in France – General expected patterns of strategies focusing on contact between age groups

2020 ◽  
Author(s):  
Benjamin Roche ◽  
Andres Garchitorena ◽  
David Roiz
Keyword(s):  
High Efficiency ◽  
Age Groups ◽  
Optimal Strategies ◽  
The Elderly ◽  
Age Classes ◽  
Epidemic Curve ◽  
Mobility Data ◽  
Mortality Burden ◽  
Expected Mortality

AbstractDue to the COVID-19 pandemic, many countries have implemented a complete lockdown of their population that may not be sustainable for long. To identify the best strategy to replace this full lockdown, sophisticated models that rely on mobility data have been developed. In this study, using the example of France as a case-study, we develop a simple model considering contacts between age classes to derive the general impact of partial lockdown strategies targeted at specific age groups. We found that epidemic suppression can only be achieved by targeting isolation of young and middle age groups with high efficiency. All other strategies tested result in a flatter epidemic curve, with outcomes in (e.g. mortality and health system over-capacity) dependent of the age groups targeted and the isolation efficiency. Targeting only the elderly can decrease the expected mortality burden, but in proportions lower than more integrative strategies involving several age groups. While not aiming to provide quantitative forecasts, our study shows the benefits and constraints of different partial lockdown strategies, which could help guide decision-making.

scholarly journals "It Is Not Good For Man To Be Alone" The Struggle against Loneliness in Old Age: Basic Assumptions for an Integrative Operational Concept –The Israeli Case

2017 ◽  
Vol 6 (1) ◽  
pp. 82
Author(s):  
Avi Bitzur ◽  
Eran Fisher
Keyword(s):  
Old Age ◽  
Local Level ◽  
Age Groups ◽  
The Elderly ◽  
Dominant Factor ◽  
Comprehensive Plan ◽  
Limited Scale ◽  
Operational Concept

The widespread expression saying that "loneliness is the No. 1 enemy of old age" has, in the 21st century, becomes obvious and banal now that suicide rates among the elderly in many countries and in Israel, the case study for this paper, is higher than among other age groups in those countries.Loneliness itself, its ramifications, consequences, and implications on the lives of the elderly have made it a dominant factor in terms of its potential damage.Old age and loneliness have been the subjects of many different definitions, studies and theories, but despite the quantity and quality of these attempts worldwide, and particularly in Israeli research, there is a conspicuous lack of any comprehensive plan that would address the implications and destructive effects of the loneliness experienced by the elderly. Many limited-scale programs exist on a local level, but they fail to address the clear need to eradicate menacing loneliness.The authors of this essay plan to outline basic principles for designing an operational concept for a national plan to combat the consequences and effects of depression among the elderly, using Israel as an example.This paper will begin with a review of the definitions and literature on the phenomenon of depression, and a review of the literature dealing with the unhealthy connection between old age and depression. We will then review various programs worldwide that deal with the phenomenon of loneliness and old age; continue to present data on the effects of loneliness on elderly Israelis; present various Israeli programs and projects that attempt to deal with this phenomenon; and conclude by detailing the proposed principles for a comprehensive operational approach that maps out this painful phenomenon in Israel and proposes a plan of action on how to best deal with it.

scholarly journals Optimal strategies to protect a sub-population at risk due to an established epidemic

2021 ◽  
Author(s):  
Elliott H. Bussell ◽  
Nik J. Cunniffe
Keyword(s):  
National Park ◽  
Optimal Strategies ◽  
The Elderly ◽  
Phytophthora Ramorum ◽  
Limited Budget ◽  
Redwood National Park ◽  
Buffer Region ◽  
The Face ◽  
Test Robustness

AbstractEpidemics can particularly threaten certain sub-populations. For example, for SARS-CoV-2, the elderly are often preferentially protected. For diseases of plants and animals, certain sub-populations can drive mitigation because they are intrinsically more valuable for ecological, economic, socio-cultural or political reasons. Here we use optimal control theory to identify strategies to optimally protect a “high value” sub-population when there is a limited budget and epidemiological uncertainty. We use protection of the Redwood National Park in California in the face of the large ongoing state-wide epidemic of sudden oak death (caused by Phytophthora ramorum) as a case study. We concentrate on whether control should be focused entirely within the National Park itself, or whether treatment of the growing epidemic in the surrounding “buffer region” can instead be more profitable. We find that, depending on rates of infection and the size of the ongoing epidemic, focusing control on the high value region is often optimal. However, priority should sometimes switch from the buffer region to the high value region only as the local outbreak grows. We characterise how the timing of any switch depends on epidemiological and logistic parameters, and test robustness to systematic misspecification of these factors due to imperfect prior knowledge.

scholarly journals The Influence of Covid-19 Vaccine on Daily Cases, Hospitalization, and Death Rate in Tennessee: A Case Study in the United States

2021 ◽  
Author(s):  
Ali Roghani
Keyword(s):  
Death Rate ◽  
Age Groups ◽  
Vaccination Strategy ◽  
The Elderly ◽  
The United States ◽  
Hospitalization Rate ◽  
Older Age ◽  
Study Cohort ◽  
Lower Death Rate

The COVID-19 outbreak highlights the vulnerability to novel infections, and vaccination remains a foreseeable method to return to normal life. However, infrastructure is inadequate for the whole population to be vaccinated immediately. Therefore, policies have adopted a strategy to vaccinate the elderly and vulnerable population while delaying others. This study uses the Tennessee official statistic from the onset of COVID vaccination (17th of December 2021) to understand how age-specific vaccination strategies reduce daily cases, hospitalization, and death rate. The result shows that vaccination strategy can significantly influence the numbers of patients with COVID-19 in all age groups and lower hospitalization and death rates just in older age groups. The Elderly had a 95% lower death rate from December to March; however, and no change in the death rate in other age groups. The Hospitalization rate was reduced by 80% in this study cohort for people aged 80 or older, while people who were between 50 to 70 had almost the same hospitalization rate. The study indicates that vaccination targeting older age groups is the optimal way to avoid higher transmissions and reduce hospitalization and death rate for older groups.

scholarly journals FEATURES OF DIAGNOSIS AND TREATMENT OF PATIENTS WITH REDUCED BITE HEIGHT

2021 ◽  
pp. 66-70
Author(s):  
А. B. Kostushun
Keyword(s):  
High Efficiency ◽  
Age Groups ◽  
The Elderly ◽  
Pathological Process ◽  
Control Group ◽  
Orthopedic Treatment ◽  
Degree Of Reduction ◽  
Height Reduction ◽  
Hard Tissues ◽  
Group 2

Aesthetic and hygienic requirements of patients with reduced bite height necessitate the use of modern orthopedic constructions. The main cause of this disease is pathological abrasion of the hard tissues of the teeth, the prevalence of which ranges from 4 to 57% at a young age, reaches 91% in the elderly and is accompanied by both morphological and functional disorders of the dental-maxillary system. The aim of the research. Research the features of the diagnosis of dental status in patients with reduced bite height and timing of their treatment. Materials and methods of research. Determine the degree of reduction in the height of the bite in persons with pathological abrasion of the hard tissues of the teeth of varying severity compared with the norm and features of its recovery. Research results and their discussion. In order to prepare for orthopedic treatment, we determined the height of the bite in 123 patients. Accordingly, they were divided into three groups. Group 1 consisted of 32 patients with included dentition defects with reduced bite height up to 2 mm (n = 32), group 2 - examined with included dentition defects with reduced bite height 2-4 mm (n = 31), group 3 are patients with included dentition defects with reduced bite height of 4-6 mm (n = 30). All persons of the main groups belonged to the second and third age groups according to the WHO, aged 35-55 years, who required orthopedic treatment with fixed constructions of dentures. The control group (n = 30) are young people who belonged to the 1st WHO age group (age - 18-34 years) with intact dentition, without concomitant somatic and dental pathology, were examined in one visit. In order to study the degree of dependence of bite height reduction between incisors, canines, premolars and molars, we studied 30 gypsum models of supergypsum of the upper and lower jaws without reduction of bite height and 93 - with varying degrees of pathological abrasion of tooth hard tissues of all examined people. The models were fixed in a standard articulator in the central occlusion position. Using a caliper, we determined the size of the tooth crowns and compared it with standard sizes. In this research, we found the dependence of the degree of reduction in the height of the bite in the area of molars - premolars - incisors and canines in the ratio 1: 1,25: 1,5. We performed orthopedic treatment and subsequent clinical observation for each patient for 6 months, examining their condition after fixation of prostheses in 1 week and in 1, 3 and 6 months after orthopedic treatment. Based on the diagnosis of bite height reduction, we provided practical recommendations on the terms of use of fixed pharmacy bridges prostheses according to the degree of bite height reduction in the examined people. In the case of patients with a decrease in bite height by 3-4 mm, permanent orthopedic treatment is possible in 90 days after fixation of temporary orthopedic constructions in the oral cavity, and in patients with a reduced bite height of more than 4 mm - in 180 days. Conclusions. According to the results of the research, a high efficiency of determining the degree of reduction in bite height in preparing patients for permanent orthopedic treatment depending on the severity of the pathological process.

scholarly journals Selection of PPI in a comorbid patient with NSAIDgastroesophagopathy: case study

2019 ◽  
pp. 48-54
Author(s):  
I. G. Pakhomova
Keyword(s):  
Sharp Increase ◽  
Older Patients ◽  
Age Groups ◽  
The Elderly ◽  
Antiinflammatory Drugs ◽  
The Past ◽  
Prevention And Treatment ◽  
Adult Morbidity ◽  
Selection Of

Over the past decades, there have been significant changes in the structure of adult morbidity. Clinicians are increasingly faced with the problems of combined pathology and development of comorbidity, as well as to solve the issues of rational tactics of management of such patients. Polypragmasia due to comorbidity leads to a sharp increase in the probability of developing systemic and undesirable effects of drugs, while prolonged use of several drugs can lead to the development of complications that develop into independent nosological forms, which is especially important in older age groups. The most common forms of comorbidity in the elderly are in one or another combination of the following diseases: hypertension, coronary heart disease, diabetes, diseases of the musculoskeletal system. It is known that the leading place in the relief of pain in the latter is occupied by non-steroidal antiinflammatory drugs (NSAIDs), the use of which can be prolonged and induce the development of serious gastrotoxic reactions. Well studied and described NSAIDs-induced gastropathy, which, in most cases, is asymptomatic even in the presence of erosive and ulcerative changes. However, NSAIDs may be associated with the emergence of various dyspeptic complaints and lesions of the esophagus, which can be viewed in the framework of NSAID-associated esophageal, especially relevant in older patients. The article deals with the problem of comorbidity, polypragmasia, therapeutic tactics in the management of comorbid patients with NSAIDsesophagogastropathy and the possibility of prescribing for the prevention and treatment of not only effective, but also safe means of correction of these clinical and endoscopic manifestations.

scholarly journals 109 Hyponatraemia in Older Patients is Often Untreated, Despite Greater Mortality Burden; Results of A Prospective Cohort Study

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i34-i36 ◽  
Author(s):  
O Thorpe ◽  
M Cuesta ◽  
W T Tormey ◽  
M Sherlock ◽  
D J Williams ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Older Patients ◽  
Prospective Observational Study ◽  
Age Groups ◽  
Young Patients ◽  
The Elderly ◽  
Plasma Sodium ◽  
Single Centre ◽  
Similar Frequency ◽  
Mortality Burden

Abstract Introduction Hyponatraemia is associated with increased morbidity and mortality, and is commoner in elderly patients. The aetiology and outcomes of hyponatraemia in the elderly has not been defined in prospective studies. Methods A single-centre 9 month prospective observational study of hyponatraemic (HN) patients (</= 130 mmol/L) was performed. Clinical outcomes in patients ≥65 years (Elderly patients, EP) and those <65 years (Young Patients, YP) were analysed, and compared with age-matched eunatremic controls, Analysis was performed using Graphpad-Prism 7. Results 1321 consecutive admissions with hyponatraemia (67% EP, median age of EP 77 (65–98) years) and 1122 eunatremic controls (63% EP, median age of EP 77 (65–99) years) were analysed. Median nadir plasma sodium was similar in both groups with HN, 128 (107–130) mmol/L EP vs 128(110–130) mmol/L YP (p = 0.62). EP hyponatraemic patients were more likely to have hypovolaemic hyponatraemia (34%) compared with YP with hyponatraemia (28%, p = 0.03). Diuretic-induced hyponatraemia was twice as common in EP (8%) compared with YP (4%, p = 0.01). Malignancy-induced SIAD occurred with similar frequency in both groups (7% in EP SIAD vs 8% in YP SIAD, p = 0.65). Respiratory disease was causative in 10% cases of EP SIAD, compared with 4% in YP SIAD, p = 0.0004. Hyponatraemia was corrected in 53% of EP, compared with 64% of YP, p = 0.0001. Length of stay and re-admissions rates were similar across hyponatraemia age groups. EP with HN were 2.4 times more likely to die in hospital, compared with eunatremic age-matched controls, (OR 2.4, 95% CI 1.6–3.7, p < 0.0001). Conclusions The causation of hyponatraemia is different in elderly patients. Hyponatraemia in EP is often uncorrected, despite increased mortality compared with eunatremic age-matched controls.

scholarly journals Modeling and Analysis of Optimal Strategies for Leveraging Ride-Sourcing Services in Hurricane Evacuation

2021 ◽  
Vol 13 (8) ◽  
pp. 4444
Author(s):  
Ding Wang ◽  
Kaan Ozbay ◽  
Zilin Bian
Keyword(s):  
New York ◽  
Large Scale ◽  
Optimal Strategies ◽  
The Elderly ◽  
Evacuation Planning ◽  
Public Agencies ◽  
Hurricane Evacuation ◽  
Market Theory ◽  
Modeling And Analysis

In many large-scale evacuations, public agencies often have limited resources to evacuate all citizens, especially vulnerable populations such as the elderly and disabled people, and the demand for additional transportation means for evacuation can be high. The recent development of ride-sourcing companies can be leveraged in evacuations as an additional and important resource in future evacuation planning. In contrast to public transit, the availability of ride-sourcing drivers is highly dependent on the price, since surge pricing will occur when the demand is high and the supply is low. The key challenge is thus to find the balance between evacuation demand and driver supply. Based on the two-sided market theory, we propose mathematical modeling and analysis strategies that can help balance demand and supply through a pricing mechanism designed for ride-sourcing services in evacuation. A subsidy is considered in the model such that lower-income and vulnerable individuals could benefit from ride-sourcing services. A hypothetical hurricane evacuation scenario in New York City in the case study showed the feasibility of the proposed method and the applicability of subsidies for ride-sourcing services in evacuation. The methodology and results given in this research can provide useful insights for modeling on-demand ride-sourcing for future evacuation planning.

scholarly journals Forecasting the scale of the COVID-19 epidemic in Kenya

2020 ◽  
Author(s):  
Samuel P. C. Brand ◽  
Rabia Aziza ◽  
Ivy K. Kombe ◽  
Charles N. Agoti ◽  
Joe Hilton ◽  
...  
Keyword(s):  
Human Mobility ◽  
Age Distribution ◽  
Age Groups ◽  
Basic Reproductive Number ◽  
Reproductive Number ◽  
Specific Rate ◽  
Epidemic Curve ◽  
Mobility Data ◽  
Modelling Framework ◽  
Epidemiological Characteristics

AbstractBackgroundThe first COVID-19 case in Kenya was confirmed on March 13th, 2020. Here, we provide forecasts for the potential incidence rate, and magnitude, of a COVID-19 epidemic in Kenya based on the observed growth rate and age distribution of confirmed COVID-19 cases observed in China, whilst accounting for the demographic and geographic dissimilarities between China and Kenya.MethodsWe developed a modelling framework to simulate SARS-CoV-2 transmission in Kenya, KenyaCoV. KenyaCoV was used to simulate SARS-CoV-2 transmission both within, and between, different Kenyan regions and age groups. KenyaCoV was parameterized using a combination of human mobility data between the defined regions, the recent 2019 Kenyan census, and estimates of age group social interaction rates specific to Kenya. Key epidemiological characteristics such as the basic reproductive number and the age-specific rate of developing COVID-19 symptoms after infection with SARS-CoV-2, were adapted for the Kenyan setting from a combination of published estimates and analysis of the age distribution of cases observed in the Chinese outbreak.ResultsWe find that if person-to-person transmission becomes established within Kenya, identifying the role of subclinical, and therefore largely undetected, infected individuals is critical to predicting and containing a very significant epidemic. Depending on the transmission scenario our reproductive number estimates for Kenya range from 1.78 (95% CI 1.44 −2.14) to 3.46 (95% CI 2.81-4.17). In scenarios where asymptomatic infected individuals are transmitting significantly, we expect a rapidly growing epidemic which cannot be contained only by case isolation. In these scenarios, there is potential for a very high percentage of the population becoming infected (median estimates: >80% over six months), and a significant epidemic of symptomatic COVID-19 cases. Exceptional social distancing measures can slow transmission, flattening the epidemic curve, but the risk of epidemic rebound after lifting restrictions is predicted to be high.

scholarly journals Significantly longer Covid-19 incubation times for the elderly, from a case study of 136 patients throughout China

2020 ◽  
Author(s):  
Ally Bi-Zhu Jiang ◽  
Richard Lieu ◽  
Siobhan Quenby
Keyword(s):  
Incubation Time ◽  
Age Groups ◽  
The Elderly ◽  
Individual Case ◽  
Age Group ◽  
Log Normal ◽  
Case Data ◽  
Larger Sample ◽  
Two Age Groups

AbstractObjectiveTo infer Covid-19 incubation time distribution from a large sample.MethodBased on individual case data published online by 21 cities of China, we investigated a total of 136 COVID-19 patients who traveled to Hubei from 21 cities of China between January 5 and January 31, 2020, remained there for 48 hours or less, and returned to these cities with onset of symptoms between January 10 and February 6, 2020. Among these patients, 110 were found to be aged 15 – 64, 22 aged 65 – 86, and 4 aged under 15.FindingsThe differential incubation time histogram of the two age groups 15 – 64 and 65 – 86 are adequately fitted by the log normal model. For the 15 - 64 age group, the median incubation time of days (uncertainties are 95 −0.90 % CL) is broadly consistent with previous literature. For the 65-86 age group, the median is days is statistically significantly longer. Moreover, for −2.0 this group, the 95 % confidence contour indicates the data cannot constrain the upper bound of the log normal parameters µ, σ by failing to close there; this is because the sample has a maximum incubation time of 17 days, beyond which we ran out of data even though the histogram has not yet peaked. Thus there is the potential of a much longer incubation time for the 65-86 age group than 10 – 14 days. Only a much larger sample can settle this.

scholarly journals Patterns of COVID-19 related excess mortality in the municipalities of Northern Italy

2020 ◽  
Author(s):  
Dino Gibertoni ◽  
Kadjo Yves Cedric Adja ◽  
Davide Golinelli ◽  
Chiara Reno ◽  
Luca Regazzi ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Age Groups ◽  
Health Policies ◽  
Age Classes ◽  
Regional Health ◽  
Mortality Burden ◽  
Italian Regions ◽  
Gender And Age ◽  
Demographic Subgroups ◽  
The Impact

The Coronavirus Disease 2019 (COVID-19) spatial distribution in Italy is inhomogeneous, because of its ways of spreading from the initial hotspots. The impact of COVID-19 on mortality has been described at the regional level, while less is known about mortality in demographic subgroups within municipalities. We aimed to describe the excess mortality (EM) due to COVID-19 in the three most affected Italian regions, by estimating EM in subgroups defined by gender and age classes within each municipality from February 23 to March 31, 2020. EM varied widely among municipalities even within the same region; it was similar between genders for the ≥75 age group, while in the other age groups it was higher in males. Thus, nearby municipalities may show a different mortality burden despite being under common regional health policies, possibly as a result of policies adopted both at the regional and at the municipality level.

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