scholarly journals Rapid Scoping Review of Evidence of Outdoor Transmission of COVID-19

2020 ◽  
Author(s):  
Mike Weed ◽  
Abby Foad
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Everyday Life ◽  
Transmission Risk ◽  
Vulnerable Groups ◽  
Contact Tracing ◽  
Magic Bullet ◽  
Health Crisis ◽  
Mass Gatherings ◽  
Outdoor Transmission

The COVID-19 pandemic is both a global health crisis, and a civic emergency for national governments, including the UK. As countries across the world loosen their lockdown restrictions, the assumption is generally made that the risk of COVID-19 transmission is lower outdoors, and this assumption has shaped decisions about what activities can re-commence, the circumstances in which they should re-commence, and the conditions under which they should re-commence. This is important for events and activities that generate outdoor gatherings of people, including both participatory and spectator sport events, protests, concerts, carnivals, festivals, and other celebrations. The review, which was designed to be undertaken rapidly in 15 days, returned 14 sources of evidence of outdoor transmission of COVID-19, and a further 21 sources that were used to set the context and understand the caveats that should be considered in interpreting the review findings. The review found very few examples of outdoor transmission of COVID-19 in everyday life among c. 25,000 cases considered, suggesting a very low risk. However risk of outdoor transmission increases when the natural social distancing of everyday life is breached, and gathering density, circulation and size increases, particularly for an extended duration. There was also evidence that weather had a behavioural effect on transmission, with temperatures that encourage outdoor activity associated with lower COVID-19 transmission. Due to lack of surveillance and tracing systems, and confounding factors and variables, there was no evidence that robustly tested transmission at outdoor mass gatherings (circa 10,000+ people), which are as likely to generate transmission from the activities they prompt (e.g. communal travel and congregation in bars) as from outdoor transmission at the gathering itself. The goal of hosts and organisers of events and activities that generate outdoor gatherings of people is to prevent the escalation of risk from sporadic transmission to the risk of transmission through a cluster outbreak. Considerations for such hosts and organisers include: (1) does the gathering prompt other behaviours that might increase transmission risk?; (2) for each part of the event or activity, how dense is the gathering, how much do people circulate, how large is the gathering, and how long are people there?; (3) is rapid contact tracing possible in the event of an outbreak? These considerations should take place relevant to the size of the underlying risk, which includes the rate of infection in the community and the likely attendance of vulnerable groups. Risk must be balanced and mitigated across the risk factors of density, circulation, size and duration. No one risk factor presents an inherently larger risk than any other, but neither is any one risk factor a magic bullet to eliminate risk. Finally, it is clear that the largest risks from gatherings come from spontaneous or informal unregulated and unmitigated events or activities which do not consider any of the issues, risks and risk factors outlined in this paper

scholarly journals Protocol for a Rapid Scoping Review of Evidence of Outdoor Transmission of COVID-19

2020 ◽  
Author(s):  
Mike Weed ◽  
Abby Foad
Keyword(s):  
Global Health ◽  
Scoping Review ◽  
Health Crisis ◽  
Mass Gatherings ◽  
Sports Events ◽  
Outdoor Transmission ◽  
The World ◽  
The Uk ◽  
Mass Participation ◽  
National Governments

The COVID-19 pandemic is both a global health crisis, and a civic emergency for national governments, including the UK. As countries across the world loosen their lockdown restrictions, the assumption is generally made that the risk of COVID-19 transmission is lower outdoors, and this assumption has shaped decisions about what activities can re-commence, the circumstances in which they should re-commence, and the conditions under which they should re-commence. This is important for events and activities that generate mass gatherings, particularly mass participation sports events such as running, but also events in other sectors such as concerts, carnivals and festivals. This paper sets out a protocol for a rapid scoping review of evidence of incidents of outdoor transmission of COVID-19, including the settings, environments and circumstances of such transmission, and their comparative prevalence to incidents of indoor transmission. Its purpose is to inform discussions about the recommencement of activities that generate mass gatherings.

scholarly journals Implementing contact tracing for tuberculosis in Kyrgyz Republic and risk factors for positivity using QuantiFERON-TB Gold plus

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Caroline Corbett ◽  
Aizat Kulzhabaeva ◽  
Tatjana Toichkina ◽  
Gulmira Kalmambetova ◽  
Sevim Ahmedov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Central Asia ◽  
Significant Risk ◽  
Contact Tracing ◽  
Smear Microscopy ◽  
Kyrgyz Republic ◽  
Latent Tb ◽  
Household Density ◽  
Latent Tb Infection

Abstract Background Effective active case finding (ACF) activities are essential for early identification of new cases of active tuberculosis (TB) and latent TB infection (LTBI). Accurate diagnostics as well as the ability to identify contacts at high risk of infection are essential for ACF, and have not been systematically reported from Central Asia. The objective was to implement a pilot ACF program to determine the prevalence and risk factors for LTBI and active TB among contacts of individuals with TB in Kyrgyz Republic using Quantiferon-TB Gold plus (QuantiFERON). Methods An enhanced ACF project in the Kyrgyz Republic was implemented in which close and household (home) contacts of TB patients from the Issyk-Kul Oblast TB Center were visited at home. QuantiFERON and the tuberculin skin test (TST) alongside clinical and bacteriological examination were used to identify LTBI and active TB cases among contacts. The association for QuantiFERON positivity and risk factors were analysed and compared to TST results. Results Implementation of ACF with QuantiFERON involved close collaboration with the national sanitary and epidemiological services (SES) and laboratories in the Kyrgyz Republic. From 67 index cases, 296 contacts were enrolled of whom 253 had QuantiFERON or TST results; of those 103 contacts had LTBI (positive TST or IGRA), and four (1.4%) active TB cases were detected. Index case smear microscopy (OR 1.76) and high household density (OR 1.97) were significant risk factors for QuantiFERON positivity for all contacts. When stratified by age, association with smear positivity disappeared for children below 15 years. TST was not associated with any risk factor. Conclusions This is the first time that ACF activities have been reported for Central Asia, and provide insight for implementation of effective ACF in the region. These ACF activities using QuantiFERON led to increase in the detection of LTBI and active cases, prior to patients seeking treatment. Household density should be taken into consideration as an important risk factor for the stratification of future ACF activities.

scholarly journals Extending the range of COVID-19 risk factors in a Bayesian network model for personalised risk assessment

2020 ◽  
Author(s):  
Georgina Prodhan ◽  
Norman Fenton
Keyword(s):  
Risk Factors ◽  
Bayesian Network ◽  
Network Model ◽  
Time Lag ◽  
Transmission Risk ◽  
Contact Tracing ◽  
Individual Risk ◽  
Bayesian Network Model ◽  
Health Authorities ◽  
The Uk

AbstractA need is emerging for individuals to gauge their own risks of coronavirus infection as it becomes apparent that contact tracing to contain the spread of the virus is not working in many societies. This paper presents an extension of an existing Bayesian network model for an application in which people can add their own personal risk factors to calculate their probability of exposure to the virus and likely severity if they do catch the illness. The data need not be shared with any central authority. In this way, people can become more aware of their individual risks and adjust their behaviour accordingly, as many countries prepare for a second wave of infections or a prolonged pandemic. This has the advantage not only of preserving privacy but also of containing the virus more effectively by allowing users to act without the time lag of waiting to be informed that a contact has been tested and confirmed COVID-19 positive. Through a nuanced assessment of individual risk, it could also release many people from isolation who are judged highly vulnerable using cruder measures, helping to boost economic activity and decrease social isolation without unduly increasing transmission risk. Although much has been written and reported about single risk factors, little has been done to bring these factors together in a user-friendly way to give an overall risk rating. The causal probabilistic model presented here shows the power of Bayesian networks to represent the interplay of multiple, dependent variables and to predict outcomes. The network, designed for use in the UK, is built using detailed data from government and health authorities and the latest research, and is capable of dynamic updates as new information becomes available. The focus of the paper is on the extended set of risk factors.

scholarly journals Environmental Pollutants, Mucosal Barriers, and Pathogen Susceptibility; The Case for Aflatoxin B1 as a Risk Factor for HIV Transmission and Pathogenesis

Pathogens ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1229
Author(s):  
Erin P. Madeen ◽  
Frank Maldarelli ◽  
John D. Groopman
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Low Income ◽  
Aflatoxin B1 ◽  
Hiv Transmission ◽  
Transmission Risk ◽  
Low Income Countries ◽  
Mucosal Barrier ◽  
Hiv Viral Load ◽  
Cytokine Activation

HIV transmission risk is dependent on the infectivity of the HIV+ partner and personal susceptibility risk factors of the HIV− partner. The mucosal barrier, as the internal gatekeeper between environment and self, concentrates and modulates the internalization of ingested pathogens and pollutants. In this review, we summarize the localized effects of HIV and dietary toxin aflatoxin B1 (AFB1), a common pollutant in high HIV burden regions, e.g., at the mucosal barrier, and evidence for pollutant-viral interactions. We compiled literature on HIV and AFB1 geographic occurrences, mechanisms of action, related co-exposures, personal risk factors, and HIV key determinants of health. AFB1 exposure and HIV sexual transmission hotspots geographically co-localize in many low-income countries. AFB1 distributes to sexual mucosal tissues generating inflammation, microbiome changes and a reduction of mucosal barrier integrity, effects that are risk factors for increasing HIV susceptibility. AFB1 exposure has a positive correlation to HIV viral load, a risk factor for increasing the infectivity of the HIV+ partner. The AFB1 exposure and metabolism generates inflammation that recruits HIV susceptible cells and generates chemokine/cytokine activation in tissues exposed to HIV. Although circumstantial, the available evidence makes a compelling case for studies of AFB1 exposure as a risk factor for HIV transmission, and a modifiable new component for combination HIV prevention efforts.

Hemmkörperentwicklung bei Hämophilie-Patienten nach Präparate wechsel

2012 ◽  
Vol 32 (S 01) ◽  
pp. S39-S42 ◽  
Author(s):  
S. Kocher ◽  
G. Asmelash ◽  
V. Makki ◽  
S. Müller ◽  
S. Krekeler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Observational Study ◽  
Retrospective Observational Study ◽  
Frequent Change ◽  
Patient Age ◽  
Treatment Regimens ◽  
Patient Âgé ◽  
The Relationship ◽  
Observation Period

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

Risk Factors of Collateralized Loan Obligations and Corporate Bonds

2020 ◽  
Vol 32 (6) ◽  
pp. 347-355
Author(s):  
Mark Wahrenburg ◽  
Andreas Barth ◽  
Mohammad Izadi ◽  
Anas Rahhal
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Asset Pricing ◽  
Systemic Risk ◽  
Corporate Bonds ◽  
Risk Exposure ◽  
Expected Returns ◽  
Yield Spreads ◽  
Pricing Factors ◽  
Return Difference

AbstractStructured products like collateralized loan obligations (CLOs) tend to offer significantly higher yield spreads than corporate bonds (CBs) with the same rating. At the same time, empirical evidence does not indicate that this higher yield is reduced by higher default losses of CLOs. The evidence thus suggests that CLOs offer higher expected returns compared to CB with similar credit risk. This study aims to analyze whether this return difference is captured by asset pricing factors. We show that market risk is the predominant risk factor for both CBs and CLOs. CLO investors, however, additionally demand a premium for their risk exposure towards systemic risk. This premium is inversely related to the rating class of the CLO.

Cardiovascular Risk in Perimenopausal Women

2019 ◽  
Vol 17 (6) ◽  
pp. 591-594 ◽  
Author(s):  
John C. Stevenson ◽  
Sophia Tsiligiannis ◽  
Nick Panay
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ovarian Function ◽  
Density Lipoprotein ◽  
Premenopausal Women ◽  
Therapeutic Interventions ◽  
Additional Risk Factor ◽  
Chd Risk ◽  
Perimenopausal Women ◽  
Chd Risk Factors

Cardiovascular disease, and particularly coronary heart disease (CHD), has a low incidence in premenopausal women. Loss of ovarian hormones during the perimenopause and menopause leads to a sharp increase in incidence. Although most CHD risk factors are common to both men and women, the menopause is a unique additional risk factor for women. Sex steroids have profound effects on many CHD risk factors. Their loss leads to adverse changes in lipids and lipoproteins, with increases being seen in low density lipoprotein (LDL) cholesterol and triglycerides, and decreases in high density lipoprotein (HDL) cholesterol. There is a reduction in insulin secretion and elimination, but increases in insulin resistance eventually result in increasing circulating insulin levels. There are changes in body fat distribution with accumulation in central and visceral fat which links to the other adverse metabolic changes. There is an increase in the incidence of hypertension and of type 2 diabetes mellitus, both major risk factors for CHD. Oestrogens have potent effects on blood vessels and their loss leads to dysfunction of the vascular endothelium. All of these changes result from loss of ovarian function contributing to the increased development of CHD. Risk factor assessment in perimenopausal women is recommended, thereby permitting the timely introduction of lifestyle, hormonal and therapeutic interventions to modify or reverse these adverse changes.

Surviving “Risk Factor Frenzy”: The Perils of Incorrectly Applying Epidemiological Research in Health Education and Promotion

2002 ◽  
Vol 21 (1) ◽  
pp. 83-100 ◽  
Author(s):  
Jonathan I. Robison ◽  
Gregory Kline
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Health Education ◽  
Health Professionals ◽  
Lifestyle Change ◽  
Negative Consequences ◽  
Epidemiological Research ◽  
Health Practitioners ◽  
Health Education And Promotion

In health education and promotion, “risk factors” for disease gathered from epidemiological research form the basis from which the majority of recommendations to individuals for lifestyle change are made. Unfortunately, many health practitioners are unaware that this type of research was never intended to be applied to individuals. The result is ongoing public confusion and anxiety concerning health recommendations and a loss of credibility for health professionals. This article: 1) briefly reviews the most commonly encountered limitations inherent in epidemiological research; 2) explores the problems and potential negative consequences of incorrectly applying epidemiological research in health education and promotion; and 3) makes recommendations to help health practitioners more skillfully interpret and incorporate into their work findings from epidemiological research.

Knowledge, awareness and perceptions of diabetes mellitus among the Saudi population

2020 ◽  
Vol 9 (6) ◽  
pp. 413-422
Author(s):  
Muhammad H Mujammami ◽  
Abdulaziz A Alodhayani ◽  
Mohammad Ibrahim AlJabri ◽  
Ahmad Alhumaidi Alanazi ◽  
Sultan Sayyaf Alanazi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Social Media ◽  
Risk Factor ◽  
Healthcare Workers ◽  
Health Workers ◽  
Saudi Population ◽  
Limited Data ◽  
High Prevalence ◽  
Associated Risk Factors

Background: High prevalence of undiagnosed cases of diabetes mellitus (DM) has increased over the last two decades, most patients with DM only become aware of their condition once they develop a complication. Limited data are available regarding the knowledge and awareness about DM and the associated risk factors, complications and management in Saudi society. Aim: This study aimed to assess knowledge of DM in general Saudi society and among Saudi healthcare workers. Results: Only 37.3% of the participants were aware of the current DM prevalence. Obesity was the most frequently identified risk factor for DM. Most comparisons indicated better awareness among health workers. Conclusion: A significant lack of knowledge about DM in Saudi society was identified. Social media and educational curriculum can improve knowledge and awareness of DM.

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