scholarly journals Assessing the Risk of Cascading COVID-19 Outbreaks from Prison-to-Prison Transfers

2021 ◽  
Author(s):  
Todd L Parsons ◽  
Lee Worden
Keyword(s):  
Large Scale ◽  
Prison System ◽  
Critical Threshold ◽  
Additional Risk ◽  
Safe Level ◽  
Health Measure ◽  
Threshold Rate ◽  
Prison Systems ◽  
The Impact ◽  
Number Of Individuals

COVID-19 transmission has been widespread across the California prison system, and at least two of these outbreaks were caused by transfer of infected individuals between prisons. Risks of individual prison outbreaks due to introduction of the virus and of widespread transmission within prisons due to poor conditions have been documented. We examine the additional risk potentially posed by transfer between prisons that can lead to large-scale spread of outbreaks across the prison system if the rate of transfer is sufficiently high. We estimated the threshold number of individuals transferred per prison per month to generate supercritical transmission between prisons, a condition that could lead to large-scale spread across the prison system. We obtained numerical estimates from a range of representative quantitative assumptions, and derived the percentage of transfers that must be performed with effective quarantine measures to prevent supercritical transmission given known rates of transfers occurring between California prisons. Our mean estimate of the critical threshold rate of transfers was 14.59 individuals transferred per prison per month in the absence of quarantine measures. Available data documents transfers occurring at a rate of 60 transfers per prison per month. At that rate, estimates of the threshold rate of adherence to quarantine precautions had mean 75.68%. While the impact of vaccination and possible decarceration measures is unclear, we include estimates of the above quantities given reductions in the probability and extent of outbreaks. We conclude that the risk of supercritical transmission between California prisons has been substantial, requiring quarantine protocols to be followed rigorously to manage this risk. The rate of outbreaks occurring in California prisons suggests that supercritical transmission may have occurred. We stress that the thresholds we estimate here do not define a safe level of transfers, even if supercritical transmission between prisons is avoided, since even low rates of transfer can cause very large outbreaks. We note that risks may persist after vaccination, due for example to variant strains, and in prison systems where widespread vaccination has not occurred. Decarceration remains urgently needed as a public health measure.

scholarly journals TP10.1.6Short term outcomes of emergency colorectal cancer resections during COVID-19 pandemic;Experience of a district general hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Aloka Suwanna Danwaththa Liyanage ◽  
Krishnan Gokul ◽  
Bheemanakone Harish Babu
Keyword(s):  
Colorectal Cancer ◽  
Large Scale ◽  
Primary Outcome ◽  
Admission Rate ◽  
District General Hospital ◽  
Infection Rates ◽  
Readmission Rates ◽  
Additional Risk ◽  
The Impact ◽  
Multicentre Cohort

Abstract Aim Surgical and oncological outcomes of emergency colorectal cancer (CRC) surgeries are poor compared to those of elective resections. SARS-Cov-2 ambience has added an additional risk on these patients during the course of their perioperative journey. The impact of peri-operative SARS-CoV-2 infection on the outcomes of these unique patients is still under scrutiny. We aimed to analyse a cohort of patients that underwent emergency CRC surgeries during pandemic in our setting. Methods We analysed a prospectively maintained database of all patients who underwent emergency CRC surgeries since 11th of March 2020 to 31st of December 2020. Primary outcome measures were Length of stay (LoS) and 90 day mortality. Secondary outcomes were post-operative complications, SARS-CoV-2 infection rates and 30 day readmission rates. Results We performed a total of 18 emergency CRC surgeries (Male: Female 1:1). Median age was 76.5 years (Range 39-89 years). Median LoS was 13 days (Range 5-110 days). 90 day mortality was 17% (3/18) and of the two patients who died (2/3), their cause of death was COVID-19 related. 4 (22%) patients had peri-operative SARS-CoV-2 infections. 30 day re-admission rate was 16% (3/18). 78% (14/18) of the patients had their cancer resected. 61% (11/18) of the procedures were palliative. Conclusions Peri-operative SARS-CoV-2 infection may have add on effect on the morbidity and mortality on patients undergoing emergency CRC surgeries. Data from large scale multicentre cohort studies would provide more insight in to this.

scholarly journals Impact of QTc formulae in the prevalence of short corrected QT interval and impact on probability and diagnosis of short QT syndrome

Heart ◽  
2017 ◽  
Vol 104 (6) ◽  
pp. 502-508 ◽  
Author(s):  
Rui Providência ◽  
Nabeela Karim ◽  
Neil Srinivasan ◽  
Shohreh Honarbakhsh ◽  
Maria João Vidigal Ferreira ◽  
...  
Keyword(s):  
Cardiac Death ◽  
Healthy Adult ◽  
Adult Population ◽  
Short Qt Syndrome ◽  
Additional Risk ◽  
Qt Syndrome ◽  
Using Data ◽  
The Impact ◽  
Number Of Individuals ◽  
Apparently Healthy

ObjectiveTo assess the prevalence of short corrected QT (QTc) intervals and its impact on short QT syndrome (SQTS) diagnosis using different QT correction formulae.MethodsObservational study. The prevalence of short QTc intervals was estimated using four different QT correction formulae in 14 662 young adults from the ‘Sudden Cardiac Death Screening of Risk FactOrS’ (SCD-SOS) cohort. Then, using data from this cohort and the pooled-cohort analysed by Gollob et al, comprising 61 patients with SQTS, we assessed the impact of the different QTc correction formulae on SQTS probability and diagnosis based on the Expert Consensus recommendations (QTc ≤330 ms or QTc 330–360 ms+1 additional risk feature).ResultsThe prevalence of individuals with a QTc ≤330 and ≤320 ms in the SCD-SOS cohort was extremely low (≤0.07% and≤0.02%, respectively), and these were more frequently identified by the Framingham correction. The different QTc correction formulae led to a shift in SQTS probability in 5%–10% of individuals in both the SCD-SOS and Gollob cohort). Intermediate probability individuals were rare (<0.1%), and no high-SQTS probability individuals were identified in the SCD-SOS cohort. Based on Consensus criteria, instead of 12 (0.08%) individuals being diagnosed with SQTS using the Bazett equation, a different number of individuals would meet diagnostic criteria with the other formulae: 11 (0.08%) using Fridericia, 9 (0.06%) with Hodges and 16 (0.11%) using the Framingham equation.ConclusionPrevalence of SQTS in the apparently healthy adult population is low. Applying different QTc correction formulae leads to significant reclassification of SQTS probability and their impact on predicting outcomes should be assessed.

The Impact of Infants in Prison on Institutional Life: A Study of the Mother/Infant Prison Programme in Western Australia

1983 ◽  
Vol 16 (3) ◽  
pp. 172-188 ◽  
Author(s):  
Janette Hartz-Karp
Keyword(s):  
Western Australia ◽  
Positive Impact ◽  
Prison System ◽  
Western World ◽  
Total Institution ◽  
Family Ties ◽  
Prison Life ◽  
Prison Systems ◽  
The Impact ◽  
Western Australian

The Western Australian prison system, following trends of other prison systems in the western world, has embarked upon a limited programme of accommodating infants with their prisoner mothers during the mother's term of imprisonment. This research canvasses other mother/infant programmes noted in the literature, pointing to the special nature of the Western Australian situation. The focus of the study is on the impact of infants in prison on institutional life and the management problems so engendered. The data indicate that overall, infants have a positive impact on prison life, muting some of the more debilitating effects of institutionalization. The finding that the impact of the mother/infant prison programme is more peripheral to institutional life than expected is explained in the light of the obduracy of the "total institution". The major concerns expressed by those interviewed: prison staff, prisoner mothers and other prisoners, are, respectively: prisoner management, mother/infant prison facilities and family ties, and concerns of justice. With these issues in mind, problems of the current programme are discussed together with suggested resolutions.

Impact of COVID-19 on Nuclear Medicine in Germany, Austria and Switzerland: An International Survey in April 2020

2020 ◽  
Vol 59 (04) ◽  
pp. 294-299 ◽  
Author(s):  
Lutz S. Freudenberg ◽  
Ulf Dittmer ◽  
Ken Herrmann
Keyword(s):  
Nuclear Medicine ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
Large Scale ◽  
Diagnostic Procedures ◽  
Protective Equipment ◽  
Current Crisis ◽  
Web Based ◽  
Public Versus Private ◽  
The Impact

Abstract Introduction Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. Materials and Methods A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. Results 113 complete responses were recorded. Nearly all participants (97 %) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are –14.4 %, –47.2 %, –47.5 %, –40.7 %, –58.4 %, and –25.2 % respectively. Furthermore, 76 % of the participants report a reduction in therapies especially for benign thyroid disease (-41.8 %) and radiosynoviorthesis (–53.8 %) while tumor therapies remained mainly stable. 48 % of the participants report a shortage of personal protective equipment. Conclusions Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.

HOME VISITS DURING THE FIRST MONTH OF DELIVERY FOR RECENTLY DELIVERED WOMEN IN UTTAR PRADESH, INDIA

2020 ◽  
Vol 6 (5) ◽  
pp. 1183-1189
Author(s):  
Dr. Tridibesh Tripathy ◽  
Dr. Umakant Prusty ◽  
Dr. Chintamani Nayak ◽  
Dr. Rakesh Dwivedi ◽  
Dr. Mohini Gautam
Keyword(s):  
Large Scale ◽  
National Level ◽  
Uttar Pradesh ◽  
Life Time ◽  
Structured Interview ◽  
The Other ◽  
Registration System ◽  
Action Group ◽  
Current Article ◽  
The Impact

The current article of Uttar Pradesh (UP) is about the ASHAs who are the daughters-in-law of a family that resides in the same community that they serve as the grassroots health worker since 2005 when the NRHM was introduced in the Empowered Action Group (EAG) states. UP is one such Empowered Action Group (EAG) state. The current study explores the actual responses of Recently Delivered Women (RDW) on their visits during the first month of their recent delivery. From the catchment area of each of the 250 ASHAs, two RDWs were selected who had a child in the age group of 3 to 6 months during the survey. The response profiles of the RDWs on the post- delivery first month visits are dwelled upon to evolve a picture representing the entire state of UP. The relevance of the study assumes significance as detailed data on the modalities of postnatal visits are available but not exclusively for the first month period of their recent delivery. The details of the post-delivery first month period related visits are not available even in large scale surveys like National Family Health Survey 4 done in 2015-16. The current study gives an insight in to these visits with a five-point approach i.e. type of personnel doing the visit, frequency of the visits, visits done in a particular week from among those four weeks separately for the three visits separately. The current study is basically regarding the summary of this Penta approach for the post- delivery one-month period.     The first month period after each delivery deals with 70% of the time of the postnatal period & the entire neonatal period. Therefore, it does impact the Maternal Mortality Rate & Ratio (MMR) & the Neonatal Mortality Rates (NMR) in India and especially in UP through the unsafe Maternal & Neonatal practices in the first month period after delivery. The current MM Rate of UP is 20.1 & MM Ratio is 216 whereas the MM ratio is 122 in India (SRS, 2019). The Sample Registration System (SRS) report also mentions that the Life Time Risk (LTR) of a woman in pregnancy is 0.7% which is the highest in the nation (SRS, 2019). This means it is very risky to give birth in UP in comparison to other regions in the country (SRS, 2019). This risk is at the peak in the first month period after each delivery. Similarly, the current NMR in India is 23 per 1000 livebirths (UNIGME,2018). As NMR data is not available separately for states, the national level data also hold good for the states and that’s how for the state of UP as well. These mortalities are the impact indicators and such indicators can be reduced through long drawn processes that includes effective and timely visits to RDWs especially in the first month period after delivery. This would help in making their post-natal & neonatal stage safe. This is the area of post-delivery first month visit profile detailing that the current article helps in popping out in relation to the recent delivery of the respondents.   A total of four districts of Uttar Pradesh were selected purposively for the study and the data collection was conducted in the villages of the respective districts with the help of a pre-tested structured interview schedule with both close-ended and open-ended questions.  The current article deals with five close ended questions with options, two for the type of personnel & frequency while the other three are for each of the three visits in the first month after the recent delivery of respondents. In addition, in-depth interviews were also conducted amongst the RDWs and a total 500 respondents had participated in the study.   Among the districts related to this article, the results showed that ASHA was the type of personnel who did the majority of visits in all the four districts. On the other hand, 25-40% of RDWs in all the 4 districts replied that they did not receive any visit within the first month of their recent delivery. Regarding frequency, most of the RDWs in all the 4 districts received 1-2 times visits by ASHAs.   Regarding the first visit, it was found that the ASHAs of Barabanki and Gonda visited less percentage of RDWs in the first week after delivery. Similarly, the second visit revealed that about 1.2% RDWs in Banda district could not recall about the visit. Further on the second visit, the RDWs responded that most of them in 3 districts except Gonda district did receive the second postnatal visit in 7-15 days after their recent delivery. Less than half of RDWs in Barabanki district & just more than half of RDWs in Gonda district received the third visit in 15-21 days period after delivery. For the same period, the majority of RDWs in the rest two districts responded that they had been entertained through a home visit.

The Impact of Quantitative Easing on Emerging Markets – Literature Review

e-Finanse ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 67-76
Author(s):  
Piotr Bartkiewicz
Keyword(s):  
Emerging Markets ◽  
Large Scale ◽  
Empirical Literature ◽  
Quantitative Easing ◽  
Methodological Choices ◽  
The Subject ◽  
Methodological Approaches ◽  
The Impact ◽  
Sufficient Precision

AbstractThe article presents the results of the review of the empirical literature regarding the impact of quantitative easing (QE) on emerging markets (EMs). The subject is of interest to policymakers and researchers due to the increasingly larger role of EMs in the world economy and the large-scale capital flows occurring after 2009. The review is conducted in a systematic manner and takes into consideration different methodological choices, samples and measurement issues. The paper puts the summarized results in the context of transmission channels identified in the literature. There are few distinct methodological approaches present in the literature. While there is a consensus regarding the direction of the impact of QE on EMs, its size and durability have not yet been assessed with sufficient precision. In addition, there are clear gaps in the empirical findings, not least related to relative underrepresentation of the CEE region (in particular, Poland).

Stress, Cortisol and Suicide Risk

2019 ◽  
Author(s):  
Daryl Brian O'Connor
Keyword(s):  
Risk Factors ◽  
Suicidal Behavior ◽  
Suicide Risk ◽  
Stressful Events ◽  
Additional Risk ◽  
Global Health Issue ◽  
History Of ◽  
Hpa Axis Activity ◽  
The Impact

Suicide is a global health issue accounting for at least 800,000 deaths per annum. Numerous models have been proposed that differ in their emphasis on the role of psychological, social, psychiatric and neurobiological factors in explaining suicide risk. Central to many models is a stress-diathesis component which states that suicidal behavior is the result of an interaction between acutely stressful events and a susceptibility to suicidal behavior (a diathesis). This article presents an overview of studies that demonstrate that stress and dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, are important additional risk factors for suicide. Evidence for other putative stress-related suicide risk factors including childhood trauma, impaired executive function, impulsivity and disrupted sleep are considered together with the impact of family history of suicide, perinatal and epigenetic influences on suicide risk.

Dietary Patterns: A New Therapeutic Approach for Depression?

2019 ◽  
Vol 20 (2) ◽  
pp. 123-129 ◽  
Author(s):  
Mariana Jesus ◽  
Tânia Silva ◽  
César Cagigal ◽  
Vera Martins ◽  
Carla Silva
Keyword(s):  
Depressive Symptoms ◽  
Dietary Patterns ◽  
Large Scale ◽  
Randomized Clinical Trials ◽  
Dietary Intervention ◽  
Common Mental Disorder ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Inverse Association ◽  
The Impact

Introduction: The field of nutritional psychiatry is a fast-growing one. Although initially, it focused on the effects of vitamins and micronutrients in mental health, in the last decade, its focus also extended to the dietary patterns. The possibility of a dietary cost-effective intervention in the most common mental disorder, depression, cannot be overlooked due to its potential large-scale impact. Method: A classic review of the literature was conducted, and studies published between 2010 and 2018 focusing on the impact of dietary patterns in depression and depressive symptoms were included. Results: We found 10 studies that matched our criteria. Most studies showed an inverse association between healthy dietary patterns, rich in fruits, vegetables, lean meats, nuts and whole grains, and with low intake of processed and sugary foods, and depression and depressive symptoms throughout an array of age groups, although some authors reported statistical significance only in women. While most studies were of cross-sectional design, making it difficult to infer causality, a randomized controlled trial presented similar results. Discussion: he association between dietary patterns and depression is now well-established, although the exact etiological pathways are still unknown. Dietary intervention, with the implementation of healthier dietary patterns, closer to the traditional ones, can play an important role in the prevention and adjunctive therapy of depression and depressive symptoms. Conclusion: More large-scale randomized clinical trials need to be conducted, in order to confirm the association between high-quality dietary patterns and lower risk of depression and depressive symptoms.

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