scholarly journals Clinical Risk, Sociodemographic Factors, and SARS-CoV-2 Infection Over Time in Ontario, Canada

2021 ◽  
Author(s):  
Jacob A. Udell ◽  
Bahar Behrouzi ◽  
Atul Sivaswamy ◽  
Anna Chu ◽  
Laura E. Ferreira-Legere ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ethnically Diverse ◽  
Community Dwelling ◽  
Health Interventions ◽  
Risk Of Infection ◽  
Infection Rates ◽  
Public Health Interventions ◽  
Multiple Risk Factors ◽  
Diverse Communities ◽  
Over Time

AbstractBackgroundSociodemographic and clinical factors are emerging as important predictors for developing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.ObjectiveTo determine whether public health interventions that culminated in a stay-at-home lockdown instituted during the first wave of the pandemic in March/April 2020 were effective at mitigating the association of any of these factors with the risk of infection.DesignPopulation-based cohort studySettingOntario, CanadaPatientsAll adults that underwent testing for SARS-CoV-2 between January 1 and June 12, 2020.MeasurementsThe outcome of interest was SARS-CoV-2 infection, determined by reverse transcription polymerase chain reaction testing. Adjusted odds ratios (ORs) were determined for sociodemographic and clinical risk factors before and after the peak of the pandemic to assess for changes in effect sizes.ResultsAmong 578,263 community-dwelling individuals, 20,524 (3.5%) people tested positive. The association between age and SARS-CoV-2 infection risk among tested community-dwelling individuals varied over time (P-interaction <0.0001). Prior to the first-wave peak of the pandemic, the likelihood of SARS-CoV-2 infection increased progressively with age compared with individuals aged 18-45 years (P<0.0001). This association subsequently reversed, with all age groups younger than 85 years at progressively higher risk of infection (P<0.0001) after the peak. Otherwise, risk factors that persisted throughout included male sex, residing in lower income neighborhoods, residing in more racially/ethnically diverse communities, immigration to Canada, and history of hypertension and diabetes. While there was a reduction in infection rates across Ontario after mid-April, there was less impact in regions with higher degrees of racial/ethnic diversity. When considered in an additive risk model, following the initial peak of the pandemic, individuals living in the most racially/ethnically diverse communities with 2, 3, or ≥4 risk factors had ORs of 1.89, 3.07, and 4.73-fold higher for SARS-CoV-2 infection compared to lower risk individuals in their community (all P<0.0001). In contrast, in the least racially/ethnically diverse communities, there was little to no gradient in infection rates across risk strata.ConclusionAfter public health interventions in March/April 2020, people with multiple risk factors residing in the most racially diverse communities of Ontario continued to have the highest likelihood of SARS-CoV-2 infection while risk was mitigated for people with multiple risk factors residing in less racially/ethnically diverse communities. Further efforts are necessary to reduce the risk of SARS-CoV-2 infection among the highest risk individuals residing in these communities.Primary Funding SourceCanadian Institutes of Health Research and the Ted Rogers Centre for Heart Research.

scholarly journals Impact of reduction of susceptibility to SARS-CoV-2 on epidemic dynamics in four early-seeded metropolitan regions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thomas J. Barrett ◽  
Karen C. Patterson ◽  
Timothy M. James ◽  
Peter Krüger
Keyword(s):  
Public Health ◽  
Growth Phase ◽  
Chronic Phase ◽  
Health Interventions ◽  
Resource Utilisation ◽  
Policy Planning ◽  
Infection Rates ◽  
Public Health Interventions ◽  
Metropolitan Regions ◽  
Epidemic Dynamics

AbstractAs we enter a chronic phase of the SARS-CoV-2 pandemic, with uncontrolled infection rates in many places, relative regional susceptibilities are a critical unknown for policy planning. Tests for SARS-CoV-2 infection or antibodies are indicative but unreliable measures of exposure. Here instead, for four highly-affected countries, we determine population susceptibilities by directly comparing country-wide observed epidemic dynamics data with that of their main metropolitan regions. We find significant susceptibility reductions in the metropolitan regions as a result of earlier seeding, with a relatively longer phase of exponential growth before the introduction of public health interventions. During the post-growth phase, the lower susceptibility of these regions contributed to the decline in cases, independent of intervention effects. Forward projections indicate that non-metropolitan regions will be more affected during recurrent epidemic waves compared with the initially heavier-hit metropolitan regions. Our findings have consequences for disease forecasts and resource utilisation.

scholarly journals SARS-CoV-2 shifting transmission dynamics and hidden reservoirs potentially limit efficacy of public health interventions in Italy

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Marta Giovanetti ◽  
Eleonora Cella ◽  
Francesca Benedetti ◽  
Brittany Rife Magalis ◽  
Vagner Fonseca ◽  
...  
Keyword(s):  
Public Health ◽  
Epidemiological Data ◽  
Health Interventions ◽  
Transmission Dynamics ◽  
Public Health Interventions ◽  
Viral Spread ◽  
Three Phase ◽  
Phylodynamic Analysis ◽  
Epidemic Wave ◽  
Over Time

AbstractWe investigated SARS-CoV-2 transmission dynamics in Italy, one of the countries hit hardest by the pandemic, using phylodynamic analysis of viral genetic and epidemiological data. We observed the co-circulation of multiple SARS-CoV-2 lineages over time, which were linked to multiple importations and characterized by large transmission clusters concomitant with a high number of infections. Subsequent implementation of a three-phase nationwide lockdown strategy greatly reduced infection numbers and hospitalizations. Yet we present evidence of sustained viral spread among sporadic clusters acting as “hidden reservoirs” during summer 2020. Mathematical modelling shows that increased mobility among residents eventually catalyzed the coalescence of such clusters, thus driving up the number of infections and initiating a new epidemic wave. Our results suggest that the efficacy of public health interventions is, ultimately, limited by the size and structure of epidemic reservoirs, which may warrant prioritization during vaccine deployment.

scholarly journals Tweeting back: predicting new cases of back pain with mass social media data

2015 ◽  
Vol 23 (3) ◽  
pp. 644-648 ◽  
Author(s):  
Hopin Lee ◽  
James H McAuley ◽  
Markus Hübscher ◽  
Heidi G Allen ◽  
Steven J Kamper ◽  
...  
Keyword(s):  
Risk Factors ◽  
Social Media ◽  
Back Pain ◽  
Health Interventions ◽  
Future Research ◽  
Preventive Interventions ◽  
Public Health Interventions ◽  
Social Media Data ◽  
Media Data ◽  
Global Health Problem

Background Back pain is a global health problem. Recent research has shown that risk factors that are proximal to the onset of back pain might be important targets for preventive interventions. Rapid communication through social media might be useful for delivering timely interventions that target proximal risk factors. Identifying individuals who are likely to discuss back pain on Twitter could provide useful information to guide online interventions. Methods We used a case-crossover study design for a sample of 742 028 tweets about back pain to quantify the risks associated with a new tweet about back pain. Results The odds of tweeting about back pain just after tweeting about selected physical, psychological, and general health factors were 1.83 (95% confidence interval [CI], 1.80-1.85), 1.85 (95% CI: 1.83-1.88), and 1.29 (95% CI, 1.27-1.30), respectively. Conclusion These findings give directions for future research that could use social media for innovative public health interventions.

scholarly journals Metabolic syndrome in adults: relation with diet and other lifestyle factors

2015 ◽  
Vol 6 (3) ◽  
pp. 99-124
Author(s):  
Ishu Kataria ◽  
Ravinder Chadha ◽  
Renuka Pathak
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Sedentary Lifestyle ◽  
Saturated Fat ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Lifestyle Risk Factors ◽  
Unhealthy Diet ◽  
Lifestyle Risk ◽  
Diet And Lifestyle

Metabolic syndrome is a constellation of risk factors that has the potential of developing into cardiovascular disease or increase the susceptibility to it. It is present worldwide with now even developing countries getting overwhelmed by its burden. With a shift towards unhealthy diet coupled with sedentary lifestyle, development of metabolic syndrome is on the rise even among young adults. One of the main causes of this problem is faulty diet, so any means to reduce the incidence of the syndrome involves the modification of the existing diets rich in saturated fat, sodium and cholesterol. This review focusses on efficacy of different dietary patterns for combating the syndrome along with other lifestyle risk factors. It also highlights newer advancements in the field of Metabolic Syndrome, which can serve as potential strategies to combat it. Public health interventions targeting adults, therefore, should center on prevention through education, modification of diet and lifestyle, and focusing on environment, so that these changes are acceptable and sustainable.

scholarly journals Genomic evolution of Neisseria gonorrhoeae since the preantibiotic era (1928–2013): antimicrobial use/misuse selects for resistance and drives evolution

BMC Genomics ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Golparian ◽  
Simon R. Harris ◽  
Leonor Sánchez-Busó ◽  
Steen Hoffmann ◽  
William M. Shafer ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Multidrug Resistant ◽  
Health Interventions ◽  
First Century ◽  
Antimicrobial Use ◽  
Genomic Evolution ◽  
Public Health Interventions ◽  
Genome Sequences ◽  
Clonal Species ◽  
Over Time

Abstract Background Multidrug-resistant Neisseria gonorrhoeae strains are prevalent, threatening gonorrhoea treatment globally, and understanding of emergence, evolution, and spread of antimicrobial resistance (AMR) in gonococci remains limited. We describe the genomic evolution of gonococci and their AMR, related to the introduction of antimicrobial therapies, examining isolates from 1928 (preantibiotic era) to 2013 in Denmark. This is, to our knowledge, the oldest gonococcal collection globally. Methods Lyophilised isolates were revived and examined using Etest (18 antimicrobials) and whole-genome sequencing (WGS). Quality-assured genome sequences were obtained for 191 viable and 40 non-viable isolates and analysed with multiple phylogenomic approaches. Results Gonococcal AMR, including an accumulation of multiple AMR determinants, started to emerge particularly in the 1950s–1970s. By the twenty-first century, resistance to most antimicrobials was common. Despite that some AMR determinants affect many physiological functions and fitness, AMR determinants were mainly selected by the use/misuse of gonorrhoea therapeutic antimicrobials. Most AMR developed in strains belonging to one multidrug-resistant (MDR) clade with close to three times higher genomic mutation rate. Modern N. gonorrhoeae was inferred to have emerged in the late-1500s and its genome became increasingly conserved over time. Conclusions WGS of gonococci from 1928 to 2013 showed that no AMR determinants, except penB, were in detectable frequency before the introduction of gonorrhoea therapeutic antimicrobials. The modern gonococcus is substantially younger than previously hypothesized and has been evolving into a more clonal species, driven by the use/misuse of antimicrobials. The MDR gonococcal clade should be further investigated for early detection of strains with predispositions to develop and maintain MDR and for initiation of public health interventions.

scholarly journals Actualización en el diagnóstico y tratamiento de la Fascitis plantar.

2020 ◽  
pp. 140-146
Author(s):  
ISABEL MIÑANO MARTINEZ
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Plantar Fasciitis ◽  
Scientific Evidence ◽  
Plantar Fascia ◽  
Degenerative Process ◽  
Multiple Risk Factors ◽  
Nerve Entrapments ◽  
Adjacent Structures ◽  
Over Time

Plantar fasciitis is a very common pathology. Over time, some aspects of this entity have generated controversy, so our objective is to group the latest available scientific evidence. Plantar fasciitis has its origin in a degenerative process resulting from repetitive microtrauma. In addition, multiple risk factors are involved that contribute to its overload the fascia and its collagen degeneration. Its diagnosis is clinical, reserving the performance of complementary tests to perform differential diagnosis with other entities, which may originate in the plantar fascia or adjacent structures, paying special attention to nerve entrapments. There are numerous treatments that have proven effectiveness, obtaining better results by individualizing each patient and with a combination of treatments.

scholarly journals Early evidence that social distancing and public health interventions flatten the COVID-19 curve in Italy

2020 ◽  
Author(s):  
Valentina Rotondi ◽  
Liliana Andriano ◽  
Jennifer Beam Dowd ◽  
Melinda C. Mills
Keyword(s):  
Health Care Systems ◽  
Scientific Evidence ◽  
Health Interventions ◽  
Infection Rates ◽  
Public Health Interventions ◽  
Social Distancing ◽  
Early Evidence ◽  
The World ◽  
Care Systems ◽  
Policy Measures

With the world experiencing one of the largest pandemics in one-hundred years, governments and policymakers are looking for scientific evidence to introduce rapid and effective policies. Here we provide evidence from two provinces in Italy with comparable early infection rates but different timing of mitigating policy measures. Lodi prohibited movement on February 23, 2020 and Bergamo 2 weeks later on March 8, before the entire lockdown of Italy on March 11. This comparison provides early evidence that rapid restriction of movement and social distancing measures may slow the transmission of the virus and “flatten the curve”, ultimately reducing pressure on health care systems

scholarly journals Influence of Connected Health Interventions for Adherence to Cardiovascular Disease Prevention: A Scoping Review

2020 ◽  
Vol 11 (04) ◽  
pp. 544-555
Author(s):  
Dahbia Agher ◽  
Karima Sedki ◽  
Rosy Tsopra ◽  
Sylvie Despres ◽  
Marie-Christine Jaulent
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Scoping Review ◽  
Health Interventions ◽  
Inclusion Criteria ◽  
Connected Health ◽  
Current Trends ◽  
Over Time

Abstract Background Recent health care developments include connected health interventions to improve chronic disease management and/or promote actions reducing aggravating risk factors for conditions such as cardiovascular diseases. Adherence is one of the main challenges for ensuring the correct use of connected health interventions over time. Objective This scoping review deals with the connected health interventions used in interventional studies, describing the ways in which these interventions and their functions effectively help patients to deal with cardiovascular risk factors over time, in their own environments. The objective is to acquire knowledge and highlight current trends in this field, which is currently both productive and immature. Methods A structured literature review was constructed from Medline-indexed journals in PubMed. We established inclusion criteria relating to three dimensions (cardiovascular risk factors, connected health interventions, and level of adherence). Our initial search yielded 98 articles; 78 were retained after screening on the basis of title and abstract, 49 articles underwent full-text screening, and 24 were finally retained for the analysis, according to preestablished inclusion criteria. We excluded studies of invasive interventions and studies not dealing with digital health. We extracted a description of the connected health interventions from data for the population or end users. Results We performed a synthetic analysis of outcomes, based on the distribution of bibliometrics, and identified several connected health interventions and main characteristics affecting adherence. Our analysis focused on three types of user action: to read, to do, and to connect. Finally, we extracted current trends in characteristics: connect, adherence, and influence. Conclusion Connected health interventions for prevention are unlikely to affect outcomes significantly unless other characteristics and user preferences are considered. Future studies should aim to determine which connected health design combinations are the most effective for supporting long-term changes in behavior and for preventing cardiovascular disease risks.

scholarly journals Risk Factors for Asymptomatic Enteric Pathogen Detection Among Men Who Have Sex With Men

2019 ◽  
Vol 6 (9) ◽  
Author(s):  
Deborah A Williamson ◽  
Eric P F Chow ◽  
Darren Lee ◽  
Kate Maddaford ◽  
Michelle Sait ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Pathogen Detection ◽  
Enteric Pathogen ◽  
Health Interventions ◽  
Enteric Pathogens ◽  
Public Health Interventions ◽  
Sex With Men ◽  
Group Sex

Abstract Improved knowledge of factors that promote outbreaks of enteric pathogens among men who have sex with men (MSM) could enable targeted public health interventions. We detected enteric pathogens in 57 of 519 (11%) asymptomatic MSM, and we found that enteric pathogen detection was associated with both oroanal sex (rimming) and group sex.

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