scholarly journals Changes in English NHS outpatient activity during the early Covid-19 period

2021 ◽  
Author(s):  
Jessica Sarah Morris ◽  
Theo Georghiou ◽  
John Appleby
Keyword(s):  
Ethnic Groups ◽  
National Policy ◽  
Population Based ◽  
Clinical Specialty ◽  
Need To Evaluate ◽  
Data Source ◽  
Remote Care ◽  
The Impact ◽  
Study Setting ◽  
Remote Consultations

Objective: To describe changes in NHS outpatient activity connected to the Covid-19 pandemic Design: Nationwide population-based retrospective study Setting: England, UK, 31 December 2018 to 25 October 2020 Data source: Outpatient Hospital Episode Statistics data Results: Between early March and late October 2020, there was a total reduction of 16.6 million outpatient attendances compared to the same period in 2019, equivalent to a 27% decline. The largest weekly drop of 48% relative to 2019 occurred the week beginning 30 March. Activity recovered more slowly than it fell, and by the end of the study period remained 16% lower than the equivalent week in 2019. Changes in patterns of attendances were broadly similar across most patient characteristic groups. There was a substantial increase in the proportion of attendances taking place remotely, peaking at more than one in three during April and May 2020. Differences were observed in trends of remote consultations between age and sex categories, ethnic groups, and proxy deprivation levels. There was also substantial variation in overall activity and use of remote consultations by clinical specialty. Conclusions: The large increase in remote outpatient consultations during the early Covid-19 period, variations in remote care use by specialty as well as proxy deprivation and ethnic groups all suggest a need to evaluate the impact of these changes particularly in light of national policy to encourage greater use of remote consultations.

scholarly journals Identifying Prenatal Opioid Exposure in Health Administrative Data for Public Health Surveillance and Epidemiologic Research

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Andi Camden ◽  
Teresa To ◽  
Joel G Ray ◽  
Tara Gomes ◽  
Li Bai ◽  
...  
Keyword(s):  
Prescription Drug ◽  
Administrative Data ◽  
Population Based ◽  
Emergency Department Visits ◽  
Prescription Data ◽  
Opioid Use ◽  
Health Administrative Data ◽  
Maternal Characteristics ◽  
Data Source ◽  
The Impact

IntroductionAccurate estimation of prenatal opioid exposure (POE) is needed for population-based surveillance & research but can be challenging with health administrative data due to varying definitions & methods. Prior research has relied primarily on infant records with a diagnosis of neonatal abstinence syndrome (NAS). Objectives and Approach1) Evaluate the impact of using different definitions of maternal opioid use in the estimation of POE; 2) Investigate whether maternal characteristics vary by the type of definition used. Population-based cross-sectional study of all hospital births (N= 454,746) from 2014-2017 in Ontario, Canada. Multiple linked population-based health administrative databases were used to identify opioid-related pre- & perinatal Emergency Department visits & hospitalizations & opioid prescriptions. We examined how pre-conception & in-pregnancy maternal characteristics varied by using different approaches to ascertain POE. ResultsThere were 9624 live/still births with POE. Ascertainment of POE was highest using maternal prescription drug data (79%) & infant hospital records with NAS (45%). Maternal characteristics varied by data source used for POE ascertainment. Opioid-related health care during pregnancy identified a high-risk phenotype, contrasted with those ascertained through prescription data, with respective rates of 64% vs. 54% for social assistance, 37% vs. 12% for polydrug use, 23% vs. 6% for alcohol use, 26% vs. 19% for 3+ live births, 13% vs. 5% for victim of violence, 12% vs. 6% for involvement in criminal justice system & 64% vs. 17% for mental health & addictions hospital care. Conclusion / ImplicationsPOE ascertainment differs by health administrative data source & ability to link both across maternal records and with infant. Prescription drug data identified the highest number of opioid-exposed births and, with linked healthcare records, is useful to identify illicit opioid use & additional risk factors. Clinically meaningful differences in maternal characteristics of opioid users exist by POE ascertainment method.

scholarly journals A nutrigenetics approach to study the impact of genetic and lifestyle factors on cardiometabolic traits in various ethnic groups: findings from the GeNuIne Collaboration

2020 ◽  
Vol 79 (2) ◽  
pp. 194-204 ◽  
Author(s):  
Karani S. Vimaleswaran
Keyword(s):  
Ethnic Groups ◽  
Large Scale ◽  
South Asians ◽  
Genetic Risk Score ◽  
High Protein Diet ◽  
Population Based ◽  
Collaborative Project ◽  
Increased Risk ◽  
The Impact ◽  
Cardiometabolic Traits

Several studies on gene–diet interactions (nutrigenetics) have been performed in western populations; however, there are only a few studies to date in lower middle-income countries (LMIC). A large-scale collaborative project called gene–nutrient interactions (GeNuIne) Collaboration, the main objective of which is to investigate the effect of GeNuIne on cardiometabolic traits using population-based studies from various ethnic groups, has been initiated at the University of Reading, UK. While South Asians with higher genetic risk score (GRS) showed a higher risk of obesity in response to a high-carbohydrate diet, South East and Western Asian populations with higher GRS showed an increased risk of central obesity in response to a high-protein diet. The paper also provides a summary of other gene–diet interaction analyses that were performed in LMIC as part of this collaborative project and gives an overview of how these nutrigenetic findings can be translated to personalised and public health approaches for the prevention of cardiometabolic diseases such as obesity, type 2 diabetes and CVD.

Infoveillance based on Social Sensors to Analyze the impact of Covid19 in South American Population (Preprint)

2020 ◽  
Author(s):  
Josimar E. Chire Saire
Keyword(s):  
Text Mining ◽  
Electronic Communication ◽  
Spanish Speakers ◽  
South American ◽  
South American Population ◽  
The People ◽  
Data Source ◽  
The Impact ◽  
General Concern ◽  
Social Sensors

BACKGROUND Infoveillance is an application from Infodemiology field with the aim to monitor public health and create public policies. Social sensor is the people providing thought, ideas through electronic communication channels(i.e. Internet). The actual scenario is related to tackle the covid19 impact over the world, many countries have the infrastructure, scientists to help the growth and countries took actions to decrease the impact. South American countries have a different context about Economy, Health and Research, so Infoveillance can be a useful tool to monitor and improve the decisions and be more strategical. The motivation of this work is analyze the capital of Spanish Speakers Countries in South America using a Text Mining Approach with Twitter as data source. The preliminary results helps to understand what happens two weeks ago and opens the analysis from different perspectives i.e. Economics, Social. OBJECTIVE Analyze the behaviour of South American Capitals in front of covid19 pandemics and show the helpfulness of Text Mining Approach for Infoveillance tasks. METHODS Text Mining process RESULTS - Argentina and Venezuela capitals are the biggest number of post during this period, opposite with Bolivia, Ecuador and Uruguay. - Most relevant users are related to mass media like radio, television or newspapers. - There is a general concern about covid19 but every country talks about different areas: Economics, Health, Environmental Impact. CONCLUSIONS Infoveillance based on Social Sensors with data coming from Twitter can help to understand the trends on the population of the capitals. Besides, it is necessary to filter the posts for processing the text and get insights about frequency, top users, most important terms. This data is useful to analyse the population from different approaches. INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1101/2020.04.06.20055749

scholarly journals The Impact of a Reentry and Aftercare Program on Recidivism

2020 ◽  
pp. 003464462097393
Author(s):  
Colin Cannonier ◽  
Monica Galloway Burke ◽  
Ed Mitchell
Keyword(s):  
Sample Selection ◽  
Cost Savings ◽  
Social Program ◽  
Recidivism Rates ◽  
Criminal Justice Reform ◽  
Heterogeneous Effects ◽  
Need To Evaluate ◽  
Reducing Recidivism ◽  
Aftercare Service ◽  
The Impact

In this article, we explore the impact of a reentry and aftercare service program on the likelihood of returning to prison by ex-offenders. Using administrative data within a difference-in-differences design, we find that this social program is associated with a reduction in recidivism rates. Benchmark estimates show that the program was associated with estimated reductions in the probability of recidivating of 6.0 to 8.7 percentage points. The estimate appears to be economically significant as it implies an estimated treated effect in the 15.8% to 19.2% range. We consider the heterogeneous effects of the program on reducing recidivism according to race, age group, and program type. The program helped to reduce recidivism among Whites but not Blacks; older participants were the main beneficiaries while the effectiveness of the program was observed among older participants. Back-of-the-envelope cost-savings analysis is incorporated to estimate the potential savings to the state arising from the reduction in recidivism rates likely attributable to the program. The findings are robust to sample selection bias, alternative specifications, and estimation techniques. Our results offer some implications for the role of faith-based social programs within the context of criminal justice reform to combat reentry of former inmates. They also provide a cautionary tale about the need to evaluate programs not just based on their overall effect.

scholarly journals Impact of type 2 diabetes and microvascular complications on mortality and cardiovascular outcomes in a multiethnic Asian population

2021 ◽  
Vol 9 (1) ◽  
pp. e001413
Author(s):  
Jonathan Yap ◽  
Kamalesh Anbalakan ◽  
Wan Ting Tay ◽  
Daniel Ting ◽  
Carol Yim Cheung ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Population Based ◽  
Cardiovascular Outcomes ◽  
Microvascular Complication ◽  
The Impact ◽  
Hba1c Levels

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.

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