scholarly journals COVID-19 endgame: from pandemic to endemic? Vaccination, reopening and evolution in a well-vaccinated population

2021 ◽  
Author(s):  
Elisha B. Are ◽  
Yexuan Song ◽  
Jessica E. Stockdale ◽  
Paul Tupper ◽  
Caroline Colijn
Keyword(s):  
Health Care Systems ◽  
Peak Level ◽  
Antigenic Drift ◽  
Health Concern ◽  
High Incidence ◽  
Care Systems ◽  
Waning Immunity ◽  
Incident Cases ◽  
Endemic State

COVID-19 remains a major public health concern, with large resurgences even where there has been widespread uptake of vaccines. Waning immunity and the emergence of new variants will shape the long-term burden and dynamics of COVID-19. We explore the transition to the endemic state, and the endemic incidence, using a combination of modelling approaches. We compare gradual and rapid reopening and reopening at different vaccination levels. We examine how the eventual endemic state depends on the duration of immunity, the rate of importations, the efficacy of vaccines and the transmissibility. These depend on the evolution of the virus, which continues to undergo selection. Slower reopening leads to a lower peak level of incidence and fewer overall infections: as much as a 60% lower peak and a 10% lower total in some illustrative simulations; under realistic parameters, reopening when 70% of the population is vaccinated leads to a large resurgence in cases. The long-term endemic behaviour may stabilize as late as January 2023, with further waves of high incidence occurring depending on the transmissibility of the prevalent variant, duration of immunity, and antigenic drift. We find that long term endemic levels are not necessarily lower than current pandemic levels: in a population of 100,000 with representative parameter settings (Reproduction number 5, 1-year duration of immunity, vaccine efficacy at 80% and importations at 3 cases per 100K per day) there are over 100 daily incident cases in the model. The consequent burden on health care systems depends on the severity of infection in immunized or previously infected individuals.

Hallucinogenic/psychedelic 5HT2A receptor agonists as rapid antidepressant therapeutics: Evidence and mechanisms of action

2021 ◽  
pp. 026988112098642
Author(s):  
Rafael Guimarães dos Santos ◽  
Jaime EC Hallak ◽  
Glen Baker ◽  
Serdar Dursun
Keyword(s):  
Health Care Systems ◽  
Treatment Compliance ◽  
Therapeutic Effects ◽  
Beneficial Effects ◽  
Antidepressant Effects ◽  
Care Systems ◽  
Drug Treatments ◽  
Fast Acting

Major depressive disorder (MDD) is among the most prevalent mental health disorders worldwide, and it is associated with a reduced quality of life and enormous costs to health care systems. Available drug treatments show low-to-moderate response in most patients, with almost a third of patients being non-responders (treatment-resistant). Furthermore, most currently available medications need several weeks to achieve therapeutic effects, and the long-term use of these drugs is often associated with significant unwanted side effects and resultant reductions in treatment compliance. Therefore, more effective, safer, and faster-acting antidepressants with enduring effects are needed. Together with ketamine, psychedelics (or classic or serotoninergic hallucinogens) such as lysergic acid diethylamide (LSD), psilocybin, and ayahuasca are among the few compounds with recent human evidence of fast-acting antidepressant effects. Several studies in the 1950s to 1970s reported antidepressive and anxiolytic effects of these drugs, which are being confirmed by modern trials (LSD, one trial; psilocybin, five trials; ayahuasca, two trials). The effects of these drugs appear to be produced primarily by their agonism at serotonin (5-hydroxytryptamine, 5-HT) receptors, especially the 5-HT2A receptor. Considering the overall burden of MDD and the necessity of new therapeutic options, the promising (but currently limited) evidence of safety and efficacy of psychedelics has encouraged the scientific community to explore more fully their beneficial effects in MDD.

scholarly journals Long-term hospital attendance of children and adults who have undergone removal of normal or inflamed appendices

2002 ◽  
Vol 181 (6) ◽  
pp. 526-530 ◽  
Author(s):  
Nicola J. Dummett ◽  
Nicola J. Maughan ◽  
Anne Worrall-Davies
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Attendance Rates ◽  
Liaison Psychiatry ◽  
Abdominal Symptoms ◽  
Secondary Health Care ◽  
Care Systems ◽  
Self Harm ◽  
Males And Females

BackgroundEarly studies suggested that presentations with unexplained acute abdominal pain were associated with increased long-term rates of hospital attendance and self-harm, especially in women, but few studies were large enough for definitive findings.AimsTo test the hypothesis that such presentations are followed by higher long-term utilisation rates of secondary health care even excluding further abdominal symptoms, and particularly for self-harm, than presentations with acute appendicitis.MethodNew hospital attendance rates, liaison psychiatry attendances and self-harm attendances of patients with normal appendices at emergency appendicectomy were compared with those of appendicitis patients.ResultsAttendance rates of all kinds were significantly higher for normal appendix patients than for appendicitis patients, with equal strengths of finding for males and females.ConclusionsPeople with normal appendices at emergency appendicectomy show higher long-term rates of hospital attendance. This has implications for how these patients are best managed by health care systems.

Public-Private Partnership in Health and Long-Term Care

2018 ◽  
pp. 103-124
Author(s):  
Wing Tung Ho ◽  
Ben Yuk Fai Fong
Keyword(s):  
Hong Kong ◽  
Long Term Care ◽  
Health Care Systems ◽  
Public Private Partnership ◽  
Term Care ◽  
Related Services ◽  
Private Partnership ◽  
Aging Populations ◽  
Care Systems

An exponential growth in elderly population reflects a proportional increase in recourses that are unaffordable and unsustainable to the economy. This rapid demand for health services and long-term care not only leads to non-financial implication like shortage of manpower and long waiting time, but this also creates a large burden on health and related services in the public sector. Involving the private sector to provide better and more efficient facilities and services and to encourage innovation will enhance productivity, speed up project and service delivery, and increase opportunities for investment in health. This chapter examines existing problems within health care systems in aging populations such as Hong Kong, explores the advantages and challenges of Public Private Partnership (PPP), identifies successful factors in establishing PPPs models, reviews the PPP projects in Hong Kong and elsewhere and recommends methods in promoting PPP in health and long-term care as sustainable solutions.

scholarly journals Purpose as a Powerful Resource in the Time of COVID-19

2020 ◽  
Vol 60 (5) ◽  
pp. 682-689 ◽  
Author(s):  
Allison E. White
Keyword(s):  
Health Care Systems ◽  
School Settings ◽  
The Past ◽  
Sense Of Purpose ◽  
Psychological Resource ◽  
Care Systems ◽  
Recommendations For Practice ◽  
Work Family ◽  
Development Literature

Coronavirus disease 2019 (COVID-19), a novel disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has claimed thousands of lives within the past few months; disrupted people’s participation in work, family, and school settings; and challenged economic and health care systems across the globe. In light of the countless challenges posed by COVID-19, a sense of purpose (i.e., a long-term life aim that guides behavior and contributes to the world beyond oneself) may be one important psychological resource for people of all ages to develop and/or recruit during this crisis. This article provides a brief overview of the purpose development literature, the argument that a growing or solidified sense of purpose can serve as an important internal resource during periods of adversity, and recommendations for practice during the COVID-19 pandemic.

scholarly journals Aflatoxin M1 levels in sow milk

2018 ◽  
Vol 68 (3) ◽  
pp. 341
Author(s):  
J. PRODANOV-RADULOVIĆ ◽  
M. ŽIVKOV-BALOŠ ◽  
S. JAKŠIĆ ◽  
Z. GRGIĆ ◽  
I. STOJANOV ◽  
...  
Keyword(s):  
Raw Materials ◽  
Aflatoxin Contamination ◽  
Health Concern ◽  
Aflatoxin M1 ◽  
Enzyme Linked Immunosorbent Assay ◽  
Milk Samples ◽  
High Incidence ◽  
Food And Feed ◽  
Special Health

Aflatoxins (AFs) are one of the most known and investigated group of mycotoxins, which can be found as contaminants in different types of food and feed. Animals are exposed to AFs mainly through the consumption of contaminated feed, particularly products of plant origin. Among AFs, aflatoxin M1 (AFM1) is the monohydroxylated derivative of AFB1 formed in the liver and excreted into the milk of lactating animals. This study encompassed the Vojvodina region of Serbia and was aimed at determining the levels of AFM1 excretion in sows’ milk in the first 3‒5 days of lactation, after consumption of naturally contaminated with AFB1 maize. A total of 110 sows’ milk samples from 11 swine farms in the specific region were analyzed by Enzyme Linked Immunosorbent Assay (ELISA). Different levels of AFM1 were detected in the majority (97%) of the examined milk samples. The obtained results showed AFM1 levels ranging from 5 to 165.4 ng/L. The results of this study pose special health concern associated with aflatoxin contamination of swine feed raw materials in this particular part of Serbia. Moreover, such high incidence of AFM1 detection in sows’ milk may suggest the occurrence of long-term low level aflatoxicosis clinical cases.

scholarly journals The Relational Vulnerability of People Experiencing Multiple Exclusion Homelessness (MEH) in Spain

2021 ◽  
Vol 18 (19) ◽  
pp. 10275
Author(s):  
Hugo Valenzuela-Garcia ◽  
José Luis Molina ◽  
Miranda J. Lubbers ◽  
Jorge Grau
Keyword(s):  
Health Care Systems ◽  
Personal Networks ◽  
Traumatic Experiences ◽  
Public And Private ◽  
Mixed Methods Approach ◽  
Care Services ◽  
Care Systems ◽  
High Degree ◽  
Geographical Locations

This paper draws on research analyzing the emotional and relational impacts of poverty and exclusion on charities’ clients in Spain since the 2008–2009 economic crisis, including people experiencing multiple exclusion homelessness (MEH). The study adopts a mixed-methods approach in which twenty in-depth cases were collected in different geographical locations, including twelve cases experiencing MEH. Unlike other disadvantaged groups, those affected by MEH suffer material shortages, traumatic experiences, psychological disorders, physical illnesses, and a high degree of relational vulnerability, as reflected in the structure and composition of their personal networks, which tend to be smaller in size, with just a few weak and temporary contacts, and with care professionals playing an important role. These charity users often need long-term socio-sanitary care, which challenges public and private health-care systems. Therefore, our contribution to this Special Issue is directed toward improving understanding of the relational characteristics of severely excluded people, how social support affects their personal networks, and the challenges this assistance poses to care services.

scholarly journals Novel Digital Architecture of a “Low Carb Program” for Initiating and Maintaining Long-Term Sustainable Health-Promoting Behavior Change in Patients with Type 2 Diabetes

JMIR Diabetes ◽  
10.2196/15030 ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. e15030 ◽  
Author(s):  
Charlotte Summers ◽  
Kristina Curtis
Keyword(s):  
Type 2 Diabetes ◽  
Behavior Change ◽  
Digital Health ◽  
Health Care Systems ◽  
Noncommunicable Diseases ◽  
Digital Architecture ◽  
Care Systems ◽  
Long Term Impact

Globally, the burden of noncommunicable diseases such as type 2 diabetes is crippling health care systems. Type 2 diabetes, a disease linked with obesity, affects 1 in every 30 people today and is expected to affect 1 in 10 people by 2030. Current provisions are struggling to manage the trajectory of type 2 diabetes prevalence. Offline, face-to-face education for patients with type 2 diabetes has shown to lack long-term impact or the capacity for widespread democratized adoption. Digitally delivered interventions have been developed for patients with type 2 diabetes, and the evidence shows that some interventions provide the capacity to support hyperpersonalization and real-time continuous support to patients, which can result in significant engagement and health outcomes. However, digital health app engagement is notoriously difficult to achieve. This paper reviews the digital behavior change architecture of the Low Carb Program and the application of health behavioral theory underpinning its development and use in scaling novel methods of engaging the population with type 2 diabetes and supporting long-term behavior change.

scholarly journals Potential long term adverse health outcomes of COVID-19

2021 ◽  
Vol 9 (1) ◽  
pp. 38-40
Author(s):  
Dibanur Rashid Siddiqua ◽  
Md Shahadat Hossain
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Potential Risk ◽  
Health Care Systems ◽  
Persistent Symptoms ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Care Systems ◽  
Post Infectious

The coronavirus disease 2019(COVID-19) pandemic poses an extraordinary challenges to patients, communities and overall health care systems. It has resulted in millions of people infected worldwide and has indirectly devastated even more individuals with prolonged post-infectious symptoms. The burden of survivors having post-COVID symptoms is likely to be huge. Multidisciplinary post-COVID-19 clinics are now playing a pivotal role addressing both persistent symptoms and potential long term sequelae. In this review, we tried to summarize the adverse health outcomes based on current evidences, assess the potential risk of long-term complications and make certain recommendations. Bangladesh Crit Care J March 2021; 9(1): 38-40

scholarly journals COVID-19 containment policies through time may cost more lives at metapopulation level

2020 ◽  
Author(s):  
Konstans Wells ◽  
Miguel Lurgi
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Systems ◽  
Informed Decision ◽  
Mitigation Strategies ◽  
Disease Spread ◽  
Informed Decision Making ◽  
Short Term ◽  
Care Systems

AbstractThe rapid and pandemic spread of COVID-19 has led to unprecedented containment policies in response to overloaded health care systems. Disease mitigation strategies require informed decision-making to ensure a balance between the protection of the vulnerable from disease and the maintenance of global economies. We show that temporally restricted containment efforts, that have the potential to flatten epidemic curves, can result in wider disease spread and larger epidemic sizes in metapopulations. Longer-term rewiring of metapopulation networks or the enforcement of feasible long-term measures that decrease disease transmissions appear to be more efficient than temporarily restricted intensive mitigation strategies (e.g. short-term mass quarantine). Our results may inform balanced containment strategies for short-term disease spread mitigation in response to overloaded health care systems and longer-term epidemiological sizes.

scholarly journals Clinical Strategies for the Treatment and Management of Patients Prescribed Long-term Opioid Therapy

Pain Medicine ◽  
2018 ◽  
Vol 20 (9) ◽  
pp. 1737-1744
Author(s):  
Jessica J Wyse ◽  
Linda Ganzini ◽  
Steven K Dobscha ◽  
Erin E Krebs ◽  
Janet Zamudio ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Drug Testing ◽  
Health Care Systems ◽  
Qualitative Interviews ◽  
The United States ◽  
Opioid Therapy ◽  
Prescribing Practices ◽  
Policy And Practice ◽  
Care Systems

Abstract Objectives Across diverse health care systems, growing recognition of the harms associated with long-term opioid therapy (LTOT) for chronic pain has catalyzed substantial changes to policy and practice designed to promote safer prescribing and patient care. Although clear goals have been defined, how clinics and providers should most effectively implement these changes has been less well defined, and facilities and providers have had substantial flexibility to innovate. Methods Qualitative interviews were conducted with 24 Department of Veterans Affairs (VA) clinicians across the United States who prescribe LTOT for chronic pain. Interviews probed the practices and initiatives providers utilized to meet opioid safety requirements and address common challenges in caring for patients prescribed LTOT. Results Innovative strategies in the design and organization of clinical practice (urine drug testing, informed consent, limiting transfer requests, specialty patient panel) and resources utilized (engaged pharmacists, non-opioid pain treatments, intra-organizational collaborations) are described. Conclusions We conclude with recommendations designed to improve opioid prescribing practices, both within the VA and in other settings.

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