Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II)

IntroductionEvidence from previous pandemics, and the current COVID-19 pandemic, has found that risk of infection/severity of disease is disproportionately higher for ethnic minority groups, and those in lower socioeconomic positions. It is imperative that interventions to prevent the spread of COVID-19 are targeted towards high-risk populations. We will investigate the associations between social characteristics (such as ethnicity, occupation and socioeconomic position) and COVID-19 outcomes and the extent to which characteristics/risk factors might explain observed relationships in Scotland.The primary objective of this study is to describe the epidemiology of COVID-19 by social factors. Secondary objectives are to (1) examine receipt of treatment and prevention of COVID-19 by social factors; (2) quantify ethnic/social differences in adverse COVID-19 outcomes; (3) explore potential mediators of relationships between social factors and SARS-CoV-2 infection/COVID-19 prognosis; (4) examine whether occupational COVID-19 differences differ by other social factors and (5) assess quality of ethnicity coding within National Health Service datasets.Methods and analysisWe will use a national cohort comprising the adult population of Scotland who completed the 2011 Census and were living in Scotland on 31 March 2020 (~4.3 million people). Census data will be linked to the Early Assessment of Vaccine and Anti-Viral Effectiveness II cohort consisting of primary/secondary care, laboratory data and death records. Sensitivity/specificity and positive/negative predictive values will be used to assess coding quality of ethnicity. Descriptive statistics will be used to examine differences in treatment and prevention of COVID-19. Poisson/Cox regression analyses and mediation techniques will examine ethnic and social differences, and drivers of inequalities in COVID-19. Effect modification (on additive and multiplicative scales) between key variables (such as ethnicity and occupation) will be assessed.Ethics and disseminationEthical approval was obtained from the National Research Ethics Committee, South East Scotland 02. We will present findings of this study at international conferences, in peer-reviewed journals and to policy-makers.

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Urban development and health inequalities

Scandinavian Journal of Public Health ◽

10.1177/14034948020300031001 ◽

2002 ◽

Vol 30 (59_suppl) ◽

pp. 59-62

Author(s):

Mark McCarthy

Keyword(s):

Urban Development ◽

Social Action ◽

Urban Areas ◽

Green Space ◽

Social Inequalities ◽

Population Level ◽

Social Differences ◽

Cultural Experiences ◽

The Life Course

Urban development has historically been seen as both a cause and solution for social inequalities in health. However, environmental and individual gradients within urban areas occur everywhere, and are resistant to change. Environments are infl uenced by the degree and type of industrialization, quality of housing, accessibility to green space and - of increasing concern - transport. Individual behaviour, however, also contributes to social differences, both through migration and by the effects on individuals of cultural experiences through the life-course. Reduction on inequalities may be possible through larger social action, for example urban regeneration. There remains an important role for public health in addressing determinants of health at the population level.

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Sociálna marginalizácia v dobe kamennej? K počiatkom sociálnych nerovností a možnostiam ich identifikácie

Musaica Archaeologica ◽

10.46283/musarch.2020.1.01 ◽

2020 ◽

Vol 5 (1) ◽

pp. 7-18

Author(s):

Jana Mellnerová Šuteková

Keyword(s):

Quality Of Life ◽

Theoretical Basis ◽

Human Population ◽

Social Inequalities ◽

Current Knowledge ◽

Cultural Anthropology ◽

Correct Identification ◽

Social Differences ◽

Theoretical Paper

The study is a theoretical paper focused on social differences and inequalities in Europe's Early Prehistory in societies of hunters-gatherers and earliest farmers. According to current knowledge, hunters-gatherers were more egalitarian with mechanisms that eliminate differences. The presence of social inequalities and differences in relation to kin (inheritance), the value of ownership associated with the quality of life at the time of neolithisation were identified at the latest. The aim of the paper is to outline the theoretical basis of research in terms of cultural anthropology and social behavior of the human population, which should lead to the correct identification of marginalized members of society.

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Victor S. D'Souza. Development Planning and Structural Inequalities: The Response of the Underprivileged. New Delhi: Sage Publications 1990. Pages 206 + Index. Price: Rs 180 (Hardbound).

The Pakistan Development Review ◽

10.30541/v30i3pp.313-317 ◽

1991 ◽

Vol 30 (3) ◽

pp. 313-317

Author(s):

Ziaul Haque

Keyword(s):

Economic Growth ◽

Economic Development ◽

Social Structure ◽

Social Transformation ◽

Social Inequalities ◽

Census Data ◽

Development Planning ◽

Capital Formation ◽

Indian Society ◽

The Social

Deveiopment planning in India, as in other developing countries, has generally been aimed at fostering an industrially-oriented policy as the engine of economic growth. This one-sided economic development, which results in capital formation, creation of urban elites, and underprivileged social classes of a modern society, has led to distortions in the social structure as a whole. On the contrary, as a result of this uneven economic development, which is narrowly measured in terms of economic growth and capital formation, the fruits of development have gone to the people according to their economic power and position in the social structure: those occupying higher positions benefiting much more than those occupying the lower ones. Thus, development planning has tended to increase inequalities and has sharpened divisive tendencies. Victor S. D'Souza, an eminent Indian sociologist, utilizing the Indian census data of 1961, 1971, and 1981, examines the problem of structural inequality with particular reference to the Indian Scheduled Castes and Scheduled Tribes - the two most underprivileged sections of the present Indian society which, according to the census of 1981, comprised 15.75 percent and 7.76 percent of India's population respectively. Theoretically, he takes the concept of development in a broad sense as related to the self-fulfIlment of the individual. The transformation of the unjust social structure, the levelling down of glaring economic and social inequalities, and the concern for the development of the underprivileged are for the author the basic elements of a planned development. This is the theoretical perspective of the first chapter, "Development Planning and Social Transformation".

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Population-based rapid assessment of avoidable blindness survey in Sohag governorate in Egypt

BMJ Open ◽

10.1136/bmjopen-2019-036337 ◽

2020 ◽

Vol 10 (10) ◽

pp. e036337

Author(s):

Heba AlSawahli ◽

Ian McCormick ◽

Caleb D Mpyet ◽

Gamal Ezzelarab ◽

Mohammad Shalaby

Keyword(s):

Cataract Surgery ◽

Census Data ◽

Rapid Assessment ◽

Population Based ◽

Vision Impairment ◽

Health System Strengthening ◽

Secondary Outcome ◽

Institutional Setting ◽

Financial Barriers

ObjectivesTo determine the prevalence and causes of blindness and vision impairment, and the coverage and quality of cataract surgical services, among population aged 50 years and older in Sohag governorate in Egypt.DesignA population-based cross-sectional survey using two-stage cluster random sampling following the rapid assessment of avoidable blindness methodology.SettingA community-based survey conducted by six teams of ophthalmologists, assistants and local guides. Enrolment and examination were door-to-door in selected clusters.ParticipantsUsing 2016 census data, 68 population units were randomly selected as clusters (of 60 people) with probability proportionate to population size. Anyone aged 50 years and older, residing in a non-institutional setting in a cluster for at least 6 months, was eligible to participate.Primary and secondary outcome measuresThe prevalence and causes of blindness and vision impairment. Secondary outcomes were CSC and effectiveness and participant-reported barriers to cataract surgery.ResultsOf 4078 participants enrolled, 4033 (98.9%) were examined. The age-adjusted and sex-adjusted prevalence of blindness, severe vision impairment and moderate vision impairment were 5.9% (95% CI 4.8% to 6.9%), 4.7% (95% CI 3.8% to 5.7%) and 18.9% (95% CI 16.8% to 21.0%), respectively. Cataract caused most of blindness (41.6%), followed by non-trachomatous corneal opacity (15.7%) and posterior segment diseases (14.5%). Cataract surgical coverage (CSC) for persons for visual acuity <3/60 was 86.8%, the proportion of cataract surgeries with poor visual outcome was 29.5% and effective CSC (eCSC) was 44.9%. eCSC was lower in women than men. The most frequently reported barrier to surgery was cost (51.5%).ConclusionsThe prevalence of blindness in Sohag governorate is higher than districts in other middle-income countries in the region. CSC was high; however, women suffer worse quality-corrected CSC than men. The quality of cataract surgery needs to be addressed, while health system strengthening across government and private settings could alleviate financial barriers.

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Symptom Burden of Patients with Advanced Pancreas Cancer (APC): A Provincial Cancer Institute Observational Study

Current Oncology ◽

10.3390/curroncol28040244 ◽

2021 ◽

Vol 28 (4) ◽

pp. 2789-2800

Author(s):

Stephanie Lelond ◽

Julie Ward ◽

Pascal J. Lambert ◽

Christina A. Kim

Keyword(s):

Cox Regression ◽

Advanced Pancreatic Cancer ◽

Symptom Burden ◽

Distress Score ◽

Ambulatory Oncology ◽

High Prevalence ◽

Associated Symptoms ◽

Report Symptom

Patients with advanced pancreatic cancer (APC) experience many disease-related symptoms. ESAS-r measures the severity of 9 symptom domains and has been validated for use in the ambulatory oncology setting. We aimed to describe symptom burden at baseline for patients with APC treated with modern chemotherapy (CT), and to determine whether symptom burden at baseline is prognostic. Patients diagnosed with APC between 2012–2016, treated with ≥1 cycle of CT, who completed ≥1 ESAS-r were identified. Descriptive statistics were used to report symptom burden and common moderate-to-severe symptoms. A joint model was used to describe the trajectory of ESAS-r during follow-up while controlling for death. Multivariable Cox regression was used to identify independent predictors of death. Of 123 patients identified, the median age was 65 and 61% had metastatic disease. The median baseline ESAS-r total symptom distress score (TSDS) was 24. A total of 86% of patients had at least one symptom score of ≥4 at baseline, with the most common being: fatigue, nausea, anxiety, and shortness of breath. Median overall survival was 10.2 months. Baseline TSDS was not predictive for worse survival in the era of modern CT. Patients with APC have a high burden of cancer-associated symptoms and a high prevalence of moderate-to-severe symptoms. Early intervention has the potential to improve quality of life in this group of patients and should be investigated.

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Non-Pharmacologic Interventions for Caregivers of People With Dementia in Latin America: A Review

Innovation in Aging ◽

10.1093/geroni/igaa057.881 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 275-276

Author(s):

Jose Aravena ◽

Jean Gajardo ◽

Laura Gitlin

Keyword(s):

Quality Of Life ◽

Latin America ◽

Depressive Symptoms ◽

Latin American ◽

Randomized Clinical Trials ◽

Social Inequalities ◽

Neuropsychiatric Symptoms ◽

People With Dementia ◽

Person With Dementia

Abstract In a scenario of increasing longevity and social inequalities, Latin-America is an important contributor to the worldwide dementia burden. Caregivers’ health is fundamental to maintain the person with dementia quality of life. However, caregiving is a culturally sensible role that requires tailored solutions. The aim is to synthesize the evidence about non-pharmacologic interventions targeted to caregivers of people with dementia in Latin-American contexts. A comprehensive review of interventions in caregivers and persons with dementia in Latin-American countries was conducted using MEDLINE, Embase, PsycINFO, and Scopus with studies published until January 27th, 2020. Randomized clinical trials of non-pharmacologic interventions targeted to caregivers of people with dementia or dyads where included. Qualitative synthesis of the evidence was presented and analyzed. Overall, 9 pilot RCT were included for the final analysis (6 Brazil, 1 Colombia, 1 Mexico, 1 Perú). The biggest study recruited 69 caregivers and the smallest 13 dyads, with follow-up range of 3-6 months. 5 control groups received at least some other non-standard care type of intervention. 8 were targeted exclusively to caregivers (4 group intervention, 3 individual, and 1 combined) and 1 multicomponent intervention. Most frequent measured outcomes were caregiver’s burden, anxiety, depressive symptoms, and quality of life, and person with dementia neuropsychiatric symptoms. Individual interventions report better results in caregiver parameters such as burden and depressive symptoms and person with dementia neuropsychiatric symptoms. Group interventions presented mixed results. Nevertheless, the quality of evidence was low. There is a critical need to study interventions for caregivers in Latin-American contexts.

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Making Sense of Water Quality: Multispecies Encounters on the Mystic River

Worldviews Global Religions Culture and Ecology ◽

10.1163/15685357-01702006 ◽

2013 ◽

Vol 17 (2) ◽

pp. 150-160 ◽

Cited By ~ 9

Author(s):

Caterina Scaramelli

Keyword(s):

Water Quality ◽

Laboratory Data ◽

Quality Data ◽

Human Beings ◽

Water Lily ◽

Water Quality Data ◽

Water Flows ◽

Making Sense ◽

Quality Of Water

This paper takes water quality as an ethnographic subject. It looks at how water quality monitors in Boston make sense of the quality of water through mundane engagement with three non-human beings who they encounter during their monitoring activities: herring, bacteria and water lily. Each of these organisms suggests a different understanding of water quality for the monitors and poses a dilemma. Water quality monitors who contribute to the production of water quality data come to know water quality as through direct interactions with these beings, mediated by both sensorial experience and laboratory data. These experiences, at the same time, confuse and redraw relationships between science, water flows, non-human vitality, including that of invasive species, and people.

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Prognostic value of health-related quality of life in patients with acute dyspnea

European Heart Journal ◽

10.1093/ehjci/ehaa946.1186 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Belkin ◽

D Wussler ◽

I Strebel ◽

E Michou ◽

N Kozhuharov ◽

...

Keyword(s):

Prognostic Value ◽

Cox Regression ◽

Acute Dyspnea ◽

Cox Regression Analysis ◽

Prognostic Accuracy ◽

Related Quality ◽

Health Related ◽

Complete Set ◽

Eq Vas

Abstract Background Previous studies have shown the prognostic value of health-related quality of life (HRQL) in stable and ambulatory chronic heart failure patients. However, it is unknown whether HRQL can predict all-cause mortality in patients presenting to the emergency department (ED) after acute onset of symptoms. In order to address this unmet need, the aim of this study was to assess the prognostic value of HRQL in patients with acute dyspnea caused by acute heart failure (AHF) and other dyspnea aetiologies for 360-day mortality. Purpose To assess prognostic value of HRQL using the generic EQ-5D and visual analogue scale (EQ VAS) in patients with acute dyspnea. Methods Basics in Acute Shortness of Breath EvaLuation (BASEL V) is a prospective, multicenter, diagnostic study enrolling adult patients presenting with acute dyspnea to the ED. For this analysis, only patients with a complete set of variables necessary for calculation of EQ-5D (range 0–10; with higher score indicating worse HRQL) and EQ VAS (range 0–100; with 100 being the best imaginable health state) at baseline were included. The endpoint was the prognostic value of EQ-5D and EQ VAS at 360 days of follow-up regarding all-cause death. Prognostic accuracy was calculated using c-statistics. In a cox regression analysis EQ-5D was treated as both, a continuous and categorical variable. Adjustments were made for clinically relevant covariates (age, sex, orthopnoea, edema, level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) at presentation, history of coronary artery disease and chronic obstructive pulmonary disease, diuretics, β-blockers and ACE-inhibitors at discharge). Results Among 2605 patients enrolled, 1141 (43,8%) had a complete set of variables allowing the calculation of EQ-5D and EQ VAS. Of these patients 594 (52.1%) had an adjudicated final diagnosis of AHF. 211 (18.5%) patients died within 360 days of follow-up. Median EQ-5D was 3 (interquartile range (IQR) 1.5–5) and median EQ VAS was 50 (IQR 40–70). The prognostic accuracy for 360-day mortality was 0.65 (95% confidence interval ((CI) 0.61–0.69) and 0.58 (95% CI 0.54–0.62) for EQ-5D and EQ VAS, respectively (p=0.002). After combining EQ-5D and EQ VAS in a logistic regression model c-statistics regarding all-cause mortality within 360 days did not improve. The prognostic accuracy of EQ-5D was comparable to that of NT-proBNP (c-statistics 0.69, p=0.385). In an adjusted cox regression analysis the hazard ratio for patients with EQ-5D >4 was 2.2 (95% CI 1.7–2.9; p<0.001). Conclusions In patients presenting with acute dyspnea HRQL is a strong prognostic instrument. Independently of the aetiology of the dyspnea the prognostic value of the generic EQ-5D for 360-day mortality is comparable to NT-proBNP. Patients with an EQ-5D >4 are at significantly higher risk for mortality within 360 days. Figure 1. Prognostic value of HRQL Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Swiss National Science Foundation, Swiss Heart Foundation

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Prediction of all-cause mortality from 24 month trajectories in patient-reported psychological, clinical and quality of life outcomes in uveal melanoma patients

Journal of Behavioral Medicine ◽

10.1007/s10865-021-00252-8 ◽

2021 ◽

Author(s):

Stephen L. Brown ◽

Peter L. Fisher ◽

Laura Hope-Stone ◽

Heinrich Heimann ◽

Rumana Hussain ◽

...

Keyword(s):

Quality Of Life ◽

Life Expectancy ◽

Uveal Melanoma ◽

Cox Regression ◽

Multivariate Analyses ◽

Tumor Diameter ◽

Control Variables ◽

Patient Reported ◽

All Cause Mortality

AbstractA number of patient-reported outcomes (PROs) predict increased mortality after primary cancer treatment. Studies, though, are sometimes affected by methodological limitations. They often use control variables that poorly predict life expectancy, examine only one or two PROs thus not controlling potential confounding by unmeasured PROs, and observe PROs at only a single point in time. To predict all-cause mortality, this study used control variables affording good estimates of life expectancy, conducted multivariate analyses of multiple PROs to identify independent predictors, and monitored PROs two years after diagnosis. We recruited a consecutive sample of 824 patients with uveal melanoma between April 2008 and December 2014. PROs were variables shown to predict mortality in previous studies; anxiety, depression, visual and ocular symptoms, visual function impairment, worry about cancer recurrence, and physical, emotional, social and functional quality of life (QoL), measured 6, 12 and 24 months after diagnosis. We conducted Cox regression analyses with a census date of December 2018. Covariates were age, gender, marital and employment status, self-reported co-morbidities, tumor diameter and thickness, treatment modality and chromosome 3 mutation status, the latter a genetic mutation strongly associated with mortality. Single predictor analyses (with covariates), showed 6-month depression and poorer functional QoL predicting mortality, as did 6–12 month increases in anxiety and 6–12 month decreases in physical and functional QoL. Multivariate analyses using all PROs showed independent prediction by 6-month depression and decreasing QoL over 6–12 months and 12–24 months. Elevated depression scores six months post-diagnosis constituted an increased mortality risk. Early intervention for depressive symptoms may reduce mortality.

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