scholarly journals Cohort profile: Actionable Register of Geneva Outpatients and inpatients with SARS-CoV-2 (ARGOS)

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e048946
Author(s):  
Camille Genecand ◽  
Denis Mongin ◽  
Flora Koegler ◽  
Dan Lebowitz ◽  
Simon Regard ◽  
...  
Keyword(s):  
Public Health ◽  
Demographic Data ◽  
Participation Rate ◽  
Contact Tracing ◽  
Test Results ◽  
Health It ◽  
Public Health Policies ◽  
The Impact ◽  
Test Result

PurposeThe Actionable Register of Geneva Outpatients and inpatients with SARS-CoV-2 (ARGOS) is an ongoing prospective cohort created by the Geneva Directorate of Health. It consists of an operational database compiling all SARS-CoV-2 test results recorded in the Geneva area since late February 2020. This article aims at presenting this comprehensive cohort, in light of some of the varying public health measures in Geneva, Switzerland, since March 2020.ParticipantsAs of 1 June 2021, the database included 360 525 patients, among which 65 475 had at least one positive test result for SARS-CoV-2. Among all positive patients, 37.6% were contacted only once, 10.6% had one follow-up call, 8.5% had two and 27.7% had three or more follow-up calls. Participation rate among positive patients is 94%. Data collection is ongoing.Findings to dateARGOS data illustrates the magnitude of COVID-19 pandemic in Geneva, Switzerland, and details a variety of population factors and outcomes. The content of the cohort includes demographic data, comorbidities and risk factors for poor clinical outcome, self-reported COVID-19 symptoms, environmental and socioeconomic factors, prospective and retrospective contact tracing data, travel quarantine data and deaths. The registry has already been used in several publications focusing on symptoms and long COVID-19, infection fatality rate and re-infection.Future plansThe data of this large real-world registry provides a valuable resource for various types of research, such as clinical research, epidemiological research or policy assessment as it illustrates the impact of public health policies and overall disease burden of COVID-19.

scholarly journals Cohort profile: Actionable Register of Geneva Outpatients with SARS-CoV-2 (ARGOS)

2021 ◽  
Author(s):  
Camille Genecand ◽  
Flora Koegler ◽  
Dan Lebowitz ◽  
Denis Mongin ◽  
Simon Regard ◽  
...  
Keyword(s):  
Public Health ◽  
Disease Burden ◽  
Demographic Data ◽  
Participation Rate ◽  
Health Policies ◽  
Contact Tracing ◽  
Valuable Resource ◽  
Disease Evolution ◽  
Public Health Policies ◽  
The Impact

Purpose The Actionable Register of Geneva Outpatients with SARS-CoV-2 (ARGOS) is an ongoing prospective cohort created by the Geneva Directorate of Health (GDH). It consists of an operational database compiling all SARS-CoV-2 test results conducted in the Geneva area since late February 2020. While the disease evolution of patients hospitalized with SARS-CoV-2 are now relatively numerous, the same cannot be said for outpatients. This article aims at presenting a comprehensive outpatient cohort in light of the varying public health measures in Geneva, Switzerland, since March 2020. Participants As of July 28, 2020, the database included 58 226 patients, among which 6848 had at least one positive test result for SARS-CoV-2. Among all positive patients, 66.8% were contacted once, and 21% of participants had 3 or more follow-up calls. Participation rate is 96.9%. Data collection is ongoing. Findings to date ARGOS data illustrates the magnitude of COVID-19 pandemic in Geneva, Switzerland, and details a variety of population factors and outcomes. The content of the cohort includes demographic data, comorbidities and risk factors for poor clinical outcome, COVID-19 symptoms, environmental and socio-economic factors, contact tracing data, hospitalizations and deaths. Future plans: The data of this large real-world registry provides a valuable resource for various types of research, such as epidemiological research or policy assessment as it illustrates the impact of public health policies and overall disease burden of COVID-19. STRENGTHS AND LIMITATIONS OF THIS STUDY - ARGOS main strength consists of its large number of cases, representative of all diagnosed cases on a regional level with the primary aim of assessing all cases. - ARGOS involves every tested individual and is not limited to hospitalized patients, thus providing a valuable resource to assess the impact of public health policies and overall disease burden of COVID-19 in a geographically defined population. - To mitigate confounding effects and improve data analysis and interpretation, we present the data according to four policy periods. - This cohort is multicentric as it includes all tests performed in Geneva's hospitals (both public and private), private practices and medical centers. - Due to operational needs, symptoms and comorbidities are self-reported, which may lead to measurement error or misclassification.

scholarly journals The impact of health information technology on the management and follow-up of test results – a systematic review

2019 ◽  
Vol 26 (7) ◽  
pp. 678-688 ◽  
Author(s):  
Andrew Georgiou ◽  
Julie Li ◽  
Judith Thomas ◽  
Maria R Dahm ◽  
Johanna I Westbrook
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Test Results ◽  
Health It ◽  
Point Change ◽  
It Systems ◽  
Results Management ◽  
The Impact

Abstract Objective To investigate the impact of health information technology (IT) systems on clinicians’ work practices and patient engagement in the management and follow-up of test results. Materials and Methods A search for studies reporting health IT systems and clinician test results management was conducted in the following databases: MEDLINE, EMBASE, CINAHL, Web of Science, ScienceDirect, ProQuest, and Scopus from January 1999 to June 2018. Test results follow-up was defined as provider follow-up of results for tests that were sent to the laboratory and radiology services for processing or analysis. Results There are some findings from controlled studies showing that health IT can improve the proportion of tests followed-up (15 percentage point change) and increase physician awareness of test results that require action (24–28 percentage point change). Taken as whole, however, the evidence of the impact of health IT on test result management and follow-up is not strong. Discussion The development of safe and effective test results management IT systems should pivot on several axes. These axes include 1) patient-centerd engagement (involving shared, timely, and meaningful information); 2) diagnostic processes (that involve the integration of multiple people and different clinical settings across the health care spectrum); and 3) organizational communications (the myriad of multi- transactional processes requiring feedback, iteration, and confirmation) that contribute to the patient care process. Conclusion Existing evidence indicates that health IT in and of itself does not (and most likely cannot) provide a complete solution to issues related to test results management and follow-up.

scholarly journals Using Unstated Cases to Correct for COVID-19 Pandemic Outbreak and Its Impact on Easing the Intervention for Qatar

Biology ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 463
Author(s):  
Narjiss Sallahi ◽  
Heesoo Park ◽  
Fedwa El Mellouhi ◽  
Mustapha Rachdi ◽  
Idir Ouassou ◽  
...  
Keyword(s):  
Public Health ◽  
A Priori ◽  
Epidemiological Models ◽  
Sir Epidemic Model ◽  
Gulf Region ◽  
Epidemiological Modeling ◽  
Public Health Policies ◽  
Sir Epidemic ◽  
The Impact ◽  
Case Data

Epidemiological Modeling supports the evaluation of various disease management activities. The value of epidemiological models lies in their ability to study various scenarios and to provide governments with a priori knowledge of the consequence of disease incursions and the impact of preventive strategies. A prevalent method of modeling the spread of pandemics is to categorize individuals in the population as belonging to one of several distinct compartments, which represents their health status with regard to the pandemic. In this work, a modified SIR epidemic model is proposed and analyzed with respect to the identification of its parameters and initial values based on stated or recorded case data from public health sources to estimate the unreported cases and the effectiveness of public health policies such as social distancing in slowing the spread of the epidemic. The analysis aims to highlight the importance of unreported cases for correcting the underestimated basic reproduction number. In many epidemic outbreaks, the number of reported infections is likely much lower than the actual number of infections which can be calculated from the model’s parameters derived from reported case data. The analysis is applied to the COVID-19 pandemic for several countries in the Gulf region and Europe.

scholarly journals COVID-19 infection among international travellers: a prospective analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050667
Author(s):  
Meaghan Lunney ◽  
Paul E Ronksley ◽  
Robert G Weaver ◽  
Lianne Barnieh ◽  
Norman Blue ◽  
...  
Keyword(s):  
Critical Care ◽  
Outcome Measures ◽  
Contact Tracing ◽  
Prospective Analysis ◽  
Pilot Programme ◽  
Negative Test ◽  
Secondary Transmission ◽  
To Receive ◽  
Test Result

ObjectivesThis report estimates the risk of COVID-19 importation and secondary transmission associated with a modified quarantine programme in Canada.Design and participantsProspective analysis of international asymptomatic travellers entering Alberta, Canada.InterventionsAll participants were required to receive a PCR COVID-19 test on arrival. If negative, participants could leave quarantine but were required to have a second test 6 or 7 days after arrival. If the arrival test was positive, participants were required to remain in quarantine for 14 days.Main outcome measuresProportion and rate of participants testing positive for COVID-19; number of cases of secondary transmission.ResultsThe analysis included 9535 international travellers entering Alberta by air (N=8398) or land (N=1137) that voluntarily enrolled in the Alberta Border Testing Pilot Programme (a subset of all travellers); most (83.1%) were Canadian citizens. Among the 9310 participants who received at least one test, 200 (21.5 per 1000, 95% CI 18.6 to 24.6) tested positive. Sixty-nine per cent (138/200) of positive tests were detected on arrival (14.8 per 1000 travellers, 95% CI 12.5 to 17.5). 62 cases (6.7 per 1000 travellers, 95% CI 5.1 to 8.5; 31.0% of positive cases) were identified among participants that had been released from quarantine following a negative test result on arrival. Of 192 participants who developed symptoms, 51 (26.6%) tested positive after arrival. Among participants with positive tests, four (2.0%) were hospitalised for COVID-19; none required critical care or died. Contact tracing among participants who tested positive identified 200 contacts; of 88 contacts tested, 22 were cases of secondary transmission (14 from those testing positive on arrival and 8 from those testing positive thereafter). SARS-CoV-2 B.1.1.7 lineage was not detected in any of the 200 positive cases.Conclusions21.5 per 1000 international travellers tested positive for COVID-19. Most (69%) tested positive on arrival and 31% tested positive during follow-up. These findings suggest the need for ongoing vigilance in travellers testing negative on arrival and highlight the value of follow-up testing and contact tracing to monitor and limit secondary transmission where possible.

scholarly journals Preoperative multidisciplinary program for bariatric surgery: a proposal for the Brazilian Public Health System

2017 ◽  
Vol 54 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Elinton Adami CHAIM ◽  
José Carlos PAREJA ◽  
Martinho Antonio GESTIC ◽  
Murillo Pimentel UTRINI ◽  
Everton CAZZO
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Health System ◽  
Public Health System ◽  
Wound Dehiscence ◽  
Pulmonary Complications ◽  
Multidisciplinary Program ◽  
The Impact ◽  
Access To Surgery

ABSTRACT BACKGROUND Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program. RESULTS There were 176 individuals who underwent the multidisciplinary program and 226 who did not. Individuals who underwent the program had significantly lower occurrence of the following variables: hospital stay; wound dehiscence; wound infection; pulmonary complications; anastomotic leaks; pulmonary thromboembolism; sepsis; incisional hernias; eventrations; reoperations; and mortality. Both loss of follow-up and weight loss failure were also significantly lower in the program group. CONCLUSION The adoption of a comprehensive preoperative multidisciplinary approach led to significant improvements in the postoperative outcomes and also in the compliance to the postoperative follow-up. It represents a reproducible and potentially beneficial approach within the context of the Brazilian public health system.

The complication of cyber manhunt: How cyber manhunt further complicated the ethical conflict between breaching the confidentiality and endangering the society in face of the COVID-19 pandemic (Preprint)

2021 ◽  
Author(s):  
Yen-Chang Chen ◽  
Yen-Yuan Chen
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Health Workers ◽  
Early Stage ◽  
Personal Information ◽  
Public Health Intervention ◽  
Contact Tracing ◽  
Online Activity ◽  
Contact Investigation ◽  
The Impact

UNSTRUCTURED While health care and public health workers are working on measures to mitigate the COVID-19 pandemic, there is an unprecedentedly large number of people spending much more time indoors, and relying heavily on the Internet as their lifeline. What has been overlooked is the influence of the increasing online activities on public health issues. In this article, we pointed out how a large-scale online activity called cyber manhunt may threaten to offset the efficacy of contact tracing investigation, a public health intervention considered highly effective in limiting further transmission in the early stage of a highly contagious disease outbreak such as the COVID-19 pandemic. In the first section, we presented a case to show how personal information obtained from contact investigation and disclosed in part on the media provoked a vehement cyber manhunt. We then discussed the possible reasons why netizens collaborate to reveal anonymized personal information about contact investigation, and specify, from the perspective of public health and public health ethics, four problems of cyber manhunt, including the lack of legitimate public health goals, the concerns about privacy breach, the impact of misinformation, and social inequality. Based on our analysis, we concluded that more moral weight may be given to protecting one's confidentiality, especially in an era with the rapid advance of digital and information technologies.

scholarly journals Modeling the impact of school reopening and contact tracing strategies on Covid-19 dynamics in different epidemiologic settings in Brazil

2021 ◽  
Author(s):  
Marcelo Eduardo Borges ◽  
Leonardo Souto Ferreira ◽  
Silas Poloni ◽  
Ângela Maria Bagattini ◽  
Caroline Franco ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Transmission Rate ◽  
Disease Incidence ◽  
Demographic Data ◽  
School Closure ◽  
Mitigation Measures ◽  
Contact Tracing ◽  
School Closures ◽  
Infection Transmission ◽  
The Impact

Among the various non–pharmaceutical interventions implemented in response to the Covid–19 pandemic during 2020, school closures have been in place in several countries to reduce infection transmission. Nonetheless, the significant short and long–term impacts of prolonged suspension of in–person classes is a major concern. There is still considerable debate around the best timing for school closure and reopening, its impact on the dynamics of disease transmission, and its effectiveness when considered in association with other mitigation measures. Despite the erratic implementation of mitigation measures in Brazil, school closures were among the first measures taken early in the pandemic in most of the 27 states in the country. Further, Brazil delayed the reopening of schools and stands among the countries in which schools remained closed for the most prolonged period in 2020. To assess the impact of school reopening and the effect of contact tracing strategies in rates of Covid–19 cases and deaths, we model the epidemiological dynamics of disease transmission in 3 large urban centers in Brazil under different epidemiological contexts. We implement an extended SEIR model stratified by age and considering contact networks in different settings – school, home, work, and elsewhere, in which the infection transmission rate is affected by various intervention measures. After fitting epidemiological and demographic data, we simulate scenarios with increasing school transmission due to school reopening. Our model shows that reopening schools results in a non–linear increase of reported Covid-19 cases and deaths, which is highly dependent on infection and disease incidence at the time of reopening. While low rates of within[&ndash]school transmission resulted in small effects on disease incidence (cases/100,000 pop), intermediate or high rates can severely impact disease trends resulting in escalating rates of new cases even if other interventions remain unchanged. When contact tracing and quarantining are restricted to school and home settings, a large number of daily tests is required to produce significant effects of reducing the total number of hospitalizations and deaths. Our results suggest that policymakers should carefully consider the epidemiological context and timing regarding the implementation of school closure and return of in-person school activities. Also, although contact tracing strategies are essential to prevent new infections and outbreaks within school environments, our data suggest that they are alone not sufficient to avoid significant impacts on community transmission in the context of school reopening in settings with high and sustained transmission rates.

scholarly journals Public Health Policies in the Akyem Abuakwa of Ghana (1850-1957)

2020 ◽  
Vol 20 (2) ◽  
pp. 129-157
Author(s):  
Samuel Adu Gyamfi ◽  
Phinehas Asiamah ◽  
Benjamin Dompreh Darkwa ◽  
Lucky Tomdi
Keyword(s):  
Public Health ◽  
Academic Research ◽  
Health Policies ◽  
Historical Study ◽  
Colonial Era ◽  
Public Health Policies ◽  
Health History ◽  
Documentary Sources ◽  
The People ◽  
The Impact

Abstract Akyem Abuakwa is one of the largest states of the Akan ethnic group in Ghana. Notwithstanding its size and important contribution to Ghana’s development, historians have paid little attention in doing academic research on the health history of the people. Using a qualitative method of research, this paper does a historical study on public health policies in Akyem Abuakwa from the 1850s to 1957. We utilised documentary and non-documentary sources to discuss the various public health policies implemented in Akyem Abuakwa from the pre-colonial era to the colonial era. We examined the impact of the policies on the people of Akyem Abuakwa and the various challenges faced by the British colonial administration in their quest to implement public health policies.

Follow-up Findings for Women With Human Papillomavirus–Positive and Atypical Squamous Cells of Undetermined Significance Screening Test Results in a Large Women's Hospital Practice

2009 ◽  
Vol 133 (9) ◽  
pp. 1426-1430 ◽  
Author(s):  
Henry Armah ◽  
R. Marshall Austin ◽  
David Dabbs ◽  
Chengquan Zhao
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Test Results ◽  
Clinical Practices ◽  
Squamous Cells ◽  
Hpv Test ◽  
The Impact ◽  
Undetermined Significance

Abstract Context.—Reflex human papillomavirus (HPV) testing has been designated in consensus guidelines as “preferred” for women with atypical squamous cells of undetermined significance (ASC-US) liquid-based cytology (LBC) results, and colposcopy is currently recommended for patients with HPV-positive ASC-US results. Data from large clinical practices using newer screening methods and current cytology terminology are limited. Objectives.—We analyzed data from patients with ASC-US LBC and positive HPV test results. We also assessed the impact of the presence or absence of an endocervical cell/ transformation zone sample (EC/TZS) on biopsy diagnoses. Design.—The information system of a large women's hospital serving an older-than-average population was searched over a 21-month period between July 1, 2005, and March 31, 2007, for HPV-positive cases interpreted as ASC-US (Bethesda System 2001) using computer-imaged LBC. Histologic diagnoses, patient ages, and presence or absence of an EC/TZS were analyzed. The average follow-up period was 7.5 months. Results.—Among 4273 women with HPV-positive ASC-US results, the cumulative cervical intraepithelial neoplasia 2 or 3 (CIN 2/3) and CIN 1 rates for 2192 women with available biopsies were 5.1% and 43.6%, respectively. Cervical intraepithelial neoplasia 2/3 and CIN 1 rates for women with HPV-positive ASC-US results were not significantly different for women with and without an EC/TZS. Conclusions.—The risk of CIN 2/3 in the study population was significantly lower than reported in widely cited trial data. Neither presence nor absence of an EC/TZS, nor the age of the patient, had a statistically significant impact on the likelihood of biopsy diagnoses of CIN 2/3 and CIN 1 for patients with HPV-positive ASC-US test results.

Digital Divide

2016 ◽  
pp. 94-101
Author(s):  
Geoff Kaufman ◽  
Mary Flanagan
Keyword(s):  
Public Health ◽  
Systems Thinking ◽  
Cognitive Processes ◽  
Digital Game ◽  
Digital Platforms ◽  
Digital Version ◽  
Digital Format ◽  
Growing Body ◽  
The Impact

With a growing body of work demonstrating the power of games to transform players' attitudes, behaviors, and cognitions, it is crucial to understand the potentially divergent experiences and outcomes afforded by digital and non-digital platforms. In a recent study, we found that transferring a public health game from a non-digital to a digital format profoundly impacted players' behaviors and the game's impact. Specifically, players of the digital version of the game, despite it being a nearly identical translation, exhibited a more rapid play pace and discussed strategies and consequences less frequently and with less depth. As a result of this discrepancy, players of the non-digital version of the game exhibited significantly higher post-game systems thinking performance and more positive valuations of vaccination, whereas players of the digital game did not. We propose several explanations for this finding, including follow-up work demonstrating the impact of platform on basic cognitive processes, that elucidate critical distinctions between digital and non-digital experiences.

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