scholarly journals Public health implications of SARS-CoV-2 variants of concern: a rapid scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055781
Author(s):  
Mari Somerville ◽  
Janet A Curran ◽  
Justine Dol ◽  
Leah Boulos ◽  
Lynora Saxinger ◽  
...  

ObjectivesThe four SARS-CoV-2 variants of concern (VOC; Alpha, Beta, Gamma and Delta) identified by May 2021 are highly transmissible, yet little is known about their impact on public health measures. We aimed to synthesise evidence related to public health measures and VOC.DesignA rapid scoping review.Data sourcesOn 11 May 2021, seven databases (MEDLINE, Embase, the Cochrane Database of Systematic Reviews, Central Register of Controlled Trials, Epistemonikos’ L-OVE on COVID-19, medRxiv, bioRxiv) were searched for terms related to VOC, public health measures, transmission and health systems. No limit was placed on date of publication.Eligibility criteriaStudies were included if they reported on any of the four VOCs and public health measures, and were available in English. Only studies reporting on data collected after October 2020, when the first VOC was reported, were included.Data extraction and synthesisTitles, abstracts and full-text articles were screened by two independent reviewers. Data extraction was completed by two independent reviewers using a standardised form. Data synthesis and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.ResultsOf the 37 included studies, the majority assessed the impact of Alpha (n=32) and were conducted in Europe (n=12) or the UK (n=9). Most were modelling studies (n=28) and preprints (n=28). The majority of studies reported on infection control measures (n=17), followed by modifying approaches to vaccines (n=13), physical distancing (n=6) and either mask wearing, testing or hand washing (n=2). Findings suggest an accelerated vaccine rollout is needed to mitigate the spread of VOC.ConclusionsThe increased severity of VOC requires proactive public health measures to control their spread. Further research is needed to strengthen the evidence for continued implementation of public health measures in conjunction with vaccine rollout. With no studies reporting on Delta, there is a need for further research on this and other emerging VOC on public health measures.

2021 ◽  
pp. 194173812110447
Author(s):  
Justin Carrard ◽  
Anne-Catherine Rigort ◽  
Christian Appenzeller-Herzog ◽  
Flora Colledge ◽  
Karsten Königstein ◽  
...  

Context: Overtraining syndrome (OTS) is a condition characterized by a long-term performance decrement, which occurs after a persisting imbalance between training-related and nontraining-related load and recovery. Because of the lack of a gold standard diagnostic test, OTS remains a diagnosis of exclusion. Objective: To systematically review and map biomarkers and tools reported in the literature as potentially diagnostic for OTS. Data Sources: PubMed, Web of Science, and SPORTDiscus were searched from database inception to February 4, 2021, and results screened for eligibility. Backward and forward citation tracking on eligible records were used to complement results of database searching. Study Selection: Studies including athletes with a likely OTS diagnosis, as defined by the European College of Sport Science and the American College of Sports Medicine, and reporting at least 1 biomarker or tool potentially diagnostic for OTS were deemed eligible. Study Design: Scoping review following the guidelines of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews (PRISMA-ScR). Level of Evidence: Level 4. Data Extraction: Athletes’ population, criteria used to diagnose OTS, potentially diagnostic biomarkers and tools, as well as miscellaneous study characteristics were extracted. Results: The search yielded 5561 results, of which 39 met the eligibility criteria. Three diagnostic scores, namely the EROS-CLINICAL, EROS-SIMPLIFIED, and EROS-COMPLETE scores (EROS = Endocrine and Metabolic Responses on Overtraining Syndrome study), were identified. Additionally, basal hormone, neurotransmitter and other metabolite levels, hormonal responses to stimuli, psychological questionnaires, exercise tests, heart rate variability, electroencephalography, immunological and redox parameters, muscle structure, and body composition were reported as potentially diagnostic for OTS. Conclusion: Specific hormones, neurotransmitters, and metabolites, as well as psychological, electrocardiographic, electroencephalographic, and immunological patterns were identified as potentially diagnostic for OTS, reflecting its multisystemic nature. As exemplified by the EROS scores, combinations of these variables may be required to diagnose OTS. These scores must now be validated in larger samples and within female athletes.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jamile Marchi ◽  
Nina Johansson ◽  
Anna Sarkadi ◽  
Georgina Warner

Background: The COVID-19 pandemic is primarily a crisis that affects people's physical health. However, it is well-known from previous epidemics and pandemics that there are other indirect negative impacts on mental health, among others. The purpose of this scoping review was to explore and summarise primary empirical research evidence on how the COVID-19 pandemic and societal infection control measures have impacted children and adolescents' mental health.Methods: A literature search was conducted in five scientific databases: PubMed, APA PsycINFO, Web of Science, CINHAL, and Social Science Premium Collection. The search string was designed using the Population (0–18 years), Exposure (COVID-19), Outcomes (mental health) framework. Mental health was defined broadly, covering mental well-being to mental disorders and psychiatric conditions.Results: Fifty-nine studies were included in the scoping review. Of these, 44 were cross-sectional and 15 were longitudinal studies. Most studies reported negative impact of the COVID-19 pandemic on child and adolescent mental health outcomes, yet the evidence was mixed. This was also the case for studies investigating societal control measures. Strong resilience, positive emotion regulation, physical activity, parental self-efficacy, family functioning and emotional regulation, and social support were reported as protective factors. On the contrary, emotional reactivity and experiential avoidance, exposure to excessive information, COVID-19 school concerns, presence of COVID-19 cases in the community, parental mental health problems, and high internet, social media and video game use were all identified as potentially harmful factors.Conclusions: Due to the methodological heterogeneity of the studies and geographical variation, it is challenging to draw definitive conclusions about the real impact of the COVID-19 pandemic on the mental health of children and adolescents. However, the existing body of research gives some insight to how parents, clinicians and policy makers can take action to mitigate the effects of COVID-19 and control measures. Interventions to promote physical activity and reduce screen time among children and adolescents are recommended, as well as parenting support programs.


2021 ◽  
Author(s):  
Madison Stoddard ◽  
Debra Van Egeren ◽  
Kaitlyn Johnson ◽  
Smriti Rao ◽  
Josh Furgeson ◽  
...  

Abstract Background: The word ‘pandemic’ conjures dystopian images of bodies stacked in the streets and societies on the brink of collapse. Despite this frightening picture, denialism and noncompliance with public health measures are common in the historical record, for example during the 1918 Influenza pandemic or the 2015 Ebola epidemic. The unique characteristics of SARS-CoV-2—its high basic reproduction number (R0), time-limited natural immunity and considerable potential for asymptomatic spread—exacerbate the public health repercussions of noncompliance with interventions (such as vaccines and masks) to limit disease transmission. Our work explores the rationality and impact of noncompliance with COVID-19 disease control measures. Methods: In this work, we used game theory to explore when noncompliance confers a perceived benefit to individuals. We then used epidemiological modeling to predict the impact of noncompliance on control of COVID-19, demonstrating that the presence of a noncompliant subpopulation prevents suppression of disease spread. Results: Our modeling demonstrating that noncompliance is a Nash equilibrium under a broad set of conditions, and that the existence of a noncompliant population can result in extensive endemic disease in the long-term after a return to pre-pandemic social and economic activity. Endemic disease poses a threat for both compliant and noncompliant individuals; all community members are protected if complete suppression is achieved, which is only possible with a high degree of compliance. For interventions that are highly effective at preventing disease spread, however, the consequences of noncompliance are borne disproportionately by noncompliant individuals. Conclusions: In sum, our work demonstrates the limits of free-market approaches to compliance with disease control measures during a pandemic. The act of noncompliance with disease intervention measures creates a negative externality, rendering COVID-19 disease control ineffective in the short term and making complete suppression impossible in the long term. Our work underscores the importance of developing effective strategies for prophylaxis through public health measures aimed at complete suppression and the need to focus on compliance at a population level.


2020 ◽  
Vol 10 (10) ◽  
pp. 688
Author(s):  
Marina Charalambous ◽  
Maria Kambanaros ◽  
Jean-Marie Annoni

Background: Quality of Life (QoL) questionnaires are used to describe the impact of aphasia on stroke survivors’ life. People with aphasia (PWA) are traditionally excluded from research, potentially leading to a mismatch between the factors chosen in the tools and the realistic needs of PWA. The purpose of this review was to determine the direct involvement of PWA in the creation of QoL and aphasia impact-related questionnaires (AIR-Qs). Methods: A scoping review methodology was conducted by an expert librarian and two independent reviewers on health sciences based on the Preferred Reporting Items for Systematic Reviews and Metanalyses extension for Scoping Reviews (PRISMA-ScR) protocol, through a literature search in five databases: Medline Complete, PubMed, PsychINFO, Scopus, and Google Scholar. Search terms included ‘stroke’, ‘people with aphasia’, ‘communication’, ‘well-being’, and ‘quality of life’. Results: Of 952 results, 20 studies met the eligibility criteria. Of these, only four AIR-Qs studies (20%) were found reporting the direct involvement of PWA, while no QoL tools did so. Evidence showed involvement in the creation phase of AIR-Q, mainly in a consultation role. Conclusions: There is an absence of a framework for conducting and reporting the involvement of PWA in qualitative participatory research studies, which limits effectiveness to promote equitable best practice in aphasia rehabilitation.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028583 ◽  
Author(s):  
Pamela Leece ◽  
Triti Khorasheh ◽  
Nimitha Paul ◽  
Sue Keller-Olaman ◽  
Susan Massarella ◽  
...  

ObjectivesWe sought to understand the implementation of multifaceted community plans to address opioid-related harms.DesignOur scoping review examined the extent of the literature on community plans to prevent and reduce opioid-related harms, characterise the key components, and identify gaps.Data sourcesWe searched MEDLINE, Embase, PsycINFO, CINHAL, SocINDEX and Academic Search Primer, and three search engines for English language peer-reviewed and grey literature from the past 10 years.Eligibility criteriaEligible records addressed opioid-related harms or overdose, used two or more intervention approaches (eg, prevention, treatment, harm reduction, enforcement and justice), involved two or more partners and occurred in an Organisation for Economic Co-operation and Development country.Data extraction and synthesisQualitative thematic and quantitative analysis was conducted on the charted data. Stakeholders were engaged through fourteen interviews, three focus groups and one workshop.ResultsWe identified 108 records that described 100 community plans in Canada and the USA; four had been evaluated. Most plans were provincially or state funded, led by public health and involved an average of seven partners. Commonly, plans used individual training to implement interventions. Actions focused on treatment and harm reduction, largely to increase access to addiction services and naloxone. Among specific groups, people in conflict with the law were addressed most frequently. Community plans typically engaged the public through in-person forums. Stakeholders identified three key implications to our findings: addressing equity and stigma-related barriers towards people with lived experience of substance use; improving data collection to facilitate evaluation; and enhancing community partnerships by involving people with lived experience of substance use.ConclusionCurrent understanding of the implementation and context of community opioid-related plans demonstrates a need for evaluation to advance the evidence base. Partnership with people who have lived experience of substance use is underdeveloped and may strengthen responsive public health decision making.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045364
Author(s):  
Bo Kim ◽  
Christopher Weatherly ◽  
Courtney Benjamin Wolk ◽  
Enola K Proctor

ObjectiveThe objective of this study was to examine how published studies of inpatient to outpatient mental healthcare transition processes have approached measuring unnecessary psychiatric readmissions.DesignScoping review using Levac et al’s enhancement to Arksey and O’Malley’s framework for conducting scoping reviews.Data sourcesMedline (Ovid), Embase (Ovid), PsycINFO, CINAHL, Cochrane and ISI Web of Science article databases were searched from 1 January 2009 through 28 February 2019.Eligibility criteria for selecting studiesWe included studies that (1) are about care transition processes associated with unnecessary psychiatric readmissions and (2) specify use of at least one readmission time interval (ie, the time period since previous discharge from inpatient care, within which a hospitalisation can be considered a readmission).Data extraction and synthesisWe assessed review findings through tabular and content analyses of the data extracted from included articles.ResultsOur database search yielded 3478 unique articles, 67 of which were included in our scoping review. The included articles varied widely in their reported readmission time intervals used. They provided limited details regarding which readmissions they considered unnecessary and which risks they accounted for in their measurement. There were no perceptible trends in associations between the variation in these findings and the included studies’ characteristics (eg, target population, type of care transition intervention).ConclusionsThe limited specification with which studies report their approach to unnecessary psychiatric readmissions measurement is a noteworthy gap identified by this scoping review, and one that can hinder both the replicability of conducted studies and adaptations of study methods by future investigations. Recommendations stemming from this review include (1) establishing a framework for reporting the measurement approach, (2) devising enhanced guidelines regarding which approaches to use in which circumstances and (3) examining how sensitive research findings are to the choice of the approach.


2021 ◽  
Author(s):  
Janet A Curran ◽  
Justine Dol ◽  
Leah Boulos ◽  
Mari Somerville ◽  
Bearach Reynolds ◽  
...  

Background: As of April 2021, three SARS-CoV-2 variants of concern (VOC: B.1.1.7, B.1.351 and P.1) have been detected in over 132 countries. Increased transmissibility of VOC has implications for public health measures and health system arrangements. This rapid scoping review aims to provide a synthesis of current evidence related to public health measures and health system arrangements associated with VOC. Methods: Rapid scoping review. Seven databases were searched up to April 7, 2021 for terms related to VOC, transmission, public health and health systems. A grey literature search was conducted up to April 14, 2021. Title, abstracts and full text were screened independently by two reviewers. Data were double extracted using a standardized form. Studies were included if they reported on at least one of the VOC and public health or health system outcomes. Results: Of the 2487 articles and 59 grey literature sources retrieved, 37 studies and 21 guidance documents were included. Included studies used a wide range of designs and methods. Most of the studies and guidance documents reported on B.1.1.7, and 18 studies and 4 reports provided data for consideration in relation to public health measures. Public health measures, including lockdowns, physical distancing, testing and contact tracing, were identified as critical adjuncts to a comprehensive vaccination campaign. No studies reported on handwashing or masking procedures related to VOC. For health system arrangements, 17 studies were identified. Some studies found an increase in hospitalization due to B.1.1.7 but no difference in length of stay or ICU admission. Six studies found an increased risk of death ranging from 15-67% with B.1.1.7 compared non-B.1.1.7, but three studies reported no change. One study reported on the effectiveness of personal protective equipment in reducing VOC transmission in the hospital. No studies reported on screening staff and visitors, adjusting service provisions, or adjusting patient accommodations and shared spaces, which is a significant gap in the literature. Guidance documents did not tend to cite any evidence and were thus assumed to be based on expert opinion. Conclusion: While the findings should be interpreted with caution as most of the sources identified were preprints, findings suggest a combination of non-pharmaceutical interventions (e.g., masking, physical distancing, lockdowns, testing) should be employed alongside a vaccine strategy to improve population and health system outcomes. While the findings are mixed on the impact of VOC on health system arrangements, the evidence is trending towards increased hospitalization and death.


2021 ◽  
Vol 10 (24) ◽  
pp. 5719
Author(s):  
Andrea Scapigliati ◽  
Drieda Zace ◽  
Tasuku Matsuyama ◽  
Luca Pisapia ◽  
Michela Saviani ◽  
...  

Introduction: Early intervention of bystanders (the first links of the chain of survival) have been shown to improve survival and good neurological outcomes of patients suffering out-of-hospital cardiac arrest (OHCA). Many initiatives have been implemented to increase the engagement of communities in early basic life support (BLS) and cardiopulmonary resuscitation (CPR), especially of lay people with no duty to respond. A better knowledge of the most effective initiatives might help improve survival and health system organization. Aim of the scoping review: To assess the impact of specific interventions involving lay communities on bystander BLS rates and other consistent clinical outcomes, and to identify relevant knowledge gaps. Methods: This scoping review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR), and was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. We performed a literature search using the PubMed, EMBASE, and Cochrane databases until 1 February 2021. The screening process was conducted based on predefined inclusion/exclusion criteria, and for each included study, we performed data extraction focusing on the type of intervention implemented, and the impact of these interventions on the specific OHCAs outcomes. Results: Our search strategy identified 19 eligible studies, originating mainly from the USA (47.4%) and Denmark (21%). The type of intervention included in 57.9% of cases was a community CPR training program, in 36.8% bundled interventions, and in 5.3% mass-media campaigns. The most commonly reported outcome for OHCAs was bystander CPR rate (94.7%), followed by survival to hospital discharge (36.8%), proportion of people trained (31.6%), survival to hospital discharge with good neurological outcome (21%), and Return of Spontaneous Circulation (10.5%). Community training programs and bundled interventions improved bystander CPR in most of the included studies. Conclusion: Based on the results of our scoping review, we identified the potential benefit of community initiatives, such as community training in BLS, even as part of bundled intervention, in order to improve bystander CPR rates and patient outcomes.


2021 ◽  
Vol 4 ◽  
pp. 27
Author(s):  
Trish O'Sullivan ◽  
Tony Foley ◽  
Joseph G. McVeigh ◽  
Suzanne Timmons

Background: The care of people with dementia is of global concern. Physiotherapeutic intervention can be of benefit to patients with dementia. Physiotherapists can play a role in assessment, falls prevention, pain management and gait re-education. Dementia care forms a significant part of the workload of a physiotherapist. However, there is a paucity of evidence on what constitutes effective education and training for physiotherapists working in dementia care. Objective: This scoping review aims to explore and map the evidence on education and training for physiotherapists working in dementia care. Inclusion criteria: Studies that explore dementia training and/or education for physiotherapists or for multidisciplinary teams, in which physiotherapists have been included. Studies that explore student physiotherapy training will also be considered. Systematic reviews, qualitative, quantitative, mixed methods studies, case studies and observational studies will be included. Methods: This scoping review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews. Databases to be searched as part of this review include: Medline, Cochrane Database of Systematic Reviews, SocINDEX, CINAHL and, PsycINFO, with no limitation on publication date. Google Scholar and Open-Grey will be searched for grey literature, limited to the first 100 searches.  Titles and abstracts will be screened for inclusion and identified full texts reviewed independently by two reviewers. Data will be extracted using a draft data extraction tool based on the JBI data extraction tool. A chronological narrative synthesis of the data will outline how the results relate to the aims and objective of this scoping review.


2020 ◽  
Vol 2020 ◽  
pp. 1-39
Author(s):  
Lorelli Nowell ◽  
Swati Dhingra ◽  
Kimberley Andrews ◽  
Julia Gospodinov ◽  
Cathy Liu ◽  
...  

Grand challenges are complex problems that are common to much of society, affect large populations, and may have several possible solutions. Incorporation of grand challenges into higher education courses can facilitate the development of collaborative problem-solving skills while providing relevant and practical opportunities to experience the dynamics involved in real-world work. Although grand challenges are becoming more commonly used in higher education, to date, there has been no synthesis of how grand challenges are incorporated and the learning outcomes of engaging in grand challenge work. In this scoping review, we examined and mapped the state of evidence for the use of grand challenges in higher education. We conducted the review according to the Johanna Briggs Institute methodology for scoping reviews and considered quantitative, qualitative, and mixed-methods studies as well as literature reviews, program descriptions, and opinion papers published in English without limitations on year of publication. We used a data extraction tool to synthesize and present our findings in a tabular form with accompanying narrative summaries. The results reveal a growing global interest in the use of grand challenges in higher education while highlighting a lack of rigorous empirical evidence on the impact on student learning.


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