scholarly journals Disparities in use of telehealth at the onset of the COVID-19 public health emergency

2020 ◽  
pp. 1357633X2096389
Author(s):  
Robert P Pierce ◽  
James J Stevermer
Keyword(s):  
Public Health ◽  
Urban Areas ◽  
Public Health Emergency ◽  
Insurance Status ◽  
Rural Residence ◽  
Cross Sectional ◽  
Face To Face ◽  
Time Period ◽  
Audio Video ◽  
Sectional Analysis

Introduction The coronavirus disease 2019 (COVID-19) pandemic resulted in an unprecedented expansion in telehealth, but little is known about differential use of telehealth according to demographics, rurality, or insurance status. Methods We performed a cross-sectional analysis of 7742 family medicine encounters at a single USA institution in the initial month of the COVID-19 public health emergency (PHE). We compared the demographics of those using telehealth during the PHE to those with face-to-face visits during the same time period; we also compared the demographics of those using full audio-video to those using audio-only. Results The likelihood of any telehealth visit in the first 30 days of telehealth expansion was higher for women, those age 65 years and older, self-pay patients, and those with Medicaid and Medicare as primary payers. The likelihood of a telehealth visit was reduced for rural residence and Black or other races. Among all telehealth visits, the likelihood of a full audio-video telehealth visit was reduced for patients who were older, Black, from urban areas, or who were self-pay, Medicaid, or Medicare payer status. Discussion Significant disparities exist in telehealth use during the COVID-19 PHE by age, race, residence and payer.

scholarly journals Do Black Lives Matter in the American Public’s Mitigation Responses to the Covid-19 Pandemic? A Cross-Sectional Analysis of Mask Wearing and Racial/ethnic Disparities in Deaths from COVID-19 in the United States

2021 ◽  
Author(s):  
Berkeley Franz ◽  
Adrienne Milner ◽  
Jomills H. Braddock
Keyword(s):  
Public Health ◽  
Residential Segregation ◽  
Ethnic Disparities ◽  
The United States ◽  
Ethnic Composition ◽  
Cross Sectional ◽  
Public Health Challenges ◽  
History Of ◽  
Sectional Analysis ◽  
Racial Ethnic

Abstract Background: Anti-black and anti-Hispanic attitudes in the U.S. must be included in efforts to understand resistance to public health measures, such as mask wearing, during the COVID-19 pandemic. Focusing on the structural and individual context of racism will enable us to improve public health and better prepare for future public health challenges. The purpose of this study was to determine the relationship between mask usage, racial segregation, and racial disparities in COVID-19 deaths.Methods: We used linear regression to assess whether the racial/ethnic composition of deaths and residential segregation predicted Americans’ decisions to wear masks in July 2020. Results: After controlling for mask mandates, mask usage increased when the White death rates relative to Black and Hispanic rates increased. Conclusions: Mask wearing may be shaped by an insensitivity to Black and Hispanic deaths and a corresponding unwillingness to engage in health protective behaviors. The broader history of systemic racism and residential segregation may also explain why white Americans do not wear masks or perceive themselves to be at risk when communities of color are disproportionately affected by COVID-19.

scholarly journals Factors associated with hypertension in Pakistan: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246085
Author(s):  
Muhammad Riaz ◽  
Ghazala Shah ◽  
Muhammad Asif ◽  
Asma Shah ◽  
Kaustubh Adhikari ◽  
...  
Keyword(s):  
Public Health ◽  
Urban Areas ◽  
Health Workers ◽  
Health Concern ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Negatively Associated ◽  
Factors Associated ◽  
Health Related

Background High blood pressure is an important public health concern and the leading risk factor for global mortality and morbidity. To assess the implications of this condition, we aimed to review the existing literature and study the factors that are significantly associated with hypertension in the Pakistani population. Methods We conducted several electronic searches in PubMed, ISI Web of Science, PsycINFO, EMBASE, Scopus, Elsevier, and manually searched the citations of published articles on hypertension from May 2019 to August 2019. We included all studies that examined factors associated with hypertension regardless of the study design. To assess the quality of the research, we used the Newcastle-Ottawa Quality Assessment Scale. We also conducted meta-analyses using the DerSimonian & Laird random-effects model to collate results from at least three studies. Results We included 30 cross-sectional and 7 case-control studies (99,391 participants country-wide) in this review and found 13 (35.1%) to be high-quality studies. We identified 5 socio-demographic, 3 lifestyle, 3 health-related, and 4 psychological variables that were significantly associated with hypertension. Adults aged between 30–60 years who were married, living in urban areas with high incomes, used tobacco, had a family history of hypertension, and had comorbidities (overweight, obesity, diabetes, anxiety, stress, and anger management issues) were positively associated with hypertension. On the other hand, individuals having high education levels, normal physical activity, and unrestricted salt in their diet were negatively associated with hypertension. Conclusion We found several socio-demographic, lifestyle, health-related, and psychological factors that were significantly (positively and negatively) associated with hypertension. Our findings may help physicians and public health workers to identify high-risk groups and recommend appropriate prevention strategies. Further research is warranted to investigate these factors rigorously and collate global evidence on the same.

scholarly journals Sex differences in susceptibility, severity, and outcomes of coronavirus disease 2019: Cross-sectional analysis from a diverse US metropolitan area

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245556 ◽  
Author(s):  
Farhaan S. Vahidy ◽  
Alan P. Pan ◽  
Hilda Ahnstedt ◽  
Yashasvee Munshi ◽  
Huimahn A. Choi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Nasopharyngeal Swab ◽  
Median Income ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Time Period ◽  
Hypoxic Respiratory Failure ◽  
Comorbidity Index ◽  
Sex Disparities ◽  
Sectional Analysis

Introduction Sex is increasingly recognized as an important factor in the epidemiology and outcome of many diseases. This also appears to hold for coronavirus disease 2019 (COVID-19). Evidence from China and Europe has suggested that mortality from COVID-19 infection is higher in men than women, but evidence from US populations is lacking. Utilizing data from a large healthcare provider, we determined if males, as compared to females have a higher likelihood of SARS-CoV-2 susceptibility, and if among the hospitalized COVID-19 patients, male sex is independently associated with COVID-19 severity and poor in-hospital outcomes. Methods and findings Using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, we conducted a cross-sectional analysis of data from a COVID-19 Surveillance and Outcomes Registry (CURATOR). Data were extracted from Electronic Medical Records (EMR). A total of 96,473 individuals tested for SARS-CoV-2 RNA in nasopharyngeal swab specimens via Polymerized Chain Reaction (PCR) tests were included. For hospital-based analyses, all patients admitted during the same time-period were included. Of the 96,473 patients tested, 14,992 (15.6%) tested positive, of whom 4,785 (31.9%) were hospitalized and 452 (9.5%) died. Among all patients tested, men were significantly older. The overall SARS-CoV-2 positivity among all tested individuals was 15.5%, and was higher in males as compared to females 17.0% vs. 14.6% [OR 1.20]. This sex difference held after adjusting for age, race, ethnicity, marital status, insurance type, median income, BMI, smoking and 17 comorbidities included in Charlson Comorbidity Index (CCI) [aOR 1.39]. A higher proportion of males (vs. females) experienced pulmonary (ARDS, hypoxic respiratory failure) and extra-pulmonary (acute renal injury) complications during their hospital course. After adjustment, length of stay (LOS), need for mechanical ventilation, and in-hospital mortality were significantly higher in males as compared to females. Conclusions In this analysis of a large US cohort, males were more likely to test positive for COVID-19. In hospitalized patients, males were more likely to have complications, require ICU admission and mechanical ventilation, and had higher mortality than females, independent of age. Sex disparities in COVID-19 vulnerability are present, and emphasize the importance of examining sex-disaggregated data to improve our understanding of the biological processes involved to potentially tailor treatment and risk stratify patients.

scholarly journals PENGARUH KINERJA TERHADAP PELAKSANAAN DETEKSI PHEIC (Public Health Emergency of International Concern)

2021 ◽  
Author(s):  
Asriwati
Keyword(s):  
Public Health ◽  
Public Health Emergency ◽  
Cross Sectional

Dalam buku ini membahas tentang pengaruh kinerja terhadap pelaksanaan deteksi PHEIC padda KKP Kelas I Medan Tahun 2020. Faktor-faktor yang mempengaruhi kinerja karyawan, sangat penting untukd iperhatikan karena merupakan salah satu cara untuk meningkatkan kualitas sumber daya manusia (karyawan). Telah dilakukan kajian dengan desain kajian observasional dengan pendekatan cross sectional terhadap 56 respoden dengan menggunakan uji corelasi. Hasil kajian menunjukkan bahwa ada hubungan kinerja berdasarkan disiplin terhadap pelaksanaan deteksi PHEIC. Disarankan kepada seluruh pegawai untuk lebih menegakkan disiplin dan bagi pegawai yang melanggar ketentuan dan peraturan hendaknya dipertimbangkan dengan cermat dan teliti bahwa hukuman yang akan dijatuhkan sesuai dengan tindakan dan perilaku yang diperbuat dan adanya pengawasan yang efektif dalam meningkatkan kinerja pegawai, kepada pimpinan agar benar-benar mengawasi pekerjaan dari setiap pegawai dengan tepat tanpa menyimpang dari sistem yang dibuat dan memastikan bahwa aktivitas yang dipantau akan mencapai tujuan.

scholarly journals Health Canada’s use of expedited review pathways and therapeutic innovation, 1995–2016: cross-sectional analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e023605 ◽  
Author(s):  
Joel Lexchin
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
Cross Sectional Study ◽  
New Drugs ◽  
Cross Sectional ◽  
Time Period ◽  
Therapeutic Value ◽  
Kappa Value ◽  
Innovative Drugs ◽  
Sectional Analysis ◽  
Health Canada

ObjectivesThis study examines the use of expedited approval pathways by Health Canada over the period 1995 to 2016 inclusive and the relationship between the use of these pathways and the therapeutic gain offered by new products.DesignCross-sectional study.Data sourcesTherapeutic Products Directorate, Biologics and Genetic Therapies Directorate, Notice of Compliance database, Notice of Compliance with conditions web site, Patented Medicine Prices Review Board, La revue Prescrire, WHO Anatomical Therapeutic Chemical classification system.Primary and secondary outcomesPercent of new drugs evaluated by Health Canada that went through an expedited pathway between 1995 and 2016 inclusive. Kappa values comparing the review status with assessments of therapeutic value for individual drugs.ResultsOf 623 drugs approved by Health Canada between 1995 and 2016, 438 (70.3%) drugs went through the standard pathway and 185 (29.7%) an expedited pathway. Therapeutic evaluations were available for 509 drugs. Health Canada used an expedited approval pathway for 159 of the 509 drugs, whereas only 55 were judged to be therapeutically innovative. Forty-two of the 55 therapeutically innovative drugs received an expedited review and 13 received a standard review. The Kappa value for the entire period for all 509 drugs was 0.276 (95% CI 0.194 to 0.359) indicating ‘fair’ agreement between Health Canada’s use of expedited pathways and independent evaluations of therapeutic innovation.ConclusionHealth Canada’s use of expedited approvals was stable over the entire time period. It was unable to reliably predict which drugs will offer major therapeutic gains. The findings in this study should provoke a discussion about whether Health Canada should continue to use these pathways and if so how their use can be improved.

scholarly journals Hypertension among Young Adults in the Shopping Malls of Kathmandu

2013 ◽  
Vol 9 (1) ◽  
pp. 33-36 ◽  
Author(s):  
S Shakya ◽  
M Timilsina ◽  
K Timilsina ◽  
M Lamsal ◽  
S Dhakal ◽  
...  
Keyword(s):  
Public Health ◽  
Blood Pressure ◽  
Urban Areas ◽  
Cross Sectional Study ◽  
Shopping Malls ◽  
Cross Sectional ◽  
Health Challenge ◽  
Study Population ◽  
Public Health Challenge ◽  
And Control

Background Hypertension is a major public health challenge in the world. Developing countries share the major burden of it. Unlike thought before, hypertension is increasing among poor, young and women. Methods It was a cross sectional study carried out in The Hypertension Screening and Awareness Program conducted in the shopping malls at the heart of Kathmandu on the occasion of World Hypertension Day 2012 by Shahid Gangalal National Heart Center, Kathmandu. The blood pressure was measured according to World Heart Organization’s guideline by registered nurses. There were total 486 participants with the mean age of 29.51±10.77years. Majority of the participants were male (67.1%). Most of the participants were less or equal to 40 years (84.6%). Mean systolic blood pressure was 112.3±14.69mmHg and mean diastolic blood pressure was 75.09±11.89 mmHg. Average mean blood pressure was 87.41±12.28mmHg in the study population. Results Despite majority of participants were at young age, prevalence of hypertension was 23.7%, pre-hypertension was 30% and 46.3% had ideal blood pressure according to JNC-7 Classification. Prevalence of hypertension was higher among male (30.39% vs. 10%). Almost two third of the hypertensive subjects were less or equal to 40 years (64.35%). Awareness, treatment and control of hypertension were 39.13%, 18.26% and 7.38% respectively. Conclusion In conclusion, Hypertension is an emerging public health challenge in urban areas of Nepal. Most importantly, it may be increasing among young population. Moreover, awareness, treatment and control rates are not satisfactory. DOI: http://dx.doi.org/10.3126/njh.v9i1.8346 Nepalese Heart Journal Vol.9(1) 2012 pp.33-36

scholarly journals Private metropolitan telepsychiatry in Australia during Covid-19: current practice and future developments

2020 ◽  
Vol 28 (5) ◽  
pp. 508-510 ◽  
Author(s):  
Jeffrey CL Looi ◽  
William Pring
Keyword(s):  
Public Health ◽  
Private Practice ◽  
Current Practice ◽  
Psychiatric Care ◽  
Public Health Emergency ◽  
Face To Face ◽  
Future Developments

Objective: This paper discusses issues arising from the rapid implementation of metropolitan telepsychiatry in private practice during the Covid-19 public health emergency. Conclusions: The relatively rapid uptake of private practice metropolitan telepsychiatry may further increase flexibility of the options for appointments through ongoing broad telepsychiatry access after the Covid-19 crisis. Telepsychiatry can be used to facilitate the temporary provision of psychiatric care, and has benefits and risks, but is not a longer-term replacement for the interpersonal richness of face-to-face consultations.

Kidney Function and Anemia Prevalence in Patients with HIV Infection.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2259-2259
Author(s):  
Michael Dickson ◽  
Samir H. Mody ◽  
Brahim Bookhart ◽  
Marya Zilberberg
Keyword(s):  
General Population ◽  
Hiv Infection ◽  
Kidney Function ◽  
Recent Analysis ◽  
Hiv Patients ◽  
Cross Sectional ◽  
Time Period ◽  
Sectional Analysis ◽  
Actual Prevalence ◽  
Prevalence Of Anemia

Abstract Background: Recent guidelines from the Infectious Diseases Society of America (IDSA) for the management of Chronic Kidney Disease (CKD) in HIV+ patients highlight that up to 30% of HIV+ patients have abnormal kidney function. These guidelines also discuss the effects of CKD on HIV disease progression and the need to diagnose and manage CKD in patients with HIV. While the presence of CKD is associated with an increased rate of anemia in the general population, the prevalence of anemia among HIV patients with CKD is less well known. This is of particular importance as anemia is known to occur in at least 20% of HIV patients overall. The current analysis was undertaken to determine the distribution of kidney function levels among HIV patients and to stratify anemia risk based on these levels. Methods: In a retrospective cross-sectional analysis of data collected between 1996 and 2004 from an integrated, commercial database of claims and laboratory values, subjects with HIV infection designated by ICD-9 code were identified. Subjects were included if they were at least 17.5 years old and had at least 1 value during this time period for plasma creatinine (PCr), serum urea nitrogen (SUN), albumin (Alb) and hemoglobin (Hb). If a subject had multiple lab values recorded, only the most recent lab value was utilized for the analysis. Subjects with any diagnosis or procedure code pertaining to dialysis were excluded. Kidney function was assessed by glomerular filtration rate (GFR) and calculated using the modification of diet in renal disease (MDRD) method as follows: GFR= 170 x [PCr]−0.999 x [Age] −0.176 x [SUN] −0.170 x [Alb]+0.318 x [0.762 if female] x [1.18 if black]. Since race was not reported in the database, this parameter was not included in the calculation. Anemia was defined as Hb <13 g/dL for men; <12 g/dL for women. Results: Of the 2,032 subjects identified with HIV, 840 (41%) met the inclusion criteria. The mean age of these subjects was 43.7±12.6 years; 72% were male; mean Hb was 14.3±1.6 g/dL. Mean GFR was 91.1±21.1 mL/min/1.73m3. See Table 1 for the incidence of anemia associated with increasing severity of CKD. Conclusions: Overall prevalence of GFR <90 mL/min/1.73m3 among HIV patients was 48.5%. This is similar to the 43.5% demonstrated in a recent analysis of HIV patients,1 and higher than the 35.9% seen in the general population.2 It may, however, be an overestimate of the actual prevalence of CKD, since race was not analyzed. In addition, patients with GFRs ≥ 60 mL/min/1.73m3 require data on proteinuria to diagnose CKD. As is the case in the general population, anemia increases in prevalence with severity of CKD. Anemia in either CKD or HIV patients is associated with increased morbidity and mortality3,4; therefore, a prompt diagnosis of anemia is warranted, as it may impact clinical treatments and outcomes in this population. Table 1: Incidence of anemia associated with worsening GFR GFR (mL/min/1.73m3)* N (%) Anemia N (% total) *lower values mean worsening kidney function. ≥ 90 433 (51.5) 52 (12) 60–89 359 (42.7) 32 (9) 30–59 44 (5.3) 11 (25) 15–29 4 (0.5) 3 (75) <15 0 0

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