Socioeconomic and Demographic Factors Contributing to COVID-19–Related Delays and Reductions in Primary Retinal Detachment Repair in a US Hot Spot

Purpose: This work evaluates demographic and socioeconomic predictors of delayed care for rhegmatogenous retinal detachments (RRDs) during the spring 2020 COVID-19 shutdown in a US hot spot. Methods: This multicenter, retrospective, case-control study took place in 3 academic vitreoretinal practices in metropolitan Boston. Consecutive patients treated for RRD during the COVID-19 state of emergency were compared with patients treated during the same period in 2018 and 2019. The primary outcome was macula status for RRD. Secondary outcomes included visual acuity, symptom duration, proportion with proliferative vitreoretinopathy, time to procedure, method of repair, and patient demographics. Results: The total number of acute RRD decreased by 13.7% from 2018 to 2020 and 17.2% from 2019 to 2020. Symptom duration was significantly longer in 2020 than 2018 and 2019 (median, 7 vs 4 days) with a higher proportion of macula-off detachments (80 of 125 [64%] in 2020 vs 75 of 145 [51.7%] in 2018 and 78 of 151 [51.6%] in 2019). The 2020 cohort included significantly fewer patients in the racial and/or ethnic minority group than in 2019 ( P = .02), and use of low-income, government-sponsored health insurance was a predictor of macula-off status during the pandemic ( P = .04). Conclusions: RRDs during the spring 2020 COVID-19 lockdown were more likely to be macula-off at presentation. Because sociodemographic factors including race, ethnicity, and income level were associated with deferral of care, ophthalmologists should consider measures targeting vulnerable populations to avoid preventable vision loss as the pandemic continues or in future health care emergencies.

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Interaction analysis of Mycobacterium tuberculosis between host environment and highly mutated genes from population genetic structure comparison

10.21203/rs.3.rs-42506/v1 ◽

2020 ◽

Author(s):

Zhezhe Cui ◽

Dingwen Lin ◽

Yue Chang ◽

Jing Ou ◽

Liwen Huang

Keyword(s):

Mycobacterium Tuberculosis ◽

Low Income ◽

Hot Spots ◽

Interaction Analysis ◽

Hot Spot ◽

Minority Group ◽

Independent Effect ◽

Cold Spot ◽

Structure Comparison ◽

Significant Difference

Abstract ObjectiveWe aimed to investigate the genetic and demographic differences and interactions between areas where observed genomic variations in Mycobacterium tuberculosis (M. Tb) are distributed uniformly in cold and hot spots. MethodsThe cold and hot spot areas were identified using the reported incidence of TB over the previous 5 years. Whole genome sequencing was performed on 291 M. tb isolates between January and June 2018. Analysis of molecular variance (AMOVA) and a multifactor dimensionality reduction (MDR) model was applied to test gene-gene-environment interactions. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were computed to test the extent to which genetic mutation affects the TB epidemic using a multivariate logistic regression model. ResultsThe percentage of the Beijing family strain in hot spots was significantly higher than that in cold spots (64.63% vs 50.69%, p = 0.022), among elderly, people from an ethnic minority group, those with a low income, low BMI and those having a history of contact with a TB patient (all p < 0.05).. Individuals from cold spot areas had a higher frequency of out-of-town travelling (p < 0.05). The mutation of Rv1186c, Rv3900c, Rv1508c, Rv0210 and a Intergenic Region (SNP site: 3847237) showed a significant difference between cold and hot spots. (p < 0.001). The best MDR model displayed a clear negative interaction effect of ethnicity with income (interaction entropy: -7.08%), mutation of Rv1186c (interaction entropy: -5.62%) and mutation of SNP position Rv0210 (interaction entropy: -4.26%). Through income, mutation of Rv1186c and mutation of Rv0210 had a low independent effect.ConclusionOur data suggests a statistically significant role of ethnicity, income and the polymorphisms of Rv1186c and Rv0210 genes in the transmission and development of M. tb. The results provide clues for the study of susceptibility genes of M. tb in different ethnic groups.

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Faculty Opinions recommendation of Primary care referral of patients with low back pain to physical therapy: impact on future health care utilization and costs.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717969063.793468611 ◽

2013 ◽

Author(s):

Steven George ◽

Jason Beneciuk

Keyword(s):

Primary Care ◽

Health Care ◽

Low Back Pain ◽

Back Pain ◽

Physical Therapy ◽

Health Care Utilization ◽

Care Utilization ◽

Low Back ◽

Future Health ◽

Future Health Care

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1707. Clinical Profile of Human T-Lymphotropic Virus Type I Infection in Pediatric Population in a Referral Hospital in Colombia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1885 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S836-S837

Author(s):

Juliana Mejia- Mertel ◽

Juan P Rojas -Hernandez

Keyword(s):

Virus Type ◽

Low Income ◽

Pacific Coast ◽

Vision Loss ◽

Pediatric Population ◽

Clinical Manifestations ◽

Low Income Countries ◽

Nutritional Deficiencies ◽

Type I ◽

T Lymphotropic Virus

Abstract Background The Human T-lymphotropic virus type 1 (HTLV-1), affects around ten to twenty million people worldwide, predominantly in intertropical regions (Africa, Japan, Melanesia, Australia, and South America Pacific Coast). The most common disorders associated are T-cell leukemia/lymphoma (ALT) and HTLV-1-associated myelopathy (HAM). Studies have reported other clinical manifestations in HTLV-1, still studies are needed in pediatric population to improve diagnosis and treatment of infected patients. Methods Descriptive, retrospective cohort study, conducted in our referral pediatric hospital in Cali, Colombia. Included pediatric patients (1 to 18 years of age) diagnosed with HTLV-1 infection, between January 2017 to March 2020. Results Twelve patients were included, seven males and five females. Eleven patients were from and resided in the Colombian Pacific coast. Ten patients showed nutritional deficiencies. None showed clinical or laboratory signs of ALT, neither neurological symptoms or physical exam suggesting HAM. In terms of associated diseases and opportunistic infections, none had a positive HIV ELISA test, and stool tests were all negative for Strongiloydes. Four presented infective dermatitis, and two showed lesions suggesting scabies. Eight patients presented respiratory symptoms with chest CT scans showing signs of chronic inflammation, bronchiectasis, and subpleural bullae as the major findings. Additional tests were carried out in bronchoalveolar fluid, four had positive galactomannan test,suggesting pulmonary aspergillosis, two exhibited positive gene PCR testing for Mycobacterium tuberculosis. Regarding inflammatory diseases, one patient presented with symptoms of Inflammatory Bowl Disease, with biopsy confirming Crohn’s disease. Another patient presente abrupt vision loss, diagnosed with Vogt Koyanagi Hadara Syndrome after ophthalmological evaluation. Summary features HTLV-1 patients Ground-glass opacity diffusely distributed in both lungs with multiple bronchiectasis involving predominantly lung bases. Cystic images diffusely distributed in both lungs, some subpleural and other centrilobular. Conclusion It is important to consider alternative manifestations of HTLV-1 infection in the pediatric population, including pulmonary disease, opportunistic co-infections, and inflammatory disorders. It is crucial to diagnose this disease in childhood to reach a better control of this neglected infection that affects predominantly vulnerable population in low-income countries. Disclosures All Authors: No reported disclosures

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Acceptance of a COVID-19 Vaccine in Japan during the COVID-19 Pandemic

Vaccines ◽

10.3390/vaccines9030210 ◽

2021 ◽

Vol 9 (3) ◽

pp. 210

Author(s):

Masaki Machida ◽

Itaru Nakamura ◽

Takako Kojima ◽

Reiko Saito ◽

Tomoki Nakaya ◽

...

Keyword(s):

Low Income ◽

Multiple Logistic Regression Analysis ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Internet Survey ◽

Protective Measure ◽

Attitudes And Beliefs ◽

Perceived Effectiveness ◽

Cross Sectional ◽

Vaccine Acceptance

Vaccination could be a key protective measure against coronavirus disease 2019 (COVID-19), and it is important to understand the acceptability of the COVID-19 vaccine among the general public. However, there is no study on the acceptance of a COVID-19 vaccine in Japan. Therefore, this study aimed to describe the COVID-19 vaccine acceptance and hesitancy situation in Japan and assess the factors associated with such issues. This was a cross-sectional study based on an internet survey completed by 2956 people. Participants were asked to indicate how likely they were to get vaccinated for COVID-19. In addition, the participants responded to questions regarding sociodemographic factors, attitudes, and beliefs regarding COVID-19 infection and vaccination. The proportion of participants with a high likelihood of getting a COVID-19 vaccine was 62.1%. Multiple logistic regression analysis showed that vaccine acceptance was lower among several sociodemographic groups, such as women, adults aged 20–49 years, and those with a low-income level. Several psychological factors, especially the perceived effectiveness of the COVID-19 vaccine, and willingness to protect others by getting oneself vaccinated, were associated with vaccine acceptance. Our results indicate that the perceived effectiveness of the vaccine and willingness to protect others may play an important role in the acceptance of the COVID-19 vaccine.

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The effects of disease-related knowledge on illness perception and psychological status of patients with COVID-19 in Hunan, China

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.33 ◽

2021 ◽

pp. 1-30

Author(s):

Man Ye ◽

Shi-hao Chen ◽

Xu-ting Li ◽

Jin Huang ◽

Ran-ran Mei ◽

...

Keyword(s):

Low Income ◽

Illness Perception ◽

Self Care ◽

The Elderly ◽

Diagnosis And Treatment ◽

Psychological Status ◽

Current Status ◽

Average Score ◽

Future Health ◽

Cross Sectional

Abstract OBJECTIVE: To assess the current status of disease-related knowledge and to analyze the relationship among the general condition, illness perception, and psychological status of patients with COVID-19. METHODS: A hospital-based cross-sectional study was conducted on 118 patients using convenience sampling. The general questionnaire, disease-related knowledge questionnaire of COVID-19, Revised Illness Perception Questionnaire (IPQ-R), and Profile of Mood States (POMS) were used to measure the current status of participants. RESULTS: The overall average score of the disease-related knowledge of patients with COVID-19 was (79.19 ± 14.25), the self-care situation was positively correlated with knowledge of prevention and control (r=0.265, P=0.004) and total score of disease-related knowledge (r= 0.206, P= 0.025); the degree of anxiety was negatively correlated with the knowledge of diagnosis and treatment (r= -0.182, P= 0.049). The score of disease-related knowledge was negatively correlated with negative cognition (volatility, consequences, emotional statements) and negative emotions (tension, fatigue, depression) (P<0.05); positively correlated with positive cognition (disease coherence) and positive emotion (self-esteem) (P<0.05). CONCLUSION It was recommended that we should pay more attention to the elderly and low-income groups, and increase the knowledge about diagnosis and treatment of COVID-19 and self-care in the future health education for patients.

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Investigating Sustainable Commuting Patterns by Socio-Economic Factors

Sustainability ◽

10.3390/su13042180 ◽

2021 ◽

Vol 13 (4) ◽

pp. 2180 ◽

Cited By ~ 1

Author(s):

Woo Jang ◽

Fei Yuan ◽

Jose Javier Lopez

Keyword(s):

Low Income ◽

Older Workers ◽

Central City ◽

Minority Group ◽

Primary Data ◽

Economic Factors ◽

Group Status ◽

Multiple Variables ◽

Commuting Patterns ◽

Socio Economic Factors

This research aims to analyze how modes of transportation differ according to socio-economic factors in an urban space. The study area is Ramsey County, the most densely populated county in Minnesota. The primary data used were from the recent 2012–2016 Census Transportation Planning Products (CTPP). We performed regression models to identify the relationship between mode of transport and socio-economic variables, and further analyzed disaggregate trip data to provide a more realistic evaluation of commuting patterns by use of multiple variables in combination. The research found that sustainable commuting patterns correlated significantly with both poverty and minority group status, but bore no significant relationship to older workers. Additionally, there was a significant correlation between commuting alone by car with both minority group status and older workers, but not with poverty. This research also confirmed that the sustainable commuting patterns of the working poor were mostly located in the downtown area, while causes of low-income workers driving alone typically involved much longer commutes to and from points throughout the study area, suggesting that more efficient commutes are a significant quality of life factor for the urban poor when evaluating residential and employment opportunities in the central city.

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Indigenous Workers as a Crucial Link in the Total Support System for Low-Income, Minority Group Aged: A Report of an Innovative Field Technique in Survey Research

Aging and Human Development ◽

10.2190/ag.2.3.c ◽

1971 ◽

Vol 2 (3) ◽

pp. 189-196 ◽

Cited By ~ 3

Author(s):

Donald P. Kent ◽

Carl Hirsch ◽

Sylvia K. Barg

Keyword(s):

Survey Research ◽

Support System ◽

Low Income ◽

Minority Group ◽

Field Technique

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YOUR FUTURE HEALTH CARE

Psychiatric Annals ◽

10.3928/0048-5713-19740901-11 ◽

1974 ◽

Vol 4 (9) ◽

pp. 79-79

Author(s):

Anonymous

Keyword(s):

Health Care ◽

Future Health ◽

Future Health Care

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Measuring reopening readiness: a universal COVID-19 index for US states

Library Hi Tech ◽

10.1108/lht-03-2021-0115 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Eunju Suh ◽

Mahdi Alhaery

Keyword(s):

Health Care ◽

Health Care Services ◽

Future Health ◽

Content Type ◽

Counter Measures ◽

Care Services ◽

Future Health Care ◽

Pandemic Severity ◽

Occupancy Rates ◽

Bed Occupancy Rates

PurposeWhile United States is among countries with the world’s highest coronavirus infections, its approaches and policies to reopen the economy vary by state. A lack of objective criteria and monitoring toward satisfying the criteria can lead to another COVID-19 outbreak and business closures. Considering the pressing need to return to normalcy without a rebound of COVID-19 infections and deaths, an index that provides a data-driven and objective insight is urgently needed. Hence, a method was devised to assess the severity of the COVID-19 pandemic and determine the degree of progress any state has made in containing the spread of COVID-19.Design/methodology/approachUsing measures such as the weekly averages of daily new deaths, ICU bed occupancy rates, positive cases and test positivity rates, two indexes were developed: COVID-19 reopening readiness and severity.FindingsA clear difference in the pandemic severity trends can be observed between states, which is possibly due to the disparity in the state’s response to coronavirus. A sharp upward trend in index values requires caution prior to moving to the next phase of reopening.Originality/valueThe composite indexes advanced in this study will provide a universal, standardized and unbiased view of each state’s readiness to reopen and allow comparisons between states. This in turn can help governments and health-care agencies take counter measures if needed as to the anticipated demand for future health-care services and minimize adverse consequences of opening.

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