Acute respiratory infections in children from a deprived urban population from Uruguay

To obtain base line data on incidence, duration, clinical characteristics and etiology of acute respiratory infections (ARI), 276 children from deprived families living in Montevideo were followed during 32 months. The target population was divided into two groups for the analysis of the results: children aged less than 12 months and those older than this age. During the follow-up period 1.056 ARI episodes were recorded. ARI incidence was 5.2 per child/year. It was 87% higher in infants than in the older group, as was the duration of the episodes. Most of the diseases were mild. Tachypnea and retractions were seldom observed, but 12 children were refered to the hospital, and 2 infants died. Viral etiology was identified in 15.3% of the episodes. RSV was the predominant agent producing annual outbreaks. Moderate to heavy colonization of the upper respiratory tract by Streptococcus pneumoniae (32.3%) and Hemophilus sp. (18.9%) was recorded during ARI episodes. This community-based study furnish original data on ARI in Uruguay. It enabled to asses the impact of these infections on childhood.

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Difficulties encountered in a community-based study of acute respiratory infections in Uruguay

Revista de Saúde Pública ◽

10.1590/s0034-89101993000200008 ◽

1993 ◽

Vol 27 (2) ◽

pp. 123-126 ◽

Cited By ~ 2

Author(s):

Maria Hortal ◽

Miguel Meny

Keyword(s):

Developing Countries ◽

Population Dynamics ◽

Cohort Study ◽

Respiratory Infections ◽

Target Population ◽

Acute Respiratory Infections ◽

Community Based ◽

Extensive Experience ◽

Methodological Problems ◽

And Coping

A cohort study on acute respiratory infections, involving 270 children observed by pediatricians in their homes every 10 days over a period of 32 months, gave the opportunity to experience logistic and methodological problems seldom described in the literature. The purpose of this article is to alert researchers as to the difficulties faced when performing community-based studies in developing countries. Although a carefully planned project was undertaken, problem areas included the establishment of the target population, population dynamics, field related problems, laboratory aspects and data management. It is hoped that other investigators may benefit from the extensive experience gained from our program in foreseeing and coping with the difficulties involved.

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The Effect of Javanese Language Videos with a Community Based Interactive Approach Method as an Educational Instrument for Knowledge, Perception, and Adherence amongst Tuberculosis Patients

Pharmacy ◽

10.3390/pharmacy9020086 ◽

2021 ◽

Vol 9 (2) ◽

pp. 86

Author(s):

Fauna Herawati ◽

Yuni Megawati ◽

Aslichah ◽

Retnosari Andrajati ◽

Rika Yulia

Keyword(s):

Intervention Group ◽

Personal Control ◽

Control Group ◽

P Value ◽

Interactive Approach ◽

Community Based ◽

Tuberculosis Patients ◽

Level Of Knowledge ◽

The Impact

The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective.

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141. Implementation of Veterans Affairs Outpatient Antimicrobial Stewardship Interventions for Asymptomatic Bacteriuria and Acute Respiratory Infections, a Stepped Wedge Randomized Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.186 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S81-S82

Author(s):

Grace Mortrude ◽

Mary Rehs ◽

Katherine Sherman ◽

Nathan Gundacker ◽

Claire Dysart

Keyword(s):

Patient Satisfaction ◽

Primary Outcome ◽

Respiratory Infections ◽

Asymptomatic Bacteriuria ◽

Educational Interventions ◽

Antibiotic Prescribing ◽

Acute Respiratory Infections ◽

Stepped Wedge ◽

Post Intervention ◽

The Impact

Abstract Background Outpatient antimicrobial prescribing is an important target for antimicrobial stewardship (AMS) interventions to decrease antimicrobial resistance in the United States. The objective of this study was to design, implement and evaluate the impact of AMS interventions focused on asymptomatic bacteriuria (ASB) and acute respiratory infections (ARIs) in the outpatient setting. Methods This randomized, stepped-wedge trial evaluated the impact of educational interventions to providers on adult patients presenting to primary care (PC) clinics for ARIs and ASB from 10/1/19 to 1/31/20. Data was collected by retrospective chart review. An antibiotic prescribing report card was provided to PC providers, then an educational session was delivered at each PC clinic. Patient education materials were distributed to PC clinics. Interventions were made in a step-wise (figure 1) fashion. The primary outcome was percentage of overall antibiotic prescriptions as a composite of prescriptions for ASB, acute bronchitis, upper-respiratory infection otherwise unspecified, uncomplicated sinusitis, and uncomplicated pharyngitis. Secondary outcomes included individual components of the primary outcome, a composite safety endpoint of related hospital, emergency department or primary care visit within 4 weeks, antibiotic appropriateness, and patient satisfaction surveys. Figure 1 Results There were 887 patients included for analysis (405 pre-intervention, 482 post-intervention). Baseline characteristics are summarized in table 1. After controlling for type 1 error using a Bonferroni correction the primary outcome was not significantly different between groups (56% vs 49%). There was a statistically significant decrease in prescriptions for bronchitis (20.99% vs 12.66%; p=0.0003). Appropriateness of prescriptions for sinusitis (OR 4.96; CI 1.79–13.75; p=0.0021) and pharyngitis (OR 5.36; CI 1.93 – 14.90; p=0.0013) was improved in the post-intervention group. The composite safety outcome and patient satisfaction survey ratings did not differ between groups. Table 1 Conclusion Multifaceted educational interventions targeting providers can improve antibiotic prescribing for indications rarely requiring antimicrobials without increasing re-visit or patient satisfaction surveys. Disclosures All Authors: No reported disclosures

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Follow-up services for delirium after COVID-19—where now?

Age and Ageing ◽

10.1093/ageing/afab014 ◽

2021 ◽

Author(s):

Shibley Rahman ◽

Kit Byatt

Keyword(s):

Service Utilisation ◽

Sustainable Business ◽

Community Based ◽

Care And Support ◽

Early Supported Discharge ◽

Business Cases ◽

Older Inpatients ◽

The Impact

Abstract Delirium is a common presentation in older inpatients with coronavirus disease 2019 (COVID-19), and a risk factor for cognitive decline at discharge. The glaring gaps in the service provision in delirium care, regardless of aetiology, after a hospital admission pre-existed the pandemic, but the pandemic arguably offers an opportunity now to address them. Whilst a delirium episode in itself is not a long-term condition, the context of it may well be, and therefore patients might benefit from personalised care and support planning. There is no reason to believe that the delirium following COVID-19 is fundamentally different from any other delirium. We propose that the needs of older patients who have experienced delirium including from COVID-19 could be addressed through a new model of post-acute delirium care that combines early supported discharge, including discharge-to-assess, with community-based follow-up to assess for persistent delirium and early new long-term cognitive impairment. Such a drive could be structurally integrated with existing memory clinic services. To succeed, such an ambition has to be flexible, adaptable and person-centred. To understand the impact on resource and service utilisation, techniques of quality improvement should be implemented, and appropriate metrics reflecting both process and outcome will be essential to underpin robust and sustainable business cases to support implementation of delirium care as a long-term solution.

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The Project TALENT Twin and Sibling Study

Twin Research and Human Genetics ◽

10.1017/thg.2012.71 ◽

2012 ◽

Vol 16 (1) ◽

pp. 437-448 ◽

Cited By ~ 5

Author(s):

Carol A. Prescott ◽

Deanna Lyter Achorn ◽

Ashley Kaiser ◽

Lindsey Mitchell ◽

John J. McArdle ◽

...

Keyword(s):

Genetic Research ◽

Original Data ◽

Family Characteristics ◽

Shared Environment ◽

Occupational Outcomes ◽

School Based ◽

The Family ◽

Specific Factors ◽

The Impact

Project TALENT is a US national longitudinal study of about 377,000 individuals born in 1942–1946, first assessed in 1960. Students in about 1,200 schools participated in a 2-day battery covering aptitudes, abilities, interests, and individual and family characteristics (Flanagan, 1962; www.projectTALENT.org). Follow-up assessments 1, 5, and 11 years later assessed educational and occupational outcomes. The sample includes approximately 92,000 siblings from 40,000 families, including 2,500 twin pairs and 1,200 other siblings of twins. Until recently, almost no behavior genetic research has been conducted with the sample. In the original data collection information was not collected with the intent to link family members. Recently, we developed algorithms using names, addresses, birthdates, and information about family structure to link siblings and identify twins. We are testing several methods to determine zygosity, including use of yearbook photographs. In this paper, we summarize the design and measures in Project TALENT, describe the Twin and Sibling sample, and present our twin-sib-classmate model. In most twin and family designs, the ‘shared environment’ includes factors specific to the family combined with between-family differences associated with macro-level variables such as socioeconomic status. The school-based sampling design used in Project TALENT provides a unique opportunity to partition the shared environment into variation shared by siblings, specific to twins, and associated with school- and community-level factors. The availability of many measured characteristics on the family, schools, and neighborhoods enhances the ability to study the impact of specific factors on behavioral variation.

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Enhanced surveillance for covid-19 response in Lagos State, Nigeria: lessons learnt, 2020 (Preprint)

10.2196/preprints.33075 ◽

2021 ◽

Author(s):

Gregory Chukwuemeka Umeh ◽

Khalid Abubakar ◽

Peter Akinmusire ◽

Adamu M. Isa ◽

Aminu Zauro ◽

...

Keyword(s):

Service Industry ◽

Respiratory Infections ◽

Health Facilities ◽

Acute Respiratory Infections ◽

Surveillance Strategy ◽

Active Case ◽

Governmental Organizations ◽

Significant Difference ◽

Lagos State ◽

The Impact

BACKGROUND The SARS-CoV-2, the novel virus which causes the coronavirus disease (COVID-19), has changed the world. No aspect of humanity is untouched from health, aviation, service industry, politics, economy, education, and entertainment to social and personal lives, since the outbreak of influenza-like illness in Wuhan, China, in December 2019. The Lagos State COVID-19 response team deployed enhanced surveillance through Active Case Search (ACS) for Acute Respiratory Infections (ARI) at health facilities and communities in the 20 Local Government Areas (LGAs) of Lagos State. Lagos State was the first state in Nigeria to deploy this specific surveillance strategy for Nigeria’s COVID-19 response. OBJECTIVE We documented the methods, findings, and review of the active case search for acute respiratory infections, part of COVID-19 response in 20 LGAs of Lagos State, between 1st April and 15th May 2020. METHODS We utilized descriptive and quantitative approaches to describe and assess the impact of the Active Case Search (ACS) for Acute Respiratory Infections (ARI) in health facilities and communities in 20 LGAs of Lagos State between 1st April and 15th May 2020. RESULTS We found a significant difference in mean scores of suspected COVID-19 cases (M=60, SD=109, before ACS for ARI compared to M=568, SD=732, after ACS for ARI, P=0.0039), confirmed cases (M=10, SD=19, before ACS for ARI compared to M=144, SD=187, after ACS for ARI, P=0.0028) and contacts (M=56, SD=116, before ACS for ARI compared to M=152, SD=177, after ACS for ARI, P=0.044) before and after ACS for ARI in 20 LGAs of Lagos State, between 1st April and 15th May 2020. CONCLUSIONS The deployment of the Lagos State government’s polio-eradication structure for the COVID-19 response is both innovative and effective. The response to COVID-19 requires robust surveillance, credible and timely communication, collaboration, coordination among government, inter-governmental organizations (e.g., WHO), non-governmental organizations, and citizens to succeed and limit the medical, economic, social, and personal losses to the COVID-19 pandemic.

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Community-based aftercare following an emergency department presentation for attempted suicide or high risk for suicide: study protocol for a non-randomised controlled trial

BMC Public Health ◽

10.1186/s12889-019-7751-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Vida V. Bliokas ◽

Alex R. Hains ◽

Jonathan A. Allan ◽

Luise Lago ◽

Rebecca Sng

Keyword(s):

Emergency Department ◽

High Risk ◽

Suicide Attempt ◽

Repeated Measures ◽

Hospital Emergency Department ◽

Hospital Emergency ◽

Community Based ◽

Treatment As Usual ◽

The Impact

Abstract Background Suicide is a major public health issue worldwide. Those who have made a recent suicide attempt are at high risk for dying by suicide in the future, particularly during the period immediately following departure from a hospital emergency department. As such the transition from hospital-based care to the community is an important area of focus in the attempt to reduce suicide rates. There is a need for evaluation studies to test the effectiveness of interventions directed to this stage (termed ‘aftercare’ interventions). Methods A controlled non-randomised two group (intervention vs treatment-as-usual control) design, using an intention-to-treat model, will evaluate the effectiveness of a suicide prevention aftercare intervention providing follow-up after presentations to a hospital emergency department as a result of a suicide attempt or high risk for suicide. The intervention is a community-based service, utilising two meetings with a mental health clinician and follow-up contacts by peer workers via a combination of face-to-face and telephone for four weeks, with the option of extension to 12 weeks. Seventy-five participants of the intervention service will be recruited to the study and compared to 1265 treatment-as-usual controls. The primary hypotheses are that over 12 months, those who participate in the aftercare follow-up intervention are less likely than controls to present to a hospital emergency department for a repeat suicide attempt or because of high risk for suicide, will have fewer re-presentations during this period and will have lower all-cause mortality. As a secondary aim, the impact of the intervention on suicide risk factors for those who participate in the service will be evaluated using pre- and post-intervention repeated measures of depression, anxiety, stress, hopelessness, belongingness, burdensomeness, and psychological distress. Enrolments into the study commenced on 1 November 2017 and are anticipated to cease in November 2019. Discussion The study aims to contribute to the understanding of effective interventions for individuals who have presented to a hospital emergency department as a result of a suicide attempt or at high risk for suicide and provide evidence in relation to interventions that incorporate peer-workers. Trial registration ACTRN12618001701213. Registered on 16 October 2018. Retrospectively registered.

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