scholarly journals A Global Study of COVID-19 Vaccination Intentions: The Role of Personal Experiences and Risk Perceptions

2021 ◽  
Author(s):  
Kaitlyn Akel ◽  
Grace Noppert ◽  
Yogambigai Rajamoorthy ◽  
Yihan Lu ◽  
Awnish Singh ◽  
...  
Keyword(s):  
Family Member ◽  
Risk Perceptions ◽  
Influential Factors ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Personal Experiences ◽  
The Us ◽  
Personal Diagnosis ◽  
Vaccine Decision Making ◽  
The Impact

Abstract Background The COVID-19 pandemic presents an opportunity to assess the impact of personal experiences on vaccine decision-making. The aim of this study was to examine the associations between experiences with COVID-19 and intention to vaccinate against COVID-19. Methods We administered 28 repeated cross-sectional, online surveys between June 2020 and June 2021 in the US and Asia. The main exposures were three types of experiences: COVID-19 diagnosis, knowing a friend/family member with COVID-19, and exposures to media containing COVID-19 patients. A series of logistic regression models estimated the association between each experience and acceptance of a hypothetical COVID-19 vaccine. We also explored perceived susceptibility as a potential mediator. Results Intent to vaccinate was lowest in the US and Taiwan, and highest in India, Indonesia, and China. Personal diagnosis with COVID-19 had the greatest impact on intentions to vaccinate across country sites compared to those who experienced a friend or family member diagnosed with COVID-19 or exposures to personal stories reported through media. In India participants that reported a personal diagnosis with COVID-19 had 12.95 times the odds (95% CI: 4.89, 34.28) of accepting a COVID-19 vaccine compared to those with no diagnosis. Higher risk perceptions were associated with higher intention to vaccinate against COVID-19. Conclusions Proximity and seriousness of experiences are influential factors for intention to vaccinate against COVID-19. This study highlights the numerous ways in which pandemic experiences may influence intention to vaccinate against COVID-19 across geographies and cultures, where the course of the pandemic differed.

Do Hospitals with a Higher Level of Maternal Care Designation Have Better Maternal Outcomes?

2018 ◽  
Vol 36 (06) ◽  
pp. 653-658 ◽  
Author(s):  
Sindhu Srinivas ◽  
Katy Kozhimannil ◽  
Peiyin Hung ◽  
Laura Attanasio ◽  
Judy Jou ◽  
...  
Keyword(s):  
High Risk ◽  
Maternal Care ◽  
Maternal Morbidity ◽  
Cross Sectional Study ◽  
Severe Maternal Morbidity ◽  
Maternal Outcomes ◽  
Cross Sectional ◽  
Discharge Data ◽  
Logistic Regression Models ◽  
The Impact

Background A recent document by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine introduced the concept of uniform levels of maternal care (LMCs). Objective We assessed LMC across hospitals and measured their association with maternal morbidity, focusing on women with high-risk conditions. Study Design We collected data from hospitals from May to November 2015 and linked survey responses to Statewide Inpatient Databases (SID) hospital discharge data in a retrospective cross-sectional study of 247,383 births admitted to 236 hospitals. Generalized logistic regression models were used to examine the associations between hospitals' LMC and the risk of severe maternal morbidity. Stratified analyses were conducted among women with high-risk conditions. Results High-risk pregnancies were more likely to be managed in hospitals with higher LMC (p < 0.001). Women with cardiac conditions had lower odds of maternal morbidity when delivered in level I compared with level IV units (adjusted odds ratio: 0.29; 95% confidence interval: 0.08–0.99; p = 0.049). There were no other significant associations between the LMC and severe maternal morbidity. Conclusion A higher proportion of high-risk pregnancies were managed within level IV units, although there was no overall evidence that these births had superior outcomes. Further prospective evaluation of LMC designation with patient outcomes is necessary to determine the impact of regionalization on maternal outcomes.

Support for cigarette filter waste policies among US adults

2021 ◽  
pp. tobaccocontrol-2020-056451
Author(s):  
Minal Patel ◽  
Alison F Cuccia ◽  
Shanell Folger ◽  
Adam F Benson ◽  
Donna Vallone ◽  
...  
Keyword(s):  
Smoking Status ◽  
Population Based ◽  
Tobacco Product ◽  
Cross Sectional ◽  
Cigarette Filter ◽  
Logistic Regression Models ◽  
Knowledge And Beliefs ◽  
Cigarette Butts ◽  
Using Data ◽  
The Impact

IntroductionLittle is known on whether cigarette filter-related knowledge or beliefs are associated with support for policies to reduce their environmental impact.MethodsA cross-sectional, population-based sample of US adults aged 18–64 years (n=2979) was used to evaluate filter-related knowledge and beliefs by smoking status using data collected between 24 October 2018 and 17 December 2018. Multivariate logistic regression models explored whether these knowledge and belief items were associated with support for two policies, a US$0.75 litter fee and a ban on sales of filtered cigarettes, controlling for demographic characteristics and smoking status.ResultsRegardless of smoking status, 71% did not know plastic was a cigarette filter component and 20% believed filters were biodegradable. Overall, 23% believed filters reduce health harms and 60% believed filters make it easier to smoke; 90% believed cigarette butts are harmful to the environment. Individuals believing cigarette butts harmed the environment were more likely to support a litter fee (adjusted OR (aOR)=2.33, 95% CI: 1.71 to 3.17). Individuals believing that filters are not biodegradable had higher odds of supporting a litter fee (OR=1.47, 95% CI: 1.15 to 1.88). Respondents believing that filters do not make cigarettes less harmful were more likely to support a litter fee (aOR=1.50, 95% CI: 1.20 to 1.88) and filter ban (aOR=2.03, 95% CI: 1.64 to 2.50). Belief that filters make it easier to smoke was associated with decreased support for a filter ban (aOR=0.69, 95% CI: 0.58 to 0.83).ConclusionsComprehensive efforts are needed to educate the public about the impact of cigarette filters in order to build support for effective tobacco product waste policy.

scholarly journals Regional Innovation Systems of Medical Technology

REGION ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 57-81
Author(s):  
Rucha Vadia ◽  
Katharina Blankart
Keyword(s):  
Knowledge Production ◽  
Spillover Effects ◽  
External Funding ◽  
Regional Innovation ◽  
Cross Sectional ◽  
Horizon 2020 ◽  
Product Categories ◽  
The Us ◽  
Number Of Publications ◽  
The Impact

We investigated the role of external funding in cardiovascular device innovation across 31 countries in Europe. We rely on the knowledge production function (KPF) framework that establishes the knowledge output of a region as a function of innovatory effort and other characteristics of that region. In a cross-sectional analysis, we investigated regional variation in knowledge production by the number of publications in cardiovascular device research obtained from the bibliometric data of the world’s largest biomedical library, the US National Library of Medicine, 2014‒2017. We mapped these publications to product categories of medical devices approved for cardiovascular diseases by the US Food and Drug Administration. Considering spatial correlation across regions of Europe in our estimates of the KPF, we investigated the impact of two types of funding mechanisms: grants reported in the publications and the volume of European Union Horizon 2020 funding received by the innovating regions. We obtained 123,487 cardiovascular device-related publications distributed across 1,051 (75% of total) regions (NUTS-3 level). Receiving external funding strongly contributes to a region’s knowledge output. The estimated elasticities of innovatory effort range between 0.51 and 0.64. These estimates were consistently larger than the elasticities of other characteristics in the region measured by gross domestic product (0.14‒0.56). We also documented spillover effects from neighboring regions when the funding was measured by the grants reported in the publications, concluding that innovatory efforts in the form of external research investments are effective for promoting innovation in the medical device industry at the regional level.

Indication-Specific Generic Uptake of Imatinib Demonstrates the Impact of Skinny Labeling

2022 ◽  
Author(s):  
Bryan S. Walsh ◽  
Aaron S. Kesselheim ◽  
Ameet Sarpatwari ◽  
Benjamin N. Rome
Keyword(s):  
Patent Protection ◽  
Cross Sectional Study ◽  
Myelogenous Leukemia ◽  
Brand Name ◽  
Generic Competition ◽  
Cross Sectional ◽  
The Us ◽  
Lower Drug ◽  
The Impact ◽  
Brand Name Drugs

PURPOSE Generic competition can be delayed if brand-name manufacturers obtain additional patents on supplemental uses. The US Food and Drug Administration allows generic drug manufacturers to market versions with skinny labels that exclude patent-protected indications. This study assessed whether use of generic versions of imatinib varied between indications included and excluded from the skinny labels. METHODS In this cross-sectional study, we identified adult patients covered by commercial insurance or Medicare Advantage plans who initiated imatinib from February 2016 (first generic availability) to September 2020. Generic versions were introduced with skinny labels that included indications covering treatment of chronic myelogenous leukemia (CML) but excluded treatment of gastrointestinal stromal tumors (GISTs) because of remaining patent protections. Logistic regression was used to determine whether use of generic versus brand-name imatinib differed between patients with a diagnosis of CML or GIST, adjusting for demographics, insurance type, prior use of brand-name drugs, and calendar month. RESULTS Among 2,000 initiators, 934 (47%) had CML and 686 (34%) had GIST. Within 3 years after generics entered the market, more than 90% of initiators in both groups used generic imatinib. Initiation of generic imatinib was slightly lower among patients with GIST than among patients with CML (85% v 88%; adjusted odds ratio 0.56; 95% CI, 0.39 to 0.80; P ≤ .001). CONCLUSION Generic versions of imatinib were dispensed frequently for indications both included (CML) and excluded (GIST) from the skinny labeling, although patients with GIST were slightly less likely to receive a generic version. The skinny labeling pathway allowed generics to enter the market before patent protection for treating patients with GIST expired, facilitating lower drug prices.

Unsociable speech

2019 ◽  
Vol 15 (3) ◽  
pp. 349-369
Author(s):  
Kristin S. Williams
Keyword(s):  
Critical Discourse Analysis ◽  
Organizational Context ◽  
Critical Dimension ◽  
Experimental Manipulation ◽  
Self Report ◽  
Cross Sectional ◽  
Content Type ◽  
Non Profit ◽  
Personal Experiences ◽  
The Impact

Purpose Cyber incivility is a form of unsociable speech and a common daily workplace stressor. The purpose of this paper is to explore the impact of cyber incivility on non-profit leaders in Canada and share an intimate portrait of their personal experiences and perceptions. Design/methodology/approach The study advances our understanding of how qualitative methods can be introduced into the study of a phenomenon which has been broadly examined in a positivist tradition. The paper draws epistemologically and methodologically on a fusion of critical discourse analysis and auto-ethnography to present emic and experiential insights. Findings The findings offer three conceptual contributions: to introduce a novel qualitative method to a dynamic field of study; to advance a critical dimension to our understanding of cyber incivility; and to explore the challenges which emerge when qualitative research must draw largely on positivist, quantitative literature. Additionally, this paper makes three contributions to our understanding of cyber incivility: by introducing organizational context conditions which encourage incivility; by identifying commonalities between incivility and bullying, by challenging the existing taxonomy; and by examining the personal experiences of non-profit leaders in Canada (in operationalized settings). Originality/value Quantitative analysis has been limited to the relationship between supervisor and employee and consisted mostly of cross-sectional self-report designs, online surveys and experimental manipulation in simulated workplace environments. This study serves up a deeper analysis from within organizational environments.

scholarly journals The Global Impact of COVID-19 on Craniomaxillofacial Surgeons

2020 ◽  
Vol 13 (3) ◽  
pp. 157-167 ◽  
Author(s):  
Justin van der Tas ◽  
Thomas Dodson ◽  
Daniel Buchbinder ◽  
Stefano Fusetti ◽  
Michael Grant ◽  
...  
Keyword(s):  
Virus Disease ◽  
Statistical Significance ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Geographic Region ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Long Term Impact ◽  
The Impact

Study Design: The COrona VIrus Disease-19 (COVID-19) pandemic has disrupted craniomaxillofacial (CMF) surgeons practice worldwide. We implemented a cross-sectional study and enrolled a sample of CMF surgeons who completed a survey. Objective: To measure the impact that COVID-19 has had on CMF surgeons by (1) identifying variations that may exist by geographic region and specialty and (2) measuring access to adequate personal protective equipment (PPE) and identify factors associated with limited access to adequate PPE. Methods: Primary outcome variable was availability of adequate PPE for health-care workers (HCWs) in the front line and surgeons. Descriptive and analytic statistics were computed. Level of statistical significance was set at P < .05. Binary logistic regression models were created to identify variables associated with PPE status (adequate or inadequate). Results: Most of the respondents felt that hospitals did not provide adequate PPE to the HCWs (57.3%) with significant regional differences ( P = .04). Most adequate PPE was available to surgeons in North America with the least offered in Africa. Differences in PPE adequacy per region ( P < .001) and per country ( P < .001) were significant. In Africa and South America, regions reporting previous virus outbreaks, the differences in access to adequate PPE evaporated compared to Europe ( P = .18 and P = .15, respectively). Conclusion: The impact of COVID-19 among CMF surgeons is global and adversely affects both clinical practice and personal lives of CMF surgeons. Future surveys should capture what the mid- and long-term impact of the COVID-19 crisis will look like.

scholarly journals Declining mental health among disadvantaged Americans

2018 ◽  
Vol 115 (28) ◽  
pp. 7290-7295 ◽  
Author(s):  
Noreen Goldman ◽  
Dana A. Glei ◽  
Maxine Weinstein
Keyword(s):  
Mental Health ◽  
Psychological Health ◽  
Positive Emotions ◽  
Well Being ◽  
The United States ◽  
Opioid Epidemic ◽  
Cross Sectional ◽  
Modest Improvement ◽  
The Us ◽  
The Impact

Although there is little dispute about the impact of the US opioid epidemic on recent mortality, there is less consensus about whether trends reflect increasing despair among American adults. The issue is complicated by the absence of established scales or definitions of despair as well as a paucity of studies examining changes in psychological health, especially well-being, since the 1990s. We contribute evidence using two cross-sectional waves of the Midlife in the United States (MIDUS) study to assess changes in measures of psychological distress and well-being. These measures capture negative emotions such as sadness, hopelessness, and worthlessness, and positive emotions such as happiness, fulfillment, and life satisfaction. Most of the measures reveal increasing distress and decreasing well-being across the age span for those of low relative socioeconomic position, in contrast to little decline or modest improvement for persons of high relative position.

scholarly journals The impact of diabetes on multiple avoidable admissions: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Joana Seringa ◽  
Ana Patrícia Marques ◽  
Bruno Moita ◽  
Cátia Gaspar ◽  
João Filipe Raposo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Age Groups ◽  
Health Care Expenditures ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Diabetes Diagnosis ◽  
Cross Sectional ◽  
Younger Adults ◽  
Logistic Regression Models ◽  
The Impact

Abstract Background Multiple admissions for ambulatory care sensitive conditions (ACSC) are responsible for an important proportion of health care expenditures. Diabetes is one of the conditions consensually classified as an ACSC being considered a major public health concern. The aim of this study was to analyse the impact of diabetes on the occurrence of multiple admissions for ACSC. Methods We analysed inpatient data of all public Portuguese NHS hospitals from 2013 to 2015 on multiple admissions for ACSC among adults aged 18 or older. Multiple ACSC users were identified if they had two or more admissions for any ACSC during the period of analysis. Two logistic regression models were computed. A baseline model where a logistic regression was performed to assess the association between multiple admissions and the presence of diabetes, adjusting for age and sex. A full model to test if diabetes had no constant association with multiple admissions by any ACSC across age groups. Results Among 301,334 ACSC admissions, 144,209 (47.9%) were classified as multiple admissions and from those, 59,436 had diabetes diagnosis, which corresponded to 23,692 patients. Patients with diabetes were 1.49 times (p < 0,001) more likely to be admitted multiple times for any ACSC than patients without diabetes. Younger adults with diabetes (18–39 years old) were more likely to become multiple users. Conclusion Diabetes increases the risk of multiple admissions for ACSC, especially in younger adults. Diabetes presence is associated with a higher resource utilization, which highlights the need for the implementation of adequate management of chronic diseases policies.

Social Response to the FDA Authorization of Heated Tobacco Products (HTPs)

2020 ◽  
Vol 6 (1) ◽  
pp. 20-29
Author(s):  
Jungmi Jun
Keyword(s):  
Social Media ◽  
Rural Areas ◽  
Risk Perceptions ◽  
Preliminary Analysis ◽  
Tobacco Industry ◽  
Semantic Networks ◽  
Public Perceptions ◽  
Tobacco Products ◽  
The Us ◽  
The Impact

Objectives: The US Food and Drug Administration (FDA) approved sales of heated tobacco products (HTPs) on April 30, 2019. In this paper, I provide a preliminary analysis of social media conversations regarding HTPs and the FDA authorization in the first 60 days. Methods: I examined 574 tweets regarding HTPs to assess tweet characteristics and semantic networks of HTPs. Results: Tweets were more likely to be neutral or anti-HTPs than pro-HTPs regardless of the author type (except for tobacco industry) or genre of the post. There was a small gap (6.4%) between the proportion of pro-HTPs and anti-HTPs among personal tweets. The proportion of pro-HTPs was larger in tweets posted by men (vs women and no sex specified) and from rural areas (vs urban). Nearly one-third of the sample mentioned cigarettes or e-cigarettes, even though the size of posts making claims on inferiority/superiority of HTPs was small. Conclusions: Social media conversations on risks of HTPs as well as surveillance on young consumer target marketing is occurring, and it will be important to assess the impact of tobacco companies' launch of HTP sales in the US to assess public perceptions on HTPs. Continuing surveillance of HTP marketing and risk perceptions will inform tobacco regulations.

scholarly journals Clustering and Healthcare Costs With Multiple Chronic Conditions in a US Cross-Sectional Study

2020 ◽  
Author(s):  
cother hajat ◽  
yakir siegal ◽  
amalia adler-waxman
Keyword(s):  
Mental Health ◽  
Chronic Conditions ◽  
Healthcare Costs ◽  
Multiple Chronic Conditions ◽  
Cross Sectional ◽  
The Us ◽  
Health Related ◽  
Insured Patients ◽  
The Impact ◽  
Hiv Aids

Objective To investigate healthcare costs and contributors to costs for multiple chronic conditions (MCCs), common clusters of conditions and their impact on cost and utilisation. Methods This was a cross-sectional analysis of US financial claims data representative of the US population, including Medicare, Medicaid and Commercial insurance claims in 2015. Outcome measures included healthcare costs and contributors; ranking of clusters of conditions according to frequency, strength of association and unsupervised (k-means) analysis; the impact of clustering on costs and contributors to costs. Results Of 1,878,951 patients, 931,045(49.6%) had MCCs, 56.5% weighted to the US population. Mean age was 53.0 years(SD16.7); 393,121(42.20%) were male. Mean annual healthcare spending was $12,601, ranging from $4,385 (2 conditions) to $33,874 (11 conditions), with spending increasing by 22-fold for inpatient services, 6-fold for outpatient services, 4.5-fold for generic drugs and 4.2-fold for branded drugs. Cluster ranking using the 3 methodologies yielded similar results: highest ranked clusters included metabolic syndrome(12.2% of US insured patients), age related diseases(7.7%), renal failure(5.6%), respiratory disorders(4.5%), cardiovascular disease(CVD)(4.3%), cancers(4.1-4.3%), mental health-related clusters(1.0-1.5%) and HIV/AIDS(0.2%). Highest spending was in HIV/AIDS clusters ($48,293), mental health-related clusters ($38,952-$40,637), renal disease ($38,551) and CVD ($37,155); with 89.9% of spending on outpatient and inpatient care combined, and 10.1% on medication. Conclusion and Relevance Over 57% of insured patients in the US may have MCCs. MCC Clustering is frequent and is associated with healthcare utilisation. The findings favour health system redesign towards a multiple condition approach for clusters of chronic conditions, alongside other cost-containment measures for MCCs.

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