scholarly journals Systematic review of quantitative preference studies of treatments for rheumatoid arthritis among patients and at risk populations.

2021 ◽  
Author(s):  
Gwenda Simons ◽  
Joshua Caplan ◽  
Rachael L. DiSantostefano ◽  
Jorien Veldwijk ◽  
Matthias Englbrecht ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
At Risk ◽  
Treatment Effectiveness ◽  
Stated Preference ◽  
Risk Groups ◽  
Treatment Preferences ◽  
Relative Importance ◽  
Prevention Studies ◽  
Study Characteristics ◽  
At Risk Populations

Abstract Treatments used for rheumatoid arthritis (RA) are under investigation for their efficacy to prevent RA in at risk groups. It is therefore important to understand treatment preferences of those at risk. We systematically reviewed quantitative preference studies of drugs to treat, or prevent RA, to inform the design of further studies and trials of RA prevention. Stated preference studies for RA treatment or prevention were identified through a search of five databases. Study characteristics and results were extracted and the relative importance of different types of treatment attributes was compared across populations. Twenty studies were included: 17 of RA treatments (15 of patients; 2 of the general public), and 3 prevention studies with first-degree relatives (FDRs). Benefits, risks, administration method and cost (when included) were important determinants of treatment choice. A benefit was more important than a risk attribute in 8/15 studies of RA treatment that included a benefit attribute, and 2/3 studies of RA prevention. There was variability in the relative importance of attributes across the few prevention studies. In studies with non-patient participants, attributes describing confidence in treatment effectiveness/safety were more important determinants of choice than in studies with patients. Most preference studies relating to RA are of treatments for established RA. Few studies examine preferences for treatments to prevent RA. Given intense research focus on RA prevention, additional preference studies in this context are needed. Variation in treatment preferences across different populations is not well understood and direct comparisons are needed.

scholarly journals Strategies to predict rheumatoid arthritis development in at-risk populations

Rheumatology ◽  
2014 ◽  
Vol 55 (1) ◽  
pp. 6-15 ◽  
Author(s):  
Elizabeth W. Karlson ◽  
Dirkjan van Schaardenburg ◽  
Annette H. van der Helm-van Mil
Keyword(s):  
Rheumatoid Arthritis ◽  
At Risk ◽  
Rheumatoid Arthritis Development ◽  
At Risk Populations

scholarly journals Key factors associated with malaria infection among patients seeking care through the public sector in endemic townships of Ayeyarwady Region, Myanmar

2021 ◽  
Author(s):  
Jillian Dunning ◽  
Nang Khaing Zar Aung ◽  
Abigail Ward ◽  
Moe Moe Aye ◽  
Christopher Lourenço ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Malaria Elimination ◽  
Risk Groups ◽  
Behavioral Risk ◽  
Rubber Plantation ◽  
Public Facilities ◽  
Causal Pathway ◽  
At Risk Populations ◽  
Most At Risk Populations

Abstract BackgroundAyeyarwady Region in Myanmar has made significant progress towards malaria elimination, with confirmed cases decreasing from 13,522 in 2013 to 122 in 2019. As transmission declines, malaria becomes increasingly focalized both in geographic hotspots and among population groups sharing certain risk factors. Developing a thorough profile of high-risk activities associated with malaria infections is critical to ensure intervention approaches are evidence-based. MethodsA test-negative study was conducted from September 2017 to May 2018 in Ngaputaw, Pathein and Thabaung townships in Ayeyarwady Region. Patients that presented to selected public facilities or community health volunteers with fever answered survey questions on demographic and behavioral risk factors, including exposure to malaria interventions, and were assigned to case and control groups based on the result of a malaria rapid diagnostic test. A random-effects logistic regression model adjusted for clustering at the facility level, as well as any variables along the causal pathway described by a directed acyclic graph, was used to determine odds ratios and association with malaria infections. ResultsA total of 119 cases and 1,744 controls were recruited from 41 public facilities, with a mean age of 31.3 and 63.7% percent male. Higher risk groups were identified as males (aOR 1.8, 95% CI: 1.2–2.9) and those with a worksite located within the forest (aOR 2.8, 95% CI: 1.4–5.3), specifically working in the logging (aOR 2.7, 95% CI: 1.5–4.6) and rubber plantation (aOR 3.0, 95% CI: 1.4–6.8) industries. Additionally, links between forest travel and malaria were observed, with risk factors identified to be sleeping in the forest within the past month (aOR 2.6, 95% CI: 1.1–6.3), and extended forest travel with durations from 3 to 14 days (aOR 8.6, 95% CI: 3.5–21.4) or longer periods (aOR 8.4, 95% CI: 3.2–21.6). ConclusionMalaria transmission is highly focalized in Ayeyarwady, and results illustrate the need to target interventions to the most at-risk populations of working males and forest goers. It will become increasingly necessary to ensure full intervention coverage of at-risk populations active in forested areas as Myanmar moves closer to malaria elimination goals.

At-Risk Groups of Men Who Have Sex With Men Can Be Reached Through Community-Based HIV Testing in Denmark

2021 ◽  
pp. 361-371
Author(s):  
Holger Nordstr⊘m Munck ◽  
Tavs Qvist ◽  
Marie Helleberg ◽  
Per Slaaen Kaye ◽  
Francois Pichon ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Testing ◽  
Prospective Observational Study ◽  
Risk Groups ◽  
Hiv Positive ◽  
Anal Sex ◽  
Community Based ◽  
At Risk Populations ◽  
Conventional Health Care ◽  
Sex With Men

This study evaluates whether the community-based HIV testing clinic Checkpoint could reach at-risk groups of men who have sex with men (MSM) and link patients to care. A prospective observational study of all Checkpoint visits during 2013–2016 and a retrospective registry study of all MSM diagnosed with HIV in Denmark during the same period were conducted. One percent of the 9,074 tests in Checkpoint were HIV-positive, accounting for 19% of all new HIV diagnoses among MSM in Denmark. Checkpoint testers reported frequent condomless anal sex. Two percent of migrant Checkpoint testers were HIV-positive compared to 1% among Danish MSM. HIV-positive MSM identified through Checkpoint were significantly younger, more of them were migrant, and a smaller proportion were late testers compared to those testing through the conventional health care system. Checkpoint reaches at-risk populations of MSM and links patients successfully to care.

scholarly journals Mindfulness and Shinrin-Yoku: Potential for Physiological and Psychological Interventions during Uncertain Times

2020 ◽  
Vol 17 (24) ◽  
pp. 9340
Author(s):  
Erica R. Timko Olson ◽  
Margaret M. Hansen ◽  
Amber Vermeesch
Keyword(s):  
At Risk ◽  
Cost Effective ◽  
Risk Groups ◽  
Rapid Review ◽  
Psychological Wellbeing ◽  
Health Issues ◽  
Review Of The Literature ◽  
Pragmatic Approach ◽  
At Risk Populations ◽  
The Relationship

Mindfulness and Shinrin-yoku (SY) translated as forest bathing, is potentially effective to alleviate mental health issues related to the COVID-19 pandemic and beyond. The purpose of this article is to provide a translational and pragmatic approach to understanding mindfulness in the context of SY and psychological wellbeing through a rapid review of the literature. The background of mindfulness and SY practice are discussed and the emotional, neuroendocrine, and neurobiological responses are examined. Next, a rapid review of the literature examined six studies, published between 2010 and 2020 to determine what is known regarding the relationship between SY, mindfulness, and psychological wellbeing. The studies included 21–360 participants with a mean age of 20–55 years. The results demonstrated a significant positive correlation between nature, mindfulness, and measures of psychological wellbeing. During uncertain events, including COVID-19, weaving mindfulness with SY may be specifically important to at-risk groups, those experiencing depression, loneliness, and social isolation, and at-risk populations such as college students, veterans, and professionals with high levels of stress. The goal of this review is to provide a thorough background and support of this cost-effective modality to promote overall psychological wellbeing as a preventative measure to those at risk or experiencing psychological illnesses.

At-Risk Groups of Men Who Have Sex With Men can be Reached Through Community-Based HIV Testing in Denmark

2021 ◽  
Vol 33 (5) ◽  
pp. 439-449
Author(s):  
Holger Nordstrom Munck ◽  
Tavs Qvist ◽  
Marie Helleberg ◽  
Per Slaaen Kaye ◽  
Francois Pichon ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Testing ◽  
Prospective Observational Study ◽  
Risk Groups ◽  
Hiv Positive ◽  
Anal Sex ◽  
Community Based ◽  
At Risk Populations ◽  
Conventional Health Care ◽  
Sex With Men

This study evaluates whether the community-based HIV testing clinic Checkpoint could reach at-risk groups of men who have sex with men (MSM) and link patients to care. A prospective observational study of all Checkpoint visits during 2013–2016 and a retrospective registry study of all MSM diagnosed with HIV in Denmark during the same period were conducted. One percent of the 9,074 tests in Checkpoint were HIV-positive, accounting for 19% of all new HIV diagnoses among MSM in Denmark. Checkpoint testers reported frequent condomless anal sex. Two percent of migrant Checkpoint testers were HIV-positive compared to 1 % among Danish MSM. HIV-positive MSM identified through Checkpoint were significantly younger, more of them were migrant, and a smaller proportion were late testers compared to those testing through the conventional health care system. Checkpoint reaches at-risk populations of MSM and links patients successfully to care.

Survey of Irradiation Practice for the Prevention of Transfusion-Associated Graft-versus-Host Disease

2016 ◽  
Vol 140 (10) ◽  
pp. 1092-1097 ◽  
Author(s):  
Aaron E. Pritchard ◽  
Beth H. Shaz
Keyword(s):  
At Risk ◽  
Graft Versus Host Disease ◽  
Human Leukocyte ◽  
Risk Groups ◽  
Blood Product Transfusion ◽  
Host Disease ◽  
Leukocyte Antigen ◽  
Graft Versus Host ◽  
Comprehensive Survey ◽  
At Risk Populations

Context.—Transfusion-associated graft-versus-host disease is a rare, often fatal complication of cellular blood product transfusion. The requirement that at-risk groups receive irradiated products reduces the incidence of transfusion-associated graft-versus-host disease. A comprehensive survey of irradiation practices has not been performed since 1989; meanwhile, new indications for irradiation have emerged. Objective.—To assess current irradiation practices at College of American Pathologists member institutions. Changes in irradiation practice indicated by comparing results of a survey of irradiation practices in 1989 with those of a survey performed in 2014 may reveal how the field has developed and what areas (if any) remain to be improved. Design.—A supplemental College of American Pathologists survey was sent out with questions regarding irradiation practices for specific conditions and circumstances. The questions included conditions for which irradiation is generally considered required for the prevention of transfusion-associated graft-versus-host disease as well as those not considered to be a special risk. Results.—An average of 2100 organizations responded to each question regarding their irradiation practices. Irradiation for transfusion from blood relatives, human leukocyte antigen–matched products, preterm infants, and Hodgkin disease were the most common indications cited. A few organizations had universal irradiation, whereas others irradiated products by floor/unit or by service. Conclusions.—For some at-risk populations irradiation of cellular blood products is more common than in 1989, whereas for others this practice has been reduced. Although gains have been made since the last national survey of irradiation practices, work remains to eliminate the possibility of transfusion-associated graft-versus-host disease from known at-risk populations.

scholarly journals National Seroprevalence of Coxiella burnetii in Chile, 2016–2017

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 531
Author(s):  
Teresa Tapia ◽  
María Fernanda Olivares ◽  
John Stenos ◽  
Rodrigo Iglesias ◽  
Nora Díaz ◽  
...  
Keyword(s):  
At Risk ◽  
Coxiella Burnetii ◽  
Q Fever ◽  
Risk Groups ◽  
National Health Survey ◽  
Linear Increase ◽  
Metropolitan Region ◽  
South American ◽  
At Risk Populations ◽  
Chilean Population

Coxiella burnetii is an intracellular bacterium and the cause of the zoonotic infection, Q fever. National surveillance data on C. burnetii seroprevalence is currently not available for any South American country, making efforts of public health to implement strategies to mitigate infections in different at-risk groups within the population extremely challenging. In the current study, we used two commercial anti-C. burnetii immunoassays to screen sera collected from a sample of the Chilean population as part of a 2016–2017 national health survey (n = 5166), nationwide and age-standardized. The seroprevalence for C. burnetii for persons ≥ 15 years was estimated to be 3.0% (95% CI 2.2–4.0), a level similar to national surveys from The Netherlands (2.4%) and USA (3.1%), but lower than Australia (5.6%). A linear increase of C. burnetii seropositivity was associated with an individual’s age, with the peak seroprevalence 5.6% (95% CI 3.6–8.6) observed in the ≥65 years’ group. C. burnetii seropositivity was significantly higher in the southern macro-zone 6.0% (95% CI 3.3–10.6) compared to metropolitan region 1.8% (95% CI 0.9–3.3), the former region being home to significant livestock industries, particularly dairy farming. These data will be useful to inform targeted strategies for the prevention of Q fever in at-risk populations in Chile.

scholarly journals Challenges and Opportunities of Targeted Behavioral Interventions for Groups at Risk for Developing Rheumatoid Arthritis

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 641
Author(s):  
Alessandra Zaccardelli ◽  
Jeffrey A. Sparks
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
At Risk ◽  
Behavioral Interventions ◽  
Risk Groups ◽  
Excess Body Weight ◽  
Behavioral Risk ◽  
Potential Efficacy ◽  
Challenges And Opportunities ◽  
Meta Analyses

Background: Rheumatoid arthritis (RA) is a serious autoimmune disease which causes painful, swollen joints and can impact quality of life and increase morbidity and mortality. There are several preclinical stages of RA that correspond to at-risk groups that include: genetic risk, risk from behaviors, elevation of RA-related autoantibodies, and early clinical disease manifestations such as undifferentiated arthritis. Early interventions are crucial to slowing progression to and potentially preventing RA onset. Modification of behaviors among at-risk individuals may decrease RA risk. There are several challenges and opportunities in implementing preventative behavioral interventions, which may vary within different at-risk groups. Methods: We performed a narrative review of the literature, including meta-analyses focused on RA risk-related behaviors as well as publications investigating the potential efficacy of behavioral modifications on RA risk. Results: There are multiple behavioral risk factors associated with RA, including smoking, obesity, low physical activity, low quality diet, and poor dental hygiene, which may contribute to progression to clinical RA. Meta-analyses have been performed for smoking, excess body weight, and physical activity. Likelihood of adopting behavioral modifications may increase as RA risk increases. Conclusions: Clinicians may be able to tailor preventative approaches to various RA at-risk groups to help reduce RA risk, but further research is needed. A better understanding of the relationship of behaviors with RA risk and optimized approaches to implementing behavioral changes may allow for clinicians to tailor their preventative approaches for at-risk individuals.

scholarly journals Review of suicide-prevention programs in Queensland: state- and community-level activities

2013 ◽  
Vol 37 (5) ◽  
pp. 660 ◽  
Author(s):  
Urska Arnautovska ◽  
Kairi Kolves ◽  
Naoko Ide ◽  
Diego De Leo
Keyword(s):  
At Risk ◽  
Suicide Prevention ◽  
Prevention Programs ◽  
Risk Groups ◽  
Treatment Level ◽  
Term Care ◽  
Predominant Type ◽  
At Risk Populations ◽  
Harm Prevention ◽  
Suicide Prevention Programs

Objective Information regarding the availability of suicide-prevention programs in Australia is sparse and rather difficult to obtain. This study aimed to report and describe suicide and/or self-harm-prevention programs in Queensland. Methods Programs were classified by type of intervention, predominant type of program, setting of delivery and targeted population-at-risk. Results Sixty-six organisations were identified, providing a total of 101 suicide-prevention programs. The majority of programs operated at the prevention or treatment level, with less than half providing continuing (long-term) care. The programs targeted 12 different risk groups and were most frequently delivered within community settings. Conclusions The findings show a diverse distribution of activities across the levels of prevention and different risk populations. This survey demonstrates the existence of remarkable gaps in coverage and provision of programs for specific high-risk groups. What is known about the topic? Although suicide prevention in Australia has recently received considerable attention, there is currently no complete list or register of suicide-prevention programs. This reduces the opportunity for people at risk to access help, as well as agencies to link and build on existing models of service. What does this paper add? This study is unique in identifying and reviewing suicide-prevention programs that are funded by national or state suicide-prevention strategies, as well as those funded by private and community-based organisations. The identified programs are matched with the actual suicide risk of the targeted subpopulations, indicating a lack or overlap of programs for specific populations. What are the implications for practitioners? This paper is particularly relevant for policy makers as it identifies potential gaps in the provision of suicide-prevention programs for specific at-risk populations in Queensland. The relevance of the paper for practitioners, however, is in encouraging them to re-examine the provision of their services considering the entire continuum of suicide-prevention activities.

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