scholarly journals The Association of Chronic Diseases with Covid-19 Outcomes and its Role on Risk Perception (Preprint)

2020 ◽  
Author(s):  
Pedro Almeida Laires ◽  
Sónia Dias ◽  
Ana Gama ◽  
Ana Marta Moniz ◽  
Ana R Pedro ◽  
...  
Keyword(s):  
Risk Perception ◽  
Chronic Diseases ◽  
Renal Diseases ◽  
Self Perception ◽  
Perception Of Risk ◽  
Targeted Interventions ◽  
Health Authorities ◽  
Increased Risk ◽  
Study Results ◽  
The Impact

BACKGROUND COVID-19 is a viral respiratory disease, which became a global threat to public health. Further understanding of the epidemiology of this virus and on the risk perception of the community may better inform health authorities for targeted interventions to reduce the impact and spread of COVID-19. OBJECTIVE In this study we aimed to examine the association between chronic diseases and worse outcomes following COVID-19 infection, and to explore its role on the self-perception of risk for worse COVID-19 outcomes. METHODS This study draws from 2 databases: 1) The nationwide database of all confirmed COVID-19 cases in Portugal, extracted in 28th of April 2020 (n=20,293); and 2) the community-based survey “COVID-19 Barometer”, which contains data on health status, perceptions and behaviors during the first wave of COVID-19 (n=171,087). We assessed the association of relevant chronic diseases (i.e. respiratory, cardiovascular, renal disease, diabetes, and cancer) with death and ICU use following COVID-19 infection, and identified determinants of self-perception of risk for severe COVID-19 disease using logistic regression models. RESULTS Respiratory, cardiovascular, and renal diseases were associated with mortality and ICU use among patients hospitalized due to COVID-19 infection (ORs [95%CI]: 1.48 [1.11-1.98]; 3.39 [1.80-6.40]; 2.25 [1.66-3.06]). Diabetes and cancer are associated with such outcomes but only when considered the full sample of COVID-19 infected cases in the country (ORs: 1.30 [1.03-1.64]; 1.40 [1.03-1.89], respectively). Older age and male sex were both associated with mortality and ICU use. The prevalence of at least one of the analyzed health conditions is high in the country’s population, particularly on those aged 65 years old or over (19.6% and 44.6%, respectively). Self-awareness of risk for severe COVID-19 disease in the country’s population is 23.9%, which is markedly increased on older people (46.4%), those with at least one chronic disease (51.7%), or those under both conditions (67.7%). All the analyzed diseases were associated with self-perception of high risk in the population. CONCLUSIONS Our study results demonstrate the association of some prevalent chronic diseases with increased risk of worse COVID-19 outcomes. It also brings further understanding on the current population risk perception for COVID-19 severe disease and useful insights into factors influencing if, in particular morbidity. Hence, this study may aid health authorities to better adapt measures to the real needs of the population and to identify those more vulnerable requiring further education and awareness on due preventive measures. CLINICALTRIAL NA

scholarly journals Perception of Risk, Self-Efficacy and Social Trust during the Diffusion of Covid-19 in Italy

2021 ◽  
Vol 18 (7) ◽  
pp. 3427
Author(s):  
Pierluigi Diotaiuti ◽  
Giuseppe Valente ◽  
Stefania Mancone ◽  
Lavinia Falese ◽  
Fernando Bellizzi ◽  
...  
Keyword(s):  
Risk Perception ◽  
Self Efficacy ◽  
Social Trust ◽  
Interpersonal Trust ◽  
Central Area ◽  
Perception Of Risk ◽  
Online Questionnaire ◽  
Convenience Sample ◽  
Perceived Trust ◽  
Health Authorities

The Coronavirus pandemic has affected the lives of people all over the world. The perception of risk and people’s consequent behaviour during a pandemic are very complex and are affected by multiple cultural and psychological factors. The aim of this study was to investigate the change in risk perception, perceived self-efficacy and the perceived trust in the behaviour of others, the decisions of health authorities and government provisions, as well as the variation of self-restraint behaviours during the spread of the Covid-19 epidemic in Italy. We used a convenience sample of 707 university students (Mage = 22.99; SD = 4.01) from a central area of Italy. Participants freely joined the research by answering an online questionnaire between February and March 2020. Three time intervals defined by the progressive containment measures implemented by the Italian Government were considered. Main outcome measures were the Generalized Self-Efficacy Scale, the Risk Perception Index, the Index of Self-restraint Behaviours, and Institutional and Interpersonal Trust Measures. Results confirmed that significant changes in the time progression have occurred in the perception of risk, in the perception of individual self-efficacy, in the value attributed to social responsibility, in interpersonal trust and in trust in health authorities. The study also identified the participants’ personality traits and locus of control as predictors (positive and negative) of perceived self-efficacy and tested a mediation model of trust on the effect of risk perception on self-restraint intentions.

scholarly journals Prescribing Analgesics to Older People: A Challenge for GPs

2020 ◽  
Vol 17 (11) ◽  
pp. 4017
Author(s):  
Ljiljana Trtica Majnarić ◽  
Thomas Wittlinger ◽  
Dunja Stolnik ◽  
František Babič ◽  
Zvonimir Bosnić ◽  
...  
Keyword(s):  
Older People ◽  
Chronic Diseases ◽  
Musculoskeletal Diseases ◽  
Age Groups ◽  
Treatment Strategies ◽  
Opioid Analgesics ◽  
Psychotropic Medications ◽  
High Rate ◽  
Increased Risk ◽  
Study Results

Background: Due to population aging, there is an increase in the prevalence of chronic diseases, and in particular musculoskeletal diseases. These trends are associated with an increased demand for prescription analgesics and an increased risk of polypharmacy and adverse medication reactions, which constitutes a challenge, especially for general practitioners (GPs), as the providers who are most responsible for the prescription policy. Objectives: To identify patterns of analgesics prescription for older people in the study area and explore associations between a long-term analgesic prescription and comorbidity patterns, as well as the prescription of psychotropic and other common medications in a continuous use. Methods: A retrospective study was conducted in 2015 in eastern Croatia. Patients were GP attenders ≥40 years old (N = 675), who were recruited during their appointments (consecutive patients). They were divided into two groups: those who have been continuously prescribed analgesics (N = 432) and those who have not (N = 243). Data from electronic health records were used to provide information about diagnoses of musculoskeletal and other chronic diseases, as well as prescription rates for analgesics and other medications. Exploratory methods and logistic regression models were used to analyse the data. Results: Analgesics have been continuously prescribed to 64% of the patients, mostly to those in the older age groups (50–79 years) and females, and they were indicated mainly for dorsalgia symptoms and arthrosis. Non-opioid analgesics were most common, with an increasing tendency to prescribe opioid analgesics to older patient groups aged 60–79 years. The study results indicate that there is a high rate of simultaneous prescription of analgesics and psychotropic medications, despite the intention of GPs to avoid prescribing psychotropic medications to patients who use any option with opioid analgesics. In general, receiving prescription analgesics does not exceed the prescription for chronic diseases over the rates that can be found in patients who do not receive prescription analgesics. Conclusion: Based on the analysis of comorbidities and parallel prescribing, the results of this study can improve GPs’ prescription and treatment strategies for musculoskeletal diseases and chronic pain conditions.

Inflammatory and Epigenetic Pathways for Perinatal Depression

2015 ◽  
Vol 18 (3) ◽  
pp. 331-343 ◽  
Author(s):  
Lindsey Garfield ◽  
Herbert L. Mathews ◽  
Linda Witek Janusek
Keyword(s):  
Early Life ◽  
Infant Health ◽  
Perinatal Depression ◽  
Life Experiences ◽  
Perinatal Period ◽  
Early Life Adversity ◽  
Targeted Interventions ◽  
Increased Risk ◽  
History Of ◽  
The Impact

Depression during the perinatal period is common and can have adverse consequences for women and their children. Yet, the biobehavioral mechanisms underlying perinatal depression are not known. Adverse early life experiences increase the risk for adult depression. One potential mechanism by which this increased risk occurs is epigenetic embedding of inflammatory pathways. The purpose of this article is to propose a conceptual model that explicates the linkage between early life adversity and the risk for maternal depression. The model posits that early life adversity embeds a proinflammatory epigenetic signature (altered DNA methylation) that predisposes vulnerable women to depression during pregnancy and the postpartum period. As proposed, women with a history of early life adversity are more likely to exhibit higher levels of proinflammatory cytokines and lower levels of oxytocin in response to the demands of pregnancy and new motherhood, both of which are associated with the risk for perinatal depression. The model is designed to guide investigations into the biobehavioral basis for perinatal depression, with emphasis upon the impact of early life adversity. Testing this model will provide a better understanding of maternal depressive risk and improve identification of vulnerable women who would benefit from targeted interventions that can reduce the impact of perinatal depression on maternal–infant health.

scholarly journals Risk Perception in Pregnancy

2015 ◽  
Vol 20 (2) ◽  
pp. 120-127 ◽  
Author(s):  
Monique Robinson ◽  
Craig E. Pennell ◽  
Neil J. McLean ◽  
Jessica E. Tearne ◽  
Wendy H. Oddy ◽  
...  
Keyword(s):  
Risk Perception ◽  
Prenatal Testing ◽  
Obstetric Care ◽  
Fertility Treatment ◽  
Care Providers ◽  
Perception Of Risk ◽  
Emotional Context ◽  
Risk Pregnancy ◽  
Increased Risk ◽  
In Pregnancy

Despite huge advances in obstetric management and technology in recent decades, there has not been an accompanying decrease in patients’ perception of risk during pregnancy. The aim of this paper is to examine the context of risk perception in pregnancy and what practitioners can do to manage it. The modern pregnancy may induce a heightened perception of risk due to increased prenatal testing and surveillance, medico-legal complexity, fertility treatment, and the increasing use of the internet and social media as a source of information. The consequences of an inflated perception of risk during pregnancy include stress, anxiety, and depression, and these issues may have long-lasting implications for patients, their babies, and their families. There are numerous resilience and vulnerability factors that can help care providers identify those who may be predisposed to increased risk perception in pregnancy, and there is a role for both obstetric care providers and psychologists engaged in obstetric settings to manage and reduce risk perception in patients where possible. Ultimately, the medical management of risk during pregnancy can be complex but a thorough understanding of the social and emotional context can assist providers to support their patients through both high- and low-risk pregnancy and birth.

scholarly journals Fear of COVID-19, Risk Perception and Stress Level in Polish Nurses During COVID-19 Outbreak

2021 ◽  
Vol 10 (1) ◽  
pp. 3-9
Author(s):  
Joanna Dymecka ◽  
◽  
Anna Machnik-Czerwik ◽  
Jakub Filipkowski ◽  
◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Perception ◽  
Perceived Stress ◽  
Perceived Risk ◽  
Negative Impact ◽  
Medical Personnel ◽  
Perceived Threat ◽  
Severe Stress ◽  
Increased Risk ◽  
Study Results

Introduction. The outbreak of COVID-19 disease causes severe stress in health care workers, especially nurses. Nurses are at high risk of contracting the disease, as well as an increased risk of developing mental health symptoms such as fear, anxiety and work-related stress. Aim. The aim of the study was to determine the relationship between fear of COVID-19, risk perception, perceived threat and stress in Polish nurses during COVID-19 outbreak. Material and Methods. 106 nurses participated in the study. Perceived Stress Scale (PSS-10), Fear of COVID-19 Scale (FOC-6), Risk of Contracting COVID-19 Scale and Perceived Threat of COVID-19 Scale were used in the study. Results. It has been shown that perceived stress, fear of COVID-19, perceived risk and threat are at high level. All the variables related to the perception of COVID-19 threat were significantly correlated with the perceived stress. The strongest relationship was between the risk of infection and perceived stress. Risk perception was statistically significant predictor of perceived stress. Conclusions. Polish nurses experience severe stress and perceive COVID-19 as a significant threat for their health and safety. In addition to protecting medical personnel from infection, nurses experiencing the highest levels of stress should be given psychological care and support, which could prevent the negative impact of the COVID-19 pandemic on their mental health. (JNNN 2021;10(1):3–9)

scholarly journals Parental decision and intent towards COVID-19 vaccination in children with asthma. An econometric analysis

2021 ◽  
Author(s):  
Olivier Drouin ◽  
Claude Montmarquette ◽  
Alexandre Prudhomme ◽  
Yann Arnaud ◽  
Pierre Fontaine ◽  
...  
Keyword(s):  
Risk Perception ◽  
Chronic Diseases ◽  
Online Survey ◽  
Herd Immunity ◽  
Strong Relationship ◽  
Cross Sectional ◽  
Increased Risk ◽  
Children With Asthma ◽  
Vaccination Decision ◽  
Parental Level

Abstract Objective . Vaccination will be instrumental in controlling the COVID-19 pandemic, and vaccination of children will be necessary to achieve herd immunity. Given that children with chronic health conditions may be at increased risk of COVID-19, it is crucial to understand factors influencing parental decisions about whether to have their child vaccinated. The study objectives were to measure parental intent to have their child with asthma vaccinated against COVID-19 and identify the determinants of their vaccination decision. Study design . This study is based on a cross-sectional exploratory observational online survey assessing parents' risk perception in the context of COVID-19. Methods . In this study conducted in August 2020, the primary outcome was parent’s answer to the question on their intention to get their child vaccinated if a vaccine against COVID-19 was available. Participants were also asked about their intention to get vaccinated themselves. Independent variables studied included sociodemographic, clinical data (e.g. presence of other chronic diseases), psychological, cognitive and risk perception related to COVID-19. Simultaneous equations models (3SLS) and seemingly unrelated regressions model (SUR) were carried out to identify factors associated with intention to have the child vaccinated and participants’ intention to get vaccinated themselves against COVID-19. Results . A total of 305 participants completed the survey. Overall, 19.1% of participants reported being unlikely or very unlikely to vaccinate their child against COVID-19 if a vaccine was available. Similarly, 21.0% were unlikely or very unlikely to get vaccinated themselves. The following factors were significantly (p ≤ 0.05) associated with parents’ decision to have their child vaccinated: parental level of education, employment status, sex of the child, presence of other chronic diseases, whether or not the child had been vaccinated against influenza in the past, parental anxiety, and consultation with a health professional since the beginning of the pandemic. There was a strong relationship between likelihood of not intending to have one’s child vaccinated and personal intent not to get vaccinated. Conclusion . These findings are essential in planning for the communication and dissemination of COVID-19 vaccination information to parents, especially for children with asthma or other chronic medical conditions.

scholarly journals Functional Fc Gamma Receptor Gene Polymorphisms and Long-Term Kidney Allograft Survival

2021 ◽  
Vol 12 ◽  
Author(s):  
Markus Wahrmann ◽  
Bernd Döhler ◽  
Marie-Luise Arnold ◽  
Sabine Scherer ◽  
Katharina A. Mayer ◽  
...  
Keyword(s):  
Cox Model ◽  
Receptor Gene ◽  
Allograft Survival ◽  
Fc Gamma Receptor ◽  
Functional Polymorphisms ◽  
Gamma Receptor ◽  
Increased Risk ◽  
Study Results ◽  
The Impact

The functional Fc gamma receptor (FcγR) IIIA polymorphism FCGR3A-V/F158 was earlier suggested to determine the potential of donor-specific HLA antibodies to trigger microcirculation inflammation, a key lesion of antibody-mediated renal allograft rejection. Associations with long-term transplant outcomes, however, have not been evaluated to date. To clarify the impact of FCGR3A-V/F158 polymorphism on kidney transplant survival, we genotyped a cohort of 1,940 recipient/donor pairs. Analyzing 10-year death-censored allograft survival, we found no significant differences in relation to FCGR3A-V/F158. There was also no independent survival effect in a multivariable Cox model. Similarly, functional polymorphisms in two other activating FcγR, FCGR2A-H/R131 (FcγRIIA) and FCGR3B-NA1/NA2 (FcγRIIIB), were not associated with outcome. There were also no significant survival differences among patient subgroups at increased risk of rejection-related injury, such as pre-sensitized recipients (> 0% panel reactivity; n = 438) or recipients treated for rejection within the first year after transplantation (n = 229). Our study results suggest that the earlier shown association of FcγR polymorphism with microcirculation inflammation may not be strong enough to exert a meaningful effect on graft survival.

Implementation of the Brøset Violence Checklist on an Acute Psychiatric Unit

2019 ◽  
Vol 25 (6) ◽  
pp. 476-486 ◽  
Author(s):  
Wendy L. Sarver ◽  
Rosanne Radziewicz ◽  
Georgean Coyne ◽  
Kelly Colon ◽  
Lisa Mantz
Keyword(s):  
Pearson Correlation ◽  
Violent Behavior ◽  
Positive Association ◽  
Screening Tools ◽  
Readmission Rates ◽  
Increased Risk ◽  
Study Results ◽  
High Level ◽  
The Impact ◽  
Additional Point

BACKGROUND: Violence on inpatient psychiatric settings has significant consequences for patients and staff. Research is needed to determine if Brøset Violence Checklist (BVC) is an accurate predictor of violence. AIMS: The study aims were to determine the relationship between BVC scores and incidence of violent behavior within 24 hours, to compare scores among those requiring high-level nursing interventions for violence, and to investigate the impact of scores on length of stay (LOS) and 30 day-readmission rates. METHOD: Retrospective cohort study. RESULTS: Logistic regression indicates 3.4 times greater risk of violence for every additional point on admission BVC (odds ratio = 3.4, 95% confidence interval = [2.29, 5.08], p < .0001). Patients requiring high-level interventions for violence had higher mean BVC scores on both Day 1 and 2 of admission. Pearson correlation was significant for positive association between BVC on admission and LOS ( p < .001). Findings did not establish a link between BVC scores and violence with 30-day readmission rates. CONCLUSIONS: Efforts toward early identification and management of agitation and disruptive behavior is encouraged. Results showed increased risk of violence with every additional point on BVC on admission; further attention should be paid to these patients on admission when using violence screening tools.

analysing the relationship between family planning workers’ contact and contraceptive switching in rural bangladesh using multilevel modelling

2005 ◽  
Vol 37 (5) ◽  
pp. 529-554 ◽  
Author(s):  
mian b. hossain
Keyword(s):  
Family Planning ◽  
Unintended Pregnancy ◽  
Contraceptive Use ◽  
Modern Method ◽  
Alternative Form ◽  
Rural Bangladesh ◽  
Outreach Workers ◽  
Increased Risk ◽  
Study Results ◽  
The Impact

with a population of over 131 million and a fertility rate of 29·9 per 1000, population growth constitutes a primary threat to continued economic growth and development in bangladesh. one strategy that has been used to cease further increases in fertility in bangladesh involves using family planning outreach workers who travel throughout rural and urban areas educating women regarding contraceptive alternatives. this study uses a longitudinal database to assess the impact of family planning outreach workers’ contact upon contraceptive switching and upon the risk of an unintended pregnancy. using longitudinal data on contraceptive use from the operations research project (orp) of the international centre for diarrhoeal disease research (icddr,b) in bangladesh, multiple decrement life table analysis and multilevel, discrete-time competing risk hazards models were used to estimate the cumulative probabilities of switching to an alternative form of contraceptive use after a woman engaged in a discussion with an outreach worker. after controlling for the effects of socio-demographic and economic characteristics, the analysis revealed that family planning outreach workers’ contact with women significantly decreases the risk of transitioning to the non-use of contraceptives. this contact also reduces the risk of an unintended pregnancy. family planning workers’ contact with women is associated with the increased risk of a woman switching from one modern method to another modern method. the study results indicate that side-effects and other method-related reasons are the two primary reasons for contraceptive discontinuation in rural bangladesh.

scholarly journals Health Impact Assessment of the construction of hydroelectric dams in Brazil

2018 ◽  
Vol 3 (1) ◽  
pp. 11-36
Author(s):  
Diego Velloso Veronez ◽  
Karina Camasmie Abe ◽  
Simone Georges El Khouri Miraglia
Keyword(s):  
Impact Assessment ◽  
Health Impact Assessment ◽  
Health Sector ◽  
Policy Decision ◽  
Health Impact ◽  
Hydroelectric Dams ◽  
Health Authorities ◽  
Study Results ◽  
Social Environmental ◽  
The Impact

Background: Brazil´s dam-building plans in Amazonia imply substantial environmental and social impacts. This study evaluates the relationship between social, environmental, and economic aspects and impacts on the health status of the population of Rondônia, Brazil, due to the implementation of the Jirau and Santo Antônio hydroelectric dams. Methods: A qualitative and retrospective Health Impact Assessment (HIA) is used to focus the study objectives. The information is arranged in a structured diagram that enables an outside reviewer to assess the aspects/impacts relationship derived from the construction of the dams. This comes with outline recommendations for health risk management that can orient national health authorities. We selected a narrative review synthesis as the most appropriate approach for the study. Results: The diagram network was built making it possible to analyse the impact changes caused by this enterprise in the health sector. Additionally, the model will serve in the implementation of a complete HIA approach in an attempt to quantitatively map the impacts and to propose recommendations. Conclusion: This effort is very important for highlighting the priorities in the public policy decision-making process, serving as a basis for the Brazilian Health System. 

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