scholarly journals Effectiveness of complete primary vaccination against COVID-19 at primary care and community level during predominant Delta circulation in Europe: multicentre study analysis by age-group, vaccine brand and time since vaccination, I-MOVE-COVID-19 and ECDC networks, July–August 2021

2021 ◽  
Author(s):  
Esther Kissling ◽  
Mariëtte Hooiveld ◽  
Iván Martínez-Baz ◽  
Clara Mazagatos ◽  
Naoma William ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Vaccination ◽  
Community Level ◽  
Age Group ◽  
Study Analysis ◽  
Symptomatic Infection ◽  
Present Sample ◽  
Care Community ◽  
Negative Study ◽  
Vaccine Effect

IntroductionIn July and August 2021, the SARS-CoV-2 Delta variant dominated in Europe. We measured COVID-19 vaccine effectiveness (VE) against symptomatic infection, using a multicentre test-negative study at primary care/community level in Europe.MethodsPatients presenting with COVID-19/ARI symptoms at primary care/community level in 10 countries were tested for SARS-CoV-2. We measured complete primary course overall VE among those aged 30–44, 45–59, 60–74 and ≥75 years, and among those 30–59 and ≥60 years by vaccine brand and by time since vaccination.ResultsOverall VE was 74% (95%CI: 69–79), 76% (95%CI: 71–80), 63% (95%CI: 48–75), 63% (95%CI: 16–83) among those aged 30–44, 45–59, 60–74 and ≥75 years, respectively. VE among those aged 30–59 years was 78% (95%CI: 75–81), 66% (95%CI: 58–73), 91% (95%CI: 87–94) and 52% (95%CI: 40–61), for Comirnaty, Vaxzevria, Spikevax and COVID-19 Vaccine Janssen, respectively. VE among those aged ≥60 years was 67% (95%CI: 52–77), 65% (95%CI: 48–76), 83% (95%CI: 64–92) for Comirnaty, Vaxzevria and Spikevax, respectively. Comirnaty VE among those aged 30–59 years was 87% (95%CI: 83–89) and 65% (95%CI: 56–71%) at 14–29 days and ≥90 days between vaccination and onset of symptoms, respectively.ConclusionsVE against the symptomatic SARS-CoV-2 Delta variant infection varied among brands, ranging from 52–91%. While some waning of the vaccine effect may be present (sample size limited this analysis to only Comirnaty), protection was 65% ≥90 days between vaccination and onset.

scholarly journals SARS-CoV-2 Infections Among Healthcare Workers Outside Hospitals

2021 ◽  
Author(s):  
Maria Fröberg ◽  
Sadaf Sakina Hassan ◽  
Ville N. Pimenoff ◽  
Susanne Akterin ◽  
K. Miriam Elfström ◽  
...  
Keyword(s):  
Primary Care ◽  
Sex Differences ◽  
Healthcare Workers ◽  
Healthcare Providers ◽  
Significant Trend ◽  
Age Group ◽  
Symptomatic Infection ◽  
Current Infection ◽  
Immunological Factors ◽  
Prior Infection

Abstract Most Covid-related infections and deaths occur in healthcare outside hospitals. We wished to explore SARS-CoV-2 infections among healthcare workers (HCWs) in this setting. All healthcare providers in Stockholm, Sweden were asked to invite HCWs at work for a study of past or present SARS-CoV-2 infections among HCWs. This study reports the results from 839 HCWs, mostly employees of primary care centers, sampled in June 2020. Prior infection, as measured using seropositivity, was found among 12% (100/839) of HCWs, ranging from 0–29% between care units. There was a significant trend of decreasing serology positivity by age (one sided p-trend 0.0467). Seropositivity was highest among HCWs < 40 years of age. Within this age group there was 19% (23/120) seropositivity among women and 11% (15/38) among men (p < 0.02). Current infection, as measured using PCR, was found in only 1% and the typical pre-symptomatic testing pattern found in only 2 subjects. SARS-CoV-2 infections had been rather common among younger HCWs in this setting, but pre-symptomatic infection appeared to be uncommon. Sex differences in SARS-CoV2 specific seropositivity in HCWs younger than 40 years and older than 50 years can be due to exposure, behavior and/or immunological factors.

Medical Education’s Role in Primary Care/Community Health: A Model from Kumasi, Ghana

1986 ◽  
Vol 2 (5) ◽  
pp. 273-277 ◽  
Author(s):  
G. Smilkstein ◽  
H.A. Addy ◽  
E.A. Gyebi-Ofosu ◽  
E.H.O. Parry
Keyword(s):  
Primary Care ◽  
Community Health ◽  
Care Community

scholarly journals Development of a research registry for primary care community-based research

2005 ◽  
Vol 22 (4) ◽  
pp. 358-360 ◽  
Author(s):  
Janine E Janosky ◽  
Susan B Laird ◽  
Jamar D Robinson ◽  
Jeannette E South-Paul
Keyword(s):  
Primary Care ◽  
Community Based ◽  
Community Based Research ◽  
Care Community

Impact of Revaccinating Children Who Initially Received Measles Vaccine Before 10 Months of Age

PEDIATRICS ◽  
1986 ◽  
Vol 77 (4) ◽  
pp. 471-476
Author(s):  
Harrison C. Stetler ◽  
Walter A. Orenstein ◽  
Roger H. Bernier ◽  
Kenneth L. Herrmann ◽  
Barry Sirotkin ◽  
...  
Keyword(s):  
Immune Response ◽  
Immune Responses ◽  
Hemagglutination Inhibition ◽  
Cytopathic Effect ◽  
Neutralizing Antibody ◽  
Primary Vaccination ◽  
Measles Vaccine ◽  
Negative Study ◽  
Enzymelinked Immunosorbent Assay ◽  
Altered Immune Response

Two hundred fifty-four infants who had received measles vaccine at &lt;10 months of age were revaccinated at ≥15 months of age, and their immune responses were compared with 129 control infants who received their first doses of measles vaccine at ≥15 months of age. Sera were collected at the time of revaccination (study infants) or primary vaccination (control infants), 3 weeks, and 8 months later and tested for antibody by hemagglutination inhibition (HI), enzymelinked immunosorbent assay (ELISA), and cytopathic effect neutralization (CPEN). Of the 121 study infants who were initially HI negative, 116 (95.9%) made HI antibody 3 weeks postrevaccination compared with 126 (99.2%) of 127 control infants (P = 0.19). Of the 63 study infants with no initial detectable antibody by any of the three tests, 14 (22.2%) had a measles-specific IgM response 3 weeks postrevaccination compared with 37 of 50 (74.0%) randomly chosen control infants. By 8 months after revaccination, the 121 initially HI-negative study infants were significantly less likely to have detectable HI antibodies than control infants (52.1% v 97.6%) (P &lt; .001). However, 96.7% of these 121 study infants had detectable neutralizing antibody 8 months postrevaccination, an antibody thought to correlate best with protection. This study confirms the altered immune response to revaccination in infants first vaccinated prior to 10 months of age; however, the data suggest that most of these infants were successfully primed and are probably protected after revaccination.

scholarly journals Integrated management of non-communicable diseases in low-income settings: palliative care, primary care and community health synergies

2018 ◽  
pp. bmjspcare-2018-001579 ◽  
Author(s):  
Daniel Munday ◽  
Vandana Kanth ◽  
Shadrach Khristi ◽  
Liz Grant
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Community Health ◽  
Low Income ◽  
Integrated Management ◽  
Premature Mortality ◽  
Communicable Diseases ◽  
Health Coverage ◽  
Non Communicable Diseases ◽  
Care Community

Palliative care is recognised as a fundamental component of Universal Health Coverage (UHC), which individual countries, led by the United Nations and the WHO, are committed to achieving worldwide by 2030—Sustainable Development Goal (SDG) 3.8. As the incidence of non-communicable diseases (NCD) in low-income and middle-income countries (LMICs) increases, their prevention and control are the central aspects of UHC in these areas. While the main focus is on reducing premature mortality from NCDs (SDG 3.4), palliative care is becoming increasingly important in LMICs, in which 80% of the need is found. This paper discusses the challenges of providing comprehensive NCD management in LMICs, the role of palliative care in addressing the huge and growing burden of serious health-related suffering, and also its scope for leveraging various aspects of primary care NCD management. Drawing on experiences in India and Nepal, and particularly a project on the India–Nepal border in which palliative care, community health and primary care-led NCD management are being integrated, we explore the synergies arising and describe a model where palliative care is integral to the whole spectrum of NCD management, from promotion and prevention, through treatment, rehabilitation and palliation. We believe this model could provide a framework for integrated NCD management more generally in rural India and Nepal and also other LMICs as they work to make NCD management as part of UHC a reality.

scholarly journals Systemic glucocorticoid usage in dogs under primary veterinary care in the UK: prevalence and risk factors

2019 ◽  
Vol 185 (4) ◽  
pp. 108-108 ◽  
Author(s):  
Doaa A Elkholly ◽  
Dan O’Neill ◽  
Andrea K Wright ◽  
Kennedy Mwacalimba ◽  
Laura S Nolan ◽  
...  
Keyword(s):  
Primary Care ◽  
Medium Size ◽  
Age Group ◽  
Systemic Glucocorticoid ◽  
Oral Preparation ◽  
Systemic Glucocorticoids ◽  
Study Population ◽  
Long Acting ◽  
The Uk ◽  
To Receive

Glucocorticoids are widely used in primary care veterinary practices. The study aimed to quantify the usage of systemic glucocorticoids (SGC) in dogs in the UK using primary care treatment records recorded during 2013 in the VetCompass Programme. From a study population of 455 557 dogs, 28 472 dogs (6.2 per cent, 95 per cent CI 6.2 to 6.3) received a total of 50 971 SGC therapy events in 2013. Prednisolone represented the most frequently used oral preparation (27 362 events, 90.0 per cent of oral events). Dexamethasone sodium phosphate was the most commonly used injectable agent (12 796 events, 62.7 per cent of injectable events). The most common breed treated was Staffordshire Bull Terriers (2236/28 472 dogs, 7.9 per cent, 95 per cent CI 7.5 to 8.2) and within-breed prevalence of SGC usage was 2236/32 635, 6.9 per cent, 95 per cent CI 6.6 to 7.1. The most commonly treated age group was dogs older than eight years (8931/28472, 31.4 per cent) and the most commonly treated bodyweight group was 10.01–20.0 kg (7918/28 472, 27.8 per cent). Dexamethasone and prednisolone were the most commonly prescribed SGC. Short-acting and intermediate-acting injectable SGC were more commonly used compared with long-acting injectable SGC. Older and medium size dogs were most likely to receive SGC and certain breeds appeared predisposed. These data can provide a useful benchmark for glucocorticoid usage and highlight the benefits from ‘Big Data’ analyses.

scholarly journals Theoretical and empirical study of the phenomenon of emotional deprivation

2021 ◽  
pp. 62-69
Author(s):  
Natalia Tsumarieva
Keyword(s):  
Mental State ◽  
Scientific Literature ◽  
Semantic Content ◽  
Age Group ◽  
Psychosomatic Disorders ◽  
Study Analysis ◽  
Emotional Needs ◽  
Theoretical Approaches ◽  
Emotional Deprivation ◽  
Negative Feelings

The aim of this article is the implementation of theoretical and empirical analysis of the essence of emotionality. Methods of study: analysis, comparison and systematization of the scientific literature concerning the phenomenon of an emotional deprivation, observation, analysis of the documentation, the method of the peer review, a conversation, a testing, a survey for the identification of the consequences of the emotional deprivation. Results. We figured out that emotional deprivation very closely connected with other kinds of deprivation and is part of the mental deprivation. The semantic content of the notion "emotional deprivation" depends on the conceptual and theoretical approaches of the author, studying of the specific conditions of its origin and also the specific of age group. However most scientists continue determine emotional deprivation as a category of mental state of the personality. Emotional deprivation is an instrument of change and transformation in the psychics, affects somatic health, causes psychosomatic disorders and mental disorders. It is generalized that emotional deprivation through negative feelings and emotions affects other mental spheres of personality – volitional, intellectual, motivational, value-oriented, changing them, deforming, complicating, ie affects the psyche in general. Conclu s ion s . Emotional deprivation can&apos;t be equated as a mental state, because it is connected indirectly with the mental state of the deprived personality, but it isn&apos;t one. To our mind, emotional deprivation is a process of long lasting stay of the personality in conditions of emotionally impoverished environment, conditioned by displeasure of emotional needs, loss, limitation, insufficiency or absence of abilities for installation of close connections, contacts and interaction with a significant person. It causes dysfunction, breaches and disarrays of the mental sphere of a personality.

scholarly journals Persistence with oral bisphosphonates and denosumab among older adults in primary care in Ireland

2020 ◽  
Author(s):  
Mary E. Walsh ◽  
Tom Fahey ◽  
Frank Moriarty
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Vitamin D ◽  
Fracture Risk ◽  
Bone Health ◽  
Pharmacological Treatment ◽  
Age Group ◽  
Oral Bisphosphonates ◽  
Factors Associated ◽  
Increase Fracture Risk

ABSTRACTPurposeGaps in pharmacological treatment for osteoporosis can reduce effectiveness. This study aimed to estimate persistence rates for oral bisphosphonates and denosumab in older primary care patients and identify factors associated with discontinuation.MethodsOlder patients newly prescribed oral bisphosphonates or denosumab between 2012 and 2017 were identified from 44 general practices (GP) in Ireland. Persistence without a coverage gap of >90 days was calculated for both medications from therapy initiation. Factors associated with time to discontinuation were explored using Cox regression analysis. Exposures included age-group, osteoporosis diagnosis, fracture history, calcium/vitamin D prescription, number of other medications, health cover, dosing frequency (bisphosphonates) and previous bone-health medication (denosumab).ResultsOf 41,901 patients, n=1,569 newly initiated on oral bisphosphonates and n=1,615 on denosumab. Two-year persistence was 49.4% for oral bisphosphonates and 53.8% for denosumab and <10% were switched to other medication. Having state-funded health cover was associated with a lower hazard of discontinuation for both oral bisphosphonates (HR=0.49, 95%CI=0.36-0.66, p<0.01) and denosumab (HR=0.71, 95%CI=0.57-0.89, p<0.01). Older age-group, number of medications and calcium/vitamin D prescription were also associated with better bisphosphonate persistence while having osteoporosis diagnosed was associated with better denosumab persistence.ConclusionPersistence for osteoporosis medications is sub-optimal. Of concern, few patients are switched to other bone-health treatments when denosumab is stopped which could increase fracture risk. Free access to GP services and medications may have resulted in better medication persistence in this cohort. Future research should explore prescribing choices in primary-care osteoporosis management and evaluate cost-effectiveness of interventions for improving persistence.SUMMARYGaps in pharmacological treatment for osteoporosis can reduce its effectiveness. This study found approximately half of older adults in primary care newly initiated on bisphosphonates or denosumab were still taking these after 2 years. Abrupt discontinuation of denosumab without switching to an alternative is concerning due to increased fracture risk.

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