scholarly journals The Epidemiology of COVID-19 and MS-Related Characteristics in a National Sample of People With MS in China

2021 ◽  
Vol 12 ◽  
Author(s):  
Yao Zhang ◽  
Hexiang Yin ◽  
Yan Xu ◽  
Tao Xu ◽  
Bin Peng ◽  
...  
Keyword(s):  
Immunoglobulin G ◽  
Immune Status ◽  
Preventive Measures ◽  
Final Analysis ◽  
National Sample ◽  
Continuous Treatment ◽  
Online Questionnaire ◽  
Protective Measures ◽  
Hospital Database ◽  
Receive Treatment

Few studies have focused on immune status and disease activity in MS patients during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study is to investigate immune status, COVID-19 infection, and attacks in MS patients during the pandemic. An online questionnaire about COVID-19 infection, MS attack, and MS treatment during the pandemic was administered to all 525 MS patients registered in our hospital database from January 1, 2011, to June 1, 2020. Only 384 responded, of which 361 patients could be included in the final analysis. During the pandemic, 42.1% of the 361 patients and 65.0% of the 234 patients on immunotherapies were exposed to teriflunomide. Compared to patients who didn't receive treatment, patients exposed to DMTs had significantly lower levels of neutrophils (P < 0.01) and immunoglobulin G (P < 0.01), and patients exposed to immunosuppressants had significantly lower levels of immunoglobulin G (P < 0.05). Over 80% of our patients followed effective protective measures and none of the 361 MS patients in our cohort contracted COVID-19. Patients whose treatment was disrupted had a significantly higher annualized relapse rate (ARR) during than before the pandemic (P < 0.01), while the ARR of patients with continuous treatment or without treatment remained unchanged. During the pandemic, the risk of MS attack due to treatment disruption possibly outweighs the risk of COVID-19 infection under preventive measures, and MS treatment maintenance might be necessary.

scholarly journals The Impact of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorder Beyond Infection Risk

2021 ◽  
Vol 12 ◽  
Author(s):  
Hexiang Yin ◽  
Yao Zhang ◽  
Yan Xu ◽  
Bin Peng ◽  
Liying Cui ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Immune Status ◽  
Immune Cell ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Online Questionnaire ◽  
Protective Measures ◽  
Cell Counts ◽  
Treatment Interruptions ◽  
The Impact

There is an increasing need for better understanding of the impact of coronavirus disease 2019 (COVID-19) on patients with neuromyelitis optica spectrum disorder (NMOSD). A few pilot studies have investigated COVID-19 infections in NMOSD, but few studies have addressed disease activity and immune status of these patients during the pandemic. We carried out a cross-sectional study to examine immune status, relapses, and COVID-19 infections in a cohort of NMOSD patients using an electronic patient registry (MSNMOBase) for multiple sclerosis and related disorders. An online questionnaire was administered to all NMOSD patients in the registry from January 1, 2011, to June 1, 2020. Clinical demographic characteristics, immune status, relapses, treatments, COVID-19 infections, and preventive measures were evaluated. Of the 752 registered patients, 535 (71.1%) with qualified data were included. A total of 486 used preventive therapies during the pandemic, including mycophenolate mofetil (71.2%), azathioprine (13.3%), and other immunosuppressants (6.4%). Neither median immune cell counts nor immunoglobulin levels (p > 0.05) were significantly different between patients with or without immunosuppression. During the pandemic, no patients were diagnosed with COVID-19, and the majority (>95%) took one or more effective protective measures (e.g., wearing a mask and social distancing). However, a significantly higher annualized relapse rate (ARR) was observed in the 33 patients with treatment interruptions due to the pandemic compared to before it (p < 0.05), whereas ARR changes were not found in patients with continuous treatments or those without treatments (p > 0.05). Interruption frequency was significantly higher in patients with relapses compared to those without (34.9 vs. 15.7%, p < 0.01). For stable NMOSD patients during the pandemic, the risk of relapse due to treatment interruption may be higher than the risk of COVID-19 infection when protective measures are used, and continuous relapse-prevention treatments may be necessary.

scholarly journals Physicians’ Knowledge, Attitude and Practice of Generic Substitution in China: A Cross-Sectional Online Survey

2021 ◽  
Vol 18 (15) ◽  
pp. 7749
Author(s):  
Mingyue Zhao ◽  
Lingyi Zhang ◽  
Zhitong Feng ◽  
Yu Fang
Keyword(s):  
Online Survey ◽  
Generic Substitution ◽  
Generic Drugs ◽  
Final Analysis ◽  
Generic Medicine ◽  
Generic Medicines ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Ordered Logistic Regression ◽  
Tertiary Hospitals

The purpose of this study is to investigate physicians’ knowledge, attitudes and practice of generic medicine substitutions in China. We conducted a cross-sectional online questionnaire survey on physicians from secondary or tertiary hospitals in China from 2020 December to 2021 April. Descriptive statistical and ordered logistic regression were used for analysis. A total of 1225 physicians were included in the final analysis, and only 330 (26.94%) of them scored 4 or above in the knowledge part, which means that the physicians have a good knowledge of generic substitutions. Of the total, 586 (47.83%) agreed or strongly agreed that generic drugs could be substituted for originator drugs and 585 (47.75%) always or often prescribed generic medicines. The percentage of physicians with a positive attitude toward or that practice prescribing generic medicine is below 50%, which needs to be improved in China. Physicians’ knowledge, their attitude toward generic substitution, if familiar with the policy of generic substitution, and incentives for prescribing generic medicines are influencing factors for the practice of generic substitution. Our studies show that the practice of generic substitution by physicians could be improved by several measures in China. We suggested that the physicians should be taught more about the bulk-buy policy and the generic-originator equivalence evaluation policy. Moreover, government incentives to promote generic substitution should be established. Our study also suggested that physicians with less working experience and female physicians should learn more about generic substitution.

scholarly journals Pediatricians’ knowledge, attitudes and practices surrounding menstruation and feminine products

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Miriam R. Singer ◽  
Nikita Sood ◽  
Eli Rapoport ◽  
Haelynn Gim ◽  
Andrew Adesman ◽  
...  
Keyword(s):  
National Sample ◽  
Anticipatory Guidance ◽  
Clinical Practices ◽  
Online Questionnaire ◽  
Menstrual Cycles ◽  
Attitudes And Practices ◽  
Menstrual Health ◽  
Logistic Regressions ◽  
Primary Care Pediatricians ◽  
Knowledge Attitudes And Practices

AbstractObjectiveThis study investigates whether primary care pediatricians adhere to the American Academy of Pediatrics (AAP) recommendations by routinely evaluating patients’ menstrual cycles and educating patients about menstruation and feminine products. Additionally, this study examines pediatricians’ knowledge and attitudes surrounding menstrual health topics.MethodsA 53-item online questionnaire was developed to evaluate pediatricians’ knowledge, attitudes and clinical practices regarding menstruation-related topics. The questionnaire was emailed to 2500 AAP members using a geographically-stratified sampling approach, with pediatricians in each state selected randomly. Mann-Whitney U tests, t-tests, and logistic regressions were used to assess associations between correlates and pediatricians’ knowledge, attitudes and practices.ResultsFive hundred and eighteen out of 2500 pediatricians participated (response rate = 20.7%), 462 met inclusion criteria; 78.8% were female, 79.2% were Caucasian. The majority of the pediatricians (58.2%) were “not at all” or only “slightly” familiar with the AAP guidelines on anticipatory guidance surrounding menarche. Many reported they do not routinely provide anticipatory guidance regarding menstruation to pre-menarchal patients (24.7%), discuss menstruation with post-menarchal patients (33.1%) or ask patients the date of their last period (28.4%). The majority were unlikely to discuss feminine products with patients. Gaps in menstruation-related knowledge were noted. Male pediatricians were significantly less likely to evaluate patients’ menstrual cycles and provide patient-education regarding menstruation-related topics, and had significantly lower self-rated and measured knowledge of these topics.ConclusionsA concerning number of pediatricians in a national sample do not abide by AAP recommendations surrounding menstruation and exhibit knowledge gaps in this area. To effectively address the health needs of female patients, pediatricians should better incorporate menstrual health care into their clinical practice.

scholarly journals Behaviours regarding preventive measures against pandemic H1N1 influenza among Italian healthcare workers, October 2009

2009 ◽  
Vol 14 (49) ◽  
Author(s):  
G La Torre ◽  
D Di Thiene ◽  
C Cadeddu ◽  
W Ricciardi ◽  
A Boccia
Keyword(s):  
Healthcare Workers ◽  
Preventive Measures ◽  
H1n1 Influenza ◽  
The United States ◽  
Pandemic H1n1 ◽  
Online Questionnaire ◽  
Pandemic H1n1 Influenza ◽  
Region Of Residence ◽  
Similar Survey ◽  
Harvard School

A survey on attitudes and behaviours towards preventive measures against pandemic H1N1 influenza 2009 was carried out during the month of October 2009 in Italy through an online questionnaire adapted to the Italian situation from a similar survey of the Harvard School of Public Health in the United States (US). Results show that the intention to get vaccinated against pandemic H1N1 influenza 2009 is generally low and that there are differences in attitudes and behaviours towards preventive measures against pandemic H1N1 influenza 2009 between physicians and nurses, especially concerning vaccination. Differences relate also to sex, region of residence and marital status.

Legal aspects of ecotourism: towards creating an international legislative framework

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vera Stanković ◽  
Ana Batrićević ◽  
Vladan Joldžić
Keyword(s):  
Cultural Values ◽  
International Organizations ◽  
Preventive Measures ◽  
Legal Aspects ◽  
Law Reform ◽  
Cultural Resources ◽  
Protective Measures ◽  
Content Type ◽  
Legal Documents ◽  
Legislative Framework

Purpose This study aims to highlight the most important preventive measures that should be proposed by policymakers and adopted by (inter)national legislative bodies by changing existing or adopting new legal documents. The implementation of these measures should be performed by state bodies responsible for ecotourism, natural and cultural resources protection and ecotourism services users. Design/methodology/approach The theoretical legal approach was applied, based on a systematic review of international legally binding and non-binding documents related to ecotourism, adopted by relevant international organizations. Analysis of norms for preventive protection of natural and cultural values was done and followed by law-reform research in the form of recommendations that should be adopted as binding. Findings International legal documents relevant to ecotourism analysed in this paper are divided into two groups. The first regulates exclusively ecotourism issues, whereas the second deals with sustainable development and indirectly refers to ecotourism, as one of its segments. Analysed international legal documents require unambiguous norms regulating preventive protective measures in ecotourism by prescribing actual obligations and prohibitions for relevant subjects. Given recommendations are grouped into five types according to the subjects they are addressing (ecotourism experts, policymakers, legislators, natural and cultural conservationists, local communities, educators). Originality/value This study is the first that points to the need to amending international legal documents related to ecotourism through recommendations regarding natural and cultural values’ preventive protection.

A Comparison of Machine Risk Acceptance Results Among Trained Users of ANSI B11-TR3

2006 ◽  
Author(s):  
J. Etherton
Keyword(s):  
Risk Assessment ◽  
Iterative Process ◽  
Preventive Measures ◽  
Acceptable Risk ◽  
Protective Measures ◽  
The World ◽  
Company Culture ◽  
Local Risk ◽  
Risk Acceptance ◽  
A Company

The ANSI guideline on machine risk assessment, B11-TR3, describes risk assessment as an iterative process. This implies that protective measures of varied levels of technology can be successively evaluated until a risk that is acceptable is attained. The theories of risk acceptance are many. Reducing risk to a level that is agreed to be 'as low as reasonably practicable' (ALARP) is said to give focus to making a decision about when risk has been adequately reduced. Main (2004) says that "Although the concept of acceptable risk is becoming more commonly adopted throughout the world, a single level of acceptability cannot be universally applied. Acceptable risk is a function of many factors, and is specific to a company, culture, and time-era." Fischhoff et al. (1981) have argued that "the risk associated with the most acceptable option is not acceptable in any absolute sense. One accepts options, not risks, which are only one feature of options." This paper describes risk assessment groups in five manufacturing workplaces and discusses training that led to acceptable risk decisions for a hazardous machine system in each workplace. The composition of the five teams in this study ranged from a team with just a single engineer to teams involving several workplace personnel. The applied preventive measures ranged from measures that were tailored to meet corporate safety goals to measures that evolved from the local risk assessment team's ingenuity. The paper concludes with suggestions on how to make the risk acceptance concept meaningful in the training of future machine risk assessment teams.

scholarly journals GPs’ knowledge, use, and confidence in national physical activity and health guidelines and tools: a questionnaire-based survey of general practice in England

2017 ◽  
Vol 67 (663) ◽  
pp. e668-e675 ◽  
Author(s):  
Robin Chatterjee ◽  
Tim Chapman ◽  
Mike GT Brannan ◽  
Justin Varney
Keyword(s):  
Physical Activity ◽  
General Practice ◽  
Medical Officer ◽  
Final Analysis ◽  
Assessment Tools ◽  
Routine Practice ◽  
Multiple Choice Questions ◽  
Knowledge Use ◽  
Online Questionnaire ◽  
Brief Advice

BackgroundPhysical activity (PA) brief advice in health care is effective at getting individuals active. It has been suggested that one in four people would be more active if advised by a GP or nurse, but as many as 72% of GPs do not discuss the benefits of physical activity with patients.AimTo assess the knowledge, use, and confidence in national PA and Chief Medical Officer (CMO) health guidelines and tools among GPs in England.Design and settingOnline questionnaire-based survey of self-selecting GPs in England that took place over a 10-day period in March 2016.MethodThe questionnaire consisted of six multiple-choice questions and was available on the Doctors.net.uk (DNUK) homepage. Quotas were used to ensure good regional representation.ResultsThe final analysis included 1013 responses. Only 20% of responders were broadly or very familiar with the national PA guidelines. In all, 70% of GPs were aware of the General Practice Physical Activity Questionnaire (GPPAQ), but 26% were not familiar with any PA assessment tools, and 55% reported that they had not undertaken any training with respect to encouraging PA.ConclusionThe majority of GPs in England (80%) are unfamiliar with the national PA guidelines. Awareness of the recommended tool for assessment, GPPAQ, is higher than use by GPs. This may be because it is used by other clinical staff, for example, as part of the NHS Health Check programme. Although brief advice in isolation by GPs on PA will only be a part of the behaviour change journey, it is an important prompt, especially if repeated as part of routine practice. This study highlights the need for significant improvement in knowledge, skills, and confidence to maximise the potential for PA advice in GP consultations.

Real-world management of advanced prostate cancer: A Canadian comparison of academic specialists and community-based prostate cancer physicians.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 29-29
Author(s):  
Sebastien J. Hotte ◽  
Antonio Finelli ◽  
Kim N. Chi ◽  
Christina M. Canil ◽  
Neil Fleshner ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
National Sample ◽  
Future Research ◽  
Castration Resistant Prostate Cancer ◽  
Online Questionnaire ◽  
Community Based ◽  
Education Practice ◽  
Consensus Recommendations ◽  
Castration Resistant ◽  
Research Consortium

29 Background: The Canadian GU Research Consortium recently conducted a consensus development conference with 27 academic prostate cancer (PC) specialists leading to 31 consensus recommendations. We conducted a survey to compare community-based practice with the consensus recommendations on the management of metastatic castration sensitive prostate cancer (mCSPC), metastatic castration resistant prostate cancer (mCRPC) and non-metastatic castration resistant prostate cancer (nmCRPC). Methods: An 87-item online questionnaire was sent to 600 Canadian community urologists, medical oncologists, radiation oncologists, and general practitioner oncologists involved in the treatment of PC. Results: Seventy-two physicians responded to the questionnaire (12% response). A discordance of >25% was observed in 15 of 31 recommendations (48%). Among the areas of discordance were treatment approach for patients with nmCRPC and PSADT < 10 months who are negative for metastases on conventional imaging but metastatic on PET-based imaging. Of the academic physicians, 89% indicated treating with agents approved for nmCRPC compared to 50% of community physicians (p=0.0005). Important discrepancies were also observed across academic and community physicians for radiation to the prostate for low-volume mCSPC which was 74% vs 27%, (p<0.0001) respectively; criteria for stopping therapy in mCRPC in which 78% of academic physicians favored continuation of therapy in the event of PSA progression only, compared to 24% of community physicians. Sequencing of therapy after prior apalutamide for nmCRPC using subsequent docetaxel treatment was observed in 81% of academic physicians vs 35% of community physicians, (p<0.0001), and use of genetic testing was favored by 74% of academics vs 36% of community physicians, (p<0.0001) for newly diagnosed metastatic prostate cancer. Conclusions: The areas of discordance between a national sample of community-based PC physicians and academic consensus recommendations represent potential areas for education, practice tools and future research.

scholarly journals Acceptance of COVID-19 preventive measures as a tradeoff between health and social outcomes

2021 ◽  
Author(s):  
Aymery Constant ◽  
Donaldson ◽  
Karine Gallopel-Morvan ◽  
Jocelyn Raude
Keyword(s):  
Process Model ◽  
Online Survey ◽  
Open Space ◽  
Preventive Measures ◽  
Negative Effects ◽  
Perceived Efficacy ◽  
Protective Measures ◽  
Perceived Severity ◽  
Acceptance Rates ◽  
Effective Public Health

Background: A better understanding of the factors underlying their acceptance may contribute greatly to the design of more effective public health programs during the current and future pandemics. The objectives of the present study were to assess their acceptance after populations experienced their negative effects, and their relationships with COVID-19 perceptions.Methods: Data were collected from 2004 individuals through an online survey conducted 6 to 8 weeks after the first lockdown in France. Participants were asked whether they supported eight COVID-19 preventive measures. COVID-19-related perceptions were also assessed using an adapted version of Witte’s Extended Parallel Process Model, together with sociodemographic and environmental variables.Results: Acceptance rate reached 86.1 % for individual protective measures, such as make mask mandatory in public open space, and 70.0% for collective restrictions, such as isolating the most vulnerable people (80%) or forbidding public gatherings (79.3%). The least popular restrictions were closing all schools/universities and non-essential commerce such as bars and restaurants (57.2%). Acceptance of collective restrictions was positively associated with their perceived efficacy, fear, and perceived severity of COVID-19, and negatively with age older than 60 years. Acceptance of individual protective measures was associated with their perceived efficacy, fear, and perceived severity of COVID-19.Discussion: Acceptance rates of COVID-19 preventive measures were rather high, but varied according to their perceived social cost, and were more related to collective than personal protection. Preventive measures that minimize social costs while controlling the spread of the disease are more likely to be accepted during pandemics.

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