scholarly journals Asbestos in High-Risk Communities: Public Health Implications

2021 ◽  
Vol 18 (4) ◽  
pp. 1579
Author(s):  
Edward A. Emmett
Keyword(s):  
Public Health ◽  
High Risk ◽  
Fiber Type ◽  
Age Distribution ◽  
Occupational Exposures ◽  
Vulnerable Groups ◽  
Behavioral Risk ◽  
Community Needs ◽  
Community Exposure ◽  
Risk Communities

Asbestos-related diseases (ARDs)—mesothelioma, lung cancer, and asbestosis—are well known as occupational diseases. As industrial asbestos use is eliminated, ARDs within the general community from para-occupational, environmental, and natural exposures are more prominent. ARD clusters have been studied in communities including Broni, Italy; Libby, Montana; Wittenoom, Western Australia; Karain, Turkey; Ambler, Pennsylvania; and elsewhere. Community ARDs pose specific public health issues and challenges. Community exposure results in higher proportions of mesothelioma in women and a younger age distribution than occupational exposures. Exposure amount, age at exposure, fiber type, and genetic predisposition influence ARD expression; vulnerable groups include those with social and behavioral risk, exposure to extreme events, and genetic predispositions. To address community exposure, regulations should address all carcinogenic elongated mineral fibers. Banning asbestos mining, use, and importation will not reduce risks from asbestos already in place. Residents of high-risk communities are characteristically exposed through several pathways differing among communities. Administrative responsibility for controlling environmental exposures is more diffuse than for workplaces, complicated by diverse community attitudes to risk and prevention and legal complexity. The National Mesothelioma Registries help track the identification of communities at risk. High-risk communities need enhanced services for screening, diagnosis, treatment, and social and psychological support, including for retired asbestos workers. Legal settlements could help fund community programs. A focus on prevention, public health programs, particularization to specific community needs, and participation is recommended.

scholarly journals Healthcare-associated foodborne outbreaks in high-income countries: a literature review and surveillance study, 16 OEDC countries, 2001 to 2019

2021 ◽  
Vol 26 (41) ◽  
Author(s):  
Idesbald Boone ◽  
Bettina Rosner ◽  
Raskit Lachmann ◽  
Michele Luca D'Errico ◽  
Luigi Iannetti ◽  
...  
Keyword(s):  
Public Health ◽  
Food Safety ◽  
High Risk ◽  
Surveillance System ◽  
Interdisciplinary Collaboration ◽  
Meat Products ◽  
Oecd Countries ◽  
Vulnerable Groups ◽  
Foodborne Outbreaks ◽  
Healthcare Associated

Background Healthcare-associated foodborne outbreaks (HA-FBO) may have severe consequences, especially in vulnerable groups. Aim The aim was to describe the current state of HA-FBO and propose public health recommendations for prevention. Methods We searched PubMed, the Outbreak Database (Charité, University Medicine Berlin), and hand-searched reference lists for HA-FBO with outbreak onset between 2001 and 2018 from Organisation for Economic Co-operation and Development (OECD) countries and HA-FBO (2012–2018) from the German surveillance system. Additionally, data from the European Food Safety Authority were analysed. Results The literature search retrieved 57 HA-FBO from 16 OECD countries, primarily in the US (n = 11), Germany (n = 11) and the United Kingdom (n = 9). In addition, 28 HA-FBO were retrieved from the German surveillance system. Based on the number of outbreaks, the top three pathogens associated with the overall 85 HA-FBO were Salmonella (n = 24), norovirus (n = 22) and Listeria monocytogenes (n = 19). Based on the number of deaths, L. monocytogenes was the main pathogen causing HA-FBO. Frequently reported implicated foods were ‘mixed foods’ (n = 16), ‘vegetables and fruits’ (n = 15) and ‘meat and meat products’ (n = 10). Consumption of high-risk food by vulnerable patients, inadequate time-temperature control, insufficient kitchen hygiene and food hygiene and carriers of pathogens among food handlers were reported as reasons for HA-FBO. Conclusion To prevent HA-FBO, the supply of high-risk food to vulnerable people should be avoided. Well working outbreak surveillance facilitates early detection and requires close interdisciplinary collaboration and exchange of information between hospitals, food safety and public health authorities.

scholarly journals Identifying At-Risk Communities and Key Vulnerability Indicators in the COVID-19 Pandemic

2021 ◽  
Author(s):  
Savannah Thais ◽  
Shaine Leibowitz ◽  
Alejandra Rios Gutierrez ◽  
Alexandra Passarelli ◽  
Stephanie Santo ◽  
...  
Keyword(s):  
Public Health ◽  
Health Inequities ◽  
Data Sources ◽  
Risk Assessments ◽  
The Public ◽  
Community Needs ◽  
Vulnerability Indicators ◽  
Disparate Data ◽  
Risk Communities ◽  
Robust Integration

AbstractThroughout the COVID-19 pandemic, certain communities have been disproportionately exposed to detrimental health outcomes and socioeconomic injuries. Quantifying community needs is crucial for identifying testing and service deserts, effectively allocating resources, and informing funding and decision making. We have constructed research-driven metrics measuring the public health and economic impacts of COVID-19 on vulnerable populations. In this work we further examine and validate these indices by training supervised models to predict proxy outcomes and analyzing the feature importances to identify gaps in our original metric design. The indices analyzed in this work are unique among COVID-19 risk assessments due to their robust integration of disparate data sources. Together, they enable more effective responses to COVID-19 driven health inequities.

Harm Reduction in the Domestic Violence Context

2019 ◽  
pp. 332-361
Author(s):  
Courtney Cross
Keyword(s):  
Public Health ◽  
Domestic Violence ◽  
Criminal Justice ◽  
High Risk ◽  
Harm Reduction ◽  
Abusive Relationships ◽  
Health Practices ◽  
High Risk Behaviors ◽  
Community Needs ◽  
The Relationship

Harm reduction is a school of thought born out of public health practices: the goal of harm reduction is to mitigate the collateral dangers associated with high-risk behaviors so that individuals engaging in those activities are exposed to less harm overall. This piece argues that there is a need for harm reduction practices to implemented in the domestic violence context, specifically when working with survivors who have not, for myriad reasons, left their abusive relationships. Harm reduction in this context would include providing services in accordance with survivors’ self-identified needs and goals—services that are not contingent on ending the relationship. Explicit incorporation of harm reduction principles into domestic violence practice would also reenergize the larger domestic violence movement by shifting the focus away from one-size-fits-all criminal justice solutions and back onto survivor autonomy and community needs.

scholarly journals Psychological and Behavioral Predictors of Vaccine Efficacy: Considerations for COVID-19

2021 ◽  
pp. 174569162198924
Author(s):  
Annelise A. Madison ◽  
M. Rosie Shrout ◽  
Megan E. Renna ◽  
Janice K. Kiecolt-Glaser
Keyword(s):  
Risk Factors ◽  
Side Effects ◽  
Vaccine Efficacy ◽  
Psychological Factors ◽  
Behavioral Interventions ◽  
Vulnerable Groups ◽  
Behavioral Risk Factors ◽  
Behavioral Risk ◽  
Vaccine Response ◽  
The Impact

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine candidates are being evaluated, with the goal of conferring immunity on the highest percentage of people who receive the vaccine as possible. It is noteworthy that vaccine efficacy depends not only on the vaccine but also on characteristics of the vaccinated. Over the past 30 years, a series of studies has documented the impact of psychological factors on the immune system’s vaccine response. Robust evidence has demonstrated that stress, depression, loneliness, and poor health behaviors can impair the immune system’s response to vaccines, and this effect may be greatest in vulnerable groups such as the elderly. Psychological factors are also implicated in the prevalence and severity of vaccine-related side effects. These findings have generalized across many vaccine types and therefore may be relevant to the SARS-CoV-2 vaccine. In this review, we discuss these psychological and behavioral risk factors for poor vaccine responses, their relevance to the COVID-19 pandemic, as well as targeted psychological and behavioral interventions to boost vaccine efficacy and reduce side effects. Recent data suggest these psychological and behavioral risk factors are highly prevalent during the COVID-19 pandemic, but intervention research suggests that psychological and behavioral interventions can increase vaccine efficacy.

Screening at ports of entry for Ebola Virus Disease in England—a descriptive analysis of screening assessment data, 2014–2015

2020 ◽  
Author(s):  
Nicki L Boddington ◽  
Sophia Steinberger ◽  
Richard G Pebody
Keyword(s):  
Public Health ◽  
High Risk ◽  
Secondary Care ◽  
Ebola Virus ◽  
Virus Disease ◽  
Descriptive Analysis ◽  
Health Assessment ◽  
Ebola Virus Disease ◽  
Screening Assessment

Abstract Background In response to the outbreak of Ebola Virus Disease (EVD) in West Africa in 2014 and evidence of spread to other countries, pre-entry screening was introduced by PHE at five major ports of entry in the England. Methods All passengers that entered the England via the five ports returning from Liberia, Guinea and Sierra Leonne were required to complete a Health Assessment Form and have their temperature taken. The numbers, characteristics and outcomes of these passengers were analysed. Results Between 14 October 2014 and 13 October 2015, a total of 12 648 passengers from affected countries had been screened. The majority of passengers were assessed as having no direct contact with EVD cases or high-risk events (12 069, 95.4%), although 535 (4.2%) passengers were assessed as requiring public health follow-up. In total, 39 passengers were referred directly to secondary care, although none were diagnosed with EVD. One high-risk passenger was later referred to secondary care and diagnosed with EVD. Conclusions Collection of these screening data enabled timely monitoring of the numbers and characteristics of passengers screened for EVD, facilitated resourcing decisions and acted as a mechanism to inform passengers of the necessary public health actions.

scholarly journals Mask-Ematics: Modeling the Effects of Masks in COVID-19 Transmission in High-Risk Environments

Epidemiologia ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 207-226
Author(s):  
Anthony Morciglio ◽  
Bin Zhang ◽  
Gerardo Chowell ◽  
James M. Hyman ◽  
Yi Jiang
Keyword(s):  
Public Health ◽  
High Risk ◽  
Disease Transmission ◽  
Large Fraction ◽  
Critical Mass ◽  
Transmission Model ◽  
Reproductive Number ◽  
High Quality ◽  
Moderate Quality ◽  
Epidemic Size

The COVID-19 pandemic has placed an unprecedented burden on public health and strained the worldwide economy. The rapid spread of COVID-19 has been predominantly driven by aerosol transmission, and scientific research supports the use of face masks to reduce transmission. However, a systematic and quantitative understanding of how face masks reduce disease transmission is still lacking. We used epidemic data from the Diamond Princess cruise ship to calibrate a transmission model in a high-risk setting and derive the reproductive number for the model. We explain how the terms in the reproductive number reflect the contributions of the different infectious states to the spread of the infection. We used that model to compare the infection spread within a homogeneously mixed population for different types of masks, the timing of mask policy, and compliance of wearing masks. Our results suggest substantial reductions in epidemic size and mortality rate provided by at least 75% of people wearing masks (robust for different mask types). We also evaluated the timing of the mask implementation. We illustrate how ample compliance with moderate-quality masks at the start of an epidemic attained similar mortality reductions to less compliance and the use of high-quality masks after the epidemic took off. We observed that a critical mass of 84% of the population wearing masks can completely stop the spread of the disease. These results highlight the significance of a large fraction of the population needing to wear face masks to effectively reduce the spread of the epidemic. The simulations show that early implementation of mask policy using moderate-quality masks is more effective than a later implementation with high-quality masks. These findings may inform public health mask-use policies for an infectious respiratory disease outbreak (such as one of COVID-19) in high-risk settings.

scholarly journals Nurse-led PrEP-RN clinic: a prospective cohort study exploring task-Shifting HIV prevention to public health nurses

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040817
Author(s):  
Patrick O'Byrne ◽  
Amanda Vandyk ◽  
Lauren Orser ◽  
Marlene Haines
Keyword(s):  
Public Health ◽  
Cohort Study ◽  
High Risk ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Secondary Outcome ◽  
Bivariate Analysis ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Risk Criteria

ObjectiveTo report the results of a nurse-led pre-exposure prophylaxis (PrEP) delivery service.DesignThis was a prospective cohort study conducted from 5 August 2018 to 4 March 2020. It involved manual chart review to collect data. Variables were described using frequencies and percentages and analysed using χ2 testing. Those significant in bivariate analysis were retained and entered into a binary multiple logistic regression. Hierarchical modelling was used, and only significant factors were retained.SettingThis study occurred in an urban public health unit and community-based sexually transmitted infection (STI) clinic in Ottawa, Canada.ParticipantsOf all persons who were diagnosed with a bacterial STI in Ottawa and everyone who presented to our STI clinic during the study period, there were 347 patients who met our high-risk criteria for PrEP; these criteria included patients who newly presented with any of the following: HIV contacts, diagnosed with a bacterial STI or single use of HIV PEP. Further, eligibility could be determined based on clinical judgement. Patients who met the foregoing criteria were appropriate for PrEP-RN, while lower-risk patients were referred to elsewhere. Of the 347 patients who met our high-risk criteria, 47% accepted and 53% declined. Of those who accepted, 80% selected PrEP-registered nurse (RN).Primary and secondary outcome measuresUptake, acceptance, engagement and attrition factors of participants who obtained PrEP through PrEP-RN.Findings69% of participants who were eligible attended their intake PrEP-RN visit. 66% were retained in care. Half of participants continued PrEP and half were lost to follow-up. We found no significant differences in the uptake, acceptance, engagement and attrition factors of participants who accessed PrEP-RN regarding reason for referral, age, ethnicity, sexual orientation, annual income, education attainted, insurance status, if they have a primary care provider, presence or absence of depression or anxiety and evidence of newly acquired STI during the study period.ConclusionsNurse-led PrEP is an appropriate strategy for PrEP delivery.

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