scholarly journals Geographical Pattern of COVID-19-Related Outcomes over the Pandemic Period in France: A Nationwide Socio-Environmental Study

2021 ◽  
Vol 18 (4) ◽  
pp. 1824
Author(s):  
Séverine Deguen ◽  
Wahida Kihal-Talantikite
Keyword(s):  
Health Care ◽  
Air Pollution ◽  
Spatial Distribution ◽  
High Risk ◽  
Living Conditions ◽  
Hospital Death ◽  
Ratio Test ◽  
Geographic Pattern ◽  
Environmental Determinants

Background: Several studies have investigated the implication of air pollution and some social determinants on COVID-19-related outcomes, but none of them assessed the implication of spatial repartition of the socio-environmental determinants on geographic variations of COVID-19 related outcomes. Understanding spatial heterogeneity in relation to the socio-environmental determinant and COVID-19-related outcomes is central to target interventions toward a vulnerable population. Objectives: To determine the spatial variability of COVID-19 related outcomes among the elderly in France at the department level. We also aimed to assess whether a geographic pattern of Covid-19 may be partially explained by spatial distribution of both long-term exposure to air pollution and deprived living conditions. Methods: This study considered four health events related to COVID-19 infection over the period of 18 March and 02 December 2020: (i) hospitalization, (ii) cases in intensive health care in the hospital, (iii) death in the hospital, and (iv) hospitalized patients recovered and returned back home. We used the percentage of household living in an overcrowding housing to characterize the living conditions and long-term exposure to NO2 to analyse the implication of air pollution. Using a spatial scan statistic approach, a Poisson cluster analysis method based on a likelihood ratio test and Monte Carlo replications was applied to identify high-risk clusters of a COVID-19-related outcome. Result: our results revealed that all the outcomes related to COVID-19 infection investigated were not randomly distributed in France with a statistically significant cluster of high risk located in Eastern France of the hospitalization, cases in the intensive health care at the hospital, death in the hospital, and recovered and returned back home compared to the rest of France (relative risk, RR = 1.28, p-value = 0.001, RR = 3.05, p = 0.001, RR = 2.94, p = 0.001, RR = 2.51, p = 0.001, respectively). After adjustments for socio-environmental determinants, the crude cluster shifts according to different scenarios suggested that both the overcrowding housing level and long-term exposure to largely NO2 explain the spatial distribution of COVID-19-related outcomes. Conclusions: Our findings suggest that the geographic pattern of COVID-19-related outcomes is largely explained by socio-spatial distribution of long-term exposure to NO2. However, to better understand spatial variations of COVID-19-related outcomes, it would be necessary to investigate and adjust it for other determinants. Thus, the current sanitary crisis reminds us of how unequal we all are in facing this disease.

A Model Program: Neonatal Nurse Practitioners Providing Community Health Care for High-Risk Infants

2008 ◽  
Vol 27 (3) ◽  
pp. 163-169 ◽  
Author(s):  
Elias Provencio Vasquez ◽  
Kathleen Pitts ◽  
Nilson Enrique Mejia
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Intervention Program ◽  
Drug Exposure ◽  
Care Providers ◽  
Neonatal Nurse Practitioners ◽  
High Risk Infants

Perinatal drug exposure costs our communities millions of dollars each year in hospital fees and in services such as foster care, child protection, and drug treatment. Infants and their families in this group require substantial long- term health care and community resources. Neonatal health care providers should take an active role in developing and implementing home visitation programs to support early hospital discharge and continuity of care for these high- risk infants and their families. Neonatal nurse practitioners should prepare in the future to practice not only in secondary- and tertiary-level neonatal centers, but also in follow-up clinics, long-term developmental centers, and the community. This article describes a home intervention program delivered by neonatal nurse practitioners for high-risk infants and their mothers. The target population is infants exposed prenatally to drugs and/or alcohol.

scholarly journals COVIDApp as an Innovative Strategy for the Management and Follow-Up of COVID-19 Cases in Long-Term Care Facilities in Catalonia: Implementation Study

10.2196/21163 ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e21163 ◽  
Author(s):  
Patricia Echeverría ◽  
Miquel Angel Mas Bergas ◽  
Jordi Puig ◽  
Mar Isnard ◽  
Mireia Massot ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Real Time ◽  
Health Care Workers ◽  
Long Term Care ◽  
Term Care ◽  
Health Crisis ◽  
Care Workers ◽  
Care Facilities

Background The coronavirus disease (COVID-19) pandemic has caused an unprecedented worldwide public health crisis that requires new management approaches. COVIDApp is a mobile app that was adapted for the management of institutionalized individuals in long-term care facilities. Objective The aim of this paper is to report the implementation of this innovative tool for the management of long-term care facility residents as a high-risk population, specifically for early identification and self-isolation of suspected cases, remote monitoring of mild cases, and real-time monitoring of the progression of the infection. Methods COVIDApp was implemented in 196 care centers in collaboration with 64 primary care teams. The following parameters of COVID-19 were reported daily: signs/symptoms; diagnosis by reverse transcriptase–polymerase chain reaction; absence of symptoms for ≥14 days; total deaths; and number of health care workers isolated with suspected COVID-19. The number of at-risk centers was also described. Results Data were recorded from 10,347 institutionalized individuals and up to 4000 health care workers between April 1 and 30, 2020. A rapid increase in suspected cases was seen until day 6 but decreased during the last two weeks (from 1084 to 282 cases). The number of confirmed cases increased from 419 (day 6) to 1293 (day 22) and remained stable during the last week. Of the 10,347 institutionalized individuals, 5,090 (49,2%) remained asymptomatic for ≥14 days. A total of 854/10,347 deaths (8.3%) were reported; 383 of these deaths (44.8%) were suspected/confirmed cases. The number of isolated health care workers remained high over the 30 days, while the number of suspected cases decreased during the last 2 weeks. The number of high-risk long-term care facilities decreased from 19/196 (9.5%) to 3/196 (1.5%). Conclusions COVIDApp can help clinicians rapidly detect and remotely monitor suspected and confirmed cases of COVID-19 among institutionalized individuals, thus limiting the risk of spreading the virus. The platform shows the progression of infection in real time and can aid in designing new monitoring strategies.

scholarly journals Health and Social Problems in Indonesian Elderly. How Can Health Care System To Overcome ?

2019 ◽  
Vol 1 (2) ◽  
pp. 86-89
Author(s):  
Iwan Rusdi
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care System ◽  
Service Provider ◽  
Elderly Population ◽  
Long Term Care ◽  
Term Care ◽  
Geriatric Service ◽  
Care System

Increasing elderly population is a problem in Indonesia. Many problems faced in elderly.  Elderly are high risk to experience a disease or illness. As well as, long term care is needed for release the disease. A changing in biopsychosocial also important for service provider to control the effect. Collaboration and partnerships is useful to develop strengthening in creating health care system. Furthermore, policy maker and service provider are also better able to review and refine their existing measure, policies, product and geriatric service, which  target elderly population in Indonesia.

scholarly journals Long-term outcomes of lifestyle intervention to prevent type 2 diabetes in people at high risk in primary health care

2021 ◽  
Author(s):  
Reeta Rintamäki ◽  
Nina Rautio ◽  
Markku Peltonen ◽  
Jari Jokelainen ◽  
Sirkka Keinänen-Kiukaanniemi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
High Risk ◽  
Lifestyle Intervention ◽  
Long Term Outcomes ◽  
Primary Health

scholarly journals COVIDApp as an Innovative Strategy for the Management and Follow-Up of COVID-19 Cases in Long-Term Care Facilities in Catalonia: Implementation Study (Preprint)

2020 ◽  
Author(s):  
Patricia Echeverría ◽  
Miquel Angel Mas Bergas ◽  
Jordi Puig ◽  
Mar Isnard ◽  
Mireia Massot ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Real Time ◽  
Health Care Workers ◽  
Long Term Care ◽  
Term Care ◽  
Health Crisis ◽  
Care Workers ◽  
Care Facilities

BACKGROUND The coronavirus disease (COVID-19) pandemic has caused an unprecedented worldwide public health crisis that requires new management approaches. COVIDApp is a mobile app that was adapted for the management of institutionalized individuals in long-term care facilities. OBJECTIVE The aim of this paper is to report the implementation of this innovative tool for the management of long-term care facility residents as a high-risk population, specifically for early identification and self-isolation of suspected cases, remote monitoring of mild cases, and real-time monitoring of the progression of the infection. METHODS COVIDApp was implemented in 196 care centers in collaboration with 64 primary care teams. The following parameters of COVID-19 were reported daily: signs/symptoms; diagnosis by reverse transcriptase–polymerase chain reaction; absence of symptoms for ≥14 days; total deaths; and number of health care workers isolated with suspected COVID-19. The number of at-risk centers was also described. RESULTS Data were recorded from 10,347 institutionalized individuals and up to 4000 health care workers between April 1 and 30, 2020. A rapid increase in suspected cases was seen until day 6 but decreased during the last two weeks (from 1084 to 282 cases). The number of confirmed cases increased from 419 (day 6) to 1293 (day 22) and remained stable during the last week. Of the 10,347 institutionalized individuals, 5,090 (49,2%) remained asymptomatic for ≥14 days. A total of 854/10,347 deaths (8.3%) were reported; 383 of these deaths (44.8%) were suspected/confirmed cases. The number of isolated health care workers remained high over the 30 days, while the number of suspected cases decreased during the last 2 weeks. The number of high-risk long-term care facilities decreased from 19/196 (9.5%) to 3/196 (1.5%). CONCLUSIONS COVIDApp can help clinicians rapidly detect and remotely monitor suspected and confirmed cases of COVID-19 among institutionalized individuals, thus limiting the risk of spreading the virus. The platform shows the progression of infection in real time and can aid in designing new monitoring strategies.

Sign in / Sign up

Export Citation Format

Share Document