Quantitative comparison of SARS-CoV-2 nucleic acid amplification test and antigen testing algorithms: a decision analysis simulation model

Background Antigen tests for SARS-CoV-2 offer advantages over nucleic acid amplification tests (NAATs, such as RT-PCR), including lower cost and rapid return of results, but show reduced sensitivity. Public health organizations recommend different strategies for utilizing NAATs and antigen tests. We sought to create a framework for the quantitative comparison of these recommended strategies based on their expected performance. Methods We utilized a decision analysis approach to simulate the expected outcomes of six testing algorithms analogous to strategies recommended by public health organizations. Each algorithm was simulated 50,000 times in a population of 100,000 persons seeking testing. Primary outcomes were number of missed cases, number of false-positive diagnoses, and total test volumes. Outcome medians and 95% uncertainty ranges (URs) were reported. Results Algorithms that use NAATs to confirm all negative antigen results minimized missed cases but required high NAAT capacity: 92,200 (95% UR: 91,200-93,200) tests (in addition to 100,000 antigen tests) at 10% prevalence. Selective use of NAATs to confirm antigen results when discordant with symptom status (e.g., symptomatic persons with negative antigen results) resulted in the most efficient use of NAATs, with 25 NAATs (95% UR: 13-57) needed to detect one additional case compared to exclusive use of antigen tests. Conclusions No single SARS-CoV-2 testing algorithm is likely to be optimal across settings with different levels of prevalence and for all programmatic priorities. This analysis provides a framework for selecting setting-specific strategies to achieve acceptable balances and trade-offs between programmatic priorities and resource constraints.

Enhancing Performance and Health Outcomes with Optimal Exercise and Nutrition Programming

Exercise and nutrition, when used as a mode to improve health outcomes is well-researched and accepted by researchers and clinicians, alike. Numerous health organizations have developed general recommendations such as physical activity and exercise to inform the public how to improve health outcomes. More often than not, these guidelines are vague and do not suggest how to achieve optimal health via exercise and nutrition. These guidelines also fail to consider physiological and psychological variability for patients and individuals aiming to follow such guidelines. For example, current recommendations include exercise intensities based on low, moderate, and vigorous activity and many people may not understand the physiological cost of such exercise intensities. Presently, accessible consumer-grade technology allows for accurate measurements of relative heart rate, exercise time, distance, and estimated caloric expenditure which is presumed easy for any person to understand. Therefore, creating guidelines that target specific and measurable variables, such as relative heart rate may be more advantageous for individualized health optimization.

Key Challenges and Opportunities for Implementing School Located Vaccination Clinics for COVID-19 and Influenza: Roundtables With School Nurses and Immunization Programs

School-located vaccination clinics (SLVs) are an established strategy to offer influenza and routine vaccinations and improve student and community health. The COVID-19 pandemic has led many communities to expand SLVs to include COVID-19 vaccines. However, these SLVs are less documented than in the past due to the fast-paced nature of the pandemic and the additional pressures put on schools and public health organizations. We conducted five virtual roundtables with 30 school nurses and state immunization program managers from across the United States to gain insight into SLVs occurring during the COVID-19 pandemic. Roundtables explored participants’ experiences planning and implementing SLVs, including factors influencing success and available resources. Findings highlighted SLVs as an opportunity to increase access and equity for vaccines. Participants shared strategies for School-located vaccination (SLV) funding, partnership building, vaccine storage and management, consent, data sharing, messaging, and promotion. These shared experiences offer useful insights for those interested in future and sustained SLV implementation.

Financial compensation and talent retention in COVID-19 era: The mediating role of career planning

This research seeks to contribute to the retention Duhok kidney & diseases transplantation center (DKDTC), and health organizations their talent in COVID-19 era. To achieve this objective, we use (IBM SPSS Amoss V.22) to analyze the mediating role of career planning (CP) in the relationship of financial compensation (FC) with talent retention (TR) in DKDTC. The data collected was analyzed through 63 questionnaires, which was distributed to the talents working in DKDTC from May 2020 to March 2021. The researchers reached several conclusions, the most important of which are that CP has a partial mediating role in the relationship between FC and TR. Therefore, this research recommends enhancing the ability of DKDTC and health organizations to TR in a COVID-19 era and they must be relying on FC, and a program that includes clear steps in CP.

Actions of a regulatory nurse in the management of surgical waiting lists

ABSTRACT Objectives: to describe the actions of the regulatory nurse in the management of waiting lines for elective surgeries in a public hospital. Methods: this is an experience report about the actions of the regulatory nurse in the management of waiting lines for elective surgeries. Results: the results of this initiative were: diminution in waiting times; elimination of discrepancies that led to access inequality; promotion of safer treatments; actions of the nurse as a manager, conducting and mediating situations between services; autonomy from the high management of the hospital with regard to the manager of waiting lists; and effective communication due to a constant feedback with the medical teams. Final Considerations: the management of the surgical waiting lists must be continuous and systematic, and it must be broader, to include teams that are not involved yet. This initiative can be replicated and improved in other health organizations.

The Girls’ Leadership Academy: A Promising, Empowerment-Based Approach to the Prevention of Sexual Violence

Sexual violence (SV) is a pernicious issue that disproportionally impacts girls and women. Although few initiatives have demonstrated effectiveness in leading to reductions in SV, global health organizations have identified empowerment-based programs as a promising approach to SV prevention. The purpose of this article is to discuss the Girls Leadership Academy (GLA), a program of the Nebraska's Women's Center for Advancement, which is a “homegrown,” theoretically grounded, practice-based SV prevention program for adolescent girls. More specifically, we discuss previous research relevant to the GLA; the theoretical underpinnings of the GLA; and the history, context, and content of the GLA.

EXPRESS: Vaccination Acceptance across Cultures: The Roles of Collectivism, Empathy, and Homophily

How does culture influence vaccination acceptance? This is an important question facing managers, policymakers, and global health organizations. Even with effective vaccines for highly contagious diseases, humankind remains at risk from vaccine hesitancy. We conduct a largescale multilevel analysis of more than 400,000 survey respondents, finding that COVID-19 vaccination intentions are higher among people from countries higher in cultural collectivism (Study 1). Follow-up studies indicate that vaccination acceptance is higher among people that endorse collectivistic values because they feel more empathy for those afflicted by the disease (Studies 2a, 2b, 3), especially when victims of the disease have similar characteristics (e.g., political affiliation, lifestyle, personality) as themselves (Study 3). To encourage vaccination acceptance, we suggest promoting collectivistic values and empathic concern, as well as homophily through the portrayal of victims with characteristics like those hesitant to accept vaccination.

The Dynamics of Cross-Sector Collaboration in Centralized Disaster Governance: A Network Study of Interorganizational Collaborations during the MERS Epidemic in South Korea

The debate continues as to which governance structure is most appropriate for collaborative disaster response, particularly between centralization and decentralization. This article aims to contribute to this debate by analyzing the structural characteristics of a multisectoral network that emerged and evolved under strong state control during the 2015 outbreak of Middle East respiratory syndrome-coronavirus (MERS) in South Korea. This study particularly focuses on the evolution of intra- and inter-sectoral collaboration ties in the network. The data for the study were collected through a content analysis of government documents and news articles. Using social network analysis, the authors found that the network evolved into a centralized structure around a small number of governmental organizations at the central level, organizing the ties between participating organizations rather hierarchically. The network displayed a preponderance of internal ties both among health and non-health organizations and among public and nonpublic health organizations, but under different influences of structural characteristics. This tendency was intensified during the peak period. Based on these findings, the authors conclude that the centralization of disaster management may not or only marginally be conducive to cross-sector collaboration during public health disasters, calling for a careful design of governance structures for disaster response.

Analysis of Disability Due to Ear and Mastoid Diseases in Kyrgyzstan

One of the main medical and social problems is disability, which causes economic losses, both for citizens and for the state. This article presents an analysis of the indicators of disability and disability due to diseases of the ear and mastoid process in Kyrgyzstan for the period 2014–2019. In the republic in general and in the Osh region in particular, there is a slight increase in persons with disabilities among the adult category of the population in all classes of diseases under medical supervision in health organizations from 2014 until 2019 and a slight decrease in 2019. With the regional distribution of the frequency of the first recognized by persons with disabilities by diseases of the ear and mastoid process among the adult population, the Osh region ranks third, among children under 18 years old - seventh in rank. In the republic, against the background of the trend of a stable decrease in the number of adults with disabilities for diseases of the ear and mastoid process registered, an increase was observed among children under 18 years old only in 2018. Against the background of a decrease in the frequency of primarily recognized persons with disabilities for diseases of the ear and mastoid process among the category of adult population of the republic, children under 18 years old showed an increase in 2017 and 2018. In the Osh region, among adults, an increase was revealed in 2015 and 2016, and among children under 18 years old, against the background of a stable indicator for four years, a sharp increase in the indicator was in 2018. There is a need for a unified and integrated approach to disability-specific rehabilitation, as well as for individual rehabilitation and habilitation programs for persons with disabilities, with close inter-agency cooperation.