Prevalence of severe adverse events among health professionals after receiving the first dose of the ChAdOx1 nCoV-19 coronavirus vaccine (Covishield) in Togo, March 2021

Background The coronavirus disease 2019 (COVID-19) vaccines can cause adverse events that can lead to vaccine hesitancy. This study aims at estimating the prevalence of severe adverse events (SAEs) and their associated factors among health professionals vaccinated with ChAdOx1 nCoV-19 vaccine in Togo. Methods A cross-sectional study was conducted from March 13th to 19th, 2021 in Togo among health professionals who received the first dose of the vaccine. An online self-administered questionnaire was used to collect sociodemographic and vaccination data. SAEs were defined as one resulting in hospitalization, medical consultation, or inability to work the day following the administration of the vaccine. Data analysis were performed using R© 4.0.1 software, and a 5% significance level was considered. Results A total of 1,639 health professionals (70.2% male) with a median age of 32 (interquartile range: 27-40) were enrolled. At least one adverse event was reported among 71.6% of participants (95% CI = [69.3-73.8]). The most commonly reported adverse events were injection site pain (91.0%), asthenia (74.3%), headache (68.7%), soreness (55.0%), and fever (47.5%). An increased libido was also reported in 3.0% of participants. Of the participants who experienced adverse events, 18.2% were unable to go to work the day after vaccination, 10.5% consulted a medical doctor, and 1.0% were hospitalized. The SAEs’ prevalence was 23.8% (95% CI = [21.8-25.9]). Being <30 years (AOR = 5.54; p<0.001), or 30-49 years (AOR = 3.62; p<0.001) and being female (AOR = 1.97; p<0.001) were associated with SAEs. Conclusions High prevalence of SAEs have been observed in health professionals in Togo after ChAdOx1 nCoV-19 vaccination especially in young people and females. However, these data are reassuring as they inform on COVID-19 vaccines’ SAE management. Systematic prescription of antalgics or antipyretics could be proposed to young people who get vaccinated.

Social protection and informality in Latin America during the COVID-19 pandemic

Latin American governments swiftly implemented income assistance programs to sustain families’ livelihoods during COVID-19 stay-at-home orders. This paper analyzes the potential coverage and generosity of these measures and assesses the suitability of current safety nets to deal with unexpected negative income shocks in 10 Latin American countries. The expansion of pre-existing programs (most notably conditional cash transfers and non-contributory pensions) during the COVID-19 crisis was generally insufficient to compensate for the inability to work among the poorest segments of the population. When COVID-19 ad hoc programs are analyzed, the coverage and replacement rates of regular labor income among households in the first quintile of the country’s labor income distribution increase substantially. Yet, these programs present substantial coverage challenges among families composed of fundamentally informal workers who are non-poor, but are at a high risk of poverty. These results highlight the limitations of the fragmented nature of social protection systems in the region.

The Social Survey, the Metropolitan Life Insurance Company, and the Beginnings of the US Public Health Service’s Sickness Surveys

The earliest sickness survey of the US Public Health Service, which started in 1915, was the Service’s first socioeconomic study of an industrial community. It was also the first to define illness as a person’s inability to work. The survey incorporated the Metropolitan Life Insurance Company’s definition of illness, which, instead of sickness rates, focused on duration of illness as a proxy of time lost from work. This kind of survey took place in the broader context of the reform movements of the Progressive Era and the social surveys conducted in the United States, which led to the creation of the Federal Commission on Industrial Relations, where the Service’s sickness survey originated. The Service’s focus on the socioeconomic classification of families and definition of illness as the inability to work enabled it to show the strong link between poverty and illness among industrial workers. The leader of the survey, Edgar Sydenstricker, and the Metropolitan Life Insurance Company came up with new ways to measure the health of the population, which also influenced the Service’s studies of the effects of the Great Depression on public health and the National Health Survey of 1935–1936. (Am J Public Health. Published online ahead of print October 28, 2021: e1–e9. https://doi.org/10.2105/AJPH.2021.306454 )

Exploring the concept inability to work fulltime in the context of work disability assessments: a qualitative study

Background In many countries inability to work fulltime is recognized as an important concept in work disability assessments. However, consensus is lacking regarding the concept and how it should be assessed. This study seeks to conceptualize and operationalize the concept of inability to work fulltime, and includes perspectives of both patients and physicians. Research questions involve identifying: 1. key elements, 2. measurable indicators, and 3. valid methods for assessing indicators of inability to work fulltime. Methods We used a qualitative study with a thematic content analysis design to conceptualize inability to work fulltime, based on nineteen semi-structured interviews conducted among insurance and occupational health physicians, and representatives of patient organizations. Results Inability to work fulltime is conceptualized as a complex concept which is strongly individually determined and variable due to time and underlying disease. Key dimensions of inability to work fulltime included besides the disease itself, also personal factors like psychological and lifestyle factors, as well as environmental factors related to the work situation and social context. Fatigue, cognitive impairments, and restrictions in functioning in- and outside work were reported as important measurable indicators. A combined use of self-assessment, assessment interviews, and testing, and assessment in the actual (work) setting was identified for assessing these indicators. Conclusion Taking into account the complex and variable nature of inability to work fulltime, we found it advisable to use multiple methods and multiple time points for the assessment. Results of this study provide starting points for further research on the operationalization of inability to work fulltime in a work disability context.

Physical, Emotional, Medical, and Socioeconomic Status of Patients With NMOSD: A Cross-Sectional Survey of 123 Cases From a Single Center in North China

Objective: This study aimed to assess the physical, emotional, medical, and socioeconomic conditions of patients with neuromyelitis optica spectrum disorder (NMOSD) in North China.Methods: A cross-sectional survey of patients with NMOSD was performed, based on an established questionnaire from the Multiple Sclerosis Patient Survival Report 2018. Logistic regression analysis was conducted to define the significant determinants of certain physical or emotional characteristics of patients. A total of 123 patients were included.Results: A total of 63.4% of participants were initially diagnosed with conditions other than NMOSD, with a median delay of 6 months for accurate diagnosis. An aggregate of 72.2% of patients had one or more relapses, corresponding to an annual relapse rate of 0.8. Paresthesia was the most frequent physical symptom among patients both at disease onset (53.7%) and throughout the duration of the disease (86.2%). Onset in elderly (&gt;50 years) patients was associated with an annual Expanded Disability Status Scale increase ≥1, compared with onset in younger (&lt;30 years) patients (P = 0.001, OR = 7.83). A total of 76.4% of patients had received attack-prevention treatments in the remission phase, and 31.7 and 10.6% of patients had ever been administered rituximab and traditional Chinese medicine, respectively. Additionally, 63.4 and 43.1% of patients reported participating in few or no social activities and being out of work because of the disease. To be noted, 76.4% of patients reported suffering from negative emotions, with the most frequent being worry (60.2%), with 20.3% of patients experiencing suicidal thoughts. The inability to work and participating in few or no social activities due to NMOSD were two determinants of experiencing negative emotions (Pwork = 0.03, ORwork = 3.34; Psocialactivities = 0.02, ORsocialactivities = 3.19).Conclusion: This study reported patient perspectives on NMOSD in North China, whereby demonstrating that the inability to work and participating in few or no social activities due to NMOSD rather than the physical impairment caused by the disease, was directly associated with patients experiencing negative emotions. This insight offers potential ways to manage patients' negative emotions by enhancing family and social support and facilitating active employment.

Topic Models Ensembles for AD-HOC Information Retrieval

Ad hoc information retrieval (ad hoc IR) is a challenging task consisting of ranking text documents for bag-of-words (BOW) queries. Classic approaches based on query and document text vectors use term-weighting functions to rank the documents. Some of these methods’ limitations consist of their inability to work with polysemic concepts. In addition, these methods introduce fake orthogonalities between semantically related words. To address these limitations, model-based IR approaches based on topics have been explored. Specifically, topic models based on Latent Dirichlet Allocation (LDA) allow building representations of text documents in the latent space of topics, the better modeling of polysemy and avoiding the generation of orthogonal representations between related terms. We extend LDA-based IR strategies using different ensemble strategies. Model selection obeys the ensemble learning paradigm, for which we test two successful approaches widely used in supervised learning. We study Boosting and Bagging techniques for topic models, using each model as a weak IR expert. Then, we merge the ranking lists obtained from each model using a simple but effective top-k list fusion approach. We show that our proposal strengthens the results in precision and recall, outperforming classic IR models and strong baselines based on topic models.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEKAMBUHAN PADA PASIEN SKIZOFRENIA DI KABUPATEN BADUNG

ABSTRAK Skizofrenia merupakan penyakit yang berpotensi tinggi menimbulkan kekambuhan. Kekambuhan skizofrenia mengakibatkan 72% penderita skizofrenia tidak mampu bekerja, 69% direhospitalisasi, 22% melakukan percobaan bunuh diri, dan 20% dipasung. Tujuan penelitian ini untuk mengetahui faktor-faktor yang berhubungan dengan kekambuhan pada pasien skizofrenia di Kabupaten Badung. Jenis penelitian ini adalah observasional analitik dengan desain Crossectional. Penelitian ini dilakukan di Poliklinik Jiwa Puskesmas I Abiansemal dan RSUD Mangusada pada Januari–Juni 2020. Sampel dalam penelitian ini adalah pasien skizofrenia yang melakukan pengobatan di lokasi penelitian. Teknik sampling menggunakan Simple Random Sampling dengan jumlah sampel 112 sampel. Data dianalisis secara Univariat, Bivariat dan Multivariat. Hasil penelitian menunjukkan proporsi pasien skizofrenia mengalami kekambuhan sebesar 35,71%. Variabel yang berhubungan dengan kekambuhan pasien skizofrenia di Kabupaten Badung yaitu dukungan keluarga (p=0,0308; PR:1,86; 95% CI:1,13-3,06), kepatuhan minum obat (p=0,0120; PR:1,87; 95 CI:1,16-3,03), tingkat pendidikan (p=0,0004; PR:2,89; 95% CI:1,47-5,69), dan status pekerjaan (p=0,0014 ; PR:4,11; 95% CI:1,37-12,30). Variabel yang paling berhubungan dengan kekambuhan pasien skizofrenia yaitu tingkat pendidikan (OR:8,9). Dapat disimpulkan terdapat hubungan antara dukungan keluarga, kepatuhan minum obat, tingkat pendidikan, dan status pekerjaan. Sebagai upaya mencegah kekambuhan, keluarga pasien skizofrenia diharapkan lebih memperhatikan faktor-faktor yang dapat menyebabkan terjadinya kekambuhan pasien skizofrenia. Kata Kunci: Skizofrenia, Kekambuhan, Dukungan Keluarga, Kepatuhan Minum Obat, Jarak Tempat Tinggal dengan Pelayanan Kesehatan Jiwa ABSTRACT Schizophrenia is a disease that potentially results of relapse. 72% patients with relaps schizophrenia causes inability to work, 69% is re-hospitalised, 22% attempted suicide, 20% are put into the stock. This study aims to describe the factors that related to the relapse of schizophrenia patients in Badung Regency. This study is observational analytic with crossectional design. This study done in Poliklinik Jiwa Puskesmas I Abiansemal and RSUD Mangusada in January-June 2020. Sample of this study were patients with schizophrenia disease that came to research area. Used Simple Random Sampling technique with 112 samples. Univariat, Bivariat, and Multivariat Analysis used in analysing data. The results showed 35.71% of schizophrenia patients had relapse. Variables were related to relapse of schizophrenia patients were family support (p=0,0308; PR:1,86; 95%CI:1,13-3,06), medication adherence (p=0,0120; PR:1,87; 95%CI:1,16-3,03), education level (p=0,0004; PR:2,89; 95%CI:1,47-5,69), and employment status (p=0,0014;PR:4,11; 95%CI:1,37-12,30). Variable most associated with relapse in schizophrenic patients is level of education (OR:8,9). It can concluded that factors related to relapse in schizophrenia patients in Badung Regency are family support, medication adherence, education level, and employment status. In effort to prevent relapse, schizophrenia patients' families are expected to pay more attention to factors that can cause schizophrenia patients to recur. Keywords: Schizophrenia, Relapse, Family Support, Medication Adherence, The Distance of Their Home's with Psichiatry Clinic

Study of Safety of Medicinal Products in Pregnant Women in Crimea

According to international epidemiological studies, about 80% of women have to use medicinal products during pregnancy, mainly during the first weeks of organogenesis in the case of an unplanned pregnancy, and for the treatment of chronic diseases or acute conditions developing during pregnancy. Specificity of pharmacokinetics and pharmacodynamics in pregnant women contributes to the development of adverse drug reactions (ADRs), many of which are serious and pose a threat to the life of the patient. The aim of the study was to retrospectively assess the frequency and development of ADRs in pregnant women living in the Republic of Crimea, based on the data in the regional safety database ARCADe (Adverse Reactions in Crimea, Autonomic Database). Materials and methods: the authors analysed spontaneous ADR reports registered in the ARCADe database from 1 January 2009 until 31 December 2018 for the category of patients described as “Pregnant women/childbirth”. Results: during the specified period, 268 ADR cases in pregnant women were added to the database. The most common reasons of ADRs in this category of patients were antibacterials for systemic use (130 cases, 48.5%), agents that have an effect on haematopoiesis and blood (54 cases, 20.15%), and agents that have an effect on the functions of the gastrointestinal tract (29 cases, 10.82%). The study of ADR clinical manifestations revealed a high incidence of local allergic reactions (140 cases, 52.2%), inhibition of haematopoiesis (60 cases, 22.4%), and dyspepsia (36 cases, 13.4%). The analysis of the severity of the registered ADRs demonstrated that in 15 cases (5.6%) the use of the prescribed medicinal product posed a threat to the patient’s life and required urgent pharmacotherapy and discontinuation of the suspected medicine, in 8 cases (3%) it resulted in hospitalisation or prolongation of hospital treatment, and in 3 cases (1.12%) it resulted in the temporary inability to work. Conclusions: the results of the study indicate the need for further retrospective and prospective studies aimed at analysing the safety of medicine use in pregnant women and assessing the risks of toxic effects on the foetus.

Pathways to Mitigate Challenges of Learner Academic Performance in a Grade 10 Economics Class in South Africa

This paper aims to explore the pathways to mitigate challenges of learner academic (LAP) performance in a Grade 10 economics class in South Africa. The challenge of poor LAP has ushered a myriad of predicaments in schools globally. These predicaments include lack of teacher inclusion in decision making, inability to work cooperatively together, and lack of professional development opportunities geared towards LAP. The study was qualitative, with 15 participants chosen through purposeful sampling from one rural school in the Thabo-Mofutsanyane education district. This paper is couched in critical emancipatory research with emphasis on the emancipation of the teachers regarding pathways they can self-develop to mitigate the challenges of LAP. The focus group discussions were used to gather information regarding pathways to mitigate the challenges of LAP in schools. The study revealed that teachers possess a very equivocal and varying experience regarding the pathways to use to mitigate the challenges of LAP. The findings suggest that for successful implementation of pathways to mitigate the challenges of LAP, schools need to invest in training teachers for team-teaching and avail the necessary resources (both human and physical) to ensure effective quality teaching and learning exist in the school. The article recommends that schools should develop policy frameworks, together with relevant stakeholders, to guide novice teachers on the strategies they can use to mitigate the challenges of LAP in their classes.

Peningkatan Kapasitas Paguyuban Sehat Ibu PKK RW 5 Pacarkembang dalam Memberikan Dukungan Sosial kepada Penderita Kanker

Perawatan penderita kanker memiliki perbedaan dengan penyakit lain. Kondisi imunitas yang menurun karena pengobatan kemoterapi, perubahan peran karena tidak dapat bekerja dan penyesuaian kondisi tubuh post kemoterapi menurunkan kesehatan mental dan kualitas hidup secara keseluruhan. Hasil penelitian menunjukkan bahwa sekitar 632 penderita (82,3%) penderita kanker berada dalam kategori skor Quality of Life (QOL) di bawah rata-rata dan kualitas hidup penderita kanker dipengaruhi oleh gejala yang dilaporkan. Tingginya resiko stress yang berkepanjangan dan gangguan mental pada penderita kanker disebabkan salah satunya karena kurangnya dukungan dari masyarakat. Tindakan pencegahan perlu dilakukan untuk meminimalisir stress baik secara fisik dan mental. Selama ini dukungan yang diberikan kepada penderita kanker utamanya masih dari sesama penderita. Dukungan melalui Paguyuban Sehat yang beranggotakan Ibu PKK RW 5 Pacarkembang bagi penderita kanker diberikan melalui tiga aspek. Aspek yang pertama adalah pengetahuan, dimana pada Paguyuban Sehat akan diberikan informasi terkait kanker, perawatan penderita kanker setelah operasi dan saat pengobatan kemoterapi atau radiasi. Aspek kedua adalah sosial, dimana penguatan dukungan diberikan kepada penderita kanker. Aspek yang ketiga adalah spiritual dimana seseorang mencari makna, tujuan, dan koneksi ke kekuatan yang lebih tinggi, dan memungkinkan individu untuk berfungsi secara efektif menuju tujuan hidupnya. Hasil dari pengabdian masyarakat ini adalah dibentuknya kader Paguyuban Sehat yang sadar terhadap resiko kanker payudara dan kanker tiroid. Kader mendapatkan pengetahuan mengenai deteksi dini kanker payudara dan tiroid serta mampu untuk mempraktikan pemeriksaan payudara sendiri dan mengenali tanda-tanda tidak normal pada payudara dan leher.Kata Kunci : kanker; dukungan sosial; kualitas hidup; pemberdayaan Capacity Building for Paguyuban Sehat in PKK RW 5 Pacarkembang in Providing Social Support for Cancer PatientsABSTRACTTreatment of cancer patients is different from other diseases. Decreased immunity due to chemotherapy treatment, changing roles due to inability to work and adjustment to post chemotherapy conditions. decreases mental health and overall quality of life. The results showed that about 632 patients (82.3%) of cancer patients were in the category of Quality of Life (QOL) score below the average and the quality of life of cancer patients was affected by the reported symptoms. The high risk of prolonged stress and mental disorders in cancer patients is due in part to the lack of support from the community. Precautions need to be taken to minimize stress both physically and mentally. So far, the support given to cancer patients mainly comes from fellow sufferers. Support through Paguyuban Sehat for cancer patients is provided in three aspects. The first aspect is knowledge, where the Healthy Paguyuban will be given information related to cancer, treatment of cancer patients after surgery and during chemotherapy or radiation treatment. The second aspect is social, where strengthening support is given to cancer sufferers. The third aspect is spiritual where a person seeks meaning, purpose, and connection to higher powers, and enables the individual to function effectively toward his or her life goals.Keywords: cancer; empowerment; social support; quality of life