Opportunistic patient advice, in brief

What can you say to a patient in 30 seconds? Importantly, can you give them useful health advice in that time? Dave Hancock examines research and guidance about Making Every Contact Count

Developing Machine Learning and Statistical Tools to Evaluate the Accessibility of Public Health Advice on Infectious Diseases among Vulnerable People

Background. From Ebola, Zika, to the latest COVID-19 pandemic, outbreaks of highly infectious diseases continue to reveal severe consequences of social and health inequalities. People from low socioeconomic and educational backgrounds as well as low health literacy tend to be affected by the uncertainty, complexity, volatility, and progressiveness of public health crises and emergencies. A key lesson that governments have taken from the ongoing coronavirus pandemic is the importance of developing and disseminating highly accessible, actionable, inclusive, coherent public health advice, which represent a critical tool to help people with diverse cultural, educational backgrounds and varying abilities to effectively implement health policies at the grassroots level. Objective. We aimed to translate the best practices of accessible, inclusive public health advice (purposefully designed for people with low socioeconomic and educational background, health literacy levels, limited English proficiency, and cognitive/functional impairments) on COVID-19 from health authorities in English-speaking multicultural countries (USA, Australia, and UK) to adaptive tools for the evaluation of the accessibility of public health advice in other languages. Methods. We developed an optimised Bayesian classifier to produce probabilistic prediction of the accessibility of official health advice among vulnerable people including migrants and foreigners living in China. We developed an adaptive statistical formula for the rapid evaluation of the accessibility of health advice among vulnerable people in China. Results. Our study provides needed research tools to fill in a persistent gap in Chinese public health research on accessible, inclusive communication of infectious diseases’ prevention and management. For the probabilistic prediction, using the optimised Bayesian machine learning classifier (GNB), the largest positive likelihood ratio (LR+) 16.685 (95% confidence interval: 4.35, 64.04) was identified when the probability threshold was set at 0.2 (sensitivity: 0.98; specificity: 0.94). Conclusion. Effective communication of health risks through accessible, inclusive, actionable public advice represents a powerful tool to reduce health inequalities amidst health crises and emergencies. Our study translated the best-practice public health advice developed during the pandemic into intuitive machine learning classifiers for health authorities to develop evidence-based guidelines of accessible health advice. In addition, we developed adaptive statistical tools for frontline health professionals to assess accessibility of public health advice for people from non-English speaking backgrounds.

A proposed structural approach to improve cow-claw health on Dutch dairy farms

Despite extensive research leading to an improved understanding of the risk factors and pathogenesis of infectious and non-infectious disorders, claw health has not structurally improved in recent decades. Several studies have shown that claw disorders harm milk production, fertility and longevity of the dairy cows and job satisfaction of the farmer. This is enough reason to structurally improve claw health on dairy farms. The focus should be on a rapid curative intervention when lameness occurs and above all the prevention of claw problems. Most claw disorder diagnoses are nowadays made during regular claw trimming by the professional trimmer or the dairy farmer. Registration of the detected disorders during claw trimming is not always done consistently, so the estimated prevalence (number of cows with a claw disorder) is in most cases an underestimation of the real prevalence. The quality of these records often makes it difficult for consultants to formulate appropriate claw health advice. To be able to give good advice on claw health, insight into the prevalence of the various hoof disorders on a farm is a key condition. However, good quality advice alone is not a guarantee for an improved claw health situation on a farm. Research has shown that in addition to high quality substantiated advice, the communication style between the consultant and the dairy farmer is essential for the interpretation and motivation of the dairy farmer to implement the advice. In this paper a 7-point plan is presented as a guidance for herd advisors who want to support dairy farmers to improve claw health.

Tailoring Digital Tools to Address the Radiation and Health Information Needs of Returnees after a Nuclear Accident

Digital tools are increasingly used for health promotion, but their utility during recovery from a nuclear disaster has yet to be established. This study analysed differences in knowledge, attitude, and practice (KAP) toward digital tools for radiation protection and health promotion, and preferences for specific application functions, among cohorts living within and outside areas affected by the Fukushima Daiichi nuclear power station (FDNPS) accident. A needs assessment was conducted by internet survey, and responses from those affected (N = 86) and not affected (N = 253) were compared and quantified by an adjusted odds ratio (aOR), using logistic regression analyses. KAP toward the radiation-related application in the affected group had an aOR of 1.95 (95% confidence interval (CI) = 1.12–3.38) for knowledge, and 5.71 (CI = 2.55–12.8) for practice. Conversely, toward the health-related application, the aOR of the affected group was 0.50 (CI = 0.29–0.86). The preference in the affected group was significantly lower for two application functions related to radiation measurement and two health-related functions (one about the effects of radiation in general and another about personal health advice in general): aOR range 0.43–0.50. Development of specific applications incorporating the findings from this survey was intended to foster a locally appropriate eHealth environment during recovery from the FDNPS accident.

Increased Pressure Leads to Decreased Trust Among the Unvaccinated: Effects of the Announcement of the Re-Introduction of Covid Passports in Denmark

On November 8 2021, a press conference was held by the Danish government to re-introduce covid passports as a way of containing increasing COVID-19 infections and make life as an unvaccinated “more burdensome”. While new vaccinations increased in the weeks following the press conference, we show that this increased pressure also decreased trust among the unvaccinated. Using a difference-in-differences design on nationally representative survey data, we estimate that trust in the strategy of managing the COVID-19 epidemic decreased with 11 percentage points among the unvaccinated. When considering “pressure” as a pandemic management strategy it is important to be aware of these unintended costs and how they may shape the unvaccinated’s compliance with other health advice and their overarching support for the political system.

Preferences and patterns of response to public health advice during the COVID-19 pandemic

With recurring waves of the Covid-19 pandemic, a dilemma facing public health leadership is whether to provide public advice that is medically optimal (e.g., most protective against infection if followed), but unlikely to be adhered to, or advice that is less protective but is more likely to be followed. To provide insight about this dilemma, we examined and quantified public perceptions about the tradeoff between (a) the stand-alone value of health behavior advice, and (b) the advice’s adherence likelihood. In a series of studies about preference for public health leadership advice, we asked 1061 participants to choose between (5) strict advice that is medically optimal if adhered to but which is less likely to be broadly followed, and (2) relaxed advice, which is less medically effective but more likely to gain adherence—given varying infection expectancies. Participants’ preference was consistent with risk aversion. Offering an informed choice alternative that shifts volition to advice recipients only strengthened risk aversion, but also demonstrated that informed choice was preferred as much or more than the risk-averse strict advice.

A Pragmatic Study of Speech Acts Pertaining to Health Advice in Covid-19 Pandemic

People use the language to make propositional statements, entities, objects, state of affairs, and so on and fulfil functions such as apologising, introducing, requesting and denying, etc. Speech act can be described as the action performed in uttering something, and the directives are functions to direct people's behaviour. Advice is a directive speech act. Different linguists classified the advice into direct, indirect, and conventionally indirect. The use of advice has been applied in communication and the written form of humankind for a long time. The speaker intended to give benefit to the hearer when he /she gives advice. The present study intended to shed light on the notion of the pragmatics of communication of health advice in covid -19. The data of this study were fifteen public health advice related to covid-19 collected from the official website of the World Health Organisation (WHO). They have been analysed pragmatically based on their type, strategies, and advisories. The study also aims to find out the consciousness of EFL learners with the health advice of covid-19 and what degree of conciseness comes and literal comprehension. The results of the pragmatic analysis have shown that the frequent type of advice is directive, the frequent strategy is imperative, and the frequent advisories is advising. At the same time, the results of the conducted interview have shown full consciousness, partial consciousness, and non-consciousness of the health advice of covid-19.

Giving travel advice in the uncertain age of COVID-19

As restrictions ease and more people holiday overseas, the importance of providing accurate travel health advice increases. Jacqueline Spinks and colleagues provide an overview of current guidance The COVID-19 pandemic has led to a dramatic drop in people travelling to other countries for pleasure; however, now that restrictions across the UK are easing, more people are seeking a break and a long-awaited holiday overseas. Practice nurses are uniquely placed to provide travel advice not just in relation to COVID-19 requirements and restrictions, but also to remind travellers of the importance of being prepared for all other communicable diseases and travel-related hazards. This article aims to provide a summary of the latest and up to date information in England (links to guidance covering the Devolved Administrations of Scotland, Wales and Northern Ireland are found in Box 1 ) and covers a summary of COVID-19, current guidance on travel during the pandemic, information about pre-planning for overseas travel, return from travel and information about being identified as a contact during travel, general travel advice; and ends with links to the most relevant guidance and information available.

The Role of Collectivism–Individualism in Attitudes Toward Compliance and Psychological Responses During the COVID-19 Pandemic

This study examined the role of individual differences in horizontal and vertical individualism and collectivism, trust and worries, and concerns about COVID-19 in predicting the attitudes toward compliance of health advice and psychological responses during the COVID-19 pandemic. Chinese university students (N=384, 324 female) completed measures of individualism and collectivism, trust, attitudes toward compliance, and psychological responses to the pandemic. Results showed that not only vertical collectivist orientation but also horizontal individualist orientation significantly predicted higher willingness to comply, whereas vertical individualist orientation significantly predicted lower willingness to comply. Vertical individualist and vertical collectivist orientations predicted higher psychological response in terms of distress, anxiety, and depression, while horizontal collectivistic orientation significantly predicted less psychological problems. Implications of the effect of individual-level cultural orientations on attitudes toward public health compliance and psychological well-being during global health crises are discussed.