The High Importance Role of Epidemiology in Health Management

Epidemiology is a scientific discipline, sometimes called “the basic science of public health”. According to what it has done in the last 200 years, epidemiology is the science and practice. One of the areas that are less addressed in the literature is the important role of epidemiology in health management. The authors believed that one of the areas that epidemiologists can work is management debate.

Why Did They Not Die?

By 1992, Francis Black published an article that investigated the question in the tittle (Why did they die?). The article suggested that the low genetic diversity of the indigenous populations helped to explain why infectious diseases threatened the survival of vulnerable indigenous groups distributed in the Amazon region of Brazil [1]. At that time, only traditional methodological tools were available to explain the influence of the genetic similarities within families residing in isolated indigenous communities. The emerging knowledge of the Human Leukocyte Antigen (HLA), Class I Major Histocompatibility Complex (MHC) A and B loci genes could explain the higher risk of infectious agents in indigenous populations compared to that of urban population groups [1].

Occurrence of Acute Respiratory Tract Infections among Children Under Five Years Attending Kinango Sub-County Hospital, Kenya

Objective: To examine occurrence of Acute Respiratory tract Infections (ARIs) and determine factors associated with ARIs among children under five years attending Kinango Sub-County Hospital. Methods: A cross-sectional survey was conducted among mother-child aged between 0-59 month’s pairs attending outpatient care. Participants were recruited using systematic sampling method. Data was collected using an interviewer-administered structured questionnaire. Descriptive statistics were used to summarize child, parental and environmental characteristics. Factors associated with ARIs were established using binary logistic regression analysis. Odds Ratio (OR), at 95% Confidence Interval (CI) and p <0.05 significant level was used to describe an association between covariates and the outcome variable. Independent factors associated with occurrence of ARIS were determined by stepwise logistic regression. Results: 385 children participated in this study. 228 children (59.2%) presented with ARIs, of which 90.8% were due to acute upper respiratory tract infections. 9.2% of the cases were due to pneumonia. Female gender aOR 3.39 [1.21-9.46], stunting aOR 3.62 [1.04-12.61], high parity aOR 11.45 [2.38-55.09], low maternal education aOR 3.54 [1.10-11.32] and recent hospitalization aOR 8.19 [1.75-38.43] increased the odds of occurrence of an ARI while normal birth weight aOR0.06 [0.01-0.62] was protective of ARIs. Conclusion: A high prevalence of ARIs among children aged below five years was observed in this study, associated with gender, stunting, parity, maternal education, birth weight and recurring hospitalization. Improvements in literacy levels, child nutrition and maternal and child health at large could help to reduce morbidity due to ARIs in this population.

Household Air Pollution Risk on Respiratory Health among Women: A Case Study of Indian District after Clean Fuel Programme

Objectives: Some of the highest exposures to air pollutants in developing countries occur inside homes where biomass fuels are used for daily cooking. Inhalation of these pollutants may cause deleterious effects on health. Study Design: A total of 450 non-smoking, non-pregnant women aged 15 years and above exposed to domestic smoke from cooking fuels from an early age, working in poorly ventilated kitchen were selected and on investigation presented various health problems. Method: Symptoms were enquired by means of using standard questionnaire adopted from that of the American Thoracic Society (ATS, 1995). Lung function was assessed by the measurement of Forced Vital Capacity (FVC), (FEV1), i.e. volume of air (in liter) that is forcefully exhaled in one second. Using ratio of FEV1 to FVC (FEVI/FVC), expressed as percentage. Results: FVC less than 80% of the predicted was considered as abnormal pulmonary function. Symptoms like chest pain, breathlessness, eye irritation, and blackout were found to be significantly higher in biomass users (P <0.05). Moreover, an increasing trend in the prevalence of symptoms/morbid conditions was observed with increase in exposure. Conclusion Thus women exposed to biomass fuels smoke suffer more from health problems and are at greater risk of respiratory illnesses when compared with other fuel users.

One Year with the COVID-19 Pandemic - Lessons Learnt? Intersectoral Collaboration Measures Established during the Crisis Could Benefit Capacity and Patient Flow Management in Daily Clinical Practice

The COVID-19 pandemic has changed the way hospitals work. Some of the urgently established measures have proven to be so useful that they should be adopted in standard care. Recent research has assessed patient management, human resource planning and communication measures in terms of their impact and practicality for continuation in daily clinical practice. Strategies that were detached from the boundaries of departments and responsibilities in the COVID-19 pandemic and that have proven themselves under extreme conditions show a beneficial influence on patient flow and resource management as well as on the communication culture. The continuation of closer interdisciplinary and cross-sectoral cooperation in a “new clinical routine” could have a positive impact on personnel concepts, communication strategies, acute care capacities and the management of patient pathways.

Electromagnetic Radiations on the Functional Potential of Spermatozoa

The growing exposure to digital communication system and tools leads to radiation toxicity to the users. Unaware of the safety measures even a kid at the age of one starts operating digital gadgets emitting Radio frequencyelectromagnetic radiations. Radiations from mobile phones laptops, note pad, Wi-Fi or other devices are reported to be harmful beyond the permissible limit. So there is a growing concern for the overall health, reproductive, and hormonal functions. Experimental studies were conducted by using a Wi-Fi network active laptop and live spermatozoa. The exposure of sperms to the source of EMF showed that the activity of the live sperms got reduced and mortality was observed depending on the exposure duration and the distance from EMF sources. After 5h of exposure to RF-EMF source the semen quality changed when compared with control. The vitality of sperm in the control was 95±1.0 after 2 hr and it was reduced to 60±1.5 percent at a distance of 1cm and 55±2.2 percent at a distance of 10 cm. After 5 hour exposure, the vitality was reduced to 63±1.86 at 1 cm distance and 70±1.42 at 10 cm distance. The reduction in vitality of sperm after exposure to RF-EMF source for 2 hour was 35% at 1cm and 40% at 10cm distance.

A Qualitative Research of Perception Investigations in Caregivers Under the COVID-19 Pandemic

We enthusiastically read the article entitled “The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study” by Liu and colleagues [1]. Although this study highlights the support needed to protect the physical and mental wellness of caregivers in the COVID-19 pandemic, the potential limitations that existed in its qualitative research methods may undermine the accuracy of data collection indicated by our previous work [2,3]. First, the information gleaned from the participants could have been more productive if the authors used focus group as it leverages the power of the group dynamics to encourage back and forth conversation leading to fully exploring and expanding participant’s true feelings, thoughts, and experiences toward the COVID-19 compared to the in-depth interviews [4]. Even though some researchers claim that in-depth interviews (e.g., phone interview) are better to investigate a sensitive subject like the COVID-19 crisis that participants may feel uncomfortable to share their thoughts in front of a group of people, the recent study confirms that 1) sensitive and intimate disclosures are more likely to occur in the focus group; 2) some certain sensitive themes only happen in the focus group; and 3) neither sensitive themes emerged exclusively nor frequently in indepth interviews compared to focus group [5]. Second, ensuring the homogeneity of interest is way more critical than the general heterogeneity like the demographics of the recruited participants [6,7]. Specifically, the desirable combination of interest consensus and common ground with diverse experience is important to generate rich information. However, the perceptions of the COVID-19 pandemic may be different between physicians and nurses based on the duty of these two different professional roles. This is because nurses are more likely to interact with COVID-19 patients directly and more frequently than physicians. Therefore, according to the primary research interest that investigates the experiences of fighting the COVID-19 pandemic, the participants should have been limited to nurses as the frontline caregivers to maintain the homogeneity of interest. Third, considering that all participants were recruited from one local hospital, convenient sampling appears better than snowball sampling as the authors can recruit participants based on their availability and accessibility [8]. This is because scheduling participants at a time when they have more energy may yield richer information data than reaching out to them through phone interviews. These suggested changes in data collection and participant enrollment should be implemented in future qualitative research for the investigation of global pandemic crisis to reach more convincing conclusions.

Exercise Habits of Armenians Before and After the Emergence of the COVID-19 Pandemic

The COVID-19 pandemic brought about a variety of changes in people’s lifestyles, including their exercise habits. This study examined changes in exercise habits in individuals of Armenian descent, before and after the emergence of COVID-19, to determine whether significant changes had occurred. Convenience sampling was used by distributing the study throughout Armenian organizations, culturally-relevant social media pages, websites, and email lists. Subjects were required to be at least 18 years of age and of Armenian descent. Survey data was collected between June and August of 2020 from 502 subjects on exercise history, health history, and anthropometry. Disease scores were assigned based on health status. Subjects with higher disease scores were 2.5 and 3.1 times more likely to not exercise prior to and after the pandemic, respectively, compared to subjects with lower disease scores (p<0.001). However, there was no significant difference in change in exercise frequency after the emergence of the pandemic. Additionally, subjects who only exercised in the gym prior to COVID-19 were more likely to decrease their exercise frequency compared to subjects who did not exercise at the gym or did not solely exercise at the gym (p<0.001). Clinicians should place greater emphasis on encouraging Armenian patients with high disease scores to exercise. Armenian patients should also be encouraged to diversify their exercise spaces beyond the gym in order to reduce the risk of decreasing exercise frequency in the event of gym closures due to unforeseen circumstances.

COVID-19 and Cannabidiol: Results from a Rapid Review

Background: SARS-CoV2 has caused over 57 million infections and over 1.3 million deaths within 11 months globally (WHO). Internationally, there is an emerging debate about potential benefits of Cannabidiol (CBD) as treatment of COVID-19. Objective: To assess the beneficial and adverse effects of CBD in the treatment of inflammation from the literature. Methods: We systematically searched Cochrane rCOVID-19 study register, CENTRAL (PubMed, Embase, CINAHL, ClinicalTrials.gov and the WHO’s International Clinical Trials Registry Platform) for studies testing CBD as inflammation intervention. All types of studies and populations were considered. All pre-clinical, clinical, and pharmacological outcomes were of interest. Results: Of 18 papers found, 9 were included: Five in vivo animal studies, 3 in vitro studies on human tissues and 1 ongoing randomized clinical trial. Outcomes in 4 in vivo animal studies and 3 human tissue studies were immune response markers, which decreased. In 1 in vivo study the outcome of monocytes was enhanced. One human study is ongoing. There was no information on adverse effects or drug-interaction. Conclusion: There is not enough evidence to support or refute CBD as a repurpose drug to treat inflammation and other symptoms of COVID-19. Clinical trials are needed to test its efficacy and adverse effects.

The Role of the Polish Interdepartmental Commission for the Maximum Admissible Concentrations and Intensities for Agents Harmful to Health in the Working Environment in the Development of Safe Working Conditions

The article discusses the principles of determining the maximum admissible concentration and intensity values for harmful agents present at workplaces as the basic criteria for ensuring safe and hygienic working conditions in Poland and in the European Union. The role of the Interdepartmental Commission for the Maximum Admissible Concentrations and Intensities of Agents Harmful to Health in the Working Environment is presented in this process. The attention was drawn to the relationship between the occupational health and safety legislation and the EC regulations on chemicals, which together provide both employers and the Member States with the necessary data and instruments to work safely with chemicals and to be able to take appropriate actions and risk management measures.