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Results 361 through 380 out of 398

in category health policy


361: The Association of Stay-at-Home Orders and the Spread of COVID-19 in Rural and Urban United States

David H Jiang, Darius J Roy et al.

162 downloads (posted 16 Jul 2021)

Background: Throughout the spring of 2020, stay-at-home orders were imposed to curb the spread of COVID-19. There is limited data on the effectiveness of stay-at-home orders, particularly in rural as compared to urban areas. Objective: To examine the association between stay-at-home order implementation and the incidence of COVID-19 in rural vs. urban counties. Design: Interrupted time series analysis using a mixed effects zero-inflated Poisson model. Participants: 3,142 U.S. counties. Interventions: Stay-at-home orders. Main Measures: COVID-19 daily incidence (primary) and mobility (secondary and intermediate measure of stay-at-home effectiveness) Key Results: Stay-at-home orders were implemented later (median March 30 vs. March 28) and were shorter (median 35 vs. 54 days) in rural than urban counties. Indoor mobility was, on average, 2.6-6.9% higher in rural than urban counties both during and after stay-at-home orders. Compared to the baseline (pre-stay-at-home) period, the number of new COVID-19 cases increased under stay-at-home by IRR 1.60 (95% CI, 1.57-1.64) in rural and 1.36 (95% CI, 1.30-1.42) in urban counties. For each day under stay-at-home orders, the number of new cases changed by a factor of 0.982 (95% CI 0.981-0.982) in rural and 0.952 (95% CI, 0.951-0.953) in urban counties compared to prior to stay-at-home. Each day after stay-at-home orders expired, the number of new cases changed by a factor of 0.995 (95% CI, 0.994-0.995) in rural and 0.997 (95% CI, 0.995-0.999) in urban counties compared to prior to stay-at-home. Conclusion: Stay-at-home orders decreased mobility and slowed the spread of COVID-19, but less effectively in rural than in urban counties. This necessitates a critical reevaluation of how stay-at-home orders are designed, communicated, and implemented in rural areas.


362: COVID-19 and regional differences in the timeliness of hip-fracture surgery: an interrupted time-series analysis

Davide Golinelli, Jacopo Lenzi et al.

162 downloads (posted 06 Jul 2021)

Background. It is of great importance to examine the impact of the healthcare reorganization adopted to confront the COVID19 pandemic on the quality of care provided by healthcare systems to non COVID 19 patients. The aim of this study is to assess the impact of the COVID19 national lockdown (March 9, 2020) on the quality of care provided to patients with hip fracture (HF) in Piedmont and Emilia-Romagna, 2 large regions of northern Italy severely hit by the pandemic. Methods. We calculated the percentage of HF patients ...


363: Use of health care services during the Covid-19 pandemic in Ethiopia: Evidence from a health facility survey

Zemzem Shigute Shuka, Anagaw Derseh Mebratie et al.

158 downloads (posted 10 Aug 2021)

Abstract Introduction: In recent years Ethiopia has made enormous strides in enhancing access to health care, especially, maternal and child health care (MCH). With the onset and spread of Covid-19, the attention of the health care system has pivoted to handling the disease, potentially at the cost of other health care needs. This paper explores whether this shift has come at the cost of non Covid related health care, especially the use of MCH services. Methods: Graphs, descriptive statistics and paired t-tests of signi...


364: Aerosol transport measurements and assessment of risk from infectious aerosols: a case study of two German cash-and-carry hardware/DIY stores

Eberhard Bodenschatz, Gholamhossein Bagheri et al.

157 downloads (posted 24 May 2021)

We report experimental results on aerosol dispersion in two large German cash-and-carry hardware/DIY stores to better understand the factors contributing to disease transmission by infectious human aerosols in large indoor environments. We examined the transport of aerosols similar in size to human respiratory aerosols (0.3m-10m) in representative locations, such as high-traffic areas and restrooms. In restrooms, the observed decay of aerosol concentrations was consistent with well-mixed air exchange. In all other locat...


365: Extraordinary attention, ordinary neglect: the high cost of disaster preparedness and response

Robert A. Hahn

154 downloads (posted 28 Oct 2020)

BackgroundFunds allocated to disaster preparedness and response in the U.S. have grown rapidly in recent decades. This analysis examines the ratio of cost per outcome of public health events classified as disasters and those not classified as disasters, e.g., smoking-related morbidity and mortality. MethodsMortality is taken as an outcome metric; the validity of this measure is assessed by examination of ratios of tangible and intangible costs of disaster and non-disaster outcomes to mortality from two conditions, usin...


366: Determinants of disease prevalence and antibiotic consumption for children under five in Nepal: analysis and modelling of demographic health survey data from 2006 to 2016

Charlotte Zheng, Abilasha Karkey et al.

153 downloads (posted 10 Jul 2020)

Abstract Objectives Our aim was to examine the geographic, socio-economic and behavioural factors associated with disease and antibiotic consumption in Nepal from 2006 to 2016; as well as explore healthcare seeking patterns and the source of antibiotics. Methods Cross-sectional data on children under five in households from Nepal was extracted from the 2006, 2011 and 2016 Demographic Health Surveys (DHS). Univariate and multivariate analyses were carried out to assess the association of disease prevalence and antibiotic...


367: The impact of changing smoking habits and smoke-free legislation on orofacial cleft incidence in the United Kingdom: evidence from two time-series studies

Matthew John Fell, Craig Russell et al.

153 downloads (posted 27 Jun 2021)

Objectives: To analyse the association between active and passive cigarette smoking and the incidence of children born with a cleft lip and/or palate within the United Kingdom. Design: First, a longitudinal time-series study was conducted with routinely collected smoking prevalence data for females over 16 years of age. Second, an interrupted time-series design was used as a natural experiment to assess the impact of smoke-free legislation using segmented Poisson regression. Setting: United Kingdom. Population: All chil...


368: Effects of Various Policy Options on COVID-19 Cases in Nova Scotia including Vaccination Rollout Schedule: A Modelling Study

Melissa Gillis, Ahmed Saif et al.

151 downloads (posted 31 Jul 2021)

Background: The COVID-19 pandemic presents a significant challenge to minimize mortality and hospitalizations due to this disease. Vaccinations have begun to roll-out; however, restriction policies required during and after the rollout remain uncertain. A susceptible-exposed-infected-recovered (SEIR) model was developed for Nova Scotia, and it accounted for the province's policy interventions, demographics, and vaccine rollout schedule. Methods: A modified SEIR model was developed to simulate the spread and outcomes fro...


369: COVID-19 Acceleration and Vaccine Status in France - Summer 2021

Christelle Baunez, Mickael Degoulet et al.

150 downloads (posted 22 Sep 2021)

ObjectivesThis note provides an assessment of COVID-19 acceleration among groups with difference vaccine status in France. MethodsWe assess viral acceleration using a novel indicator introduced in Baunez et al. (2021). The acceleration index relates the percentage change of tests that have been performed on a given day to the percentage change in the associated positive cases that same day. We compare viral acceleration among vaccinated and unvaccinated individuals in France over the period May 31st - August 29, 2021. ...


370: Monday effect on confirmed cases of COVID-19 in Japan

Kuninori Nakagawa, Taro Kanatani

145 downloads (posted 22 Jul 2021)

We examined the phenomenon of fewer new confirmed cases on Monday in Japan, which we refer to as the Monday effect. In Japan, prefectures aggregate and announce the number of daily confirmed cases. We analyzed the impact of this effect in each prefecture. The effect is mainly found in prefectures with populations of 2 million or more. This effect is also constantly observed in the three major metropolitan areas in Japan. However, the magnitude of the observed effect is uncorrelated with both the number of positives per ...


371: A Simple Mathematical Tool to Help Distribute Doses of Two-Dose Covid-19 Vaccines among Non-Immunized and Partly-Immunized Population

Aanandita Kapoor, Krishan Mohan Kapoor

144 downloads (posted 12 May 2021)

Background: Full immunization with two doses of Covid vaccine has been found to be a critical factor in preventing morbidity and mortality from the Covid-19 infection. However, due to the shortage of vaccines, a significant portion of the population is not getting vaccination in many countries. Also, the distribution of vaccine doses between prospective first dose recipient and second dose recipient is not uniformly planned, as seen in India's various states and union territories. It is recommended to give second vaccin...


372: Federal Vaccine Policy and Interstate Variation in COVID-19 Vaccine Coverage in India

Kanchan Mukherjee

144 downloads (posted 24 Aug 2021)

Abstract Introduction: On August 13, 2021, India completed 30 weeks of vaccination against COVID-19 for its eligible citizens. While the vaccination has made progress, there has been no study analyzing the federal/union vaccine policy and its effect on vaccination coverage across Indian states. In this context, this study analyses the federal vaccination policy and its effect on interstate variation in vaccine coverage and the correlation of state economy with vaccination coverage. Methods: The study analyses vaccine po...


373: COVID-19 vaccine hesitancy and vaccine passports: Vaccination or restriction?

Shohei Okamoto, Kazuki Kamimura et al.

144 downloads (posted 22 Sep 2021)

Objectives: While the development of vaccines against the novel coronavirus (COVID-19) brought the hope of establishing herd immunity, which might help end the global pandemic, vaccine hesitancy can hinder the progress towards herd immunity. In this study, we assess the determinants of vaccine hesitancy, reasons for hesitation, and effectiveness of vaccine passports in relaxing public health restrictions. Methods: Through an online survey that includes a conjoint experiment of a demographically representative sample of ...


374: Awareness and perceptions among members of a Japanese cancer patient advocacy group concerning the financial relationships between the pharmaceutical industry and physicians: a mixed-methods analysis of survey data

Anju Murayama, Yuki Senoo et al.

141 downloads (posted 03 Jul 2021)

Abstract Objectives Financial conflicts of interest (FCOI) between pharmaceutical companies (Pharma) and healthcare domains may unduly influence physician-led clinical practice and patient-centered care. However, the extent of awareness and perceptions of FCOI among Japanese cancer patients remains unclear. This study aimed to assess these factors and their impacts on physician trustworthiness among Japanese cancer patients. Methods A cross-sectional study using self-administered surveys was conducted on a Japanese canc...


375: Methodological proposal to explore and design future health innovation policies and opportunities for Responsible Research and Innovation (RRI)

Arturo Arguello, Alicia Ortega-Rodriguez et al.

139 downloads (posted 12 May 2021)

Responsible Research and Innovation (RRI) seeks to align the research results with the needs of society to respond to current and future problems, also encompassing financial instruments, innovative public policies, and the distribution of resources. These policies should prioritize research in those areas with the greatest impact on society, and particularly in health research, this impact should be focused on responding to clinical problems of the population rather than economic impact. A methodology is proposed that ...


376: Construction and Validation of the Ohio Children's Opportunity Index

Naleef Fareed, Priti Singh et al.

139 downloads (posted 13 May 2021)

Objective. To describe the development of an area-level measure of children's opportunity, the Ohio Children's Opportunity Index (OCOI). Data Sources/Study Setting. Secondary data were collected from US census based-American Community Survey (ACS), US Environmental Protection Agency, US Housing and Urban Development, Ohio Vital Statistics, US Department of Agriculture-Economic Research Service, Ohio State University Center for Urban and Regional Analysis, Ohio Incident Based Reporting System, IPUMS National Historical G...


377: Impacts of Regional Lockdown Policies on COVID-19 Transmission in India in 2020

Aarushi Kalra, Paul Novosad

139 downloads (posted 10 Aug 2021)

Objective: To assess the impact of non-pharmaceutical interventions (NPIs) on the first wave of COVID transmission and fatalities in India. Methods: We collected data on NPIs, using government notifications and news reports, in six major Indian states from March to August 2020, and we matched these with district-level data on COVID related deaths and Google Mobility reports. We used a district fixed effect regression approach to measure the extent to which district-level lockdowns and mobility restrictions helped reduce...


378: Systematic review protocol exploring the impact of the COVID-19 pandemic on the wellbeing of general practitioners

Laura Jefferson, Su Golder et al.

139 downloads (posted 07 Aug 2021)

Background Over recent years chronic stress and burnout have been reported by doctors working in general practice in the UK NHS and internationally. The COVID-19 pandemic has changed general practitioners working lives; adding potential pressures from avoiding infection and addressing pent-up demand for care, but also changing processes such as rapidly taking up remote consultations. To date, there has been a focus on exploring the impact of the pandemic on the wellbeing of hospital clinicians. No registered systematic ...


379: Beyond poverty as a proxy: reducing inequality in infant mortality by identifying and targeting higher risk births

Antonio Ramos, Chad Hazlett et al.

135 downloads (posted 23 Jul 2021)

Infant mortality remains high and uneven in much of sub-Saharan Africa. Given finite resources, reducing premature mortality requires effective tools to identifying left- behind populations at greatest risk. While countries routinely use income- or poverty- based thresholds to target policies, we examine whether models that consider other factors can substantially improve our ability to target policies to higher-risk births. Using machine learning methods, and 25 commonly available variables that can be observed prior t...


380: Data Driven Monitoring in Community Based Management of SAM children using Psychometric Techniques: An Operational Framework

ANKUR JOSHI, Abhijit P Pakhare et al.

135 downloads (posted 22 Jun 2021)

Background- The success of the Community Based Management of Severe Malnutrition (CSAM)programme, largely depends on the knowledge and skills of Front-Line Workers (FLWs).A robust supportive supervision system in CSAM should be tailored to individualistic learning needs by distinguishing the FLWs as per their ability and simultaneously identifying the task domains to be emphasized more in supervisory visits.This paper details the ability assessment strategy developed and employed in the selected geographical locations i...