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3.
Health Care Manage Rev ; 45(4): 277, 2020.
Artigo em Inglês | MEDLINE | ID: covidwho-1440669
5.
J Health Commun ; 26(7): 473-479, 2021 07 03.
Artigo em Inglês | MEDLINE | ID: covidwho-1409987

RESUMO

Pregnant women are especially vulnerable to COVID-19 while the short- and long-term impact of COVID-19 on maternal and infant health is only partially understood. We assessed the amount of uncertainty and anxiety pregnant women experienced about COVID-19 and whether, and the extent to which, they engaged in information seeking about COVID-19. In total, 320 pregnant women from 38 states took part in this research. The results showed that pregnant women experienced uncertainty and anxiety about pregnancy and breastfeeding and engaged in information seeking from their healthcare providers. Pregnant women's uncertainty influenced information seeking via anxiety, but the effect varied depending on participants' assessments of coping, communication, and target efficacy. While healthcare providers need to discuss ways to avoid COVID-19 infection, participants were assured that their providers had a plan to help them if they became infected with COVID-19.


Assuntos
Ansiedade/psicologia , COVID-19/psicologia , Comportamento de Busca de Informação , Pandemias , Gestantes/psicologia , Incerteza , Aleitamento Materno/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Humanos , Relações Médico-Paciente , Gravidez/psicologia , Estados Unidos/epidemiologia
6.
J Health Soc Behav ; 62(3): 271-285, 2021 09.
Artigo em Inglês | MEDLINE | ID: covidwho-1409986

RESUMO

At the center of the COVID-19 pandemic lies a ubiquitous feature of medicine. Medicine is permeated with ignorance. Seizing this moment to assess the current state of medical sociology, this article articulates a sociology of medical ignorance. We join insights from earlier medical sociological scholarship on uncertainty with emerging research in the sociology of ignorance to help make sense of the omnipresent but sometimes invisible dynamics related to the unknowns in medicine. Then we examine two streams of inquiry with a focus on uncertainty and ignorance-(1) research on the interconnections between technology, medical authority, and ignorance and (2) research on lay expertise within the context of ever-present uncertainties. For decades, and to good effect, medical sociologists have asked, "What does medicine know, and what are the consequences of such knowing?" Going forward, we encourage medical sociologists to examine the unknown in medicine and the consequences of not knowing.


Assuntos
COVID-19/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Movimento contra Vacinação , Atitude Frente a Saúde , COVID-19/prevenção & controle , Vacinas contra COVID-19/uso terapêutico , Humanos , Sociologia , Tecnologia , Incerteza , Recusa de Vacinação
7.
Curr Opin Infect Dis ; 34(5): 415-422, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: covidwho-1408785

RESUMO

PURPOSE OF REVIEW: To examine the literature assessing safety of air travel relating to coronavirus disease 2019 (COVID-19) transmission from January 2020 to May 2021. The COVID-19 pandemic has had an unprecedented impact on air travel and global mobility, and various efforts are being implemented to determine a safe way forward. As the pandemic evolves, so do the challenges that force various stakeholders, including the aviation industry, health authorities, and governments, to reassess and adapt their practices to ensure the safety of travellers. RECENT FINDINGS: The literature was reviewed for multiple aspects of air travel safety during the COVID-19 pandemic. Recurring themes that surfaced included the pivotal role of commercial air travel in the geographic spread of COVID-19, the efficacy of travel restrictions and quarantines, inflight transmission risk and the role of preventive measures, the utility of pre and post flight testing, the development of effective vaccines and subsequent challenges of vaccine passports, and the ongoing threat of novel highly transmissible variants. SUMMARY: Much uncertainty lies ahead within the domains of these findings, and ongoing research, discourse and review will be necessary to navigate and determine the future direction and safety of air travel. Recovery will be slow, necessitating innovative, multipronged and collaborative solutions.


Assuntos
COVID-19/transmissão , Pandemias/prevenção & controle , Viagem Aérea , Humanos , SARS-CoV-2/patogenicidade , Viagem , Incerteza
8.
Plast Reconstr Surg ; 148(4): 899-906, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: covidwho-1398200

RESUMO

SUMMARY: In the wake of the death toll resulting from coronavirus disease of 2019 (COVID-19), in addition to the economic turmoil and strain on our health care systems, plastic surgeons are taking a hard look at their role in crisis preparedness and how they can contribute to crisis response policies in their own health care teams. Leaders in the specialty are charged with developing new clinical policies, identifying weaknesses in crisis preparation, and ensuring survival of private practices that face untenable financial challenges. It is critical that plastic surgery builds on the lessons learned over the past tumultuous year to emerge stronger and more prepared for subsequent waves of COVID-19. In addition, this global health crisis presents a timely opportunity to reexamine how plastic surgeons can display effective leadership during times of uncertainty and stress. Some may choose to emulate the traits and policies of leaders who are navigating the COVID-19 crisis effectively. Specifically, the national leaders who offer empathy, transparent communication, and decisive action have maintained high public approval throughout the COVID-19 crisis, while aggressively controlling viral spread. Crises are an inevitable aspect of modern society and medicine. Plastic surgeons can learn from this pandemic to better prepare for future turmoil.


Assuntos
COVID-19/prevenção & controle , Liderança , Papel Profissional , Cirurgia Plástica/organização & administração , COVID-19/economia , COVID-19/epidemiologia , COVID-19/transmissão , Controle de Doenças Transmissíveis/normas , Saúde Global , Humanos , Pandemias/economia , Pandemias/prevenção & controle , Equipe de Assistência ao Paciente/economia , Equipe de Assistência ao Paciente/organização & administração , SARS-CoV-2/patogenicidade , Cirurgiões/organização & administração , Cirurgia Plástica/economia , Incerteza
10.
Psychodyn Psychiatry ; 49(3): 384-387, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1394603

RESUMO

The author, an experienced psycho-oncologist, offers clinical insights that consider the importance of death anxiety in psychodynamic psychotherapy treatments during the COVID-19 pandemic. He reviews the contributions of Ernst Becker, Wilfred Bion and Sheldon Solomon, and formulates ideas of his own based on decades of experience treating patients with cancer. This short essay focuses on how to help patients during the COVID-19 pandemic work through fear and uncertainty while developing adaptive skills.


Assuntos
Ansiedade/psicologia , Ansiedade/terapia , Atitude Frente a Morte , COVID-19/psicologia , Psicoterapia Psicodinâmica/métodos , Adaptação Psicológica , Medo , Humanos , Pandemias , SARS-CoV-2 , Incerteza
11.
Proc Biol Sci ; 288(1947): 20201556, 2021 03 31.
Artigo em Inglês | MEDLINE | ID: covidwho-1388073

RESUMO

An epidemic can be characterized by its strength (i.e., the reproductive number [Formula: see text]) and speed (i.e., the exponential growth rate r). Disease modellers have historically placed much more emphasis on strength, in part because the effectiveness of an intervention strategy is typically evaluated on this scale. Here, we develop a mathematical framework for the classic, strength-based paradigm and show that there is a dual speed-based paradigm which can provide complementary insights. In particular, we note that r = 0 is a threshold for disease spread, just like [Formula: see text] [ 1], and show that we can measure the strength and speed of an intervention on the same scale as the strength and speed of an epidemic, respectively. We argue that, while the strength-based paradigm provides the clearest insight into certain questions, the speed-based paradigm provides the clearest view in other cases. As an example, we show that evaluating the prospects of 'test-and-treat' interventions against the human immunodeficiency virus (HIV) can be done more clearly on the speed than strength scale, given uncertainty in the proportion of HIV spread that happens early in the course of infection. We also discuss evaluating the effects of the importance of pre-symptomatic transmission of the SARS-CoV-2 virus. We suggest that disease modellers should avoid over-emphasizing the reproductive number at the expense of the exponential growth rate, but instead look at these as complementary measures.


Assuntos
COVID-19 , Epidemias , Infecções por HIV , COVID-19/epidemiologia , Infecções por HIV/epidemiologia , Humanos , SARS-CoV-2 , Incerteza
12.
Am J Epidemiol ; 190(7): 1377-1385, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: covidwho-1387704

RESUMO

This primer describes the statistical uncertainty in mechanistic models and provides R code to quantify it. We begin with an overview of mechanistic models for infectious disease, and then describe the sources of statistical uncertainty in the context of a case study on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe the statistical uncertainty as belonging to 3 categories: data uncertainty, stochastic uncertainty, and structural uncertainty. We demonstrate how to account for each of these via statistical uncertainty measures and sensitivity analyses broadly, as well as in a specific case study on estimating the basic reproductive number, ${R}_0$, for SARS-CoV-2.


Assuntos
COVID-19/transmissão , Medidas em Epidemiologia , Modelos Estatísticos , Incerteza , Número Básico de Reprodução , Doenças Transmissíveis , Humanos , Método de Monte Carlo , Pandemias , SARS-CoV-2
13.
Medicina (Kaunas) ; 57(2)2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: covidwho-1389436

RESUMO

Uncertainty analysis is the process of identifying limitations in knowledge and evaluating their implications for scientific conclusions. Uncertainty analysis is a stable component of risk assessment and is increasingly used in decision making on complex health issues. Uncertainties should be identified in a structured way and prioritized according to their likely impact on the outcome of scientific conclusions. Uncertainty is inherent to the rare diseases (RD) area, where research and healthcare have to cope with knowledge gaps due to the rarity of the conditions; yet a systematic approach toward uncertainties is not usually undertaken. The uncertainty issue is particularly relevant to multifactorial RD, whose etiopathogenesis involves environmental factors and genetic predisposition. Three case studies are presented: the newly recognized acute multisystem inflammatory syndrome in children and adolescents associated with SARS-CoV-2 infection; the assessment of risk factors for neural tube defects; and the genotype-phenotype correlation in familial Mediterranean fever. Each case study proposes the initial identification of the main epistemic and sampling uncertainties and their impacts. Uncertainty analysis in RD may present aspects similar to those encountered when conducting risk assessment in data-poor scenarios; therefore, approaches such as expert knowledge elicitation may be considered. The RD community has a main strength in managing uncertainty, as it proactively develops stakeholder involvement, data sharing and open science. The open science approaches can be profitably integrated by structured uncertainty analysis, especially when dealing with multifactorial RD involving environmental and genetic risk factors.


Assuntos
COVID-19/epidemiologia , Febre Familiar do Mediterrâneo/epidemiologia , Defeitos do Tubo Neural/epidemiologia , Doenças Raras/epidemiologia , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Incerteza , Causalidade , Febre Familiar do Mediterrâneo/genética , Genótipo , Humanos , Conhecimento , Fenótipo , Doenças Raras/etiologia , Medição de Risco , Fatores de Risco , SARS-CoV-2
14.
Int J Environ Res Public Health ; 18(9)2021 04 27.
Artigo em Inglês | MEDLINE | ID: covidwho-1389363

RESUMO

SARS-CoV-2 continues to widely circulate in populations globally. Underdetection is acknowledged and is problematic when attempting to capture the true prevalence. Seroprevalence studies, where blood samples from a population sample are tested for SARS-CoV-2 antibodies that react to the SARS-CoV-2 virus, are a common method for estimating the proportion of people previously infected with the virus in a given population. However, obtaining reliable estimates from seroprevalence studies is challenging for a number of reasons, and the uncertainty in the results is often overlooked by scientists, policy makers, and the media. This paper reviews the methodological issues that arise in designing these studies, and the main sources of uncertainty that affect the results. We discuss the choice of study population, recruitment of subjects, uncertainty surrounding the accuracy of antibody tests, and the relationship between antibodies and infection over time. Understanding these issues can help the reader to interpret and critically evaluate the results of seroprevalence studies.


Assuntos
COVID-19 , SARS-CoV-2 , Anticorpos Antivirais , Humanos , Prevalência , Estudos Soroepidemiológicos , Incerteza
15.
Front Public Health ; 9: 661482, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1389256

RESUMO

This paper examines the effects of pandemic uncertainty on socially responsible investments. We use the overall corporate sustainability performance index in the Global-100 Most Sustainable Corporations in the World dataset to measure socially responsible investments. The global pandemic uncertainty is also measured by the World Pandemic Uncertainty Index. We focus on the panel dataset from 2012 to 2020, and the results show that the World Pandemic Uncertainty Index is positively related to socially responsible investments. The main findings remain significant when we utilize various panel estimation techniques.


Assuntos
COVID-19/economia , Investimentos em Saúde/economia , Investimentos em Saúde/estatística & dados numéricos , Modelos Econômicos , Pandemias/estatística & dados numéricos , Responsabilidade Social , Incerteza , Humanos , SARS-CoV-2
16.
PLoS One ; 16(4): e0250029, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1388909

RESUMO

With the aim of studying the spread of the SARS-CoV-2 infection in the Tuscany region of Italy during the first epidemic wave (February-June 2020), we define a compartmental model that accounts for both detected and undetected infections and assumes that only notified cases can die. We estimate the infection fatality rate, the case fatality rate, and the basic reproduction number, modeled as a time-varying function, by calibrating on the cumulative daily number of observed deaths and notified infected, after fixing to plausible values the other model parameters to assure identifiability. The confidence intervals are estimated by a parametric bootstrap procedure and a Global Sensitivity Analysis is performed to assess the sensitivity of the estimates to changes in the values of the fixed parameters. According to our results, the basic reproduction number drops from an initial value of 6.055 to 0 at the end of the national lockdown, then it grows again, but remaining under 1. At the beginning of the epidemic, the case and the infection fatality rates are estimated to be 13.1% and 2.3%, respectively. Among the parameters considered as fixed, the average time from infection to recovery for the not notified infected appears to be the most impacting one on the model estimates. The probability for an infected to be notified has a relevant impact on the infection fatality rate and on the shape of the epidemic curve. This stresses the need of collecting information on these parameters to better understand the phenomenon and get reliable predictions.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , Número Básico de Reprodução , Controle de Doenças Transmissíveis , Humanos , Itália/epidemiologia , Modelos Estatísticos , Pandemias , SARS-CoV-2/isolamento & purificação , Incerteza
17.
J Grad Med Educ ; 12(3): 281-282, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-1383970
18.
Korean J Med Educ ; 32(2): 89-90, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-1383931
19.
20.
Mol Biol Evol ; 38(4): 1537-1543, 2021 04 13.
Artigo em Inglês | MEDLINE | ID: covidwho-1387956

RESUMO

The rooting of the SARS-CoV-2 phylogeny is important for understanding the origin and early spread of the virus. Previously published phylogenies have used different rootings that do not always provide consistent results. We investigate several different strategies for rooting the SARS-CoV-2 tree and provide measures of statistical uncertainty for all methods. We show that methods based on the molecular clock tend to place the root in the B clade, whereas methods based on outgroup rooting tend to place the root in the A clade. The results from the two approaches are statistically incompatible, possibly as a consequence of deviations from a molecular clock or excess back-mutations. We also show that none of the methods provide strong statistical support for the placement of the root in any particular edge of the tree. These results suggest that phylogenetic evidence alone is unlikely to identify the origin of the SARS-CoV-2 virus and we caution against strong inferences regarding the early spread of the virus based solely on such evidence.


Assuntos
COVID-19/virologia , Genoma Viral , Mutação , Filogenia , SARS-CoV-2/genética , Algoritmos , Animais , Teorema de Bayes , Evolução Molecular , Humanos , Funções Verossimilhança , Cadeias de Markov , Modelos Genéticos , Modelos Estatísticos , Método de Monte Carlo , Mutação de Sentido Incorreto , RNA Viral/genética , Incerteza
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