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1.
BMC Psychol ; 9(1): 1, 2021 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-33388086

RESUMEN

BACKGROUND: Adapting and translating already developed tools to different cultures is a complex process, but once done, it increases the validity of the construct to be measured. This study aimed to assess the 12 items WHODAS-2 and test its psychometric properties among road traffic injury victims in Ethiopia. This study aimed to translate the 12 items WHODAS- 2 interview-based tools into Amharic and examine the psychometric properties of the new version among road traffic injury victims. METHODS: The 12 items WHODAS 2 was first translated into Amharic by two experts. Back translation was done by two English experts. A group of experts reviewed the forward and backward translation. A total of 240 patients with road traffic injury completed the questionnaires at three selected Hospitals in Amhara Regional State. Internal consistency was; assessed using Chronbach's alpha, convergent, and divergent validity, which were; tested via factor analysis. Confirmatory factor analysis (CFA); was computed, and the model fit; was examined. RESULTS: The translated Amharic version 12 -items WHODAS-2 showed that good cross-cultural adaptation and internal consistency (Chronbach's α =0.88). The six factor structure best fits data (model fitness indices; CFI = 0.962, RMSEA = 0.042, RMR = 0.072, GFI = 0.961, chi-square value/degree of freedom = 1.42, TLI = 0.935 and PCLOSE = 0.68). Our analysis showed that from the six domains, mobility is the dominant factor explaining 95% of variability in disability. CONCLUSION: The 12 items interview-based Amharic version WHODAS-2; showed good cultural adaptation at three different settings of Amhara Regional State and can be used to measure dis-ability following a road traffic injury.


Asunto(s)
Actividades Cotidianas/psicología , Personas con Discapacidad/psicología , Tamizaje Masivo/estadística & datos numéricos , Psicometría/estadística & datos numéricos , Encuestas y Cuestionarios/normas , Heridas y Traumatismos/psicología , Adolescente , Adulto , Evaluación de la Discapacidad , Etiopía , Humanos , Persona de Mediana Edad , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Traducciones , Organización Mundial de la Salud , Adulto Joven
4.
J Korean Med Sci ; 36(2): e14, 2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33429473

RESUMEN

BACKGROUND: The quarantine process at a country's port of entry has an important role in preventing an influx of coronavirus disease 2019 (COVID-19) cases from abroad and further minimizing the national healthcare burden of COVID-19. However, there has been little published on the process of COVID-19 screening among travelers entering into a country. Identifying the characteristics of COVID-19 infected travelers could help attenuate the further spread of the disease. METHODS: The authors analyzed epidemiological investigation forms and real-time polymerase chain reaction (PCR) results for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) of entrants to Incheon International Airport between March 11 to April 30, 2020. We performed univariate and multivariate logistic regression analysis to determine the odds of positive SARS-CoV-2 result. RESULTS: A total of 11,074 entrants underwent reverse-transcription PCR for SARS-CoV-2, resulting 388 confirmed cases of COVID-19 infection. COVID-19 had a strong association with the reported loss of smell or taste and association with self-reported fever, chill, cough, and vomiting. If a traveler reported contact with an individual with either respiratory symptoms or confirmed COVID-19 in the last two weeks directly prior to landing, the probability of a positive result was increased. CONCLUSION: If overseas travelers experience loss of smell or taste in the two weeks prior to arrival, they may require an immediate examination to rule out COVID-19 at a port of entry. As to measure body temperature upon arrival at a port of entry, it is important to screen for any occurrence of fever within the two weeks prior to travel. Also, information with epidemiological relevance, such as recent contact with an individual suffering from any respiratory symptoms or with confirmed COVID-19, should be included in COVID-19 screening questionnaires for international travelers.


Asunto(s)
Viaje en Avión/estadística & datos numéricos , /epidemiología , Tamizaje Masivo/métodos , /aislamiento & purificación , Adulto , Ageusia/diagnóstico , Femenino , Fiebre/diagnóstico , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Masculino , Cuarentena/métodos , República de Corea/epidemiología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
5.
J Korean Med Sci ; 36(2): e16, 2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33429475

RESUMEN

BACKGROUND: One of the challenges neurosurgeons are facing in the global public health crisis caused by the coronavirus disease 2019 (COVID-19) pandemic is to balance COVID-19 screening with timely surgery. We described a clinical pathway for patients who needed emergency brain surgery and determined whether differences in the surgery preparation process caused by COVID-19 screening affected clinical outcomes. METHODS: During the COVID-19 period, patients in need of emergency brain surgery in our institution were managed using a novel standardized pathway designed for COVID-19 screening. We conducted a retrospective review of patients who were hospitalized through the emergency room and underwent emergency brain surgery. A total of 32 patients who underwent emergency brain surgery from February 1 to June 30, 2020 were included in the COVID-19 group, and 65 patients who underwent surgery from February 1 to June 30, 2019 were included in the pre-COVID-19 group. The baseline characteristics, disease severity indicators, time intervals of emergency processes, and clinical outcomes of the two groups were compared. Subgroup analysis was performed between the immediate surgery group and the semi-elective surgery group during the COVID-19 period. RESULTS: There were no significant differences in baseline characteristics and severity indicators between the pre-COVID-19 group and COVID-19 group. The time interval to skin incision was significantly increased in the COVID-19 group (P = 0.027). However, there were no significant differences in the clinical outcomes between the two groups. In subgroup comparison, the time interval to skin incision was shorter in the immediate surgery group during the COVID-19 period compared with the pre-COVID-19 group (P = 0.040). The screening process did not significantly increase the time interval to classification and admission for immediate surgery. The time interval to surgery initiation was longer in the COVID-19 period due to the increased time interval in the semi-elective surgery group (P < 0.001). CONCLUSION: We proposed a clinical pathway for the preoperative screening of COVID-19 in patients requiring emergency brain surgery. No significant differences were observed in the clinical outcomes before and after the COVID-19 pandemic. The protocol we described showed acceptable results during this pandemic.


Asunto(s)
Encéfalo/cirugía , /diagnóstico , Vías Clínicas , Procedimientos Neuroquirúrgicos/métodos , Anciano , Encéfalo/patología , Cuidados Críticos/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Tratamiento de Urgencia , Femenino , Humanos , Masculino , Tamizaje Masivo/métodos , Persona de Mediana Edad , Estudios Retrospectivos , /aislamiento & purificación
6.
BMC Fam Pract ; 22(1): 20, 2021 01 14.
Artículo en Inglés | MEDLINE | ID: mdl-33446099

RESUMEN

BACKGROUND: The purpose of this study is to forward the implementation of an operational evidence-based state screening program of common diseases in Ukraine, where currently no state-based and evidence-based screening (EBS) exists. EBS should be performed by Family Doctors in a primary care setting and concern prevalent diseases in adults, such as: obesity (BMI), hypertension (BP measurement), diabetes (glycaemia), dyslipidemia (cholesterol/lipids), colon cancer (FOBT/colonoscopy), breast cancer (mammography), STIs (chlamydia, syphilis), HIV, HBV, HCV (i.e. serology or other rapid tests), HPV (swabs), cervical cancer (test Pap). depression (i.e., PHQ-9), and smoking (i.e., Fagerstrom). METHODS: Four needs-based research actions were led among citizens and healthcare professionals, based on multidimensional empowerment. Internal Strengths and Weaknesses of the ongoing implementation process were identified through these studies, whereas external Opportunities and Threats were determined by the present socio-cultural and political context. This SWOT analysis is likely to guide future state-based initiatives to accomplish EBS implementation in Ukraine. RESULTS: Internal Strengths are the bottom-up multidimensional empowerment approach, teaching of EBS and the development of an internet-based platform "Screening adviser" to assist shared decision making for person-centred EBS programs. Internal Weaknesses identified for the Family Doctors are a heterogeneous screening and the risk of decreasing motivation to screen. External Opportunities include the ongoing PHC reform, the existent WONCA and WHO support, and the existence of EBS programs in Europe. External Threats are the lack of national guidelines, not fully introduced gate keeping system, the vulnerable socio-economic situation, the war situation in the East of Ukraine and the Covid-19 pandemic. CONCLUSIONS: We started EBS implementation through research actions, based on a multidimensional empowerment of citizens, HCP and in EBS pathways involved stakeholder teams, to foster a sustainable operational human resource to get involved in that new EBS pathway to implement. The presented SWOT-analysis of this ongoing implementation process allows to plan and optimize future steps towards a state based and supports EBS program in Ukraine.


Asunto(s)
Medicina Basada en la Evidencia , Medicina Familiar y Comunitaria , Tamizaje Masivo/organización & administración , Medicina Estatal , Conflictos Armados , Femenino , Humanos , Masculino , Ucrania/epidemiología
7.
BMC Psychol ; 9(1): 7, 2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33413695

RESUMEN

BACKGROUND: Harms of colorectal cancer (CRC) screening include psychosocial consequences. We have not identified studies using a participant-relevant questionnaire with adequate measurement properties to investigate these harms. However, Brodersen et al. have previously developed a core questionnaire consequences of screening (COS) for use in screening for life-threatening diseases. Therefore, the objectives were: (1) To investigate content validity of COS in a CRC screening setting and in case of gaps in content coverage (2) generate new items and themes and (3) test the possibly extended version of COS for dimensionality and differential item functioning (DIF) using Rasch Models. METHODS: We performed two-part-focus-groups with CRC screenees. Screenees were recruited by strategic sampling. In the first part 16 screenees with false-positive results (n = 7) and low-risk polyps (n = 9) were interviewed about their CRC screening experiences and in the second part COS was examined for content validity. When new information was developed in the focus groups, new items covering this topic were generated. Subsequently, new items were, together with COS, tested in the subsequent interviews. A random subsample (n = 410) from a longitudinal questionnaire study, not yet published, was used to form the data for this paper. We analysed multidimensionality and uniform DIF with Andersen's conditional likelihood ratio test. We assessed individual item fit to the model. We also analysed Local Dependence (LD) and DIF by partial gamma coefficients using Rasch Models. RESULTS: COS was found relevant in a CRC screening setting. However, new information was discovered in the focus groups, covered by 18 new CRC screening-specific items. The Rasch analyses only revealed minor problems in the COS-scales. The 18 new items were distributed on four new CRC screening-specific dimensions and one single item. CONCLUSION: An extended version of COS specifically for use in a CRC screening setting has been developed. The extended part encompasses four new scales and one new single item. The original COS with the CRC-screening specific extension is called consequences of screening in colorectal cancer (COS-CRC). COS-CRC possessed reliability, unidimensionality and invariant measurement.


Asunto(s)
Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer , Tamizaje Masivo , Neoplasias Colorrectales/psicología , Detección Precoz del Cáncer/psicología , Grupos Focales , Humanos , Tamizaje Masivo/psicología , Medición de Resultados Informados por el Paciente , Psicometría , Investigación Cualitativa , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
9.
Waste Manag ; 119: 365-373, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33127277

RESUMEN

The use of plastic waste as resource gains more and more attention. In this context, material recycling is especially focused on packaging plastics. Further waste streams that contain a significant amount of plastics are mixed commercial and municipal solid waste. To assess the potential of plastics for recycling and energy recovery from these material streams large-scale experiments were conducted. The potential of mechanical pre-processing with the aim of generating a 3D-plastics pre-concentrate was assessed. The focus of these investigations was put on the relevance of the screening stage and its influence on down-stream material processing via ballistic separation and sensor-based sorting. Results demonstrate not only that the screening of both waste streams leads to enrichment of plastics in coarse particle size ranges (especially >80 mm) and transfer of contaminants, organics and minerals to fine fractions (especially <10 mm), but also that sensor-based sorting performance can be significantly enhanced due to cleaning effects on plastics, induced by the material circulation and the resulting interparticle friction in a drum screen. On the downside, the material rotation in a drum screen leads to tail-formation that can create plant down-time through clogging as well as material losses and impairment of pre-concentrates.


Asunto(s)
Plásticos , Eliminación de Residuos , Tamizaje Masivo , Reciclaje , Residuos Sólidos
13.
Soc Sci Med ; 268: 113571, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33310396

RESUMEN

The value of digital healthcare has been lauded in Canada at local, provincial, and national levels. Digital medicine is purported to enhance patient access to care while promising cost savings. Using institutional ethnography, we examined the potential for publicly funded digital testing for HIV and other sexually transmitted infections (STI) in Ontario, Canada. Our analyses draw from 23 stakeholder interviews with healthcare professionals conducted between 2019 and 2020, and textual analyses of government documents and private, for-profit digital healthcare websites. We uncovered a "two-tiered" system whereby private digital STI testing services enable people with economic resources to "pay to skip the line" queuing at public clinics and proceed directly to provide samples for diagnostics at local private medical labs. In Ontario, private lab corporations compete for fee-for-service contracts with government, which in turn organises opportunities for market growth when more patient samples are collected vis-à-vis digital testing. However, we also found that some infectious disease specimens (e.g., HIV) are re-routed for analysis at government public health laboratories, who may be unable to manage the increase in testing volume associated with digital STI testing due to state budget constraints. Our findings on public-private laboratory funding disparities thus discredit the claims that digital healthcare necessarily generates cost savings, or that it enhances patients' access to care. We conclude that divergent state funding relations together with the creeping privatisation of healthcare within this "universal" system coordinate the conditions through which private corporations capitalise from digital STI testing, compounding patient access inequities. We also stress that our findings bring forth large scale implications given the context of the global COVID-19 pandemic, the rapid diffusion of digital healthcare, together with significant novel coronavirus testing activities initiated by private industry.


Asunto(s)
Infecciones por VIH/diagnóstico , Tamizaje Masivo/economía , Política , Enfermedades de Transmisión Sexual/diagnóstico , /métodos , Humanos , Tamizaje Masivo/métodos , Ontario
14.
Adv Exp Med Biol ; 1307: 231-255, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32314318

RESUMEN

An ideal screening test for gestational diabetes should be capable of identifying not only women with the disease but also the women with a high risk of developing gestational diabetes mellitus (GDM). Screening and diagnosis are the main steps leading to the way of management. There is a lack of consensus among healthcare professionals regarding the screening methods worldwide. Different study groups advocate a variety of screening methods with the support of evidence-based comprehensive data. Some of the organizations suggest screening for high risk or all pregnant women, while others prefer to offer definitive testing without screening. Glycemic thresholds are also not standardized to decide GDM among different guidelines. Prevalence rates of GDM vary between populations and with the choice of glucose thresholds for both screening and definitive tests. One-step or two-step methods have been used for GDM diagnosis. However, screening includes selecting patients with historical risk factors, 50 g 1-h glucose challenge test, fasting plasma glucose, random plasma glucose, and hemoglobin A1c with different cutoffs. In this chapter, screening and diagnosis methods of GDM accepted by different study groups will be discussed which will be followed by the evaluation of different glycemic thresholds. Then the advantages and disadvantages of used methods will be explained and the chapter will finish with an evaluation of the current international guidelines.


Asunto(s)
Diabetes Gestacional , Tamizaje Masivo , Glucemia/análisis , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiología , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Embarazo
17.
Water Res ; 188: 116501, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33091804

RESUMEN

Natural swimming ponds (NSPs) are artificially created bodies of water intended for human recreation, characterised by the substitution of chemical disinfection with natural biological processes for water purification. NSPs are growing in popularity, however little is known regarding the public health risks. A screening level risk assessment was undertaken as an initial step in assessing the first Canadian public NSP located in Edmonton, Alberta. Risk of enteric pathogens originating from pool bathers was assessed under normal conditions and following accidental faecal release events. The performance of the natural treatment train for health protection was quantified with and without the addition of UV disinfection of naturally-treated water, and compared to the US EPA benchmark to provide a reference point to consider acceptability. Estimated levels of pathogen contamination of the pond were dependant upon the discrete number of shedders present, which in turn depended upon the prevalence of infection in the population. Overall performance of the natural disinfection system was dependant upon the filtration rate of the natural treatment system or turnover time. Addition of UV disinfection reduced the uncertainty around the removal efficacy, and mitigated the impact of larger shedding events, however the impact of UV disinfection on the natural treatment biome is unknown. Further information is needed on the performance of natural barriers for pathogen removal, and therefore challenge studies are recommended. Given the identified risks, the pool is posted that there is risk from accidental faecal releases, as in any natural water body with swimmers. Screening level risk assessment was a valuable first step in understanding the processes driving the system and in identifying important data gaps.


Asunto(s)
Estanques , Piscinas , Alberta , Salud , Humanos , Tamizaje Masivo , Medición de Riesgo , Natación , Microbiología del Agua
19.
Anaesthesia ; 76(1): 54-60, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32592515

RESUMEN

Pre-operative anaemia (haemoglobin < 13.0 g.dl-1 ) is a modifiable peri-operative risk-factor. This is screened for using formal laboratory testing. A non-invasive finger-probe sensor that can accurately measure haemoglobin is a possible alternative. This study considers the accuracy of non-invasive haemoglobin measurement using the Rad-67™ Rainbow (Masimo Corp., Irvine, CA, USA) compared with formal laboratory testing and its usefulness in detecting pre-operative anaemia. A total of 392 patients had measurements taken for non-invasive haemoglobin and perfusion index values using the Rad-67 Rainbow, alongside further peri-operative parameters and a formal laboratory haemoglobin test. Bland-Altman and sensitivity analysis showed that the limits of agreement between non-invasive and formal laboratory haemoglobin testing were between -1.95 g.dl-1 and 2.23 g.dl-1 (p < 0.001). The overall performance of non-invasive haemoglobin measurement was better in men than women (ROC 91.1% vs. 78.2%) and less biased in men, mean -0.08 (SD 1.09, 95%Cl -0.23-0.07) compared with women (mean 0.38 (SD 0.99, 95%CI 0.24-0.52)). Pre-operative anaemia was more prevalent in women than men (50.3% vs. 14.4%). The sensitivity of non-invasive anaemia detection (haemoglobin < 13 g.dl-1 ) was 66% for women and 52% for men. A non-invasive haemoglobin value of 14.0 g.dl-1 had an overall 91% sensitivity for detecting pre-operative anaemia (82% in men and 93% in women). The Rad-67 Rainbow is inadequate for the estimation of formal laboratory haemoglobin and lacks sensitivity for detecting pre-operative anaemia, especially in women. Further advancement in technology and accuracy is needed before it can be recommended as a routine pre-operative screening test.


Asunto(s)
Anemia/diagnóstico , Hemoglobinometría/métodos , Oximetría/métodos , Cuidados Preoperatorios/métodos , Adulto , Anciano , Anemia/epidemiología , Femenino , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Perfusión , Estudios Prospectivos , Curva ROC , Factores Sexuales
20.
J Med Internet Res ; 23(1): e23897, 2021 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-33320825

RESUMEN

BACKGROUND: Confirmed COVID-19 cases have been registered in more than 200 countries, and as of July 28, 2020, over 16 million cases have been reported to the World Health Organization. This study was conducted during the epidemic peak of COVID-19 in Italy. The early identification of individuals with suspected COVID-19 is critical in immediately quarantining such individuals. Although surveys are widely used for identifying COVID-19 cases, outcomes, and associated risks, no validated epidemiological tool exists for surveying SARS-CoV-2 infection in the general population. OBJECTIVE: We evaluated the capability of self-reported symptoms in discriminating COVID-19 to identify individuals who need to undergo instrumental measurements. We defined and validated a method for identifying a cutoff score. METHODS: Our study is phase II of the EPICOVID19 Italian national survey, which launched in April 2020 and included a convenience sample of 201,121 adults who completed the EPICOVID19 questionnaire. The Phase II questionnaire, which focused on the results of nasopharyngeal swab (NPS) and serological tests, was mailed to all subjects who previously underwent NPS tests. RESULTS: Of 2703 subjects who completed the Phase II questionnaire, 694 (25.7%) were NPS positive. Of the 472 subjects who underwent the immunoglobulin G (IgG) test and 421 who underwent the immunoglobulin M test, 22.9% (108/472) and 11.6% (49/421) tested positive, respectively. Compared to NPS-negative subjects, NPS-positive subjects had a higher incidence of fever (421/694, 60.7% vs 391/2009, 19.5%; P<.001), loss of taste and smell (365/694, 52.6% vs 239/2009, 11.9%; P<.001), and cough (352/694, 50.7% vs 580/2009, 28.9%; P<.001). With regard to subjects who underwent serological tests, IgG-positive subjects had a higher incidence of fever (65/108, 60.2% vs 43/364, 11.8%; P<.001) and pain in muscles/bones/joints (73/108, 67.6% vs 71/364, 19.5%; P<.001) than IgG-negative subjects. An analysis of self-reported COVID-19 symptom items revealed a 1-factor solution, the EPICOVID19 diagnostic scale. The following optimal scores were identified: 1.03 for respiratory problems, 1.07 for chest pain, 0.97 for loss of taste and smell 0.97, and 1.05 for tachycardia (ie, heart palpitations). These were the most important symptoms. For adults aged 18-84 years, the cutoff score was 2.56 (sensitivity: 76.56%; specificity: 68.24%) for NPS-positive subjects and 2.59 (sensitivity: 80.37%; specificity: 80.17%) for IgG-positive subjects. For subjects aged ≥60 years, the cutoff score was 1.28, and accuracy based on the presence of IgG antibodies improved (sensitivity: 88.00%; specificity: 89.58%). CONCLUSIONS: We developed a short diagnostic scale to detect subjects with symptoms that were potentially associated with COVID-19 from a wide population. Our results support the potential of self-reported symptoms in identifying individuals who require immediate clinical evaluations. Although these results come from the Italian pandemic period, this short diagnostic scale could be optimized and tested as a screening tool for future similar pandemics.


Asunto(s)
/diagnóstico , Encuestas Epidemiológicas , Tamizaje Masivo/normas , Psicometría , Autoinforme , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , /fisiopatología , Femenino , Fiebre/epidemiología , Humanos , Inmunoglobulina G/análisis , Inmunoglobulina M/análisis , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Reproducibilidad de los Resultados , Adulto Joven
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