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2.
Stud Health Technol Inform ; 282: 137-143, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34085964

RESUMO

We present a pilot study on three Italian Universities using a multi-domain set of indicators for Inclusion. The indicators are expressed in the coding system of the International Classification of Functioning Disability and Health - ICF - (World Health Organization, 2001). We selected three medium-sized Italian Universities: Brescia, Trieste and Venice. We combined a student-centered Universal Design philosophy for the built environment and Universal Design for Learning for the instructional environment. We identified four ICF Environmental Chapters (E1, E3, E4 and E5) and made them specific to the Academic context. Within the four Environmental Chapters targeting the physical, instructional, cultural, communicative, social and recreational domains we developed a 35-item checklist to fill out. The indicators were qualitative, quantitative or a mixture of the two. The three Universities shared the same instruments. Our main finding is that, although accommodations for students with disabilities exist as mandated by Italian law, the prevailing implementation is an individual accommodation based approach, rather than a universal design approach for the benefit to the greatest extent of the student population.


Assuntos
Pessoas com Deficiência , Universidades , Saúde Global , Humanos , Projetos Piloto , Estudantes
3.
Med Clin North Am ; 105(4): 681-697, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34059245

RESUMO

Diabetes mellitus is a significant worldwide health concern and cutaneous manifestations are common. This review describes characteristic skin findings of diabetes, general skin findings related to diabetes, and findings related to diabetes treatment with a focus on clinical presentation, diagnosis, pathophysiology, epidemiology, and treatment. As the prevalence of diabetes continues to rise, cutaneous manifestations of diabetes mellitus likely will be encountered more frequently by physicians in all disciplines including dermatologists and primary care physicians. Accordingly, knowledge regarding the prevention, diagnosis, and management of cutaneous manifestations is an important aspect in the care of patients with diabetes.


Assuntos
Complicações do Diabetes/patologia , Diabetes Mellitus/epidemiologia , Dermatopatias/diagnóstico , Dermatopatias/prevenção & controle , Dermatopatias/fisiopatologia , Acantose Nigricans/etiologia , Acantose Nigricans/patologia , Acantose Nigricans/terapia , Dermatologistas/estatística & dados numéricos , Pé Diabético/etiologia , Pé Diabético/patologia , Pé Diabético/terapia , Saúde Global/estatística & dados numéricos , Humanos , Conhecimento , Lipodistrofia/etiologia , Lipodistrofia/patologia , Lipodistrofia/terapia , Pessoa de Meia-Idade , Necrobiose Lipoídica/etiologia , Necrobiose Lipoídica/patologia , Necrobiose Lipoídica/terapia , Médicos de Atenção Primária/estatística & dados numéricos , Prevalência , Escleredema do Adulto/etiologia , Escleredema do Adulto/patologia , Escleredema do Adulto/terapia , Dermatopatias/epidemiologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-34063779

RESUMO

While the coronavirus 2019 (COVID-19) pandemic is spreading all over the world, misinformation, without prudent journalistic judgments of media content online, has begun circulating rapidly and influencing public opinion on social media. This quantitative study intends to advance the previous misinformation research by proposing and examining a theoretical model following an "influence of presumed influence" perspective. Two survey studies were conducted on participants located in the United States (N = 1793) and China (N = 504), respectively, to test the applicability of the influence of presumed influence theory. Results indicated that anger and anxiety significantly predicted perceived influence of misinformation on others; presumed influence on others positively affected public support in corrective and restrictive actions in both U.S. and China. Further, anger toward misinformation led to public willingness to self-correct in the U.S. and China. In contrast, anxiety only took effects in facilitating public support for restrictive actions in the U.S. This study conducted survey research in China and the U.S. to expand the influence of presumed influence (IPI) hypothesis to digital misinformation in both Western and non-Western contexts. This research provides implications for social media companies and policy makers to combat misinformation online.


Assuntos
Mídias Sociais , China , Comunicação , Saúde Global , Humanos , Estados Unidos
5.
BMJ Glob Health ; 6(5)2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34016578

RESUMO

The recent growth of medicine sales online represents a major disruption to pharmacy markets, with COVID-19 encouraging this trend further. While e-pharmacy businesses were initially the preserve of high-income countries, in the past decade they have been growing rapidly in low-income and middle-income countries (LMICs). Public health concerns associated with e-pharmacy include the sale of prescription-only medicines without a prescription and the sale of substandard and falsified medicines. There are also non-health-related risks such as consumer fraud and lack of data privacy. However, e-pharmacy may also have the potential to improve access to medicines. Drawing on existing literature and a set of key informant interviews in Kenya, Nigeria and India, we examine the e-pharmacy regulatory systems in LMICs. None of the study countries had yet enacted a regulatory framework specific to e-pharmacy. Key regulatory challenges included the lack of consensus on regulatory models, lack of regulatory capacity, regulating sales across borders and risks of over-regulation. However, e-pharmacy also presents opportunities to enhance medicine regulation-through consolidation in the sector, and the traceability and transparency that online records offer. The regulatory process needs to be adapted to keep pace with this dynamic landscape and exploit these possibilities. This will require exploration of a range of innovative regulatory options, collaboration with larger, more compliant businesses, and engagement with global regulatory bodies. A key first step must be ensuring that national regulators are equipped with the necessary awareness and technical expertise to actively oversee this e-pharmacy activity.


Assuntos
Saúde Global , Assistência Farmacêutica , Farmácia , Tecnologia , 59585 , Humanos , Índia , Quênia , Legislação de Medicamentos , Nigéria , Assistência Farmacêutica/tendências , Farmácias , 59565
6.
JMIR Public Health Surveill ; 7(6): e27917, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-33975277

RESUMO

BACKGROUND: The United States of America has the highest global number of COVID-19 cases and deaths, which may be due in part to delays and inconsistencies in implementing public health and social measures (PHSMs). OBJECTIVE: In this descriptive analysis, we analyzed the epidemiological evidence for the impact of PHSMs on COVID-19 transmission in the United States and compared these data to those for 10 other countries of varying income levels, population sizes, and geographies. METHODS: We compared PHSM implementation timing and stringency against COVID-19 daily case counts in the United States and against those in Canada, China, Ethiopia, Japan, Kazakhstan, New Zealand, Singapore, South Korea, Vietnam, and Zimbabwe from January 1 to November 25, 2020. We descriptively analyzed the impact of border closures, contact tracing, household confinement, mandated face masks, quarantine and isolation, school closures, limited gatherings, and states of emergency on COVID-19 case counts. We also compared the relationship between global socioeconomic indicators and national pandemic trajectories across the 11 countries. PHSMs and case count data were derived from various surveillance systems, including the Health Intervention Tracking for COVID-19 database, the World Health Organization PHSM database, and the European Centre for Disease Prevention and Control. RESULTS: Implementing a specific package of 4 PHSMs (quarantine and isolation, school closures, household confinement, and the limiting of social gatherings) early and stringently was observed to coincide with lower case counts and transmission durations in Vietnam, Zimbabwe, New Zealand, South Korea, Ethiopia, and Kazakhstan. In contrast, the United States implemented few PHSMs stringently or early and did not use this successful package. Across the 11 countries, national income positively correlated (r=0.624) with cumulative COVID-19 incidence. CONCLUSIONS: Our findings suggest that early implementation, consistent execution, adequate duration, and high adherence to PHSMs represent key factors of reducing the spread of COVID-19. Although national income may be related to COVID-19 progression, a country's wealth appears to be less important in controlling the pandemic and more important in taking rapid, centralized, and consistent public health action.


Assuntos
/prevenção & controle , Saúde Global/estatística & dados numéricos , Saúde Pública/legislação & jurisprudência , /epidemiologia , Bases de Dados Factuais , Humanos , Quarentena , Instituições Acadêmicas/organização & administração , Estados Unidos/epidemiologia , Local de Trabalho/organização & administração
8.
Glob Heart ; 16(1): 22, 2021 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-34040935

RESUMO

Background: The emergence of novel coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), has presented an unprecedented global challenge for the healthcare community. The ability of SARS-CoV-2 to get transmitted during the asymptomatic phase, and its high infectivity have led to the rapid transmission of COVID-19 beyond geographic regions facilitated by international travel, leading to a pandemic. To guide effective control and interventions, primary data is required urgently, globally, including from low- and middle-income countries where documentation of cardiovascular manifestations and risk factors in people hospitalized with COVID-19 is limited. Objectives: This study aims to describe the cardiovascular manifestations and cardiovascular risk factors in patients hospitalized with COVID-19. Methods: We propose to conduct an observational cohort study involving 5000 patients recruited from hospitals in low-, middle- and high-income countries. Eligible adult COVID-19 patients will be recruited from the participating hospitals and followed-up until 30 days post admission. The outcomes will be reported at discharge and includes the need of ICU admission, need of ventilator, death (with cause), major adverse cardiovascular events, neurological outcomes, acute renal failure, and pulmonary outcomes. Conclusion: Given the enormous burden posed by COVID-19 and the associated severe prognostic implication of CVD involvement, this study will provide useful insights on the risk factors for severe disease, clinical presentation, and outcomes of various cardiovascular manifestations in COVID-19 patients particularly from low and middle income countries from where the data remain scant.


Assuntos
/epidemiologia , Doenças Cardiovasculares/virologia , Saúde Global , Estudos Observacionais como Assunto/métodos , Estudos de Coortes , Hospitalização , Humanos , Estudos Multicêntricos como Assunto , Pandemias , Prognóstico , Fatores de Risco
9.
Glob Heart ; 16(1): 29, 2021 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-34040942

RESUMO

The current COVID-19 pandemic has challenged health systems and communities globally. As such, several countries have embarked on national COVID-19 vaccination programmes in order to curb spread of the disease. However, at present, there isn't yet enough dosages to enable vaccination of the general population. Different vaccine prioritization strategies are thus being implemented in different communities in order to permit for a systematic vaccination of individuals. Here, on behalf of the World Heart Federation, we emphasize the need for individuals with Cardiovascular disease to be prioritized in national vaccine prioritization programmes as these are high risk individuals.


Assuntos
Doenças Cardiovasculares/complicações , Prioridades em Saúde , /provisão & distribução , Comorbidade , Saúde Global , Humanos , Sociedades Médicas
11.
Lancet Digit Health ; 3(6): e349-e359, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34045001

RESUMO

BACKGROUND: Until broad vaccination coverage is reached and effective therapeutics are available, controlling population mobility (ie, changes in the spatial location of a population that affect the spread and distribution of pathogens) is one of the major interventions used to reduce transmission of SARS-CoV-2. However, population mobility differs across locations, which could reduce the effectiveness of pandemic control measures. Here we assess the extent to which socioeconomic factors are associated with reductions in population mobility during the COVID-19 pandemic, at both the city level in China and at the country level worldwide. METHODS: In this retrospective, observational study, we obtained anonymised daily mobile phone location data for 358 Chinese cities from Baidu, and for 121 countries from Google COVID-19 Community Mobility Reports. We assessed the intra-city movement intensity, inflow intensity, and outflow intensity of each Chinese city between Jan 25 (when the national emergency response was implemented) and Feb 18, 2020 (when population mobility was lowest) and compared these data to the corresponding lunar calendar period from the previous year (Feb 5 to March 1, 2019). Chinese cities were classified into four socioeconomic index (SEI) groups (high SEI, high-middle SEI, middle SEI, and low SEI) and the association between socioeconomic factors and changes in population mobility were assessed using univariate and multivariable linear regression. At the country level, we compared six types of mobility (residential, transit stations, workplaces, retail and recreation, parks, and groceries and pharmacies) 35 days after the implementation of the national emergency response in each country and compared these to data from the same day of the week in the baseline period (Jan 3 to Feb 6, 2020). We assessed associations between changes in the six types of mobility and the country's sociodemographic index using univariate and multivariable linear regression. FINDINGS: The reduction in intra-city movement intensity in China was stronger in cities with a higher SEI than in those with a lower SEI (r=-0·47, p<0·0001). However, reductions in inter-city movement flow (both inflow and outflow intensity) were not associated with SEI and were only associated with government control measures. In the country-level analysis, countries with higher sociodemographic and Universal Health Coverage indexes had greater reductions in population mobility (ie, in transit stations, workplaces, and retail and recreation) following national emergency declarations than those with lower sociodemographic and Universal Health Coverage indexes. A higher sociodemographic index showed a greater reduction in mobility in transit stations (r=-0·27, p=0·0028), workplaces (r=-0·34, p=0·0002), and areas retail and recreation (rxs=-0·30, p=0·0012) than those with a lower sociodemographic index. INTERPRETATION: Although COVID-19 outbreaks are more frequently reported in larger cities, our analysis shows that future policies should prioritise the reduction of risks in areas with a low socioeconomic level-eg, by providing financial assistance and improving public health messaging. However, our study design only allows us to assess associations, and a long-term study is needed to decipher causality. FUNDING: Chinese Ministry of Science and Technology, Research Council of Norway, Beijing Municipal Science & Technology Commission, Beijing Natural Science Foundation, Beijing Advanced Innovation Program for Land Surface Science, National Natural Science Foundation of China, China Association for Science and Technology.


Assuntos
Dinâmica Populacional , Fatores Socioeconômicos , Viagem , Adulto , Telefone Celular , China , Cidades , Saúde Global , Humanos , Dinâmica Populacional/tendências , Vigilância da População/métodos , Estudos Retrospectivos
12.
PLoS One ; 16(5): e0252273, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34048477

RESUMO

BACKGROUND: The aim of the study was to visualize the global spread of the COVID-19 pandemic over the first 90 days, through the principal component analysis approach of dimensionality reduction. METHODS: This study used data from the Global COVID-19 Index provided by PEMANDU Associates. The sample, representing 161 countries, comprised the number of confirmed cases, deaths, stringency indices, population density and GNI per capita (USD). Correlation matrices were computed to reveal the association between the variables at three time points: day-30, day-60 and day-90. Three separate principal component analyses were computed for similar time points, and several standardized plots were produced. RESULTS: Confirmed cases and deaths due to COVID-19 showed positive but weak correlation with stringency and GNI per capita. Through principal component analysis, the first two principal components captured close to 70% of the variance of the data. The first component can be viewed as the severity of the COVID-19 surge in countries, whereas the second component largely corresponded to population density, followed by GNI per capita of countries. Multivariate visualization of the two dominating principal components provided a standardized comparison of the situation in the161 countries, performed on day-30, day-60 and day-90 since the first confirmed cases in countries worldwide. CONCLUSION: Visualization of the global spread of COVID-19 showed the unequal severity of the pandemic across continents and over time. Distinct patterns in clusters of countries, which separated many European countries from those in Africa, suggested a contrast in terms of stringency measures and wealth of a country. The African continent appeared to fare better in terms of the COVID-19 pandemic and the burden of mortality in the first 90 days. A noticeable worsening trend was observed in several countries in the same relative time frame of the disease's first 90 days, especially in the United States of America.


Assuntos
/epidemiologia , Saúde Global , Pandemias , África/epidemiologia , Europa (Continente)/epidemiologia , Humanos , Estados Unidos/epidemiologia
13.
Int J Health Plann Manage ; 36(S1): 5-8, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34051109

RESUMO

This Special Issue is dedicated to the healthcare workers across the globe. It draws together studies from different disciplines and regions to identify important lessons learned on weaknesses as well as on opportunities for health workforce innovation through a global health lens. Beginning with strategic reflections on the role of the health workforce and public health competences in responding to the COVID-19 pandemic crisis, major themes include the protection and experiences of frontline healthcare workers, the role of health systems and policy, planning and management issues, and education and health labour markets. Developed in collaboration with European Public Health Association 'Health Workforce Research' section, the Special Issue contributes to the WHO International Year of Health and Care Workers (YHCW) in 2021 in recognition of their dedication to providing care during the COVID-19 pandemic, even risking their own health and life.


Assuntos
Saúde Global , Mão de Obra em Saúde , Desenvolvimento de Pessoal , Desastres , Humanos , Pandemias
17.
JAMA Netw Open ; 4(5): e2112131, 2021 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-33974053

RESUMO

Importance: The COVID-19 pandemic continues to affect millions of people globally, with increasing reports of neurological manifestations but limited data on their incidence and associations with outcome. Objective: To determine the neurological phenotypes, incidence, and outcomes among adults hospitalized with COVID-19. Design, Setting, and Participants: This cohort study included patients with clinically diagnosed or laboratory-confirmed COVID-19 at 28 centers, representing 13 countries and 4 continents. The study was performed by the Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) from March 1 to September 30, 2020, and the European Academy of Neurology (EAN) Neuro-COVID Registry (ENERGY) from March to October 2020. Three cohorts were included: (1) the GCS-NeuroCOVID all COVID-19 cohort (n = 3055), which included consecutive hospitalized patients with COVID-19 with and without neurological manifestations; (2) the GCS-NeuroCOVID COVID-19 neurological cohort (n = 475), which comprised consecutive patients hospitalized with COVID-19 who had confirmed neurological manifestations; and (3) the ENERGY cohort (n = 214), which included patients with COVID-19 who received formal neurological consultation. Exposures: Clinically diagnosed or laboratory-confirmed COVID-19. Main Outcomes and Measures: Neurological phenotypes were classified as self-reported symptoms or neurological signs and/or syndromes assessed by clinical evaluation. Composite incidence was reported for groups with at least 1 neurological manifestation. The main outcome measure was in-hospital mortality. Results: Of the 3055 patients in the all COVID-19 cohort, 1742 (57%) were men, and the mean age was 59.9 years (95% CI, 59.3-60.6 years). Of the 475 patients in the COVID-19 neurological cohort, 262 (55%) were men, and the mean age was 62.6 years (95% CI, 61.1-64.1 years). Of the 214 patients in the ENERGY cohort, 133 (62%) were men, and the mean age was 67 years (95% CI, 52-78 years). A total of 3083 of 3743 patients (82%) across cohorts had any neurological manifestation (self-reported neurological symptoms and/or clinically captured neurological sign and/or syndrome). The most common self-reported symptoms included headache (1385 of 3732 patients [37%]) and anosmia or ageusia (977 of 3700 patients [26%]). The most prevalent neurological signs and/or syndromes were acute encephalopathy (1845 of 3740 patients [49%]), coma (649 of 3737 patients [17%]), and stroke (222 of 3737 patients [6%]), while meningitis and/or encephalitis were rare (19 of 3741 patients [0.5%]). Presence of clinically captured neurologic signs and/or syndromes was associated with increased risk of in-hospital death (adjusted odds ratio [aOR], 5.99; 95% CI, 4.33-8.28) after adjusting for study site, age, sex, race, and ethnicity. Presence of preexisting neurological disorders (aOR, 2.23; 95% CI, 1.80-2.75) was associated with increased risk of developing neurological signs and/or syndromes with COVID-19. Conclusions and Relevance: In this multicohort study, neurological manifestations were prevalent among patients hospitalized with COVID-19 and were associated with higher in-hospital mortality. Preexisting neurological disorders were associated with increased risk of developing neurological signs and/or syndromes in COVID-19.


Assuntos
/mortalidade , Saúde Global/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Doenças do Sistema Nervoso/mortalidade , Adulto , Idoso , Feminino , Mortalidade Hospitalar , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/virologia , Razão de Chances , Prevalência
19.
OMICS ; 25(5): 279-284, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33961517

RESUMO

This expert review offers an analysis of the global governance of the COVID-19 pandemic. The pandemic is not only a health crisis but also a crisis of global governance. For example, the nation states in dealing with the crises of the pandemic have turned inwards, toward native and national solutions, and therefore away from the much-needed global cooperation to respond to the pandemic. This is an important concern for systems medicine and integrative biology in both normative and instrumental sense. Moreover, if we are to "pandemic-proof" the planet and the life science innovation ecosystem, new ways of understanding global governance are called for. This article examines the ways in which national governments have reacted to the crises triggered and embodied by the COVID-19 pandemic, surfaces the different approaches and conflicts between scientific experts and policy makers, and reveals the failure of science and politics. I analyze the uneven and disjointed way Western democratic governments have responded to the crisis and the way unchecked normative values and ideas have influenced the pandemic policy and prevented effective measures to contain the pandemic. Finally, the complex relationships between politics, knowledge, science, and governments are explored and clarified, and the way the COVID-19 crisis highlighted the long-standing tensions between technocracy and democracy. In conclusion, it is time to think critically and reflexively for all knowledge actors in systems science and innovate both planetary health and its global governance.


Assuntos
/epidemiologia , Saúde Global , Pandemias , /prevenção & controle , Controle de Doenças Transmissíveis , Política de Saúde , Humanos , Invenções , Pandemias/prevenção & controle , Política , Competência Profissional
20.
Spat Spatiotemporal Epidemiol ; 37: 100417, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33980401

RESUMO

This study investigated the spatio-temporal variations in the occurrence of COVID-19 (confirmed cases and deaths) in relation to climate fluctuations in 61 countries, scattered around the world, from December 31, 2019 to May 28, 2020. Logarithm transformation of the count variable (COVID-19 cases) was used in a multiple linear regression model to predict the potential effects of weather variables on the prevalence of the disease. The study revealed strong associations (-0.510 ≤ r ≤ -0.967; 0.519 ≤ r ≤ 0.999) between climatic variables and confirmed cases of COVID-19 in majority (68.85%) of the selected countries. It showed evidences of 1 to 7-day delays in the response of the infection to changes in weather pattern. Model simulations suggested that a unit fall in temperature and humidity could increase (0.04-18.70%) the infection in 19.67% and 16.39% of the countries, respectively, while a general reduction (-0.05 to 9.40%) in infection cases was projected in 14.75% countries with a unit drop in precipitation. In conclusion, the study suggests that effective public health interventions are crucial to containing the projected upsurge in COVID-19 cases during both cold and warm seasons in the southern and northern hemispheres.


Assuntos
/epidemiologia , Clima , Saúde Global , Pneumonia Viral/epidemiologia , Análise Espacial , Humanos , Pandemias , Pneumonia Viral/virologia
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