Showing papers in "Journal of Preventive Medicine and Public Health in 2020"

Impact of Rumors and Misinformation on COVID-19 in Social Media.

Abstract: The coronavirus disease 2019 (COVID-19) pandemic has not only caused significant challenges for health systems all over the globe but also fueled the surge of numerous rumors, hoaxes, and misinformation, regarding the etiology, outcomes, prevention, and cure of the disease. Such spread of misinformation is masking healthy behaviors and promoting erroneous practices that increase the spread of the virus and ultimately result in poor physical and mental health outcomes among individuals. Myriad incidents of mishaps caused by these rumors have been reported globally. To address this issue, the frontline healthcare providers should be equipped with the most recent research findings and accurate information. The mass media, healthcare organization, community-based organizations, and other important stakeholders should build strategic partnerships and launch common platforms for disseminating authentic public health messages. Also, advanced technologies like natural language processing or data mining approaches should be applied in the detection and removal of online content with no scientific basis from all social media platforms. Furthermore, these practices should be controlled with regulatory and law enforcement measures alongside ensuring telemedicine-based services providing accurate information on COVID-19.

Estimate of the Basic Reproduction Number for COVID-19: A Systematic Review and Meta-analysis.

Abstract: OBJECTIVES: The outbreak of coronavirus disease 2019 (COVID-19) is one of the main public health challenges currently facing the world. Because of its high transmissibility, COVID-19 has already caused extensive morbidity and mortality in many countries throughout the world. An accurate estimation of the basic reproduction number (R0) of COVID-19 would be beneficial for prevention programs. In light of discrepancies in original research on this issue, this systematic review and meta-analysis aimed to estimate the pooled R0 for COVID-19 in the current outbreak. METHODS: International databases (including Google Scholar, Science Direct, PubMed, and Scopus) were searched to identify studies conducted regarding the R0 of COVID-19. Articles were searched using the following keywords: "COVID-19" and "basic reproduction number" or "R0." The heterogeneity among studies was assessed using the I2 index, the Cochran Q test, and T2. A random-effects model was used to estimate R0 in this study. RESULTS: The mean reported R0 in the identified articles was 3.38±1.40, with a range of 1.90 to 6.49. According to the results of the random-effects model, the pooled R0 for COVID-19 was estimated as 3.32 (95% confidence interval, 2.81 to 3.82). According to the results of the meta-regression analysis, the type of model used to estimate R0 did not have a significant effect on heterogeneity among studies (p=0.81). CONCLUSIONS: Considering the estimated R0 for COVID-19, reducing the number of contacts within the population is a necessary step to control the epidemic. The estimated overall R0 was higher than the World Health Organization estimate.

Letter to the Editor: Coronavirus Disease 2019 (COVID-19), Infectivity, and the Incubation Period.

Abstract: This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/bync/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Dear Editor, We read with great interest the recent publication entitled “A Chinese case of coronavirus disease 2019 (COVID-19) did not show infectivity during the incubation period: based on an epidemiological survey” [1]. Bae concluded that “the epidemiological findings support the claim that the COVID-19 virus does not have infectivity during the incubation period [1].” In fact, a pathogen should not have infectivity during the incubation period or development of disease. However, the exact incubation period of COVID-19 is still unknown. In a recent report by Linton et al. [2], the incubation range was estimated as between 2 days and 14 days with 95% confidence. Exceptional cases might occur with an unusually short or long incubation period. Nevertheless, the reliability of history-taking should also be addressed. How the author was able to confirm the reliability of the patient’s self-reported history is an interesting issue for further discussion. In our country, Thailand, it is not uncommon for patients to disguise their clinical history, which can cause delays in the diagnosis of COVID-19 and exacerbate the local transmission of the disease. pISSN 1975-8375 eISSN 2233-4521

Social Determinants of COVID-19 in Massachusetts, United States: An Ecological Study.

Abstract: Objectives The aim of this study was to assess how different social determinants of health (SDoH) may be related to variability in coronavirus disease 2019 (COVID-19) rates in cities and towns in Massachusetts (MA). Methods Data about the total number of cases, tests, and rates of COVID-19 as of June 10, 2020 were obtained for cities and towns in MA. The data on COVID-19 were matched with data on various SDoH variables at the city and town level from the American Community Survey. These variables included information about income, poverty, employment, renting, and insurance coverage. We compared COVID-19 rates according to these SDoH variables. Results There were clear gradients in the rates of COVID-19 according to SDoH variables. Communities with more poverty, lower income, lower insurance coverage, more unemployment, and a higher percentage of the workforce employed in essential services, including healthcare, had higher rates of COVID-19. Most of these differences were not accounted for by different rates of testing in these cities and towns. Conclusions SDoH variables may explain some of the variability in the risk of COVID-19 across cities and towns in MA. Data about SDoH should be part of the standard surveillance for COVID-19. Efforts should be made to address social factors that may be putting communities at an elevated risk.

The Relationship Between Obesity, Overweight, and the Human Development Index in World Health Organization Eastern Mediterranean Region Countries

Abstract: Objectives Obesity is regarded as one of the most prominent health threats worldwide and a serious risk factor for non-communicable diseases, such as diabetes mellitus type 2, high blood pressure, cardiovascular diseases, and some types of cancer. Given the role that societal development-as reflected by the Human Development Index (HDI)-may play in the prevalence of obesity and overweight, this study aimed to investigate the degree to which the prevalence of obesity and overweight is affected by HDI and its components. Methods In this ecological study, the required data on HDI and its components were gathered from the latest report of the United Nations Development Program, and data on obesity and overweight were acquired from the latest reports published on the World Health Organization website. Statistical analyses were conducted using SPSS version 24.0. Results The prevalence of obesity was determined to be significantly higher among females than males, and the gross national index per capita was found to be significantly higher for males than females (pl0.05). Significant positive correlations were found between HDI and its components and sex, as well as indices of obesity and overweight. Conclusions A significant positive correlation exists between HDI and obesity. As policy-makers attempt to improve the general welfare of the people, they should be aware of potential unwanted effects of development on the risk of obesity and overweight among the population.

The Delay in Confirming COVID-19 Cases Linked to a Religious Group in Korea.

Abstract: OBJECTIVES: As of March 3, 2020, the Shincheonji religious group accounted for the majority of Korean cases of coronavirus disease 2019 (COVID-19). Nonetheless, the most likely cause of the broad spread of COVID-19 among members of the Shincheonji religious group remains largely unknown. METHODS: We obtained data of laboratory-confirmed cases related to the Shincheonji religious group from press releases by Korean public health authorities and news reports. We measured the period from the date of illness onset to the date of COVID-19 confirmation. RESULTS: We analysed data from 59 cases (median age, 30 years). The estimated median period between the date of symptom onset and the date of COVID-19 confirmation was 4 days (95% confidence interval, 1-12). CONCLUSIONS: There was a delay in COVID-19 confirmation from the date of illness onset among the cases linked to the Shincheonji religious group. This delay likely contributed to the occurrence of many cases of COVID-19 in the group.

Association of Comorbidities With Pneumonia and Death Among COVID-19 Patients in Mexico: A Nationwide Cross-sectional Study.

Abstract: OBJECTIVES: The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death. METHODS: This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaria de Salud de Mexico). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age. RESULTS: Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions. CONCLUSIONS: Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico.

The Effects of Border Shutdowns on the Spread of COVID-19.

Abstract: Objectives At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, some countries imposed entry bans against Chinese visitors. We sought to identify the effects of border shutdowns on the spread of the COVID-19 outbreak. Methods We used the synthetic control method to measure the effects of entry bans against Chinese visitors on the cumulative number of confirmed cases using World Health Organization situation reports as the data source. The synthetic control method constructs a synthetic country that did not shut down its borders, but is similar in all other aspects. Results Six countries that shut down their borders were evaluated. For Australia, the effects of the policy began to appear 4 days after implementation, and the number of COVID-19 cases dropped by 94.4%. The border shutdown policy took around 13.2 days to show positive effects and lowered COVID-19 cases by 91.7% on average by the end of February. Conclusions The border shutdowns in early February significantly reduced the spread of the virus. Our findings are informative for future planning of public health policies.

Forecasting COVID-19 Transmission and Healthcare Capacity in Bali, Indonesia.

Abstract: OBJECTIVES: In the current early phase of the coronavirus disease 2019 (COVID-19) outbreak, Bali needs to prepare to face the escalation of cases, with a particular focus on the readiness of healthcare services. We simulated the future trajectory of the epidemic under current conditions, projected the impact of policy interventions, and analyzed the implications for healthcare capacity. METHODS: Our study was based on the first month of publicly accessible data on new confirmed daily cases. A susceptible, exposed, infected, recovered (SEIR) model for COVID-19 was employed to compare the current dynamics of the disease with those predicted under various scenarios. RESULTS: The fitted model for the cumulative number of confirmed cases in Bali indicated an effective reproduction number of 1.4. Interventions have decreased the possible maximum number of cases from 71 125 on day 86 to 22 340 on day 119, and have prolonged the doubling time from about 9 days to 21 days. This corresponds to an approximately 30% reduction in transmissions from cases of mild infections. There will be 2780 available hospital beds, and at the peak (on day 132), the number of severe cases is estimated to be roughly 6105. Of these cases, 1831 will need intensive care unit (ICU) beds, whereas the number of currently available ICU beds is roughly 446. CONCLUSIONS: The healthcare system in Bali is in danger of collapse; thus, serious efforts are needed to improve COVID-19 interventions and to prepare the healthcare system in Bali to the greatest extent possible.

Characteristics of the COVID-19 Outbreak in Korea From the Mass Infection Perspective.

Abstract: On December 31, 2019, the Chinese government officially announced that the country had some cases of pneumonia with an unknown cause. By February 8, 2020, there were 24 confirmed cases in Korea, and the number of cases has steadily increased since then. On March 9, 2020, the cumulative number of confirmed cases in Korea was 7382, with 51 deaths. This study examines the characteristics of the coronavirus disease 2019 (COVID-19) outbreak from the perspective of the large-scale number of confirmed COVID-19 cases and deaths. This study is significant in that it emphasizes the precautionary principle in preventing and managing infectious diseases, and makes suggestions for urgently needed public health policies.

The Pandemic League of COVID-19: Korea Versus the United States, With Lessons for the Entire World.

Abstract: Coronavirus disease 2019 (COVID-19) is inflicting a brutal blow on humankind, and no corner of the world has been exempted from its wrath. This study analyzes the chief control measures and the distinctive features of the responses implemented by Korea and the United States to contain COVID-19 with the goal of extracting lessons that can be applied globally. Even though both nations reported their index cases on the same day, Korea succeeded in flattening the curve, with 10 752 cases as of April 28, 2020, whereas the outbreak skyrocketed in the United States, which had more than 1 million cases at the same time. The prudent and timely execution of control strategies enabled Korea to tame the spread of the virus, whereas the United States paid a major price for its delay, although it is too early to render a conclusive verdict. Information pertaining to the number of people infected with the virus and measures instituted by the government to control the spread of COVID-19 was retrieved from the United States Centers for Disease Control and Prevention and the Korea Centers for Disease Control and Prevention websites and press releases. Drawing lessons from both nations, it is evident that the resolution to the COVID-19 pandemic lies in the prudent usage of available resources, proactive strategic planning, public participation, transparency in information sharing, abiding by the regulations that are put into place, and how well the plan of action is implemented.

The Effectiveness of Community-based Social Distancing for Mitigating the Spread of the COVID-19 Pandemic in Turkey.

Abstract: OBJECTIVES: The objective of this study was to demonstrate the effects of community-based social distancing interventions after the first coronavirus disease 2019 (COVID-19) case in Turkey on the course of the pandemic and to determine the number of prevented cases. METHODS: In this ecological study, the interventions implemented in response to the first COVID-19 cases in Turkey were evaluated and the effect of the interventions was demonstrated by calculating the effective reproduction number (Rt) of severe acute respiratory syndrome coro navirus 2 (SARS-CoV-2) when people complied with community-based social distancing rules. RESULTS: Google mobility scores decreased by an average of 36.33±22.41 points (range, 2.60 to 84.80) and a median of 43.80 points (interquartile range [IQR], 24.90 to 50.25). The interventions caused the calculated Rt to decrease to 1.88 (95% confidence interval, 1.87 to 1.89). The median growth rate was 19.90% (IQR, 10.90 to 53.90). A positive correlation was found between Google mobility data and Rt (r=0.783; p<0.001). The expected number of cases if the growth rate had not changed was predicted according to Google mobility categories, and it was estimated to be 1 381 922 in total. Thus, community-based interventions were estimated to have prevented 1 299 593 people from being infected. CONCLUSIONS: Community-based social distancing interventions significantly decreased the Rt of COVID-19 by reducing human mobility, and thereby prevented many people from becoming infected. Another important result of this study is that it shows health policy-makers that data on human mobility in the community obtained via mobile phones can be a guide for measures to be taken.

Age-period-cohort analysis of cardiovascular disease mortality in Japan, 1995-2018

Abstract: Objectives This study aimed to analyze the mortality of heart disease (HD), ischemic heart disease (IHD), and cerebrovascular disease (CeVD) through an age-period-cohort (APC) analysis. Methods We used data on mortality due to cardiovascular disease from 1995 to 2018 in Japan, as determined by Vital Statistics. Age groups from 0 years to 99 years were defined by 5-year increments, and cohorts were defined for each age group of each year with a 1-year shift. We used Bayesian APC analysis to decompose the changes in the diseases' mortality rates into age, period, and cohort effects. Results The period effects for all diseases decreased during the analyzed periods for both men and women. The cohort effects for men increased substantially in cohorts born from around 1940 to the 1970s for all types of cardiovascular diseases. The cohort effects of HD decreased in the cohorts born in the 1970s or later for both men and women. Regarding IHD and CeVD, either a non-increase or decrease of cohort effects was confirmed for cohorts born in the 1970s or later for men, but the effects for women showed a continuously increasing trend in the cohorts born in the 1960s or later. Conclusions The cohort effects for IHD and CeVD showed increasing trends in younger generations of women. This suggests that preventive approaches against cardiovascular diseases are needed, particularly for women.

A Hidden Key to COVID-19 Management in Korea: Public Health Doctors.

Abstract: Public health doctors of Korea contributed significantly to massive coronavirus disease 2019 (COVID-19) testing. They were immediately dispatched to epicenters of the COVID-19 pandemic, and have run tests at screening centers, airport quarantines and hospitals. However, their expertise from in-field experience has been often neglected. It is time to reorganize public health doctor system to better prepare for future epidemics. Transforming and strengthening their roles as public health experts through systematic training is crucial.

Interpretation of the Basic and Effective Reproduction Number.

Abstract: In epidemiology, the basic reproduction number (R0) is a term that describes the expected number of infections generated by 1 case in a susceptible population. At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, R0 was frequently referenced by the public health community and the wider public. However, this metric is often misused or misinterpreted. Moreover, the complexity of the process of estimating R0 has caused difficulties for a substantial number of researchers. In this article, in order to increase the accessibility of this concept, we address several misconceptions related to the threshold characteristics of R0 and the effective reproduction number (Rt). Moreover, the appropriate interpretation of the metrics is discussed. R0 should be considered as a population-averaged value that pools the contact structure according to a stochastic transmission process. Furthermore, it is necessary to understand the unavoidable time lag for Rt due to the incubation period of the disease.

The Impact of Abuse on the Quality of Life of the Elderly: A Population-based Survey in Iran

Abstract: Objectives The quality of life (QoL) of the elderly and elder abuse are growing public health concerns. This study aimed to evaluate the prevalence of abuse and the association between QoL and abuse in older adults. Methods Multistage random cluster sampling, along with valid QoL (LEIPAD: LEIden, the Netherlands; PADua, Italy; Helsinki, Finland) and abuse questionnaires, were used to assess QoL and elder abuse. Path analysis was performed using Mplus. SPSS and AMOS were used for the other analyses. Results A total of 386 elderly individuals with a mean age of 68.00±6.10 years were interviewed, of whom 200 (51.8%), 289 (74.9%), and 376 (97.4%) were women, educated, and married, respectively. Moreover, 167 (43.2%) had low-to-moderate QoL, and 108 (27.9%) had experienced a moderate level of abuse. QoL and abuse were inversely associated (r=-0.253), with men (β=-0.24) more affected than women (β=-0.21). Musculoskeletal disorders were also strong determinants of QoL in the elderly. QoL was strongly associated with emotional abuse, while abuse was highly related to the social component of QoL. Furthermore, emotional abuse was the type of abuse most significantly associated with the self-care, depression/anxiety, cognitive, and social components of QoL. Sexual abuse, violation of personal rights, and neglect were the main determinants of the physical functioning, life satisfaction, and sexual domains of QoL, respectively. Conclusions Nearly half of the elderly individuals lacked a high QoL, and at least one-fourth had experienced some form of abuse. Elder abuse was correlated inversely with QoL. Therefore, preventive interventions are recommended to decrease elder abuse in the family, community, and other settings.

Anticipating the Need for Healthcare Resources Following the Escalation of the COVID-19 Outbreak in the Republic of Kazakhstan.

Abstract: Objectives The lack of advance planning in a public health emergency can lead to wasted resources and inadvertent loss of lives. This study is aimed at forecasting the needs for healthcare resources following the expansion of the coronavirus disease 2019 (COVID-19) outbreak in the Republic of Kazakhstan, focusing on hospital beds, equipment, and the professional workforce in light of the developing epidemiological situation and the data on resources currently available. Methods We constructed a forecast model of the epidemiological scenario via the classic susceptible-exposed-infected-removed (SEIR) approach. The World Health Organization's COVID-19 Essential Supplies Forecasting Tool was used to evaluate the healthcare resources needed for the next 12 weeks. Results Over the forecast period, there will be 104 713.7 hospital admissions due to severe disease and 34 904.5 hospital admissions due to critical disease. This will require 47 247.7 beds for severe disease and 1929.9 beds for critical disease at the peak of the COVID-19 outbreak. There will also be high needs for all categories of healthcare workers and for both diagnostic and treatment equipment. Thus, Republic of Kazakhstan faces the need for a rapid increase in available healthcare resources and/or for finding ways to redistribute resources effectively. Conclusions Republic of Kazakhstan will be able to reduce the rates of infections and deaths among its population by developing and following a consistent strategy targeting COVID-19 in a number of inter-related directions.

Unconventional Answers to Unprecedented Challenges: The Swedish Experience During the COVID-19 Outbreak.

Abstract: Since its early stages, the coronavirus disease 2019 (COVID-19) pandemic has posed immense challenges in meeting the public health and healthcare and social care needs of migrants. In line with other reports from United Kingdom and United States, data from Sweden's health authority show that migrants have been disproportionately affected by COVID-19. Following the World Health Organization's statements, as well as the European Public Health Association's call for action, several centres in Sweden's most populated areas have activated tools to implement national plans for community outreach through initiatives targeting migrants and ethnic minority groups. Unconventional means should be promoted to mitigate the impact of COVID-19 on migrants and the health of the public at large.

Age-period-cohort Analysis of Healthy Lifestyle Behaviors Using the National Health and Nutrition Survey in Japan.

Abstract: Objectives This study conducted an age-period-cohort (APC) analysis of trends in healthy lifestyle behaviors in Japan. Methods We used National Health and Nutrition Survey data on salt intake and prevalence of smoking, drinking, and physical activity between 1995 and 2018 in Japan. Age groups were defined from 20 years to 69 years old in 10-year increments. Cohorts were defined for each age group of each year with a 1-year shift, and cohorts born in 1926-1935 (first cohort) until 1989-1998 (last cohort) were examined. We conducted a Bayesian APC analysis, calculating estimated values for each behavior by age group, period, and cohort. Results Estimated salt intake decreased from cohorts born in the 1930s to the 1960s, but increased thereafter in both genders, and the magnitude of increase was larger for men. Estimated smoking prevalence increased in the cohorts starting from the 1930s for men and the 1940s for women, and then decreased starting in the cohorts born in the 1970s for both genders. Although estimated drinking prevalence decreased starting in the cohorts born in approximately 1960 for men, for women it increased until the cohorts born in approximately 1970. Estimated physical activity prevalence decreased starting in the cohorts born in the 1940s in both genders, but the magnitude of decrease was larger for women. Conclusions Trends in cohort effects differed by gender, which might be related to changes in the social environment for women. Improvements in dietary and exercise habits are required in more recently born cohorts of both genders.

Relationship Between Non-alcoholic Fatty Liver Disease and Decreased Bone Mineral Density: A Retrospective Cohort Study in Korea.

Abstract: Objectives The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease. Methods This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient's age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors. Results Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant. Conclusions NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.

The Effect of Prenatal Cadmium Exposure on Attention-deficit/Hyperactivity Disorder in 6-Year-old Children in Korea.

Abstract: Objectives Prenatal cadmium (Cd) exposure may be associated with attention-deficit/hyperactivity disorder (ADHD) in children. Therefore, the objective of this study was to examine the relationship between Cd exposure during gestation and ADHD at 6 years of age. Methods As part of an ongoing cohort study (the Environment and Development of Children study), 479 mother-child pairs from Seoul, Korea were included for analysis between 2008 and 2011. The whole blood concentration of Cd was analyzed using atomic absorption spectrophotometry. The parents were surveyed about ADHD behaviors in their children at age 6. Multivariable linear regression models were used to investigate the relationship between prenatal exposure to Cd and ADHD at 6 years of age. Results Increased prenatal Cd concentrations were associated with increased scores for ADHD for girls, but not for boys, at age 6. A 2-fold increase in the prenatal Cd level was significantly associated with a 22.3% (95% confidence interval, 11.6 to 34.1) increase in ADHD in girls at 6 years of age, as indicated by the linear regression model. Conclusions Our results identified significant associations between prenatal Cd exposure and ADHD scores in 6-year-old girls.

Verification of the Reliability and Validity of the Short Form 36 Scale in Indonesian Middle-aged and Older Adults

Abstract: Objectives: The Short Form 36 (SF-36) questionnaire is increasingly being used to measure health-related quality of life (HRQoL) in Indonesia. However, evidence that it is valid for use in Indonesian adults is lacking. This study assessed the validity and reliability of the SF-36 in Indonesian middle-aged and older adults. Methods: Adults aged 46-81 years (n=206) in Yogyakarta, Indonesia completed the SF-36, another measure of HRQoL (the EuroQoL visual analogue scale [EQ-VAS]), and measures assessing their demographic characteristics. Fifty-four percent (n=121) completed the SF-36 measure again 1 week later. Confirmatory factor analysis was conducted to confirm the factor structure of the SF-36. Internal consistency reliability was estimated using Cronbach’s alpha, and test-retest reliability was assessed using intraclass correlations. Convergent and discriminant validity were assessed by computing correlations among SF-36 subscales, between subscales and the 2 component scores, and between component scores and EQ-VAS scores. Results: Most scaling assumptions were met. The hypothetical factor structure fit the data poorly (root mean square error of approximation [RMSEA]=0.108) and modification was required for a good fit (RMSEA=0.060). Scores on all subscales demonstrated acceptable internal consistency (α>0.70) and test-retest reliability (r>0.70). Divergent validity was supported by weak to moderate inter-scale correlations (r=0.19 to 0.64). As expected, the 2 summary scores were moderately to strongly correlated with the EQ-VAS (r>0.60). Conclusions: The findings adequately support the use of SF-36 in Indonesian middle-aged and older adults, although the optimal algorithm for computing component scores in Indonesia warrants further investigation.

The Relationships Among Occupational Safety Climate, Patient Safety Climate, and Safety Performance Based on Structural Equation Modeling.

Abstract: OBJECTIVES The aim of the present study was to investigate the relationships among hospital safety climate, patient safety climate, and safety outcomes among nurses. METHODS In the current cross-sectional study, the occupational safety climate, patient safety climate, and safety performance of nurses were measured using several questionnaires. Structural equation modeling was applied to test the relationships among occupational safety climate, patient safety climate, and safety performance. RESULTS A total of 211 nurses participated in this study. Over half of them were female (57.0%). The age of the participants tended to be between 20 years and 30 years old (55.5%), and slightly more than half had less than 5 years of work experience (51.5%). The maximum and minimum scores of occupational safety climate dimensions were found for reporting of errors and cumulative fatigue, respectively. Among the dimensions of patient safety climate, non-punitive response to errors had the highest mean score, and manager expectations and actions promoting patient safety had the lowest mean score. The correlation coefficient for the relationship between occupational safety climate and patient safety climate was 0.63 (p<0.05). Occupational safety climate and patient safety climate also showed significant correlations with safety performance. CONCLUSIONS Close correlations were found among occupational safety climate, patient safety climate, and nurses' safety performance. Therefore, improving both the occupational and patient safety climate can improve nurses' safety performance, consequently decreasing occupational and patient-related adverse outcomes in healthcare units.

Sexual Intercourse and Its Correlates Among School-aged Adolescents in Indonesia: Analysis of the 2015 Global School-based Health Survey

Abstract: OBJECTIVES: This study aimed to determine the prevalence and correlates of sexual intercourse among junior secondary and high school students in Indonesia from the 2015 Global School-based Health Survey (GSHS). METHODS: The survey was conducted among 11 110 students from 75 schools in Indonesia using a self-administered questionnaire. Univariate and multivariate analyses were conducted to explore associations between sexual intercourse and socio-demographic variables, substance use, mental distress, and protective factors. RESULTS: Overall, 5.3% of students reported having ever had sex (6.9% of boys and 3.8% of girls). Of students who engaged in sexual intercourse, 72.7% of boys and 90.3% of girls had an early sexual debut (before reaching the age of 15) and around 60% had multiple sex partners. Sexual intercourse was associated with gender, school grade, smoking, alcohol consumption, drug use, suicidal ideation, truancy, peer support, and parental supervision. CONCLUSIONS: These findings indicate a pressing need to develop more comprehensive sexual health education in the national curriculum. An effective strategy should also address other risky behaviours.

Association Between Atrial Fibrillation and the Risk of Dementia in the Korean Elderly: A 10-Year Nationwide Cohort Study

Abstract: OBJECTIVES The objective of this study was to determine the effect of atrial fibrillation (AF) on the risk of dementia in the Korean elderly. METHODS A 10-year retrospective cohort study was conducted using the National Health Insurance Service-Senior Cohort database. We excluded those who were under 65 years of age as of January 2006 (n=46 113), those who were diagnosed with dementia between 2002 and 2005 (n=9086), and those with a history of stroke prior to AF diagnosis (n=8392). We used a Cox proportional hazards model with a time-varying covariate to determine whether AF is associated with the risk of dementia after adjusting for potential confounders. RESULTS In univariable Cox regression, the hazard ratio (HR) of dementia according to AF status was 1.28 (95% confidence interval [CI], 1.23 to 1.33). After adjusting for potential confounders, AF was found to increase the risk of dementia (HR, 1.12; 95% CI, 1.07 to 1.17), Alzheimer dementia (HR, 1.12; 95% CI, 1.07 to 1.17), and vascular dementia (HR, 1.10; 95% CI, 1.03 to 1.18). In patients diagnosed with AF, the incidence of dementia was lower (HR, 0.50; 95% CI, 0.47 to 0.52) in patients who were treated with oral anticoagulants. CONCLUSIONS Investigating the potential risk factors of dementia in an aged society is important. We found a slightly higher risk of dementia in those with AF than in those without AF, and we therefore concluded that AF is a potential risk factor for dementia.

A Chinese Case of Coronavirus Disease 2019 (COVID-19) Did Not Show Infectivity During the Incubation Period: Based on an Epidemiological Survey

Abstract: Controversy remains over whether the novel coronavirus 2019 (COVID-19) virus may have infectivity during the incubation period before the onset of symptoms. The author had the opportunity to examine the infectivity of COVID-19 during the incubation period by conducting an epidemiological survey on a confirmed patient who had visited Jeju Island during the incubation period. The epidemiological findings support the claim that the COVID-19 virus does not have infectivity during the incubation period.

Role of Information and Communication Technology and Women's Empowerment in Contraceptive Discontinuation in Indonesia.

Abstract: Objectives This study investigated the role of information and communication technology and women's empowerment in contraceptive discontinuation in Indonesia. Methods The study used data from the 2017 Indonesia Demographic and Health Survey and monthly contraceptive calendar data. A Gompertz proportional hazards model was used for analysis. Results The 12-month contraceptive discontinuation rate was higher among women who had used the Internet in the past year, women who were mobile phone owners, and women who reported having fully participated in household decision-making than among their counterparts. These factors significantly impacted the risk of contraceptive discontinuation in Indonesia, even after controlling for contraceptive method, age, parity, contraceptive intent, education, work status, place of residence, and wealth status. Conclusions After adjustment for the control variables, a higher risk of contraceptive discontinuation was associated with having used the Internet in the past year, owning a mobile phone, and not participating in household decision-making. Higher contraceptive discontinuation risk was also associated with using contraceptive pills, older age, lower parity, intent of spacing births, more education, current unemployment, and rural residence, and the risk was also significantly higher for those in the lowest household wealth quintile than for those in the fourth household wealth quintile. The association of contraceptive discontinuation with the use of modern information and communication technology and relatively disempowerment in household decision-making may imply that information regarding family planning and contraception should be conveyed via social media as part of setting up an eHealth system. This must include a strong communication strategy to empower and educate women in contraceptive decision-making.

Public Sector Workers' Mental Health in Argentina: Comparative Psychometrics of the Perceived Stress Scale.

Abstract: Fil: Miranda, Agustin Ramiro. Universidad Nacional de Cordoba. Facultad de Medicina. Escuela de Fonoaudiologia; Argentina. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Cordoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Cordoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina

Yemen's Cholera Epidemic Is a One Health Issue.

Abstract: Yemen has been faced with the worst cholera epidemic of modern times, with more than 1 million suspected cases and 3000 deaths at the time of writing. This problem is largely due to the longstanding civil war between pro-government forces and the Houthi armed movement, which has severely damaged already vulnerable sanitation and healthcare facilities and systems in the country. It is further compounded by a dire lack of basic amenities, chronic malnutrition, and unfavourable weather conditions. Another contributory component may be aerial transfer by cholera-infected chironomid insects. To contain the spread of cholera in Yemen, a nation-wide armistice should be negotiated, and national and local committees must be convened to coordinate efforts on the ground. Community isolation facilities with proper sanitation, reliable disposal systems, and a clean water supply should be set up to isolate and treat sick patients. The continuity of vaccination programmes should be ensured. Public health campaigns to educate local communities about good hygiene practices and nutrition are also necessary. The One Health paradigm emphasizes a multi-sectoral and transdisciplinary understanding and approach to prevent and mitigate the threat of communicable diseases. This paradigm is highly applicable to the ongoing cholera crisis in Yemen, as it demands a holistic and whole-of-society approach at the local, regional, and national levels. The key stakeholders and warring parties in Yemen must work towards a lasting ceasefire during these trying times, especially given the extra burden from the mounting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak worldwide.