Project description:The focus on treatment of COVID19 patients during the Sars-CoV-2 outbreak has most likely implications for the extent and quality of diagnosis and treatment of non-COVID19 patients. Medical care of cancer patients is a particularly sensitive area. To draw holistic conclusions, it is necessary to analyze the provision of healthcare as broadly as possible with regard to the dimensions of access, processes and outcome during the Sars-CoV-2 pandemic. This will be implemented exemplarily for the early detection, diagnosis and treatment of colorectal cancer (CRC) and pancreatic cancer (PaCa) in Saxony. Patients with diagnosis, treatment or early detection measures for type 2 diabetes (T2D), coronary heart disease (CHD) and multiple sclerosis (MS) serve as comparison groups.
Project description:BackgroundDuring Covid-19 pandemic, the Italian government adopted restrictive limitations and declared a national lockdown on March 9, which lasted until May 4 and produced dramatic consequences on people's lives. The aim of our study was to assess the impact of prolonged lockdown on behavioral and psychological symptoms of dementia (BPSD).MethodsBetween April 30 and June 8, 2020, we interviewed with a telephone-based questionnaire the caregivers of the community-dwelling patients with dementia who had their follow-up visit scheduled from March 9 to May 15 and canceled due to lockdown. Among the information collected, patients' BPSDs were assessed by the Neuropsychiatric Inventory (NPI). Non-parametric tests to compare differences between NPI scores over time and logistic regression models to explore the impact of different factors on BPSD worsening were performed.ResultsA total of 109 visits were canceled and 94/109 caregivers completed the interview. Apathy, irritability, agitation and aggression, and depression were the most common neuropsychiatric symptoms experienced by patients both at baseline and during Covid-19 pandemic. Changes in total NPI and caregiver distress scores between baseline and during lockdown, although statistically significant, were overall modest. The logistic regression model failed to determine predictors of BPSD worsening during lockdown.ConclusionThis is one of the first studies to investigate the presence of BPSD during SARS-CoV-2 outbreak and related nationwide lockdown, showing only slight, likely not clinically relevant, differences in BPSD burden, concerning mostly agitation and aggression, anxiety, apathy and indifference, and irritability.
Project description:PurposeWe investigate the impact of a specific macroeconomic shock that occurred as a response to the SARS-COV-2 outbreak, namely the strict lockdown imposed in Spain on the March 14, 2020.MethodsWe use fortnightly purchase data relating to over 50,000 households from a supermarket chain in Catalonia from March to June in 2019 and 2020. Using a panel data approach, we analyse the impact of the lockdown on the caloric content, sugar composition, and alcohol content in beverages and food purchases bought before and after lockdown. We corrected our results to take into account the likelihood of stockpiling.ResultsThe lockdown is related to an increase in unhealthy beverage and food purchases. We find heterogeneous effects across groups of the sample based on cardholder characteristics. Families with children or babies and those in the upper two income quintiles had the unhealthiest changes. As the lockdown went through phases of relaxation, households made better food decisions but maintained unhealthy beverage choices.ConclusionsThe very restrictive lockdown negatively impacted the characteristics of food and beverage purchases made by Spaniards. However, we are unsure whether there was substitution to restaurant and bar visits. Additional work to find out whether there were permanent changes in purchasing behaviour after lockdown ended is needed in the future.
Project description:The literature on municipal solid waste in relation to COVID-19 is scarce. Based on the experience of Italy, the present article contributes to the strategies aimed at preventing a second virus outbreak. In fact, the mismanagement of municipal solid waste could undermine the strategies during the ease of the lockdown. During the SARS-COV-2 outbreak in Italy, there was a general decrease in the selective collection rate (-15% in one municipality with a well-developed door-to-door collection system). Delays in the publication of guidelines on waste management impacted on the safety of the operators collecting potentially infected waste. Contrarily to expectations, single-use masks and gloves do not have significant impact on waste management, accounting for <1% of the residual municipal solid waste collected annually. However, the dispersion of abandoned masks and gloves outside indoor environments is creating environmental problems. Recommendations on waste management and the protection of waste operators are discussed. Finally, guidelines on the most appropriate waste treatment are presented and analyzed. The results presented in this article show that the MSW management sector has found useful solutions to tackle COVID-19; however, these solutions are not being shared sufficiently. The case study analyzed in the present work could help define strategies for preventing or controlling similar future epidemics or pandemic episodes.
Project description:Interventions: Group 1: A qualitative interview study as well as a cross-sectional questionnaire survey is conducted with patients, oncologists and nurses working in the field of oncology (subproject 1). This is complemented by retrospective analysis of quantitative data derived from the registry of colon cancer centres (subproject 2) and data from the statutory health insurance (subproject 3).
Primary outcome(s): Aim: Assessment of ethical and psychosocial challenges in cancer care via semi-structured interviews with stakeholders (oncologists, nurses, patients) between January and July 2021. Assessment of psychosocial burden of oncologists, nurses and patients between February and July 2021 via questionnaires.
patients: Mini-SCL, EORTC QLQ-C30, NCCN Distress Thermometer, FACT-19
oncologists: PHQ-9, PHQ-15, GAD-7, Maslach Burnout Inventory, Moral Distress Thermometer, FACT-19, sociodemographic questionnaire
nurses: PHQ-9, PHQ-15, GAD-7, Maslach Burnout Inventory, Moral Distress Thermometer, FACT-19, BERNCA, sociodemographic questionnaire
Study Design: Allocation: ; Masking: ; Control: ; Assignment: ; Study design purpose: other
Project description:The SARS-CoV-2 Omicron outbreak is ongoing in Shanghai, home to 25 million population. Here, we presented a novel mathematical model to evaluate the Omicron spread and Zero-COVID strategy. Our model provided important parameters, the average quarantine ratio, the detection interval from being infected to being tested positive, and the spreading coefficient to understand the epidemic progression better. Moreover, we found that the key to a relatively accurate long-term forecast was to take the variation/relaxation of the parameters into consideration based on the flexible execution of the quarantine policy. This allowed us to propose the criteria for estimating the parameters and outcome for the ending stage that is likely to take place in late May. Altogether, this model helped to give a correct mathematical appraisal of the SARS-CoV-2 Omicron outbreak under the strict Zero-COVID policy in China.
Project description:COVID-19 is an emerging infectious disease caused by the widespread transmission of the coronavirus SARS-CoV-2. Some of those infected become seriously ill. Others do not show any symptoms, but can still contribute to transmission of the virus. SARS-CoV-2 is excreted in the oral cavity and can be spread via aerosols. Aerosol generating procedures in dental health care can increase the risk of transmission of the virus. Due to the risk of infection of both dental healthcare workers and patients, additional infection control measures for all patients are strongly recommended when providing dental health care. Consideration should be given to which infection control measures are necessary when providing care in both the current situation and in the future.
Project description:We investigated the changes in 25-hydroxy vitamin D [25-(OH)D] concentrations values, during the first and the second pandemic waves and the impact of the lockdown periods, with their different approaches to home confinement, among different age groups. Daily cloud-modified vitamin D UV dose (UVDVC), for the area of interest (Milano, Italy), was obtained. Single-center 25-(OH)D determinations from 40,996 individuals in a 2019 (pre-pandemic), 32,355 individuals from 1 January to 31 August 2020 (containing the first pandemic wave) and 27,684 individuals from 1 June to 30 November 2020 (containing the second wave) were compared to investigate both the effect of the lockdown on vitamin D status and the association between 25-(OH)D and SARS-CoV-2 positivity. No direct association was found between UVDVC, 25-(OH)D status and SARS-CoV-2 infection. The stringent confinement implemented during the first wave lockdown has not had any effect on 25-(OH)D status, although some peculiar time-restricted profile behaviors can be deduced, possibly due to vitamin D supplementation habits and features of those patients who presented to the hospital during the lockdown period. Although our data do not suggest any direct relationship between 25-(OH)D status, sun exposure, and SARS-CoV-2 infection, an indirect protective role cannot be excluded.
Project description:The novel SARS-CoV-2 virus, as it manifested in India in April 2020, showed marked heterogeneity in its transmission. Here, we used data collected from contact tracing during the lockdown in response to the first wave of COVID-19 in Punjab, a major state in India, to quantify this heterogeneity, and to examine implications for transmission dynamics. We found evidence of heterogeneity acting at multiple levels: in the number of potentially infectious contacts per index case, and in the per-contact risk of infection. Incorporating these findings in simple mathematical models of disease transmission reveals that these heterogeneities act in combination to strongly influence transmission dynamics. Standard approaches, such as representing heterogeneity through secondary case distributions, could be biased by neglecting these underlying interactions between heterogeneities. We discuss implications for policy, and for more efficient contact tracing in resource-constrained settings such as India. Our results highlight how contact tracing, an important public health measure, can also provide important insights into epidemic spread and control.
Project description:The novel SARS-CoV-2 virus shows marked heterogeneity in its transmission. Here, we used data collected from contact tracing during the lockdown in Punjab, a major state in India, to quantify this heterogeneity, and to examine implications for transmission dynamics. We found evidence of heterogeneity acting at multiple levels: in the number of potentially infectious contacts per index case, and in the per-contact risk of infection. Incorporating these findings in simple mathematical models of disease transmission reveals that these heterogeneities act in combination to strongly influence transmission dynamics. Standard approaches, such as representing heterogeneity through secondary case distributions, could be biased by neglecting these underlying interactions between heterogeneities. We discuss implications for policy, and for more efficient contact tracing in resource-constrained settings such as India. Our results highlight how contact tracing, an important public health measure, can also provide important insights into epidemic spread and control.