• Armstrong Mejia posted an update 6 months, 3 weeks ago

    Moreover, a higher DDS was significantly associated with a lower likelihood of having symptoms of hyperactivity/inattention, peer relationship problems and prosocial behaviour problems after adjustment for confounders (preschoolers’ age, gender, cognitive ability, parental migration status, primary caregiver’s education and household socio-economic status).

    The prevalence of mental health problems was high among preschoolers in rural China. Improving child dietary diversity might be an important strategy to consider in the design of interventions to improve child mental health.

    The prevalence of mental health problems was high among preschoolers in rural China. Improving child dietary diversity might be an important strategy to consider in the design of interventions to improve child mental health.

    To describe epidemiologic and genomic characteristics of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in a large skilled nursing facility (SNF), and the strategies that controlled transmission.

    Cohort study during March 22-May 4, 2020 of all staff and residents at a 780-bed SNF in San Francisco, California.

    Contact tracing and symptom screening guided targeted testing of staff and residents; respiratory specimens were also collected through serial point prevalence surveys (PPS) in units with confirmed cases. Cases were confirmed by real-time reverse transcription-polymerase chain reaction testing for SARS-CoV-2; whole genome sequencing (WGS) characterized viral isolate lineages and relatedness. Infection prevention and control (IPC) interventions included restricting from work any staff who had close contact to a confirmed case; restricting movements between units; implementing surgical face masking facility-wide; and recommended PPE (isolation gown, gloves, N95 respirator and eye protection) for clinical interactions in units with confirmed cases.

    Of 725 staff and residents tested through targeted testing and serial PPS, twenty-one (3%) were SARS-CoV-2-positive; sixteen (76%) staff and 5 (24%) residents. Fifteen (71%) were linked to a single unit. Targeted testing identified 17 (81%) cases; PPS identified 4 (19%). Most (71%) cases were identified prior to IPC intervention. WGS was performed on SARS-CoV-2 isolates from four staff and four residents; five were of Santa Clara County lineage and the three others were distinct lineages.

    Early implementation of targeted testing, serial PPS, and multimodal IPC interventions limited SARS-CoV-2 transmission within the SNF.

    Early implementation of targeted testing, serial PPS, and multimodal IPC interventions limited SARS-CoV-2 transmission within the SNF.Basic reproductive numbers during COVID-19, either through standard approaches or through time-varying approaches, are key for understanding the pandemic growth. However, improper usage and interpretations and computational difficulties during lockdowns could be misleading for planning and mitigation.

    Care homes are vulnerable to widespread transmission of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) with poor outcomes for staff and residents. Infection control interventions in care homes need to not only be effective in containing the spread of coronavirus disease 2019 (COVID-19) but also feasible to implement in this special setting which is both a healthcare institution and a home.

    We developed an agent-based model that simulates the transmission dynamics of COVID-19 via contacts between individuals, including residents, staff members, and visitors in a care home setting. We explored a representative care home in Scotland in our base case and explore other care home setups in an uncertainty analysis. We evaluated the effectiveness of a range of intervention strategies in controlling the spread of COVID-19.

    In the presence of the reference interventions that have been implemented in many care homes, including testing of new admissions, isolation of symptomatic residents, and restricted public visiting, routine testing of staff appears to be the most effective and practical approach. Routine testing of residents is no more effective as a reference strategy while routine testing of both staff and residents only shows a negligible additive effect. check details Modeling results are very sensitive to transmission probability per contact, but the qualitative finding is robust to varying parameter values in our uncertainty analysis.

    Our model predictions suggest that routine testing should target staff in care homes in conjunction with adherence to strict hand hygiene and using personal protective equipment to reduce risk of transmission per contact.

    Our model predictions suggest that routine testing should target staff in care homes in conjunction with adherence to strict hand hygiene and using personal protective equipment to reduce risk of transmission per contact.This is an historical account of Canadian pioneers working in amyotrophic lateral sclerosis (ALS) in the 1970s and 1980s. Key contributions included the development of specialized clinics, the ALS Society of Canada, human motor unit estimates in vivo, use of transcranial magnetic stimulation (TMS), the dementias of ALS, the importance of neurofilaments and axonal flow, neuroinflammation and immunity related to ALS, use of tissue culture to study pathogenesis, and the story of ALS in Guam. Their work set the stage for future generations of ALS physicians and scientists to bring about meaningful therapies and hopefully a cure for ALS.

    Assessments of antibiotic prescribing in ambulatory care have largely focused on viral acute respiratory infections (ARIs). It is unclear whether antibiotic prescribing for bacterial ARIs should also be a target for antibiotic stewardship efforts. In this study, we evaluated antibiotic prescribing for viral and potentially bacterial ARIs in patients seen at emergency departments (EDs) and urgent care centers (UCCs).

    This retrospective cohort included all ED and UCC visits by patients who were not hospitalized and were seen during weekday, daytime hours during 2016-2018 in the Veterans Health Administration (VHA). Guideline concordance was evaluated for viral ARIs and for 3 potentially bacterial ARIs acute exacerbation of COPD, pneumonia, and sinusitis.

    There were 3,182,926 patient visits across 129 sites 80.7% in EDs and 19.3% in UCCs. Mean patient age was 60.2 years, 89.4% were male, and 65.6% were white. Antibiotics were prescribed during 608,289 (19.1%) visits, including 42.7% with an inappropriate indication.

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