At-risk Population Groups Research Articles

The Development and Validation of a Disordered Eating Screening Tool for Current and Former Athletes: The Athletic Disordered Eating (ADE) Screening Tool.

Current and former athletes are one of the most at-risk population groups for disordered eating (DE), impacting their dietary practices, body composition, performance and health during and following their athletic careers. Few comprehensive DE screening tools exist for this group. To help address this, the current study utilised a mixed-methods approach of Classic Test Theory (CTT) and Item Response Theory (IRT) to develop and validate a DE screening tool suitable for current and former athletes. Novel scale development methodologies were used to develop and assess the validity (content, face, cross-cultural, construct), test-retest reliability, internal consistency reliability, factor analysis and Rasch analysis of a new DE scale. A new validated Athletic Disordered Eating (ADE) screening tool was created, with 17 items and four subscales (food control, bingeing, body control, body discontent), with an internal consistency reliability of 0.91, excellent content and construct validity, an Intraclass Correlation Coefficient of 0.97 and excellent Rasch model fit. The ADE screening tool has been dually developed for research purposes and as a clinically applicable screening tool to detect DE in current and former athletes and is suitable for a global use across sporting categories, diverse genders and levels of competition.

Changes in Health-Related Quality of Life of Patients Treated for Esophageal Cancer in Eldoret, Kenya

Purpose: The study objectives were: to determine the demographic and clinical characteristics of patients treated for EC in Eldoret and to determine the change in health-related quality of life of patients treated for EC. Methodology: A longitudinal study was conducted at three cancer centers in Eldoret, Kenya. Participants were interviewed at enrollment (pre-treatment) and three months post-treatment. The study included patients aged 18 and above with histologically confirmed esophageal cancer. Consecutive sampling method was used to enroll study participants until a predetermined sample size of 59 was achieved. Independent variables considered were patient characteristics (demographic and clinical), and baseline HRQoL while the dependent variable was 3 months post-treatment HRQoL. Patients' characteristic data was analyzed using descriptive statistics (frequencies and percentages); change in HRQoL was calculated using the analysis of variance (ANOVA) test and the results were presented using tables. Findings: At baseline, 59 patients (68% female, mean age 56.3 years) were enrolled. The most common complaints were dysphagia (100%) and weight loss (74.6%). The baseline mean HRQoL score was 107.1, indicating a compromised quality of life at the start of treatment. After treatment, patients receiving chemotherapy plus surgery showed improved HRQoL, while radiotherapy alone was associated with deterioration. The differences were statistically significant (p-values: 0.04 and 0.0092, respectively). Multivariate regression revealed that only baseline HRQoL was significantly associated with post-treatment HRQoL (p=0.0065).This study sheds light on the underexplored aspect of HRQoL in Kenyan esophageal cancer patients. The findings emphasize the impact of treatment modalities on HRQoL, with chemotherapy plus surgery showing better outcomes. The study underscores the importance of considering patients' baseline HRQoL in assessing post-treatment outcomes. Addressing these factors can inform targeted interventions to improve the overall well-being of esophageal cancer patients in Kenya. Further research with larger, more diverse samples is warranted to enhance the generalizability of these findings. Unique Contribution to Theory Practice and Policy: This study highly recommends community sensitization and awareness of esophageal cancer to the at-risk population groups, further research on HRQoL as a prognostic marker for patients with esophageal cancer and more high-quality studies on HRQoL with large sample sizes are needed to determine the association between characteristics of the patients and health-related quality of life.

Prevention of alcohol exposed pregnancies in Europe: the FAR SEAS guidelines

IntroductionDrinking during pregnancy is the leading cause of birth defects and child developmental disorders in Europe. The adverse effects of drinking during pregnancy may include physical, behavioural and cognitive problems, known collectively as fetal alcohol spectrum disorders (FASD). Evidence-based comprehensive recommendations at the European level on how to implement preventive and treatment policies to reduce alcohol-exposed pregnancies are needed. FAR SEAS, a tendered service contract (number 20,187,106) awarded by the European Commission, aimed at developing guidelines to respond to this knowledge gap.MethodsFAR SEAS recommendations were built on (1) a two-phase review of interventions, (2) an international expert consultation, and (3) a pilot study on prevention of FASD conducted in the Mazovia region of Poland. The review of interventions included nineteen electronic open access databases, several repositories of grey literature and a key informant consultation covering most European Union (EU) countries and an additional guidelines search. After triangulating sources, 94 records were collected. Experts contributed in the design of the research questions, addressing the gaps in the literature and reviewing the recommendations formulated. The Polish pilot added nuances from real world practice to the formulated recommendations, resulting in the final set of guidelines for dissemination.ResultsThe FAR SEAS Guidelines comprise 23 recommendations grouped into different topics areas of policies, communication strategies, screening, brief intervention and referral to treatment, treatment and social services. The recommendations highlight the need to respect women’s autonomy and avoid discrimination and stigmatization; using universal screening for women of childbearing age, including detection of other psychosocial risks (such as domestic violence); and individualized, comprehensive and multidisciplinary supportive interventions for those who require it, such as those with alcohol use disorders, including women’s partners. Policies to prevent FASD should be multicomponent, and public health communication should combine information about the risks together with self-efficacy messages to promote changes.ConclusionsThe FAR SEAS guidelines are a tool to support policy-makers and service managers in implementing effective programmes to reduce prenatal alcohol exposure among general and at-risk population groups. FASD prevention has to involve comprehensive and multi-level evidence-based policies and practice, with services and activities tailored to the needs of women at differing levels of risk, and with due attention to reducing stigma.

Situation, Risks and Prevention Strategies of Elder Abuse: A Lesson for Nepal

The purpose of this paper is to identify and summarize the body of research on elder abuse in order to offer a more thorough understanding of the topic. Specifically, the goal is to identify and discuss the situation, risks and preventive measures related to elder abuse in light of Nepal's aging population. This narrative review was conducted after searching the article databases including Google Scholar, PubMed and Nepjol. A total of twenty seven journal articles, four systematic review articles, five books, five reports, one dissertation, two national acts of Nepal, four webpage articles and one methodological journal article were reviewed during a period from September 2022 to June 2023. The narrative review in the area of elder abuse is reflected in this article. Studies have shown that several misuse hazards are higher for senior citizens. Elder abuse is any single or recurrent act that hurts or distresses an older person and takes place in any relationship where there is an expectation of trust. The aging populations of many nations, including Nepal, are growing quickly, as are the number of senior abuse incidents. There are numerous government organizations, international and national non-governmental organizations, and local bodies doing admirable work concerning the investigation of elder abuse and the provision of assistance to elder abuse victims through the sharing of research experiences and the practical implementation of various prevention strategies. However, much more needs to be done for this at-risk population group in our society. In addition to raising social security for all seniors, it is recommended that each municipality in Nepal build an Elderly Service Center.

Changes in the Epidemiology of Hepatocellular Carcinoma in Carinthia, Austria, 2012-2023.

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths and remains a major burden on healthcare systems worldwide. The incidence of HCC continues to rise globally, despite preventative efforts being made. This study aimed to investigate epidemiological changes observed in the etiology and survival outcomes of HCC patients at Klinikum Klagenfurt am Wörthersee between 2012 and 2023. This was a retrospective, single-center cohort study. Two time-periods (2012-2017 and 2018-2023) were created to enable comparison between the respective intervals. IBM SPSS was used to analyze statistical data. More patients were diagnosed with HCC during the second time period (n = 128, n = 148). The median age of diagnosis was 72.5 years (SD 8.6). Patients were on average 2 years younger in the second time period compared to the first (p = 0.042). Alcohol remained the leading underlying etiology of HCC and no statistically significant change was seen over time (p = 0.353). Nevertheless, a clear upward trend in the number of NASH cases was evident over time (n = 15, n = 28, respectively). Nearly half of the patient population had a normal AFP (<7 µg/L) level at the time of diagnosis (n = 116, 42.6%). The survival time for HCC patients remained similar between time periods, with a median overall survival time of 20.5 months (95% CI 16.8-24.2, p = 0.841), despite improvements in management strategies and the availability of new systemic treatments. More advanced-stage HCC cases were documented in the second period (BCLC-C, n = 23 to n = 46, p = 0.051). An increased number of HCC patients without liver cirrhosis were identified during the second time period (n = 22, n= 47, respectively, p = 0.005). NASH was the most common underlying etiology in patients without liver cirrhosis (50%) compared to alcohol use in being the primary cause in cirrhotic patients (65%, p < 0.001). HCC continues to be an important health concern in our society. The number of HCC patients without liver cirrhosis is steadily increasing, with NAFLD/NASH, due to underlying lifestyle diseases playing an important etiological role. Continued efforts should be made to prevent HCC and to screen at-risk population groups. Preventative strategies and screening techniques should be adjusted in light of the changing epidemiological landscape of HCC, where more focus will have to be placed on detecting HCC in patients without underlying cirrhosis.

Factors Causing Maternal Death due to COVID-19 in Several Countries: A Literature Review

Background: Since 2019, the world has been faced with a global crisis. The spread of SARS-CoV-2 has an impact on all populations, including pregnant women, who are among the most vulnerable and at-risk population groups. The worldwide spread of the virus is called the COVID-19 pandemic. This study aims to explore the factors that cause maternal death during pregnancy and postpartum due to COVID-19 in several countries.Method: A literature review was conducted to explore broadly the causes of maternal deaths due to COVID in several countries. Article search on three databases, namely PubMed, Google Scholar, and ScienceDirect. A total of 7 articles were analyzed. The data studied are cases of death and their causes.Results: The study was conducted in the period 2018 to 2021 with the type of research using retrospective data. When compared to before the pandemic, there was a significant increase in the number of maternal deaths. Factors that increase the risk of maternal death come from direct and indirect factors. Indirect factors such as age, health facility access, inadequate tools, and health services, access to knowledge, cultural practice, and poverty. Direct factors are comorbidities such as obesity, diabetes, cardiovascular disease, hypertension, and immune impairment. Pregnant women who do not have comorbidities can have a poor prognosis with undetected causes of death. Health facilities need to conduct early screening so that direct and indirect factors can be minimized to prevent maternal mortality.

ATAGI Targeted Review 2022: Vaccination for prevention of herpes zoster in Australia

In November 2016, herpes zoster (HZ) vaccination for older adults, using the live-attenuated zoster vaccine (Zostavax; ZVL) was added to the Australian National Immunisation Program (NIP) with the aim of reducing morbidity from HZ and its complications, particularly for people at increased risk. Prior to the program, there were on average 5.6 cases of HZ per 1,000 persons annually in Australia, with highest risk of disease in older and in immunocompromised people. The burden of complications of HZ, such as post-herpetic neuralgia (PHN), was also highest in older and immunocompromised groups. No formal comprehensive program evaluation has been undertaken since program commencement. This review examined published literature and available vaccine administration data to summarise the evidence and considerations underpinning current use of HZ vaccines and potential future program directions in Australia. There have been modest reductions in the incidence of HZ and its complications since program introduction. However, five years into the program, challenges remain, including suboptimal vaccine coverage and significant safety concerns arising from inadvertent use of ZVL in immunocompromised people, who are contraindicated to receive this vaccine. This reduces opportunities to offset the burden of HZ-related disease. The recombinant subunit zoster vaccine (Shingrix; RZV), first registered in Australia in 2018, became available on the Australian market in June 2021. This vaccine has higher efficacy than ZVL and, as a non-live vaccine, can be used in both immunocompetent and immunocompromised people. RZV has potential to address the unmet needs of at-risk population groups. However, it has not yet demonstrated cost-effectiveness for inclusion as a funded vaccine under the NIP. The Australian HZ vaccination program has had limited effectiveness in meeting its aim in highest risk groups. Future options and challenges anticipated in using vaccination to reduce the burden of HZ and its complications are discussed in this review.

Surviving Multiple Pandemics. Socio-Economic Impact of COVID-19 among the Elderly in Botswana: A Call for a Holistic Pastoral Approach

Amid the COVID-19 and HIV and AIDS crises, elderly people have been identified as the most affected and at-risk population group. This paper uses existing studies and research from different disciplines to explore the socio-economic impact of these multiple pandemics among the elderly in Botswana. We propose an elderly-inclined Holistic Pastoral Care intervention in surviving multiple pandemics. The intervention incorporates the inclusion of older people on pandemic outbreaks emergency task forces or other inter-agency platforms and coordination mechanisms at the national level. The paper further calls for deliberate and intentional socio-economic equality and attention for the greatest benefit of the elderly people. In conclusion, the paper recommends to all stakeholders, sustainable, socio-economic, Inclusive Holistic Pastoral Care in favour and targeting the elderly for long-term survival of these Multiple Pandemics of COVID-19 and HIV and AIDS. Keywords: COVID-19, HIV and AIDS, The Elderly, Socio-Economic Impact, Holistic Pastoral Approach

Concept of the Mobile Monitoring System

In connection with the spread of viral diseases caused by COVID-19, its high dynamics and the formation of infection outbreaks were observed. The experience from the first wave of the pandemic showed that, although state-wide measures are effective, they have a significant economic impact and more effective solutions are therefore necessary. In the activities aimed at combating the pandemic caused by COVID-19, one of the most effective means is the isolation of sick patients and the most vulnerable population groups, where the level of risk is the highest. No universally applicable technical solutions which are available on the commercial market would assist in population isolation, in case of protection and monitoring. Creating a mobile monitoring system to protect isolated and at-risk population groups against the spread of viral diseases is highly relevant within Slovakia and with great potential for applicability abroad. This article is focused on the project description that was approved in connection with the protection against the spread of COVID-19, the definition of its main goals, methodology, activities, and benefits.

Concept of the Mobile Monitoring System

In connection with the spread of viral diseases caused by COVID-19, its high dynamics and the formation of infection outbreaks were observed. The experience from the first wave of the pandemic showed that, although state-wide measures are effective, they have a significant economic impact and more effective solutions are therefore necessary. In the activities aimed at combating the pandemic caused by COVID-19, one of the most effective means is the isolation of sick patients and the most vulnerable population groups, where the level of risk is the highest. No universally applicable technical solutions which are available on the commercial market would assist in population isolation, in case of protection and monitoring. Creating a mobile monitoring system to protect isolated and at-risk population groups against the spread of viral diseases is highly relevant within Slovakia and with great potential for applicability abroad. This article is focused on the project description that was approved in connection with the protection against the spread of COVID-19, the definition of its main goals, methodology, activities, and benefits.

Herpes simplex virus type 2 seroprevalence and associated factors in fertility-treatment-seeking population: A cross-sectional survey in the United Arab Emirates.

Herpes simplex virus type 2 (HSV-2) is a common genitally-transmitted viral infection affecting more than 400 million individuals globally. In the United Arab Emirates (UAE), in specific at-risk population groups, the burden of HSV-2 has not been reported. This study investigated the prevalence of HSV-2 IgG antibodies in patients seeking fertility treatment and characterized patients with seropositivity to HSV-2 IgG antibodies. A cross-sectional sample of patients seeking fertility treatment in a major fertility clinic in Abu Dhabi, UAE was surveyed from April to May 2021. Patients were consecutively invited to complete self-administered questionnaires and provide blood for HSV-2 testing. Information on sociodemographics, medical history, and infertility was collected. Serum specimens were screened using an enzyme-linked immunosorbent assay for HSV-2 IgG antibodies detection. Two hundred and ninety-nine patients were surveyed and provided blood samples. The mean age of the patients was 35.9 ± 6.8 [mean ± standard deviation (SD)] years with 89.3% being women. Sixty-six percent were overweight or obese, 25.0% had at least one chronic comorbidity, and 19.6% reported ever-had genital infection. More than two-thirds (68.3%) of the patients were infertile for ≥ 6 months. Of the 42 infertile males, 69.0% had an abnormal semen analysis. HSV-2 IgG antibodies was detected in 12.4% of patients. The HSV-2 IgG seropositive patients had a higher mean age (39.5 vs. 35.4 years; p < 0.001) compared to seronegative patients. HSV-2 IgG antibodies seropositivity was more common in males (15.6%) than females (12.0%), in patients with secondary (14.1%) vs. primary (9.2%) infertility, or in males with abnormal (10.3%) vs. normal (7.7%) semen. Exposure to HSV-2 at any time in patients seeking fertility treatment in the UAE was found to be slightly common in more than one out of 10 patients. Tailored health campaigns on HSV-2 prevention are warranted.

Perceptions on Extending the Use of Technology after the COVID-19 Pandemic Resolves: A Qualitative Study with Older Adults.

The COVID-19 pandemic of the last two years has affected the lives of many individuals, especially the most vulnerable and at-risk population groups, e.g., older adults. While social distancing and isolation are shown to be effective at decreasing the transmission of the virus, these actions have also increased loneliness and social isolation. To combat social distancing from family and friends, older adults have turned to technology for help. In the health sector, these individuals also had a variety of options that strengthened eHealth care services. This study analyzed the technologies used during the COVID-19 pandemic by a group of older people, as well as explored their expectations of use after the pandemic period. Qualitative and ethnographic interviews were conducted with 10 Portuguese older adults, and data were collected over a period of seven months between 2020 and 2021. The research demonstrated that the use of current and new technologies in the post-pandemic future is likely to be related to overcoming: (i) insecurity regarding privacy issues; (ii) difficulties in using technologies due to the level of use of digital technology; and (iii) the human distancing and impersonal consequences of using these technologies.

A Retrospective Analysis to Review Access of HIV Self-testing During SARS-COV-2 Lockdown in Eswatini Community Settings, Eswatini: Quantitative Methods Study

The HIV self-testing (HIVST) program was introduced to reach people living with HIV who are still undiagnosed and also to ensure that HIV-negative individuals get access to effective HIV prevention services. HIV self-testing offers a discreet and convenient way to test, with the potential to reach individuals in need of HIV testing services but who may not otherwise test. The purpose of this study was to uncover access to HIVST during the first SARS-COV-2 lockdown period in 2020. This was a cross-sectional design approach that applied the RE-AIM framework principle. The study used historical data from the four regions in Eswatini (Shiselweni, Manzini, Lubombo, and Hhohho). These regions were selected based on ensuring adequate coverage and representativeness. Data were analysed using bivariate logistic regression analysis in Stata15 to assess the association between categorical variables, and the level of significance was set at a P-value less than 0.05. The results showed a total of 6158 clients were reached with HIVST kits. A total of 3031 (50%) were females, and 3127(51%) were males, and more outcomes were based on risk profiles and age. It is concluded that HIVST is one key strategy in reaching males who ordinarily lag when it comes to HIV testing services in Eswatini. These results show that access to HIV self-testing during the lockdown period in Eswatini illustrated positive advances as it reached the most at-risk population groups and has a potential for extended sustained use to benefit specific high-HIV-risk population groups. Keywords: Access, HIV-Self testing, Risk, SARS-COV-2, Population.

Gunshot casualties in Israel: A decade of violence

ObjectiveThe purpose of this study was to identify and characterize casualties hospitalized with assault (non-terror) related gunshot wounds (GSW) in Israel as a basis for determining the incidence, trends and at-risk population groups. MethodsThis retrospective cohort study is based on data from the Israel National Trauma Registry. The data includes GSW casualties hospitalized between January 1, 2011 and December 31, 2020. Attempted suicide, unintentional injury, legal intervention, children (ages 0–9) and terror (Israeli-Arab conflict) related GSW were excluded. The remaining population was classified with an ICD-9-CM diagnosis code of 965.0–965.4. ResultsThe study population included 2,763 GSW admissions. A noticeable increase in GSW casualties was reported, from 206 hospitalization in 2011 to 456 in 2020. The proportion of Arab casualties increased from 73.3% of all GSW casualties in 2011 to 90.8% in 2020, far more than their proportion in the population (∼20%). The majority of the GSW casualties were males (95.8%) and between the ages of 20 and 29 (42.2%). Among severe/critical casualties, 19% of Arabs and 9.9% of Jews arrived by private car. Severe thoracic and abdominal injuries were the prominent injuries among fatal casualties (47.6 and 40.8, respectively). While the all-severity mortality rate was 5.6% (n = 147), 24.4% (n = 135) of severe/critical (ISS16+) casualties died, with no significant differences between Jews and Arabs. Forty percent of deaths occurred in the emergency department. ConclusionsThis study establishes that during the past decade in Israel, not only has there been a continuous increase in hospitalizations due to GSW, but also Arabs are at great risk of such related hospitalizations. Preventive strategies targeting at-risk groups are crucial for minimizing morbidity and mortality related to GSW in Israel.

Knowledge of the Health Implications of Oral Sex among Registered Nurses in Nigeria: An Online Pilot Study

Abstract Introduction Oral sex is a pleasurable act that has its health implications, particularly sexually transmitted oral infections. In Nigeria, nurses constitute one of the at-risk population groups due to reports of risky sexual behavior among them. This study seeks to investigate the knowledge of nurses in Nigeria on the health implications of oral sex. Methods This study was a survey of a pilot volunteer sample (n = 129) of registered nurses in Nigeria. The study tool was an anonymous questionnaire that was circulated electronically to nurses via social media platforms. Data collected was analyzed using the SPSS Version 20 software (IBM Corp, New York, New York, United States). Results The majority (90.7%) of the 129 respondents had received training on oral health, 49.6% had engaged in oral sex before, and 58.1% were willing to engage in oral sex in future. History of previous oral health training was the only background characteristic found to be statistically significantly associated with the knowledge of oral sex-related health implications among nurses (p-value = 0.004); other characteristics (such as gender, age, and marital status) were not statistically significant (p-values &gt;0.05). From multivariate analysis, history of oral health training was also found to be a statistically significant predictor of such knowledge (p-value = 0.015). Conclusion Oral health knowledge is a significant determinant of the knowledge of oral sex-related health implications. This study also provides the preliminary evidence that forms the base on which further research should be conducted in this area.

Nutrition-sensitive education and social protection policies have implications for food-based dietary guidelines for Ghana

Ghana continues to address persistent malnutrition through political action and programme development. Government-led efforts have included the formulation of multi-sectoral policies and programmes to improve the diet and nutritional status of various at-risk population groups. Globally, an important tool for promoting healthy diets are Food-Based Dietary Guidelines (FDBGs). To achieve and sustain the desired goal of promoting healthy eating habits and lifestyles, FBDGs require, among many factors, supportive national policies and programmes. When coherently incorporated in relevant nutrition-related policies and programmes, FBDGs enhance their impact on shaping and sustaining healthier dietary habits. In this context, it is essential to understand the national policy and programme environment and its potential contribution during the formulation of FBDGs. The present review aimed to identify existing nutrition-related education and social protection policies and programmes in Ghana and their relevance to the development and implementation of FBDGs. Previously conducted scoping reviews, gap analyses, and a benchmarking report of Ghana’s public health nutrition policies were used as information sources to identify relevant policies and programmes. Additionally, websites of relevant government ministries, departments and agencies were searched to retrieve applicable policies or actions that were not included in previous reviews. Nutrition-related education policies that were identified primarily support school health services, whereas social protection policies broadly target social assistance, social welfare, social equity and insurance-based policies and programmes. Specific ways these policies and programmes could support the development and implementation of Ghana’s dietary guidelines include embedding FBDGs in the school nutrition curriculum to motivate healthier food choices by schoolchildren and using FBDGs to plan meals provided as part of the country’s school feeding programme. Regarding social protection, existing instruments such as food transfers, social pensions and conditional cash transfers could be aligned with FBDGs to ensure vulnerable households can access foods and follow recommended guidelines. Although some nutrition actions are incorporated in existing policies and programmes, there are opportunities to improve their nutrition sensitivity. Key words: Ghana, food-based dietary guidelines, nutrition education, social

Dynamics of SARS-CoV-2 Antibody Response in a Longitudinal Cohort of Healthcare Workers from India

Introduction: Coronavirus Disease 2019 (COVID-19) pandemic has affected healthcare systems worldwide. Healthcare Workers (HCWs) form one of the most at-risk population groups for acquiring infection. Trend analysis of anti Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) antibody titres in vaccination naïve HCWs will give an insight into the role of natural protective immunity against re-infection. Aim: To understand the dynamics of anti SARS-CoV-2 antibody response and its protective role against re-infection in a cohort of HCWs. Materials and Methods: This observational longitudinal cohort study was conducted in a tertiary care hospital in Gurugram, North India from June to December 2020. The study was approved by the Institutional Ethics Committee. Serum specimens from 230 HCWs were tested for anti-spike protein Immunogloublin G (IgG) antibodies by chemiluminescence immunoassay. The HCWs with positive antibody status and previous Polymerase Chain Reaction (PCR) confirmed infection (n=47) were followed-up over 180 days for serial antibody titres at four visits, each at a gap of 30-45 days. Participants were classified into asymptomatic (n=18), mild (n=17) and moderate (n=12) disease categories based on severity of previous COVID19 illness. SPSS version 22.0 was used for statistical analysis. Intergroup comparison of means was done using Kruskal-Wallis test and chi-square test. p&lt;0.05 was considered statistically significant. Results: Positivity rate for anti SARS-CoV-2 IgG antibodies was 25.7%. Seroconversion rate was 90.74% in HCWs with history of previous Real Time-Polymerase Chain Reaction (RTPCR) confirmed COVID-19 infection. Incidence of infection in seronegative group (n=171) was 12.96 per 10,000 person days while in seropositive group, it was 1.29 per 10,000 person days. Risk ratio for infection (baseline seronegative vs baseline seropositive) was determined to be 8.12 [95% Confidence Interval (CI) 1.068-61.755]. Incidence of PCR confirmed SARSCoV-2 re-infection was inversely associated with antibody titres (p=0.018). Antibody response trend showed a peak in mean titres in the 46-90 days period followed by steep decline till 135 days and a gradual waning till 180 days. Conclusion: Significant postinfection immunity is offered by even low to moderate amounts of antibodies and this occurs regardless of whether a seropositive HCW had previous asymptomatic or symptomatic infection. These findings have significant implications in establishing the protective role of anti-spike protein antibodies against subsequent infection.

Social Inequities in the Impact of COVID-19 Lockdown Measures on the Mental Health of a Large Sample of the Colombian Population (PSY-COVID Study).

The identification of general population groups particularly vulnerable to the impact of COVID-19 lockdown measures on mental health and the development of healthcare policies are priority challenges in the current and future pandemics. This study aimed to identify the personal and social determinants of the impact of COVID-19 lockdown measures on mental health in a large sample of the Colombian population. In this cross-sectional study, an anonymous online survey was answered by 18,061 participants from the general population residing in Colombia during the first wave of the COVID-19 outbreak (from 20 May to 20 June 2020). The risk of depression, anxiety, and somatization disorders were measured using the Patient Health Questionnaire (PHQ-2), Generalized Anxiety Disorder Scale (GAD-2), and Somatic Symptom Questionnaire (SSQ-5), respectively. Overall, 35% of participants showed risk of depression, 29% of anxiety, and 31% of somatization. According to the analysis of social determinants of health, the most affected groups were people with low incomes, students, and young adults (18–29 years). Specifically, low-income young females were the most at-risk population group. These findings show how the lockdown measures affected the general population’s mental health in Colombia and highlight some social risk factors in health.

Young-Onset Dementia More Prevalent Than Previously Estimated

Young-Onset Dementia More Prevalent Than Previously Estimated

A critical review of the South African legal framework on adolescent access to HIV prevention interventions

HIV remains a leading cause of death globally, with adolescents continuing to be one of the most at-risk population groups. Effective public health responses require an enabling legal environment to facilitate adolescent access to HIV prevention tools. South Africa (SA) is a good case study of a country with legislative reforms supporting public health HIV prevention programmes. A desktop review was conducted of relevant SA laws compared with key international norms such as age of independent consent and the right to confidentiality. This article reflects on whether the SA legal framework is a facilitator or barrier to adolescent access to key HIV prevention services such as HIV testing and HIV education. The findings indicate a clear recognition of evolving capacity and the inclusion of protections aimed at enhancing decisionmaking. International legal norms are, however, scattered, and not comprehensive enough to inform certain national policy choices. As such, developing a coherent approach to the evolving capacity and protection relating to age-appropriate decision-making can be a challenge for states legislating on adolescent access to HIV prevention interventions. This article highlights the fact that SA has largely created an enabling legal environment for adolescent access to HIV prevention. Nevertheless, there are a number of weaknesses in the SA legal framework, such as the divergent approaches between criminal and civil law regarding sexual activity among adolescents. It is recommended that further research be conducted on legal reform toward a coherent approach to support adolescent access to HIV prevention services.