At-risk Population Groups Research Articles

Professional burnout syndrome: Alexithymia, empathy and communication mechanismsи

IntroductionProfessional burnout syndrome (PBS) is currently considered from the perspective of value-oriented sense –of underlying psychological factors contributing to PBS development promotes the relevance of this study.ObjectivesThe study population included 81 medical professionals from out-patient polyclinic healthcare institution, among which 47(58%) healthcare professionals showed symptoms of burnout (mean age – 38,5±11,4 years old).Methods‘Attitude to Work and Professional Burnout’ by V.A. Vinokur, ‘Coping Strategies’ by S. Folkman and R. Lazarus Р., Spielberg’s Questionnaire; TAS-26; Emotional Response Scale by A. Megrabyan and N. Epstein.ResultsThe correlation analysis revealed certain interdependencies between the professional burnout symptoms and personal qualities of subjects. Thus, the higher burnout level correlated with increased emotional burnout (r=0,871; p=0,016), reduced professional satisfaction (r=0,624; p=0,031), poorer health and adaptation (r=0,872; p=0,023), increased state anxiety (r=0,551; p=0,000), increased alexithymia scores (r=0,823; p=0,017); reduced empathy scores as emotional response to others’ emotional experience (r=0,466; p=0,000) and reduced willingness to involve into other people’s issues (r=0,564; p=0,032). No statistically significant correlations between TAS total alexithymia score and empathy score were demonstrated.ConclusionsThe healthcare professionals employed at the out-patient polyclinic units belong to the at-risk population group of professional burnout syndrome development. The individuals with higher burnout levels show typical specific correlations of empathy forms: in particular, decreased ability to differentiate one’s feelings from feelings of others, increased emotional sensitivity and reduced willingness to involve into other people’s issues are usually observed.

The Blooming Risks - At Whose Cost?

The trajectories of Obesity across the U.S. today and around the world could be much faster than earlier projected. Current data in the U.S., confirms the rates of Obesity prevalence are heightened. Without further strategic interventions, it is expected that a vast majority of U.S. population could be at higher risk of being overweight or obese by 2030. Yet after decades of surveillance and interventions, the rates of Obesity prevalence continue to rise with no end in sight. Is this a case of risk mismatch? Can society continue to ignore the trends of dismissal results in Obesity prevention whilst the epidemic continues to rip across communities? Obesity continues to rise across America today, and around the world leading to series of needless deaths, especially among at-risk population groups. These risks are too high to be ignored. Given the opportunity, the author seeks to be a contributing partner to assist in mitigating these impending risks. This paper by literature reviews, seeks to add to current understanding plausible strategic insights for the prevalence of Obesity in the U.S., and reasons why they cannot continue to be ignored. *The Blooming Risks: At Whose Cost? (2018) was recently updated in 2020, with new data in light of the current COVID-19 Pandemic.

Prevalence and Associated Factors of Clinical Vitamin A Deficiency Among Pre-School Children 1-5 Years of Age in Rural Kebeles in Farta District, South Gondar Zone, Ethiopia: A Mixed Methods Study.

BackgroundGlobally, pre-school children are the most at-risk population groups for vitamin A deficiency (VAD). The 2009 World Health Organization (WHO) report stated that one-third (190 million) of pre-school children worldwide are deficient in vitamin A. Both clinical and subclinical VAD have been a long-standing problem in developing countries. In Ethiopia, VAD was recognized as a public health problem 4–5 decades before. Since then, researches conducted in other parts of the country still showed varied and high prevalence, which is 2–8 times higher than WHO cut-off points. This community-based study was therefore conducted on pre-school children of rural kebeles in Farta district to determine the prevalence of clinical VAD (Bitot’s spot and night blindness) and associated factors.MethodsA community-based cross-sectional mixed quantitative and qualitative study was conducted. Randomly selected 588 pre-school children participated in the study. The clinical aspect of the study investigated the presence of Bitot’s spots on the children’s eye with the aid of a magnifying loop and torch. Data on the history of night blindness were obtained from mothers/caregivers by using WHO standard questions. The qualitative study data were obtained via a key informant interview with the mothers/caregivers whose child has clinical VAD. Quantitative data were entered using Epi Data statistical software and analysed by using SPSS version 20 statistical software package. A bivariable logistic regression was employed, and variables that showed significant association with clinical VAD (P < 0.2) were entered a multivariable logistic regression model to identify independent predictors of clinical VAD.ResultsThe prevalence of Bitot’s spot and night blindness was 0.8% and 1.2%, respectively. Pre-school children who were from highland (AOR: 3.71; 95% CI: 1.01–13.68), a mother having antenatal care (ANC) visit during pregnancy of a child (AOR: 8.63; 95% CI: 2.58–28.79), family monthly income (AOR: 8.63; 95% CI: 2.58–28.79) and handwashing frequency were found to be determinants of VAD (p < 0.05).ConclusionClinical vitamin A deficiency in the study area is of public health concern because the prevalence of Bitot’s and night blindness was above the WHO threshold level. Accordingly, effective preventive measures should be designed to reduce VAD prevalence.

Hydroxychloroquine, Parachutes And How to Understand 'The Evidence'

It is deliberately misleading to make general claims that hydroxychloroquine doesn’t work for CoViD-19. It is even more misleading to claim that “the evidence” proves that hydroxychloroquine doesn’t work. To understand this, consider the use of parachutes. Consider someone who claimed that parachutes don’t work to stop death or serious injury when jumping out of a plane. What if they further claimed that “the evidence” proves that parachutes don’t work? Now consider if this same person advocated that because parachutes “don’t work”, we should ban their use and demanded that conscientious pilots who give a parachute to someone jumping out of a plane should lose their pilot’s license. Surely, such claims would be considered false and misleading. Two classic parodies, published in the British Medical Journal, showed that the above statements about parachutes are technically true. In 2003, a straight-faced literature search found no high quality, randomized, placebo-controlled trials of parachutes. The fact that people usually get squashed to smithereens when they hit the ground without a parachute was just epidemiological data. There’s no proof the parachute makes any difference. It could be due to confounding factors or bias. Subsequently, in 2018, a group of researchers actually did a randomized, placebo-controlled trial of the use of parachutes when jumping from a plane. There was no difference in death or serious injury in those who wore a parachute and those who didn’t. However, the participants jumped out of a plane 60cm off the ground while it was stationary. So, it would, or course, be misleading to make the claim that the “evidence says that parachutes don’t work.” That is, the general claim that parachutes “don’t work” cannot be derived from studies where they are not used in the situation where they can provide benefit. Of course, everyone is going to survive whether you give them a parachute or not when jumping from 60 cm. It is egregiously misleading, and it would be lethal, to deprive someone of a parachute when jumping from 10,000 feet based on a study that tested a parachute at 60 cm. Now let’s look at hydroxychloroquine. CoViD-19 is a disease with very different stages. And the vast majority of people, especially young people, are not going to die from CoViD-19. The suggestion from a significant amount of epidemiological data is that, if given early in the course of the disease, HCQ might prevent progression to critical illness or death in at-risk population groups. However, the randomized controlled trials (RCTs) performed to test the effect of hydroxychloroquine have been the equivalent of testing the effect of parachutes in the following circumstances: after a 60 cm jump; or pulling the rip-cord 2 feet above the ground after free-falling; or putting the parachute on someone after they hit the ground. Different RCTs on hydroxychloroquine have had variable characteristics including the following: control groups with average ages in the 30s and 40s; a cohort with 99% of patients with mild to moderate disease; a cohort with death rates of 0.4%; a cohort with zero incidence of death or mechanical ventilation; patients already on ventilators or even ECMO; patients having symptoms up to 14 days before being commenced on hydroxychloroquine; patients having symptoms an average of 16 days before commencement of hydroxychloroquine.

Factors associated with HIV testing and intention to test for HIV among the general population of Nonthaburi Province, Thailand.

BackgroundResearch on HIV testing in Thailand has largely focused on at-risk population groups, with limited information about the prevalence of correlates of HIV testing among the Thai general population. This study addresses this gap in research by using a population-based probability sample to examine correlates of HIV testing experience and intention to test.MethodsWe conducted a cross-sectional survey in Nonthaburi, Thailand during October-December 2012 using tablet computers to collect self-administered questionnaires from 2138 men and women (aged 15–59 years) identified through three-stage stratified cluster sampling.FindingsAlmost half of the respondents, 962 (45%), reported having been tested for HIV while an almost equal proportion, 1032 (48.3%), indicated their intention to test for HIV. Being sexually experienced, having a history of sexually transmitted infection, personally knowing someone infected with HIV, and youth were associated with both history of HIV testing and intention to test for HIV. High perceived risk of HIV, knowledge of an HIV testing location, and having been married were associated with having been tested for HIV. Having been tested for HIV and HIV/AIDS education were associated with intention to test for HIV. The most common reasons for testing were routine medical checkup and antenatal care. The major reasons for not testing were perception of having no or low risk.ConclusionA substantially low proportion of the respondents reported a history of HIV testing and intention to test for HIV. Culturally appropriate programs that address HIV risk perception and provide accurate information related to HIV infection and HIV testing may be beneficial in increasing uptake of HIV testing among the general population in Thailand.

The US Educational Response to the COVID-19 Pandemic

This paper examines the United States federal and state educational responses to the spread of the COVID-19 pandemic, as well as states’ plans for reopening schools. The virus entered the United States in January 2020. As the virus spread, most school districts began to close in March. At the end of June, the United States has experienced the highest number of cases and deaths due to COVID-19 in the world, and infection rates appear to be rising once again. Given the great physical and socioeconomic diversity of the United States, the federal and state response to COVID-19 and plans to reopen schools in the autumn have emphasized flexibility and adaptation. However, the implementation of remote (online) learning has highlighted and exacerbated long-standing racial and economic inequalities in US society related to technology access, school engagement, and school-parent relationships. These inequalities may be exacerbated as schools attempt to reopen and students continue to face inconsistent access to learning, learning loss during the spring semester and summer, and COVID-19 spread among the most at-risk population groups. Further research and practical interventions, such as tutoring, should be implemented to address educational equality issues and improve access, whether to in-person or remote instruction.

So Much Trouble on My Mind: African American Males Coping With Mental Health Issues and Racism

BackgroundThe current discussion examines the mental health needs and challenges of African American males within a social context undergirded by racism. There is a dearth of empirical research on African American males in this regard.ObjectiveTo effectively address the needs of this population, this article reviews the extant literature on cultural, social, and contextual factors that may be salient factors in the mental health status and outcomes for African American males.MethodsThis includes an examination of the roles of race, religious participation, social support, gender role expectation in mental health and well-being outcomes.Findings/ConclusionThe current discussion is intended to serve as a prospective guide for future research, prevention, and intervention initiatives designed to improve such outcomes for a vulnerable and at-risk population group.

Current burden of serious fungal infections in Republic of Congo.

The Republic of Congo (RoC) is characterised by a high prevalence of tuberculosis and HIV/AIDS, which largely drive the epidemiology of serious fungal infections. We aimed to estimate the current burden of serious fungal infections in RoC. Using local, regional or global data and estimates of population and at-risk population groups, deterministic modelling was employed to estimate national incidence or prevalence of the most serious fungal infections. Our study revealed that about 5.4% of the Congolese population (283450) suffer from serious fungal infections yearly. The incidence of cryptococcal meningitis, Pneumocystis jirovecii pneumonia and disseminated histoplasmosis in AIDS patients was estimated at 560, 830 and 120 cases per year. Oral and oesophageal candidiasis collectively affects 12320 HIV-infected patients. Chronic pulmonary aspergillosis, 67% post-tuberculosis, probably has a prevalence of 3420. Fungal asthma (allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitisation) probably has a prevalence of 3640 and 4800, although some overlap due to disease definition is likely. The estimated prevalence of recurrent vulvovaginal candidiasis and tinea capitis is 85440 and 178400 respectively. Mostly related to agricultural activity, fungal keratitis affects an estimated 700 Congolese yearly. These data underline the urgent need for an intensified awareness towards Congolese physicians to fungal infections and for increased efforts to improve diagnosis and management of fungal infections in the RoC.

The European and Russian policies on preventing cyberterrorism (on the example of fight against Cyber Jihad

The subject of this research is to determine similarities and differences in the fight against &amp;ldquo;Cyber Jihad&amp;rdquo; in policy of the European Union and the Russian Federation. The object of this research is the prevention of cyberterrorism as a threat to national and international security, associated with the dynamic development of information technologies worldwide, absence of censorship and the wide availability of materials published on the Internet. The author describes the legal framework for countering cyberterrorism in the European Union and the Russian Federation. Special attention is given to the difference in approaches in the European and Russian legislation towards fight against undesirable materials in the global network, difficulties related to countering "Cyber-Jihad", identification of people from risk groups who may be involved in terrorist activities as a result of hostile propaganda. The scientific novelty of this work consists in the empirical proof that the difference in approaches to countering cyberterrorism in the European Union and the Russian Federation significantly reduces the results of fight against the global "Cyber Jihad". The author reveals the key legal, technical and ideological difficulties in the fight against "Cyber-Jihad", underlines the need for coordination of the efforts of Europe and Russia in this area, as well as indicates the importance of prevention and ideological counter-propaganda among youth and at-risk population groups.

Homocysteine: Its Possible Emerging Role in At-Risk Population Groups.

Increased plasma homocysteine is a risk factor for several pathological disorders. The present review focused on the role of homocysteine (Hcy) in different population groups, especially in risk conditions (pregnancy, infancy, old age), and on its relevance as a marker or etiological factor of the diseases in these age groups, focusing on the nutritional treatment of elevated Hcy levels. In pregnancy, Hcy levels were investigated in relation to the increased risk of adverse pregnancy outcomes such as small size for gestational age at birth, preeclampsia, recurrent abortions, low birth weight, or intrauterine growth restriction. In pediatric populations, Hcy levels are important not only for cardiovascular disease, obesity, and renal disease, but the most interesting evidence concerns study of elevated levels of Hcy in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Finally, a focus on the principal pathologies of the elderly (cardiovascular and neurodegenerative disease, osteoporosis and physical function) is presented. The metabolism of Hcy is influenced by B vitamins, and Hcy-lowering vitamin treatments have been proposed. However, clinical trials have not reached a consensus about the effectiveness of vitamin supplementation on the reduction of Hcy levels and improvement of pathological condition, especially in elderly patients with overt pathologies, suggesting that other dietary and non-dietary factors are involved in high Hcy levels. The importance of novel experimental designs focusing on intra-individual variability as a complement to the typical case–control experimental designs and the study of interactions between different factors it should be emphasized.

‘Testing’ Times: Fighting COVID-19 Deaths in India

We use case fatality rate (CFR) to estimate the severity of Covid-19 deaths in India during the nationwide lockdown period (March 25th to May 31st 2020). Although CFR plummeted during the period, state level data shows high variation. We examine how pre-existing factors such as ability to practice social distancing, health capacity and size of vulnerable population affect CFR across states. We find that although these pre-existing factors matter, they have rather limited impact on CFR. On the other hand testing has a significant impact on CFR. We find that testing is relatively more helpful in reducing CFR for the unfavourably placed group of states- lower capacity to socially distance, lower per capita health expenditure and higher proportion of at-risk population groups. However, it seems to aid states with better medical infrastructure. We also find that testing has a higher impact on reducing CFR for states with more aggressive and higher coverage of testing. Our results show that for an ongoing pandemic like Covid-19, aggressive and higher coverage testing is the way to go.

Infant and young child nutritional status and their caregivers\u2019 feeding knowledge and hygiene practices in internally displaced person camps, Somalia

BackgroundIn an attempt to design an educational programme targeting caregivers of children aged 6 to 59 months in internally displaced persons camps in Somalia, the objective of this study was twofold. First, to explore the nutritional situation of all children aged 6–59 months enrolled in a nutrition programme provided by Save the Children in 2017 in internally displaced persons camps. Second, to identify gaps in the caregivers’ hygiene and feeding practices.MethodsIn a study of 1655 households, 1655 caregivers for 2370 children aged 6 to 59 months enrolled in a nutrition programme provided by Save the Children answered an adapted questionnaire on hygiene and feeding practices. At the same time, based on standard criteria in the questionnaire, naturalistic observations of caregivers’ hygiene practices were conducted. Every child in the study was measured with anthropometric Mid-Upper-Arm Circumference measurements for the classification of Moderate Acute Malnutrition, Severe Acute Malnutrition and Global Acute Malnutrition. Descriptive statistics were used for analysis.Results1) There was Severe (12.1%) and Global Acute (19.9%) Malnutrition among children included in the nutrition programme, more frequently in the 6–24 month age group compared to the 25–59 month age group (p < 0.01). 2). The practices in the households were below what could generally be considered hygienic. 3) There was poor caregivers’ knowledge of breastfeeding benefits and complementary foods.ConclusionChild malnutrition might derive from gaps in the caregiver’s knowledge, attitudes, and practices regarding hygiene and infant feeding. An awareness of these gaps can be helpful in designing future educational programmes that target caregivers, particularly in at-risk population groups.

Mental illness prevention in post-ACS men: A partcipatory action research

Abstract Background The prevalence of social determinants of health (i.e. rurality, low education and poverty) among men put them at an elevated risk for comorbid cardiac disease and mental illness. While, men are particularly vulnerable to mental illnesses (i.e. depression, anxiety) after an acute coronary syndrome (ACS), they are typically averse to seeking medical care, especially for mental health issues. Targeting interventions to at-risk population groups is a well documented approach. However, little in the literature presents how to prevent mental illness in cardiac men. This study aims to develop, implement and pilot a psychoeducational program tailored for post-ACS men. Methods A mixed method including a scoping review, a qualitative study and a quasi-experimental pilot study. Results In total, 42 articles were retrieved to extract key components of cardiac men-sensitive psychoeducation programs. We led 22 focus groups and 14 semi-structured interviews (119 men in total). The mean age was 51.2 years [45-77]. We integrated the gathered data gathered from the scoping review and the qualitative study to develop a psychoeducational program (3 group sessions). The pilot study involved 48 men who completed the baseline, the 3-month and the 6-month data collections. We observed 80% of compliance. Findings show a significant improvement in PHQ-9, GAD-7, IES-R, CSI and EQ-5D scales. We also observed changes in the CMNI-22, a measure of attitudes, beliefs, and behaviors associated with both traditional and non-traditional masculine gender roles. Men appreciated the time flexibility (sessions were scheduled based on participants’ availability) and the responsiveness of the sessions (content was discussed based on their needs and interests). Life partners were invited and 65% attended to all sessions. Conclusions The program was a success and we expect to transform it into a peer-led intervention to improve its delivery in the community and its accessibility for rural and remote areas. Key messages At-risk population-sensitive approaches are key for compliance and effectiveness. Group sessions are effective approaches to improve men’s mental heatlh literacy.

Beyond Universal Health Care: Barriers to Breast Cancer Screening Participation in Canada

PurposeDespite well-established preventive screening guidelines for breast cancer, screening rates do not meet targets in both the United States and Canada. Although access to preventive care is an important factor toward participation, breast cancer screening rates in Canada vary despite a universal health care system. The objective of this study is to understand features within the Canadian population that potentiate screening disparities through a systematic review of the literature. MethodsA search of MEDLINE and Embase was performed to identify relevant studies published from 2005 onward. Titles and abstracts were screened, followed by full-text screening. Inclusion criteria were defined as studies reporting on disparities in image-based screening for breast cancer. ResultsThree hundred twenty-four studies were retrieved, from which 29 studies were selected on the basis of the predetermined inclusion criteria. Population groups identified at risk for low image-based screening participation included those of low socioeconomic status, individuals with comorbidities, new immigrants and refugees, those in remote geographic locations, individuals with intellectual or developmental disabilities, and ethnocultural minorities. Barriers to image-based screening can be improved by targeting measures specific to these at-risk groups at the individual, organization, and policy levels. ConclusionsMultiple at-risk population groups exist for preventive cancer screening within a universal health care system. By understanding specific characteristics within these vulnerable populations, effective intervention strategies can be established to improve breast cancer preventive care.

“For how long are we going to take the tablets?” Kenyan stakeholders’ views on priority investments to sustainably tackle soil-transmitted helminths

Recent global commitments to shift responsibility for Neglected Tropical Disease (NTD) control to affected countries reflect a renewed emphasis on sustainability, away from aid-dependency. This calls for a better understanding of how domestic stakeholders perceive investments in different strategies for NTD control. Soil transmitted helminths (STH) are among the NTDs targeted for elimination as a public health problem by international agencies through mass drug administration, provided periodically to at-risk population groups, often using drugs donated by pharmaceutical companies. This study was conducted in Kenya at a time when responsibilities for long running STH programmes were transitioning from external to national and sub-national agencies. Following an initial assessment in which we identified key domestic stakeholders and reviewed relevant scientific and government documents, the perspectives of stakeholders working in health, education, community engagement and sanitation were investigated through semi-structured interviews with national level policymakers, county level policymakers, and frontline implementers in one high-STH burden county, Kwale. Our conceptual framework on sustainability traced a progression in thinking, from ensuring financial stability through the technical ability to adapt to changing circumstances, and ultimately to a situation where a programme is prioritised by domestic policymakers because empowered communities demand it. It was clear from our interviews that most Kenyan stakeholders sought to be at the final stage in this progression. Interviewees criticised long-term investment in mass drug administration, the approach favoured predominantly by external agencies, for failing to address underlying causes of STH. Instead they identified three synergistic priority areas for investment: changes in institutional structures and culture to reduce working in silos; building community demand and ownership; and increased policymaker engagement on underlying socioeconomic and environmental causes of STH. Although challenging to implement, the shift in responsibility from external agencies to domestic stakeholders may lead to emergence of new strategic directions.

Estimation of PM2·5-associated disease burden in China in 2020 and 2030 using population and air quality scenarios: a modelling study

Air pollution and its adverse effects on public health remain a considerable problem in China, where policies have been implemented to improve the situation. We aimed to estimate the disease burden associated with particulate matter (PM)2·5 across China for 2020 and 2030 to identify the populations and regions most at risk, quantify the health benefits of air quality improvement targets, and determine the effect of population growth and ageing on this disease burden. In this modelling study, we investigated premature deaths associated with PM2·5 across China on the basis of air quality scenarios proposed by the expert group involved in the formulation of the 13th Five-Year Plan for Eco-Environmental Protection and population scenarios based on the Shared Socioeconomic Pathways of the Intergovernmental Panel on Climate Change. We used the integrated exposure-response model used for the Global Burden of Disease Study to estimate the number of PM2·5-related premature deaths under each scenario. The projected health benefits of the air-quality-improving targets are substantial, and could reduce the number of PM2.5-related premature deaths in China by approximately 129 278 by 2020 and 217 988 by 2030, compared with 2010. However, since China's population is increasing and ageing, the number of PM2.5-related premature deaths was estimated to increase by 84 102 by 2020 and by 244 191 by 2030, indicating that the health benefits induced by air quality improvements could be offset by the effect of the population increasing in size and ageing. To reduce the future disease burden in China, targets that are stricter than the interim target and stringent policies to improve air quality and protect public health are needed, especially for at-risk population groups, such as older individuals (aged >55 years) and patients with cardiovascular diseases, particularly in regions with a high disease burden. National Key Research and Development Program of China, National Natural Science Foundation of China, Beijing Natural Science Foundation, National High-level Talents Special Support Plan of China for Young Talents, and Special Foundation of Basic Science and Technology Resources Survey of Ministry of Science and Technology of China.

Are outdoor gyms located in areas of greatest need and impact? An audit in Sydney, Australia

ABSTRACTOutdoor gyms are increasingly available and have the potential to revitalize public parks and provide equitable access to physical activity opportunities. A comprehensive online search was conducted for outdoor gyms in Greater Sydney including: number, location, equipment type, installation/upgrade year, funding, consultation and promotional strategies. Proportions of outdoor gyms in suburbs identified as having greater need or impact were calculated. The search identified 209 outdoor gyms, about one third (n = 77; 36.8%) located in the most disadvantaged suburbs. Where installation/upgrade year was determined, the majority (n = 50; 87.7%) occurred in the past five years. There was limited community consultation (n = 17; 8.1%) and promotional strategies (n = 22; 10.5%). Increasing the accessibility of outdoor gyms through good design, location and promotion could be an important public health strategy to increase physical activity among at-risk populations. Further research to affirm their use, suitability and perceived social and health benefits in at-risk population groups is recommended.

Review of the 2017 WHO Guideline: Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups. An opportunity lost in translation.

Review of the 2017 WHO Guideline: Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups. An opportunity lost in translation.

Epidemiological characteristics associated with uptake of pneumococcal vaccine among older adults living in the community in Singapore: Results from the National Health Surveillance Survey 2013.

In Singapore, pneumococcal vaccination is recommended for the elderly (i.e. those ≥65 years of age) and people with chronic medical conditions. We investigated epidemiological characteristics associated with the uptake of pneumococcal vaccine based on a nationally representative cross-sectional sample of community-living adults aged ≥50 years. The data were obtained from the National Health Surveillance Survey (NHSS) 2013. Associations between pneumococcal vaccination and sociodemographic and health-related variables were analysed using univariable and multivariable logistic regression models. Among 3672 respondents aged ≥50 years in the NHSS, 7.8% had taken the pneumococcal vaccination. A higher level of education and higher monthly household income were sociodemographic characteristics independently associated with pneumococcal vaccine uptake. Health-related characteristics predictive of pneumococcal vaccine uptake were better self-rated health and having a regular family doctor/general practitioner. Among those who responded to the two questions on vaccinations, 3.9% had been vaccinated against both seasonal influenza and pneumococcal infection, while 11.1% had taken only seasonal influenza vaccination in the past year. There is a need to boost pneumococcal vaccination coverage among community-dwelling older adults. These findings provide insights into reviewing and tailoring public-health strategies and programmes to increase vaccine uptake in at-risk population groups.

A mathematical model for the seasonal transmission of schistosomiasis in the lake and marshland regions of China.

Schistosomiasis, a parasitic disease caused by \textit{ Schistosoma Japonicum}, is still one of the most serious parasitic diseases in China and remains endemic in seven provinces, including Hubei, Anhui, Hunan, Jiangsu, Jiangxi, Sichuan, and Yunnan. The monthly data of human schistosomiasis cases in Hubei, Hunan, and Anhui provinces (lake and marshland regions) released by the Chinese Center for Disease Control and Prevention (China CDC) display a periodic pattern with more cases in late summer and early autumn. Based on this observation, we construct a deterministic model with periodic transmission rates to study the seasonal transmission dynamics of schistosomiasis in these lake and marshland regions in China. We calculate the basic reproduction number R0, discuss the dynamical behavior of solutions to the model, and use the model to fit the monthly data of human schistosomiasis cases in Hubei. We also perform some sensitivity analysis of the basic reproduction number R0 in terms of model parameters. Our results indicate that treatment of at-risk population groups, improving sanitation, hygiene education, and snail control are effective measures in controlling human schistosomiasis in these lakes and marshland regions.