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  • 文章类型: Journal Article
    背景:假期的重要性,传统,家庭对人类文化和职业参与的庆祝活动被忽视了。这项研究的目的是探索老年人在COVID-19大流行期间如何在社交和身体上保持距离的情况下经历假期和庆祝活动。
    方法:对风险研究的数据进行了二次分析。17名社区成年人(11名女性和6名男性),年龄71-87岁,瑞典参加。在大流行的第一年,他们接受了四次远程采访。采用定性内容分析对数据进行分析。没有消费者/社区参与。
    结果:关于参与者希望的三个类别,计划,决定,适应,避免,经验丰富的假期和庆祝活动与社会和身体的距离包括在不可预测的时间的期望和准备;不断需要重新评估;几乎所有的结果都不同。
    结论:尽管有流行病限制,但庆祝的愿望表明了老年人假期的重要性和意义。庆祝活动会因为很多原因而中断,不仅像正在进行的大流行一样极端。为了以后生活中的健康,社会关怀,和社会需要了解固有的组成部分,并承认支持参与偶尔的事件,如假期的方式,传统,家庭庆祝活动。
    BACKGROUND: The importance of holidays, traditions, and family celebrations to human culture and occupational engagement has been neglected. The aim of this study was to explore how older adults experienced holidays and celebrations with social and physical distancing during the COVID-19 pandemic.
    METHODS: A secondary analysis was made on data from the At-Risk Study. Seventeen community-living adults (11 women and 6 men) aged 71-87 years, from Sweden participated. They were interviewed remotely four times during the first year of the pandemic. Data were analysed with qualitative content analysis. No consumer/community involvement occurred.
    RESULTS: Three categories on how the participants hoped for, planned, decided, adapted, avoided, and experienced holidays and celebrations with social and physical distancing included expectations and preparations in unpredictable times; the constant need for re-evaluation; and almost everything turned out differently.
    CONCLUSIONS: The desire to celebrate despite pandemic restrictions shows the importance and meaning holidays hold for older adults. Celebrations can be disrupted for many reasons, not only as extreme as the ongoing pandemic. For wellbeing in later life health care, social care, and society need to understand the inherent components and acknowledge ways of supporting participation in occasional events such as holidays, traditions, and family celebrations.
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  • 文章类型: Journal Article
    背景:了解影响个体健康决策的因素是一个动态的研究问题。特别是,在中国宣布放松对COVID-19疫情的管制后,健康风险迅速升级。“不再受控制”的病毒和信息流行病的融合创造了一个独特的社会时期,在此期间,多种因素可能会影响人们的决策。在这些因素中,老年人的预防意图,作为一个易受影响的健康团体,值得特别注意。
    目的:本研究旨在探讨老年人从事预防行为的意向及其影响因素,包括社会,媒体,和个人因素,在继后时代的背景下。借鉴沟通的结构影响模型,本研究检验了3种不同类型媒体曝光在认知和结构社会资本与保护行为意向之间的潜在中介作用,以及负面情绪在社会资本和媒体曝光之间的调节作用。
    方法:在本研究中,网络调查被用来收集自我报告的社会资本定量数据,媒体曝光,负面情绪,以及在中国60岁以上(N=399)的老年人中预防COVID-19的意图。
    结果:结果表明,认知社会资本显著影响保护行为意图(P<.001)。手机暴露发挥了额外的影响作用(P<.001)。相比之下,报纸、广播和电视暴露介导了结构性社会资本对保护行为意向的影响(P<.001)。此外,负面情绪在认知社会资本与手机暴露的关系中起调节作用(P<.001)。
    结论:这项研究表明,在各种媒体渠道中使用量身定制的传播策略可以有效地提高应对中国主要流行病的老年人的健康意识。考虑到他们多样化的社会资本特征和情绪状态。
    BACKGROUND: Understanding the factors influencing individuals\' health decisions is a dynamic research question. Particularly, after China announced the deregulation of the COVID-19 epidemic, health risks escalated rapidly. The convergence of \"no longer controlled\" viruses and the infodemic has created a distinctive social period during which multiple factors may have influenced people\'s decision-making. Among these factors, the precautionary intentions of older individuals, as a susceptible health group, deserve special attention.
    OBJECTIVE: This study aims to examine the intention of older adults to engage in preventive behaviors and the influencing factors, including social, media, and individual factors, within the context of the postepidemic era. Drawing upon the structural influence model of communication, this study tests the potential mediating roles of 3 different types of media exposure between cognitive and structural social capital and protective behavior intention, as well as the moderating role of negative emotions between social capital and media exposure.
    METHODS: In this study, a web survey was used to collect self-reported quantitative data on social capital, media exposure, negative emotions, and the intention to prevent COVID-19 among older adults aged ≥60 years (N=399) in China.
    RESULTS: The results indicate that cognitive social capital significantly influenced protective behavior intention (P<.001), with cell phone exposure playing an additional impactful role (P<.001). By contrast, newspaper and radio exposure and television exposure mediated the influence of structural social capital on protective behavior intention (P<.001). Furthermore, negative emotions played a moderating role in the relationship between cognitive social capital and cell phone exposure (P<.001).
    CONCLUSIONS: This study suggests that using tailored communication strategies across various media channels can effectively raise health awareness among older adults dealing with major pandemics in China, considering their diverse social capital characteristics and emotional states.
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  • 文章类型: Journal Article
    COVID-19大流行给整个医疗保健系统的临床实践和护理计划的提供带来了重大挑战。锻炼计划,在德国大多数儿科肿瘤中心实施,是一个相对较新的护理计划,但具有较高的临床影响和健康益处。
    大流行对德国儿科癌症患者和幸存者锻炼计划的交付和可用性的影响和后果尚不清楚。一项全国调查分析了限制,运动计划交付和科学研究的挑战和新方法。
    向锻炼计划的提供者分发了两个阶段的在线调查(急性诊所,非临床机构,康复设施)通过已建立的网络ActiveOncoKids。数据是在2022年和2023年的大流行期间使用开放和封闭问题的组合收集的。
    总共,n=27(回应率:82%)和n=17(回应率:63%)提供者参加了第一次和第二次调查,分别。调查结果指出,2020年和2021年,85%的锻炼计划受到了限制,2022年略有减少。在大流行期间,在随访期间,锻炼计划中出现了具有重大影响的限制,并逐渐下降。而急性治疗范围内的限制具有中等或较小的影响,但持续超过。提供所提供的锻炼计划需要进行调整,包括数字方法,从远处和位置变化进行监督干预。
    研究结果突出了适应性,儿科肿瘤学运动项目的需求和潜力。我们假设运动专业人员已经使用与大流行相关的挑战来审查和修改现有概念,并根据当地条件和提供运动计划的新颖工具进行了调整。然而,在某些患者和幸存者中,明显缺乏与运动相关的护理。为了满足和满足所有相关需求,必须进一步扩大方案。
    UNASSIGNED: The COVID-19 pandemic has presented major challenges to clinical practice and delivery of care programs throughout all health care systems. Exercise programs, that are implemented in most centers for pediatric oncology in Germany, are a relatively new care program however with high clinical impact and health benefits.
    UNASSIGNED: The impact and consequences of the pandemic on the delivery and availability of exercise programs in Germany for pediatric cancer patients and survivors are unknown. A national survey analyzed restrictions, challenges and novel approaches of exercise program delivery and scientific research.
    UNASSIGNED: A two-stage online survey was distributed to providers of exercise programs (acute clinics, non-clinical institutions, rehabilitation facilities) via the established Network ActiveOncoKids. Data was collected during the pandemic in 2022 and 2023 using a combination of open and closed questions.
    UNASSIGNED: In total, n = 27 (response rate: 82%) and n = 17 (response rate: 63%) providers participated in the first and second survey, respectively. Findings pointed out restrictions in 85% of all exercise programs in 2020 and 2021, with slight reductions in 2022. During pandemic, restrictions with major impact arose within exercise offers during follow-up and declined gradually. Whereas restrictions within the setting of acute therapy had medium or minor impact but persisted beyond. Delivery of provided exercise programs necessitated adaptions, including digital methods, supervised interventions from a distance and change of locations.
    UNASSIGNED: The findings highlight the adaptability, the demand and the potential of exercise programs in pediatric oncology. We assume that exercise professionals have used the pandemic-related challenges to review and modify existing concepts and made adaptations according to local conditions and novel tools for the provision of exercise programs. Nevertheless, a conspicuous lack of exercise-related care has become evident in certain patients and survivors. Further expansion of programs is imperative to address and accommodate all pertinent needs.
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  • 文章类型: Journal Article
    背景和目标:生活空间评估(LSA)是评估老年人流动性和参与度的评估工具。迄今为止,尚无研究调查阿拉伯语社区中LSA的有效性和可靠性.这项研究的目的是检查阿拉伯语版本的LSA的可靠性和有效性,并调查年龄较大的讲阿拉伯语的成年人的行动限制的潜在预测因素。材料和方法:本研究涉及75名讲阿拉伯语的老年人(平均年龄为67.2±5.9)。LSA给药两次,间隔一周,评估其测试-重测可靠性。LSA的内部一致性和重测可靠性使用Cronbach的α和类内相关系数(ICC)进行评估,分别。LSA的有效性是通过分析其与跌倒恐惧相关的结果指标的相关性来确定的。抑郁症,生活质量,下肢力量,物理性能,和步态速度。结果:LSA综合评分的重测可靠性显示出良好的结果(ICC=0.83)。LSA的有效性得到了其分数和性别等因素之间显著相关性的支持,教育水平,以及所有其他结果指标。值得注意的是,在讲阿拉伯语的老年人中,女性和步态速度较低是行动不便的重要预测因素,在进行的多元逻辑回归分析中占方差的49%(R2=49%)。结论:LSA的阿拉伯语版本已被证明是对讲阿拉伯语的老年人的流动性和参与度的可靠且有效的衡量标准。这项研究支持阿拉伯LSA在涉及老年人的研究和临床环境中的应用,并强调需要进一步调查以充分了解其在其他患有神经和肌肉骨骼疾病的阿拉伯语个体中的心理特征。
    Background and Objectives: The Life-Space Assessment (LSA) serves as an assessment tool for evaluating mobility and participation in older adults. To date, no studies have investigated the validity and reliability of the LSA within Arabic-speaking communities. The purpose of this study was to examine the reliability and validity of an Arabic version of the LSA and to investigate the potential predictors of mobility restrictions in older Arabic-speaking adults. Materials and Methods: This study involved a cohort of 75 Arabic-speaking older adults (with a mean age of 67.2 ± 5.9). The LSA was administered twice, with a one-week interval, to assess its test-retest reliability. The internal consistency and test-retest reliability of the LSA were assessed using Cronbach\'s alpha and intra-class correlation coefficients (ICCs), respectively. The validity of the LSA was determined by analyzing its correlation with outcome measures related to the fear of falling, depression, quality of life, lower limb strength, physical performance, and gait speed. Results: The test-retest reliability of the LSA composite score demonstrated good results (ICC = 0.83). The validity of the LSA was supported by significant correlations between its scores and factors such as gender, education level, and all other outcome measures. Notably, being female and having a lower gait speed emerged as significant predictors of mobility restrictions in older Arabic-speaking adults, accounting for 49% of the variance (R2 = 49%) in the multiple logistic regression analysis conducted. Conclusions: The Arabic version of the LSA has proven to be a reliable and valid measure of mobility and participation among older Arabic-speaking adults. This study endorses the application of the Arabic LSA in both research and clinical settings involving older adults and emphasizes the need for further investigation to fully understand its psychometric features in other Arabic-speaking individuals afflicted with neurological and musculoskeletal conditions.
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  • 文章类型: Journal Article
    背景:2022年全球人类猴痘(mpox)爆发主要影响与男性发生性关系的男性(MSM)。在中国,与男性发生性关系的年轻男性(YMSM)由于其性活动和在2022年底放宽的COVID-19限制而处于潜在的高痘病毒感染风险。
    目的:本研究旨在调查4种不同情景下接受水痘疫苗接种和进行水痘检测的行为意向,并探讨其与背景和行为理论相关因素的关系。
    方法:于2022年9月对中国6个代表性省份18-29岁的YMSM进行了在线横断面调查。招募的参与者(招募率=2918/4342,67.2%)被要求自我管理一份匿名问卷,该问卷是根据有关水痘和经典健康行为理论的先验知识设计的。关于参与者背景的数据,水痘知识和认知,水痘疫苗接种和测试认知,收集接受水痘疫苗接种和进行水痘检测的行为意向。进行描述性分析以及单变量和多变量线性回归。使用地理检测器测量行为意图的分层异质性。
    结果:共纳入2493个YMSM,平均年龄为24.6(SD2.9)岁。根据情景,有接受水痘疫苗接种的行为意向的患病率从66.2%到88.4%不等。流行状况和成本各不相同。在所有情况下,无论是否存在症状和费用,均具有水痘测试意图的患病率均超过90%。与疫苗接种意向相关的积极因素包括水痘知识(ba=0.060,95%CI0.016-0.103),天花感知易感性(BA=0.091,95%CI0.035-0.146),天花的严重程度(BA=0.230,95%CI0.164-0.296),由天花引起的情绪困扰(BA=0.270,95%CI0.160-0.380),水痘疫苗接种的感知益处(BA=0.455,95%CI0.411-0.498),水痘疫苗接种的自我效能(ba=0.586,95%CI0.504-0.668),并有1名男性性伴侣(ba=0.452,95%CI0.098-0.806),而负面因素是疫苗接种障碍(ba=-0.056,95%CI-0.090至-0.022)。与测试意图相关的积极因素是感知到的天花严重程度(ba=0.283,95%CI0.241-0.325),羊痘检测的感知益处(BA=0.679,95%CI0.636-0.721),水痘测试自我效能感(BA=0.195,95%CI0.146-0.245),有1个男性性伴侣(BA=0.290,95%CI0.070-0.510),并与MSM面对面聚会(ba=0.219,95%CI0.072-0.366),而负面因素是天花引起的情绪困扰(ba=-0.069,95%CI-0.137至-0.001)。
    结论:在中国YMSM中,进行水痘测试的意图是最佳的,而水痘疫苗接种意向还有改进的空间。未来的国家应对措施应该提高YMSM的水痘知识,传播有关水痘和预防措施的最新信息,改善预防性服务的可访问性和隐私性,并就积极应对相关的情绪困扰提供建议。
    BACKGROUND: The worldwide human monkeypox (mpox) outbreak in 2022 mainly affected men who have sex with men (MSM). In China, young men who have sex with men (YMSM) were at a potential high risk of mpox infection due to their sexual activeness and the eased COVID-19 restrictions at the end of 2022.
    OBJECTIVE: This study aimed to investigate the behavioral intention of receiving mpox vaccination and undergoing mpox testing in 4 different scenarios and explore their associations with background and behavioral theory-related factors among Chinese YMSM.
    METHODS: An online cross-sectional survey was conducted among YMSM aged 18-29 years from 6 representative provinces of China in September 2022. Participants recruited (recruitment rate=2918/4342, 67.2%) were asked to self-administer an anonymous questionnaire designed based on prior knowledge about mpox and classic health behavior theories. Data on the participants\' background, mpox knowledge and cognition, mpox vaccination and testing cognition, and the behavioral intention of receiving mpox vaccination and undergoing mpox testing were collected. Descriptive analysis and univariate and multivariate linear regressions were performed. Geodetector was used to measure the stratified heterogeneity of behavioral intention.
    RESULTS: A total of 2493 YMSM with a mean age of 24.6 (SD 2.9) years were included. The prevalence of having a behavioral intention of receiving mpox vaccination ranged from 66.2% to 88.4% by scenario, varying in epidemic status and cost. The prevalence of having an mpox testing intention was above 90% in all scenarios regardless of the presence of symptoms and the cost. The positive factors related to vaccination intention included mpox knowledge (ba=0.060, 95% CI 0.016-0.103), perceived susceptibility of mpox (ba=0.091, 95% CI 0.035-0.146), perceived severity of mpox (ba=0.230, 95% CI 0.164-0.296), emotional distress caused by mpox (ba=0.270, 95% CI 0.160-0.380), perceived benefits of mpox vaccination (ba=0.455, 95% CI 0.411-0.498), self-efficacy of mpox vaccination (ba=0.586, 95% CI 0.504-0.668), and having 1 male sex partner (ba=0.452, 95% CI 0.098-0.806), while the negative factor was perceived barriers to vaccination (ba=-0.056, 95% CI -0.090 to -0.022). The positive factors related to testing intention were perceived severity of mpox (ba=0.283, 95% CI 0.241-0.325), perceived benefits of mpox testing (ba=0.679, 95% CI 0.636-0.721), self-efficacy of mpox testing (ba=0.195, 95% CI 0.146-0.245), having 1 male sex partner (ba=0.290, 95% CI 0.070-0.510), and having in-person gatherings with MSM (ba=0.219, 95% CI 0.072-0.366), while the negative factor was emotional distress caused by mpox (ba=-0.069, 95% CI -0.137 to -0.001).
    CONCLUSIONS: Among Chinese YMSM, the intention of undergoing mpox testing is optimal, while the mpox vaccination intention has room for improvement. A future national response should raise YMSM\'s mpox knowledge, disseminate updated information about mpox and preventive measures, improve preventive service accessibility and privacy, and provide advice on positively coping with the associated emotional distress.
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  • 文章类型: Journal Article
    目前的研究调查了COVID-19大流行和由此产生的限制对智力和发育障碍个体的影响。进行了半结构化的焦点小组,以收集参加当地社区机构日间节目的参与者的数据。结果表明,COVID-19大流行及其安全限制影响了参与者对该疾病的知识,编程和工作,关系,活动,和情绪的方式与其他人群的其他发现相似和不同。讨论了这些发现对研究和实践的意义。
    The current study examined the impact that the COVID-19 pandemic and resulting restrictions have had on individuals with intellectual and developmental disability. Semi-structured focus groups were conducted to collect data from participants who attended day programming by local community agency. Results indicate that the COVID-19 pandemic and its safety restrictions impacted participants\' knowledge of the disease, programming and work, relationships, activities, and emotions in ways that were both similar to and different from other findings in other populations. Implications of these findings for research and practice are discussed.
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  • 文章类型: Journal Article
    先前的研究表明,日常活动对老年人的心理健康至关重要,在COVID-19大流行期间,此类活动有所减少。虽然以前的研究已经证实了严格的限制和精神疾病的增加之间的联系,在这种关系中,日常活动作为中介者的作用仍未得到充分探索。我们分析了在大流行的初始阶段,日常活动的减少是否介导了这些COVID-19限制对精神疾病的影响。
    我们使用了第8波共享电晕调查的数据,涵盖了来自25个欧洲国家和以色列的41,409名受访者,以及牛津政府反应追踪器(OxCGRT)关于COVID-19限制的数据。使用多层次回归和多层次中介分析来检验限制之间的关系,日常活动和心理健康。
    与社交活动相比,步行和购物的减少与精神疾病的增加有明显更强的关联。此外,步行的减少可能占限制和精神疾病增加之间关系的四分之一,但是其他激活的中介作用可以忽略不计。
    该研究强调了维持日常活动的重要作用,尤其是走路,以减轻欧洲老年人群中与大流行相关的限制的负面心理影响。
    Previous research has shown that daily activities are crucial for mental health among older people, and that such activities declined during the COVID-19 pandemic. While previous studies have confirmed a link between stringent restrictions and an increase in mental ill-health, the role of daily activities as a mediator in this relationship remains underexplored. We analyzed whether reductions in daily activities mediated the impact of these COVID-19 restrictions on mental ill-health during the pandemic\'s initial phase.
    We used data from Wave 8 SHARE Corona Survey covering 41,409 respondents from 25 European countries and Israel as well as data on COVID-19 restrictions from the Oxford Government Response Tracker (OxCGRT). Multilevel regression and multilevel-mediation analysis were used to examine the relationships between restrictions, daily activities and mental ill-health.
    Reductions in walking and shopping showed a notably stronger association with increases in mental ill-health compared to social activities. Furthermore, declines in walking could account for about a quarter of the relationship between restrictions and increased mental ill-health, but the mediating effects of the other activates were negligible.
    The study highlights the essential role of maintaining daily activities, particularly walking, to mitigate the negative psychological effects of pandemic-related restrictions among older populations in Europe.
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  • 文章类型: Journal Article
    在芬兰,在病例增加后,实施了国家和地方限制以控制COVID-19大流行,它改变了人们的日常生活。我们研究的目的是探索与COVID-19公共卫生指导相关的公共卫生沟通和依从性,recommendations,以及芬兰最北部的两个城市的限制,Inari和Utsjoki.我们采访了在市政当局工作的代表和运营商,以了解和了解他们的经验。结果表明,居民遵守不同的COVID-19行动,总的来说,沟通被认为是好的。总之,指导方针很容易遵循,但需要个人自己的活动。准则也以萨米语出版。国家边界限制是通信和信息中具有挑战性的一部分,和指导方针有时被发现是矛盾的。国家边境行动需要市政当局的资源,例如,测试,这对资源本来就很低的市政当局提出了更多的要求。在未来,必须考虑大流行的当地情况,协调行动并努力进行地方合作。投资于清晰的沟通很重要,接触到所有年龄段的人,和三种萨米语。
    In Finland, national and local restrictions were implemented to control the COVID-19 pandemic after the increase of cases, and it changed the everyday life of people. The purpose of our study was to explore public health communication and compliance related to the COVID-19 public health instructions, recommendations, and restrictions in two municipalities in Northernmost Finland, Inari and Utsjoki. We interviewed the representatives and operators working in the municipalities to understand and learn about their experiences. Results suggested that residents complied with different COVID-19 actions, and overall, communication was found to be good. Altogether, guidelines were easy to follow but required the individual\'s own activity. Guidelines were also published in Sámi language. National border restrictions were a challenging part of communication and information, and guidelines were found to be contradictory at times. National border actions required resources from the municipalities, e.g. testing, which caused more demands on municipalities operating with already low resources. In the future, it is essential to consider the local situation of the pandemic and harmonise actions and put effort on local cooperation. It is important to invest in clear communication, which reaches people of all ages, and in three Sámi languages.
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  • 文章类型: Journal Article
    自中国2019年首例冠状病毒病(COVID-19)确诊病例以来,COVID-19仍然是一个全球性威胁,并对医疗实践产生重大影响。这项研究旨在调查COVID-19大流行对淡路岛医疗实践的影响,日本的一个偏远岛屿。
    首先,我们对COVID-19在淡路岛流行前和流行期间的流行病学特征进行了调查。接下来,使用问卷,我们对在兵库县淡路医疗中心全职工作的医生进行了调查,这是淡路岛唯一指定的传染病医院。
    淡路岛的COVID-19感染率低于兵库县和整个日本,虽然峰值同时发生。门诊就诊以及住院患者,即,住院病人,在大流行期间,由于手术和住院的限制,疾病组成比例没有变化。问卷结果显示,在大流行期间,在我们医院全职工作的医生工作更少,睡眠更多。此外,从医疗事务部门获得的数据显示,加班时间减少,带薪假期天数增加。
    流行病学,COVID-19大流行对淡路岛的影响与日本的趋势相似,但是调查问卷的结果表明,在我们医院全职工作的医生不一定受到不利影响。
    UNASSIGNED: Since the first confirmed case of coronavirus disease 2019 (COVID-19) in China, COVID-19 continues to be a global threat and exerts a significant impact on medical practices. This study aims to investigate the impact of the COVID-19 pandemic on medical practices in Awaji Island, a remote island in Japan.
    UNASSIGNED: First, we conducted a survey on the epidemiological characteristics of COVID-19 on Awaji Island before and during the pandemic. Next, using a questionnaire, we conducted a survey with doctors working full time at Hyogo Prefectural Awaji Medical Center, which is the only designated infectious disease hospital on Awaji Island.
    UNASSIGNED: The COVID-19 infection rate of Awaji Island was lower than that of Hyogo Prefecture and of Japan as a whole, although the peaks occurred simultaneously. Outpatient visits as well as hospitalized patients, i.e., inpatients, decreased during the pandemic as a result of restrictions on surgeries and hospitalizations, with no changes in the disease composition ratio. The results of the questionnaire show that during the pandemic, doctors working full time at our hospital worked less and slept more. Furthermore, data obtained from the Medical Affairs Department showed a decrease in overtime hours worked and an increase in the number of days of paid holidays taken.
    UNASSIGNED: Epidemiologically, the impact of the COVID-19 pandemic on Awaji Island showed a similar trend to that in Japan, but the results of the survey questionnaire indicated that doctors working full time at our hospital were not necessarily adversely affected.
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  • 文章类型: Journal Article
    背景:法国在2020年9月至2021年6月期间实施了联合非药物干预措施(NPI)来管理COVID-19大流行。其中包括2020年秋季的封锁-这是自疫情爆发以来的第二次封锁-以抵消第二波疫情,随后是长时间的夜间宵禁,并在2021年春天对阿尔法波进行了第三次封锁。到目前为止,干预措施是孤立评估的,忽略区域之间通过移动性的空间连通性,这可能会影响NPI的有效性。
    方法:围绕2020年9月至2021年6月,我们开发了一个基于区域的流行病群体模型,该模型基于从日常手机数据中观察到的流动性通量,并将该模型与区域医院接诊情况拟合。该模型整合了疫苗接种和变异传播的数据。方案旨在评估Alpha变体的影响,以传播性和住院风险增加为特征,疫苗接种运动和替代政策决定。
    结果:空间模型更好地捕获了在区域动态中观察到的异质性,与忽略区域间流动性的模型相比。第三次封锁与第二次封锁在豁免折扣后同样有效,阿尔法,和季节性(生殖数量R0的区域减少中位数分别为51%和52%)。晚上6点晚上宵禁,酒吧和餐馆关闭,2021年1月实施,大幅减少了COVID-19的传播。最初导致R0的区域中位数减少49%,到2021年3月减少到43%。如果没有接种疫苗,实施的干预措施不足以对抗阿尔法波。提出以走走停停的方式进行一系列封锁的反事实情景将减少住院和限制天数,以获得足够低的阈值触发和解除限制。
    结论:流动性引起的空间连通性影响干预措施的有效性,尤其是在流动性较高的地区。傍晚的宵禁与美食部门的关闭使当局推迟了第三波浪潮。如果实施得足够早,断断续续的封锁可能会大大降低医疗保健和社会负担,与观察到的封锁-宵禁-封锁的应用相比,但可能是以牺牲几个劳动力部门为代价的。这些发现有助于表征已实施战略的有效性并改善大流行的防范。
    BACKGROUND: France implemented a combination of non-pharmaceutical interventions (NPIs) to manage the COVID-19 pandemic between September 2020 and June 2021. These included a lockdown in the fall 2020 - the second since the start of the pandemic - to counteract the second wave, followed by a long period of nighttime curfew, and by a third lockdown in the spring 2021 against the Alpha wave. Interventions have so far been evaluated in isolation, neglecting the spatial connectivity between regions through mobility that may impact NPI effectiveness.
    METHODS: Focusing on September 2020-June 2021, we developed a regionally-based epidemic metapopulation model informed by observed mobility fluxes from daily mobile phone data and fitted the model to regional hospital admissions. The model integrated data on vaccination and variants spread. Scenarios were designed to assess the impact of the Alpha variant, characterized by increased transmissibility and risk of hospitalization, of the vaccination campaign and alternative policy decisions.
    RESULTS: The spatial model better captured the heterogeneity observed in the regional dynamics, compared to models neglecting inter-regional mobility. The third lockdown was similarly effective to the second lockdown after discounting for immunity, Alpha, and seasonality (51% vs 52% median regional reduction in the reproductive number R0, respectively). The 6pm nighttime curfew with bars and restaurants closed, implemented in January 2021, substantially reduced COVID-19 transmission. It initially led to 49% median regional reduction of R0, decreasing to 43% reduction by March 2021. In absence of vaccination, implemented interventions would have been insufficient against the Alpha wave. Counterfactual scenarios proposing a sequence of lockdowns in a stop-and-go fashion would have reduced hospitalizations and restriction days for low enough thresholds triggering and lifting restrictions.
    CONCLUSIONS: Spatial connectivity induced by mobility impacted the effectiveness of interventions especially in regions with higher mobility rates. Early evening curfew with gastronomy sector closed allowed authorities to delay the third wave. Stop-and-go lockdowns could have substantially lowered both healthcare and societal burdens if implemented early enough, compared to the observed application of lockdown-curfew-lockdown, but likely at the expense of several labor sectors. These findings contribute to characterize the effectiveness of implemented strategies and improve pandemic preparedness.
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