How social learning shapes the efficacy of preventative health behaviors in an outbreak

The global pandemic of COVID-19 revealed the dynamic heterogeneity in how individuals respond to infection risks, government orders, and community-specific social norms. Here we demonstrate how both individual observation and social learning are likely to shape behavioral, and therefore epidemiological, dynamics over time. Efforts to delay and reduce infections can compromise their own success, especially when disease risk and social learning interact within sub-populations, as when people observe others who are (a) infected and/or (b) socially distancing to protect themselves from infection. Simulating socially-learning agents who observe effects of a contagious virus, our modelling results are consistent with with 2020 data on mask-wearing in the U.S. and also concur with general observations of cohort induced differences in reactions to public health recommendations. We show how shifting reliance on types of learning affect the course of an outbreak, and could therefore factor into policy-based interventions incorporating age-based cohort differences in response behavior.

Health Problems Encountered by Short-Term European Volunteers in a Nongovernmental Organization in Cambodia

Short-term volunteers are susceptible to a wide spectrum of morbidities, mostly infectious diseases preventable with general hygiene and preventive measures. This study aimed to identify the health problems encountered by European short-term volunteers collaborating for 1 month with a nongovernmental organization (NGO) in Cambodia and to describe their characteristics. A prospective, descriptive observational study was conducted on short-term volunteers who collaborated with an NGO in Cambodia during August 2018. Informed consent and sociodemographic, clinical, and preventative health-related questionnaire data were provided by 198 volunteers. The health problems encountered were confirmed in a primary care consultation with healthcare professionals. Univariate and bivariate analyses were performed. The median age of the volunteers was 22 years (interquartile range = 21–24), and 64% were women. Some (18.2%) had allergies, 8.6% had preexisting health conditions, and 10.6% were under regular treatment. A total of 77.3% visited a pretravel consultation clinic, 39.9% completed a specific pretravel health course, 21.7% took malaria prophylaxis, 92.4% received hepatitis A vaccination, and 82.3% received typhoid fever vaccination. Medical assistance was sought by 112 (57.3%) of the volunteers. The average number of health problems was 2.5 (standard deviation = 1.5), and the total number of health problems attended by the medical team was 279. The most common health problems were upper respiratory infections (12.2 per 1,000 person-days), wounds (10.8 per 1,000 person-days), and diarrhea (6.3 per 1,000 person-days). Short-term volunteers experienced a high rate of health problems during their stay in Cambodia, but most of the problems were mild and preventable and resolved quickly. Pretravel consultation and specific pretravel health training seemed to increase disease awareness.

Promoção da Saúde e Medicalização: Notas Inquietantes em Conversas de Foucault com Canguilhem

Este artigo visa problematizar práticas de promoção de saúde no Brasil, a partir da história da saúde pública no país, em uma analítica da medicalização e da gestão higienista do hospital, da cidade, dos pobres e do Estado. Busca-se pensar como emerge junto com a saúde na atenção básica um modo de gerir a política pública de saúde como tática medicalizante dos corpos, do espaço, do hospital, da comunidade e das relações sociais. Interroga-se no seguinte ensaio temático um conjunto de práticas que operam um mecanismo biopolítico e de governo da vida e das existências por meio de intensa medicalização na atuação preventivista da saúde. Portanto, questiona-se o estilo de vida saudável na sociedade contemporânea a partir de uma estratégia medicalizadora do direito à saúde com Michel Foucault e Georges Canguilhem.Palavras-chave: Saúde. Medicalização. Práticas. Biopolítica. Prevenção. Health Promotion And Medicalization: Disturbing Notes In Talk Of Foucault With CanguilhemABSTRACTThis article aims to problematize health promotion practices in Brazil, based on the history of public health in the country, in an analysis of medicalization and hygienist management of the hospital, the city, the poor and the State. It seeks to think about how a way to manage public health policy emerges together with health in primary care as a medicalizing tactic of bodies, space, hospital, community and social relations. in the following thematic essay a set of practices that operate a biopolitical and government mechanism of life and existences through intense medicalization in preventative health action. Therefore, the healthy lifestyle in contemporary society is questioned based on a medicalizing strategy of the right to health.Keywords: Health. Medicalization. Practices. Biopolitics. Prevention.

COVID-19 in Africa: rethinking the tools to manage future pandemics

Corona virus disease 2019 (COVID-19) remains an incurable, progressive pneumonia-like illness characterized by fever, dry cough, fatigue, and headache during its early stages. COVID-19 has ultimately resulted in mortality in at least 2 million people worldwide. Millions of people globally have already been affected by this disease, and the numbers are expected to increase, perhaps until an effective cure or vaccine is identified.Although Africa was initially purported by the World Health Organization (WHO) to be severely hit by the pandemic, Africa recorded the least number of cases during the first wave, with lowest rates of infections, compared to Asia, Europe, and the Americas. This statistic might be attributed to the low testing capacity, existing public health awareness and lessons learnt during Ebola epidemic. Nonetheless, the relatively low rate of infection should be an opportunity for Africa to be better prepared to overcome this and future epidemics.In this paper, the authors provide insights into the dynamics and transmission of the severe acute respiratory syndrome corona virus (SARS-CoV-2) during the first wave of the pandemic; possible explanations into the relatively low rates of infection recorded in Africa; with recommendations for Africa to continue to fight Covid-19; and position itself to effectively manage future pandemics. Keywords: Covid-19; Ebola; Science Leadership in Africa; Vaccine; SARS-COV-2; Preventative Health; Future Pandemics.

The Impact of Community Health Coalitions On Preventative Health Outcomes: A Systematic Review

Background/Objective: Six out of ten deaths in the United States are caused by chronic diseases. There are multiple approaches to prevention and/or early detection of chronic diseases through screenings, nutrition, physical activity, and more. Unfortunately, a large portion of the US population have low rates of preventative care. Community health coalitions have the potential to improve preventative health outcomes by partnering with key members of communities to design programs that best fit community needs. In this systematic review, we examine evidence that community health coalitions can improve preventative health outcomes. Methods: PubMed, WebofScience, CINAHL, and PsycINFO were searched for (outcome OR health outcome) AND (prevention) AND (diabetes OR hypertension OR cancer OR prenatal) AND (community-based participatory research OR community coalition OR coalition OR health coalition). After screening 490 articles, 30 full-text, peer-reviewed, English articles meeting inclusion criteria of health coalition, prevention, health outcomes reported, and conducted in the United States were reviewed. Results: 27 of the 30 studies showed community health coalitions having a positive impact. Roughly half of the articles were randomized control trials. Community members and academia were represented in 80% and 77%, respectively, of the coalitions described, while other representations included faith-based organizations, health care, public health, industry, and education. Diabetes and cancer represented 74% of the targeted preventions addressed. 90% of the interventions focused on educating the community, and 33% focused on increasing health screening rates. 60% utilized trained community members to deliver interventions. 60% reported health measurements, 33% reported screening rates, and 30% reported knowledge and awareness. Conclusion, Impact, & Implications: While the evidence suggests community health coalitions are effective in improving preventative health outcomes, the quality of the studies remain low. There is a need for increased rigor of study design and assessment in order to determine the true efficacy of community health coalitions. The majority of the randomized-control trials in this review were rated as low-quality, highlighting the difficulty of designing a randomized, controlled study in a community. Inadequate funding, lack of rigorous design, or ethical challenges can limit the quality of the assessment. Further, although prenatal care was included as a search term, there were no coalitions found that addressed this type of preventative care. This points to a future need for the creation of or increased publications from prenatal health coalitions.

Technology Use Among Older Adults to Manage their Health During a Global Pandemic

Risk of severe COVID-19 illness increases with age, and older adults are more likely to be hospitalized and die from COVID-19 and related complications as compared to their younger counterparts. This reality, combined with pandemic-related lockdown and social distancing policies, has increased in-home isolation for older adults. This includes cancelling in-person healthcare appointments and conducting many appointments via tele-health. As older adults have had to quickly pivot to learning new technologies, little is known about their experiences with navigating virtual healthcare during the pandemic. Therefore, this qualitative study aims to address that gap. One-on-one interviews (N=29) were conducted with older adults (Mean age=71.5; 86% female) via phone/Zoom. Participants were asked about their healthcare experiences during the pandemic and the role technology played. Interviews were transcribed and thematically analyzed using Nvivo12 software. Findings demonstrate that participants used technology to schedule medical appointments, engage in virtual visits with their providers, set reminders to take medications, and undertake their daily exercise routine. Post-lockdown, some participants preferred in-person visits due to the nature of their diagnosis, personal preference, or unfamiliarity with the needed technology. Older adults encountered challenges including cancelled appointments, miscommunication with providers, and lack of skill to use technologies. Cancellation of appointments and postponement of treatments affected the health of some of the participants. Implications of this research can inform tele-health approaches with older patients, as well as provider communication and coordination of care. Leveraging technology for preventative health approaches can also assist older adults in ongoing health maintenance and promote well-being.

Evidence Review: Religious Marginalities and COVID Vaccination - Access and Hesitancy

Religious minority affiliation or status can play a very important role in influencing people's access to vaccines as well as their willingness to undergo vaccination. Many studies focus on class, ethnicity and geographic location when examining how social inequalities impact vaccination programmes. However, religious marginality is often overlooked. Here we explore how being situated on the margins, on account of religious affiliation, shapes experiences of vaccine access and uptake. The issues addressed are important for COVID-19 vaccination roll out, but also contain lessons for all vaccination programmes and many other preventative health measures. In this brief, we present key considerations for addressing differentials in access to and willingness to undergo vaccinations that are linked to religious minority status, experiences, authorities or doctrine. We explain why the study and awareness of religious marginality is crucial for the success of vaccination programmes broadly and specifically as they apply to COVID-19 vaccination. We also explore ways in which religious marginality intersects with other identity markers to influence individual and community access to vaccines. Finally, we examine vaccine hesitancy in relation to religious minorities and outline approaches to community health engagement that are socio-religiously sensitive, as well as practical, to enhance vaccination confidence.

Invincibility threatens vaccination intentions during a pandemic

Some people feel they are invincible to the novel coronavirus SARS-CoV-2 (COVID-19). They believe that being infected with COVID-19 would not be a serious threat to their health. While these people may or may not be correct in their personal risk assessment, we find that such perceived invincibility may undermine community efforts to achieve herd immunity. Multi-level analysis of survey respondents across 51 countries finds that perceived invincibility from COVID-19 is negatively associated with believing there is a need to prevent the spread of COVID-19 in one’s community (n = 218,956) and one’s willingness to inoculate against the disease (n = 71,148). These effects are most pronounced among individuals from countries lower in cultural collectivism (e.g., USA, UK, Canada) and highlight the need to consider the interplay of individual and cultural factors in our efforts to understand, predict, and promote preventative health behavior during a pandemic.

Evidence Review: Religious Marginalities and COVID Vaccination - Access and Hesitancy

Religious minority affiliation or status can play a very important role in influencing people's access to vaccines as well as their willingness to undergo vaccination. Many studies focus on class, ethnicity and geographic location when examining how social inequalities impact vaccination programmes. However, religious marginality is often overlooked. Here we explore how being situated on the margins, on account of religious affiliation, shapes experiences of vaccine access and uptake. The issues addressed are important for COVID-19 vaccination roll out, but also contain lessons for all vaccination programmes and many other preventative health measures. In this brief, we present key considerations for addressing differentials in access to and willingness to undergo vaccinations that are linked to religious minority status, experiences, authorities or doctrine. We explain why the study and awareness of religious marginality is crucial for the success of vaccination programmes broadly and specifically as they apply to COVID-19 vaccination. We also explore ways in which religious marginality intersects with other identity markers to influence individual and community access to vaccines. Finally, we examine vaccine hesitancy in relation to religious minorities and outline approaches to community health engagement that are socio-religiously sensitive, as well as practical, to enhance vaccination confidence.

‘The Japanese Stand Today as Teachers of the Whole World’: American Food Reform and the Russo-Japanese War

Japanese food first became the focus of serious attention in the United States during the Russo-Japanese War (1904–1905), when Japan’s victory over the Russian empire signaled that nation’s arrival as a new world power. This newfound interest had nothing to do with gastronomy. The conviction driving it was that diet and preventative health care in the Japanese military, which had been critical to its unexpected success, could serve as models for the United States. Military doctors, home economists, dietitians, businesses, vegetarians, and physical fitness fans joined this discourse, each with their own agendas. Many participants were women whose advocacy linked the supposed innate feminine propensity for nurturing and care giving with a shared faith in science to solve the problems facing the modern world. All believed Japan’s rice, vegetable, and fish-based diet contributed to the exceptional physical strength and stamina of the Japanese people because, unlike their own, “it was plain, rational, and easily digested, metabolized and assimilated.” More enthusiasm than knowledge in their claims, but this mattered little since the goal was not to popularize Japanese culinary culture, but to reform U.S. eating habits. This article examines the American discourse on Japanese food and health and how it shaped and reflected domestic political, social, and economic priorities in the 20th Century’s first decade.