Impact of COPD diagnosis in the face of multi-morbidity: Primary care patients\u27 perspectives

Poster presented at the 2014 Primary Health Care Research Conference, 23-25 July 2014, Canberra, Australi

Diagnosis of COPD in the face of multimorbidity, patients\u27 perspectives

Abstract presented at the 18th Congress of the Asian Pacific Society of Respirology, 11-14 November 2013, Yokohama, Japan

Digital health and universal health coverage: opportunities and policy considerations for Pacific Island health authorities

The emergence of digital health tools offer opportunities to complement and support the health system in the delivery of health services, especially in resource-constrained settings. Low- and middle-income countries have implemented various digital health interventions to support a range of health functions including patient information collection, diagnostics, supply-chain management, and remote clinical monitoring. The use of digital health in Pacific Island countries and territories (PICTs) is increasing. Effective implementation is hampered by misalignment between system design and contextual realities among other factors. Health service delivery in PICTs are highly resource sensitive, digital health must add demonstrable benefit to justify the expenditure of resources that could otherwise be allocated to facilities, equipment, staff, medicines and other commodities. This policy brief aims to identify health system challenges in the region which digital health interventions may address for decision-makers. It aims to identify policy and implementation factors to increase the likelihood of sustainable and scalable adoption of DHIs, and identify health resources to best capitalize on opportunities that digital health solutions offer. Recommendations suggest the need for each country or territory in the region to assess and determine their own priorities and opportunities, and devise digital health strategies in response. Recommendations outlined in the brief suggest the need to develop national-level digital health strategies to identify timelines and priorities, support mechanisms to strengthen digital health governance, human resource and institutional capacity. The brief aims to provide recommendations to aid relevant stakeholders to strengthen and support the use of ICTs to deliver equitable and integrated person-centered health care in the region

Surfactants-based remediation as an effective approach for removal of environmental pollutants—A review

Deterioration of environmental quality and equilibrium by rampant industrial expansion, accelerated urbanization and unchecked population growth has become a high-priority concern. The release of an alarming number of toxic polluting agents such as volatile organic compounds, dyes, heavy metals, pharmaceuticals, pesticides, industrial wastes, and personal care products due to natural or anthropogenic activities pose direct adverse effects on human health and living entities. This issue is inescapably increased because of the lack of efficient technologies for the proper disposal, management, and recycling of waste. It is of paramount importance to track alternative solutions to address these pollution problems for an eco-sustainable environment. Conventional remediation techniques are either inefficient, cumbersome or restricted due to certain techno-economic limitations. Environmental compatibility and high pollutant-removal efficacy make surfactants valuable for removal of organic pollutants and toxic heavy metal ions from different mediums. In this review, we present recent and up-to-date information on micelles/surfactants-assisted abatement of a vast number of toxic agents of emerging concern from water/wastewater including volatile organic compounds, personal care products, pharmaceutically active residues, toxic metals, dye pollutants, pesticides, and petroleum hydrocarbons. Based on the literature survey, it can be concluded that micelles-assisted water and soil treatment technology can have a better future on large-scale decontamination of wastewater. Though bio-surfactants are environmentally friendlier matrices and have successfully been employed for environmental decontamination; their large-scale applicability is challenging owing to high costs. Additional research efforts on the development and employment of novel bio-surfactants might render wastewater treatment technology greener, smarter and economical

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Activating primary care COPD patients with multi-morbidity through tailored self-management support

Given the dearth of COPD self-management interventions that specifically acknowledge multi-morbidity in primary care, we aimed to activate COPD patients through personalised self-management support that recognised the implications of co-morbidities. This single-group experimental study included patients aged 40-84 with a spirometry diagnosis of COPD and at least one co-morbidity. A self-management education programme for COPD in the context of multi-morbidity, based on the Health Belief Model, was tailored and delivered to participants by general practice nurses in face-to-face sessions. At 6 months\u27 follow-up, there was significant improvement in patient activation (p \u3c 0.001), COPD-related quality of life (p = 0.012), COPD knowledge (p \u3c 0.001) and inhaler device technique (p = 0.001), with no significant change in perception of multi-morbidity (p = 0.822) or COPD-related multi-morbidity (0.084). The programme improved patients\u27 self-efficacy for their COPD as well as overall health behaviour. The findings form an empirical basis for further testing the programme in a large-scale randomised controlled trial

Activating primary care COPD patients with multi-morbidity (APCOM) pilot project

Abstract from the 8th International Primary Care Respiratory Group (IPCRG) World Conference, 25-28 May 2016, Amsterdam, The Netherlands