Studies of prevalence: how a basic epidemiology concept has gained recognition in the COVID-19 pandemic.

BACKGROUND Prevalence measures the occurrence of any health condition, exposure or other factors related to health. The experience of COVID-19, a new disease caused by SARS-CoV-2, has highlighted the importance of prevalence studies, for which issues of reporting and methodology have traditionally been neglected. OBJECTIVE This communication highlights key issues about risks of bias in the design and conduct of prevalence studies and in reporting them, using examples about SARS-CoV-2 and COVID-19. SUMMARY The two main domains of bias in prevalence studies are those related to the study population (selection bias) and the condition or risk factor being assessed (information bias). Sources of selection bias should be considered both at the time of the invitation to take part in a study and when assessing who participates and provides valid data (respondents and non-respondents). Information bias appears when there are systematic errors affecting the accuracy and reproducibility of the measurement of the condition or risk factor. Types of information bias include misclassification, observer and recall bias. When reporting prevalence studies, clear descriptions of the target population, study population, study setting and context, and clear definitions of the condition or risk factor and its measurement are essential. Without clear reporting, the risks of bias cannot be assessed properly. Bias in the findings of prevalence studies can, however, impact decision-making and the spread of disease. The concepts discussed here can be applied to the assessment of prevalence for many other conditions. CONCLUSIONS Efforts to strengthen methodological research and improve assessment of the risk of bias and the quality of reporting of studies of prevalence in all fields of research should continue beyond this pandemic

Meta-análisis de prevalencia: Revisión sistemática de los métodos utilizados, propuesta de una herramienta para evaluar la calidad y evaluación de los diferentes métodos estadísticos utilizados para meta analizar prevalencias

Introducción: Una revisión sistemática tiene como objetivo recolectar toda la información empírica a partir de estudios primarios que cumplen ciertos criterios de inclusión y responden una pregunta de investigación, esta utiliza métodos específicos que buscan minimizar los sesgos y reportar hallazgos confiables. Actualmente se desarrollan revisiones sistemáticas a partir de ensayos clínicos que son considerados la mejor evidencia. Las revisiones sistemáticas publicadas que resumen datos de prevalencia han incrementado durante los últimos años, estas se publican bajo metodología diversa dentro de sus componentes principales como la selección de estudios, evaluación de calidad de los estudios incluidos y métodos estadísticos para la realización de meta-análisis de prevalencia. Objetivo: Describir y evaluar los métodos utilizados en meta análisis de prevalencia y a partir de esto proponer una herramienta para evaluar la calidad de estudios de prevalencia a incluir en los meta análisis. Materiales y Métodos: El proyecto se desarrolló en tres etapas en la primera se realizó una revisión sistemática de los meta-análisis de prevalencia publicados en población adulta entre 2011 y 2015, en la segunda etapa se identificaron todas las herramientas de evaluación de calidad y reporte que incorporaran componentes relacionados con la evaluación de calidad de los estudios de prevalencia prevalencia. En la tercera etapa se evaluaron los métodos de transformación binomial, logit, log y doble arco seno para metaanálisis de proporciones. Resultados: En la primera etapa se identificaron 235 estudios que cumplieron con los criterios de inclusión, la especialidad médica en la que más publicaciones se identificaron fue psiquiatría (19%), el (59%) de los meta análisis no llevaron a cabo una evaluación de calidad. El método más utilizado para meta-analizar fue método de combinación del efecto de medidas dicotómicas (54%). En la segunda etapa se identificaron 25 herramientas, nueve evaluaron la calidad de los estudios de prevalencia, seis la calidad de estudios observacionales y no aleatorizados, siete evaluaron la calidad del reporte en estudios observacionales y tres herramientas evaluaron diferentes características en estudios observacionales. Se realizó una propuesta inicial de una herramienta unificada para evaluar el riesgo sesgo de los estudios de prevalencia con cuatro dominios y un aspecto relacionado con el reporte. En la tercera etapa se utilizó la encuesta de la Situación Nutricional en Colombia ENSIN 2010, se utilizó la prevalencia de actividad física en subregiones y se asumieron estos como la representación de estudios individuales para un meta-análisis; se plantearon tres escenarios en donde se sobre representó la prevalencia, se aumentó la heterogeneidad y el último extrapoló los valores de la prevalencia a la población total. Se encontró que el método de transformación que mejor representa la verdadera prevalencia es el método de doble del arco seno. Conclusiones: Las revisiones sistemáticas de prevalencia se desarrollan de diferentes maneras con diferentes herramientas metodológicas. Cabe destacar que no existe un instrumento unificado de evaluación de calidad y de reporte que sea una guía estándar para los autores que hacen RS de prevalencia. Se sugiere utilizar métodos estadísticos meta-analíticos diseñados para proporciones.Abstract: Introduction: A systematic review aims to collect all the empirical information from primary studies that meet certain inclusion criteria and answer a research question, this uses specific methods that seek to minimize biases and report reliable findings. Currently systematic reviews are developed from clinical trials that are considered the best evidence. The published systematic reviews that summarize prevalence data have increased during the last years, these are published under diverse methodology within its main components such as the selection of studies, quality assessment of the included studies and statistical methods for the realization of meta-analysis of prevalence Objective: To describe and evaluate the methods used in meta-analysis of prevalence and from this to propose a tool to evaluate the quality of prevalence studies to be included in the meta-analysis. Materials and Methods: The project was developed in three phases: in the first one a systematic review of the meta-analysis of prevalence published in the adult population between 2011 and 2015 was carried out, in the second phase all the tools for quality assessment and reporting that incorporated components related to the quality assessment of prevalence studies were identified. In the third phase, the methods of binomial transformation, logit, log, and double arcsine were evaluated for meta-analysis of proportions. Results: In the first phase, 235 studies that met the inclusion criteria were identified- The medical specialty in which most publications were identified was psychiatry (19%), and (59%) of the meta-analyzes did not carry out a quality assessment. The method most used for meta-analysis was the effect of dichotomous measures combination method (54%). In the second phase 25 tools were identified, nine evaluated the quality of the prevalence studies, six the quality of observational and non-randomized studies, seven evaluated the quality of the report in observational studies and three tools evaluated different characteristics in observational studies. An initial proposal was made of a unified tool to assess the risk bias of the prevalence studies with four domains and an aspect related to the report. In the third phase the survey of the Nutritional Situation in Colombia, ENSIN 2010 was used, taking into account the prevalence of physical activity in sub-regions and these were assumed as the representation of individual studies for a meta-analysis; Three scenarios were proposed in which the prevalence was over-represented, heterogeneity was increased and the last one extrapolated the values of prevalence to the total population. It was found that the method of transformation that best represents the true prevalence is the double arcsine method. Conclusions: Prevalence systematic reviews are conducted in different ways with different methodological tools. It should be noted that there is no unified instrument for quality assessment and reporting that is a standard guide for authors who do prevalence SRs. Meta-analytical statistical methods designed for proportions are suggested.Maestrí

Empathy for others' suffering and its mediators in mental health professionals

Empathy is a complex cognitive and affective process that allows humans to experience concern for others, comprehend their emotions, and eventually help them. In addition to studies with healthy subjects and various neuropsychiatric populations, a few reports have examined this domain focusing on mental health workers, whose daily work requires the development of a saliently empathic character. Building on this research line, the present population-based study aimed to (a) assess different dimensions of empathy for pain in mental health workers relative to general-physicians and non-medical workers; and (b) evaluate their relationship with relevant factors, such as moral profile, age, gender, years of experience, and workplace type. Relative to both control groups, mental health workers exhibited higher empathic concern and discomfort for others' suffering, and they favored harsher punishment to harmful actions. Furthermore, this was the only group in which empathy variability was explained by moral judgments, years of experience, and workplace type. Taken together, these results indicate that empathy is continuously at stake in mental health care scenarios, as it can be affected by contextual factors and social contingencies. More generally, they highlight the importance of studying this domain in populations characterized by extreme empathic demands.Fil: Santamaria Garcia, Hernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Báez Buitrago, Sandra Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: García, Adolfo Martín. Instituto de Neurología Cognitiva. Laboratorio de Psicología Experimental y Neurociencia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Universidad Nacional de Cuyo. Facultad de Educación Elemental y Especial; ArgentinaFil: Flichtentrei, Daniel. Intramed; ArgentinaFil: Prats, Lucía María. Intramed; Argentina. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; ArgentinaFil: Mastandueno, Ricardo. Intramed; ArgentinaFil: Sigman, Mariano. Universidad Torcuato di Tella; ArgentinaFil: Matallana, Diana. Pontificia Universidad Javeriana; ColombiaFil: Cetkovich Bakmas, Marcelo Gustavo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Ibanez Barassi, Agustin Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentin

Proceso de reflexividad de nosotras, las profesionales en formación de trabajo social para develar los efectos de poder instalados en los elementos epistemológicos y socioculturales en tres campos de práctica profesional (FFMM - ICBF - monitoria académica) de la Corporación Universitaria Minuto de Dios.

Este trabajo es una forma diferente de investigar, puesto que rompe con las recetas investigativas y le apuesta a unir lo subjetivo con lo objetivo desde un proceso de reflexividad, que le apunta a develar los efectos de poder en las prácticas profesionales. Por lo tanto, a lo largo del documento se evidenciaron experiencias en tres campos específicos (Fuerzas Militares, Instituto Colombiano de Bienestar Familiar y Monitoria Académica de la Corporación Universitaria Minuto de Dios), que nos permitieron analizar los mecanismos de poder inmersos en nuestro que hacer desde los marcos epistemológicos y socioculturales de cada una, para llegar a afirmar que la reflexividad permite en el accionar diario ser conciente y actuar con responsabilidad ante la población

Proceso de reflexividad de nosotras, las profesionales en formación de trabajo social para develar los efectos de poder instalados en los elementos epistemológicos y socioculturales en tres campos de práctica profesional (FFMM - ICBF - monitoria académica) de la Corporación Universitaria Minuto de Dios.

Este trabajo es una forma diferente de investigar, puesto que rompe con las recetas investigativas y le apuesta a unir lo subjetivo con lo objetivo desde un proceso de reflexividad, que le apunta a develar los efectos de poder en las prácticas profesionales. Por lo tanto, a lo largo del documento se evidenciaron experiencias en tres campos específicos (Fuerzas Militares, Instituto Colombiano de Bienestar Familiar y Monitoria Académica de la Corporación Universitaria Minuto de Dios), que nos permitieron analizar los mecanismos de poder inmersos en nuestro que hacer desde los marcos epistemológicos y socioculturales de cada una, para llegar a afirmar que la reflexividad permite en el accionar diario ser conciente y actuar con responsabilidad ante la población

How to update a living systematic review and keep it alive during a pandemic: a practical guide.

BACKGROUND The covid-19 pandemic has highlighted the role of living systematic reviews. The speed of evidence generated during the covid-19 pandemic accentuated the challenges of managing high volumes of research literature. METHODS In this article, we summarise the characteristics of ongoing living systematic reviews on covid-19, and we follow a life cycle approach to describe key steps in a living systematic review. RESULTS We identified 97 living systematic reviews on covid-19, published up to 7th November 2022, which focused mostly on the effects of pharmacological interventions (n = 46, 47%) or the prevalence of associated conditions or risk factors (n = 30, 31%). The scopes of several reviews overlapped considerably. Most living systematic reviews included both observational and randomised study designs (n = 45, 46%). Only one-third of the reviews has been updated at least once (n = 34, 35%). We address practical aspects of living systematic reviews including how to judge whether to start a living systematic review, methods for study identification and selection, data extraction and evaluation, and give recommendations at each step, drawing from our own experience. We also discuss when it is time to stop and how to publish updates. CONCLUSIONS Methods to improve the efficiency of searching, study selection, and data extraction using machine learning technologies are being developed, their performance and applicability, particularly for reviews based on observational study designs should improve, and ways of publishing living systematic reviews and their updates will continue to evolve. Finally, knowing when to end a living systematic review is as important as knowing when to start

Vaccines for the common cold.

BACKGROUND The common cold is a spontaneously remitting infection of the upper respiratory tract, characterised by a runny nose, nasal congestion, sneezing, cough, malaise, sore throat, and fever (usually < 37.8 ºC). Whilst the common cold is generally not harmful, it is a cause of economic burden due to school and work absenteeism. In the United States, economic loss due to the common cold is estimated at more than USD 40 billion per year, including an estimate of 70 million workdays missed by employees, 189 million school days missed by children, and 126 million workdays missed by parents caring for children with a cold. Additionally, data from Europe show that the total cost per episode may be up to EUR 1102. There is also a large expenditure due to inappropriate antimicrobial prescription. Vaccine development for the common cold has been difficult due to antigenic variability of the common cold viruses; even bacteria can act as infective agents. Uncertainty remains regarding the efficacy and safety of interventions for preventing the common cold in healthy people, thus we performed an update of this Cochrane Review, which was first published in 2011 and updated in 2013 and 2017. OBJECTIVES To assess the clinical effectiveness and safety of vaccines for preventing the common cold in healthy people. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (April 2022), MEDLINE (1948 to April 2022), Embase (1974 to April 2022), CINAHL (1981 to April 2022), and LILACS (1982 to April 2022). We also searched three trials registers for ongoing studies, and four websites for additional trials (April 2022). We did not impose any language or date restrictions. SELECTION CRITERIA Randomised controlled trials (RCTs) of any virus vaccine compared with placebo to prevent the common cold in healthy people. DATA COLLECTION AND ANALYSIS We used Cochrane's Screen4Me workflow to assess the initial search results. Four review authors independently performed title and abstract screening to identify potentially relevant studies. We retrieved the full-text articles for those studies deemed potentially relevant, and the review authors independently screened the full-text reports for inclusion in the review, recording reasons for exclusion of the excluded studies. Any disagreements were resolved by discussion or by consulting a third review author when needed. Two review authors independently collected data on a data extraction form, resolving any disagreements by consensus or by involving a third review author. We double-checked data transferred into Review Manager 5 software. Three review authors independently assessed risk of bias using RoB 1 tool as outlined in the Cochrane Handbook for Systematic Reviews of Interventions. We carried out statistical analysis using Review Manager 5. We did not conduct a meta-analysis, and we did not assess publication bias. We used GRADEpro GDT software to assess the certainty of the evidence and to create a summary of findings table.  MAIN RESULTS: We did not identify any new RCTs for inclusion in this update. This review includes one RCT conducted in 1965 with an overall high risk of bias. The RCT included 2307 healthy young men in a military facility, all of whom were included in the analyses, and compared the effect of three adenovirus vaccines (live, inactivated type 4, and inactivated type 4 and 7) against a placebo (injection of physiological saline or gelatin capsule). There were 13 (1.14%) events in 1139 participants in the vaccine group, and 14 (1.19%) events in 1168 participants in the placebo group. Overall, we do not know if there is a difference between the adenovirus vaccine and placebo in reducing the incidence of the common cold (risk ratio 0.95, 95% confidence interval 0.45 to 2.02; very low-certainty evidence). Furthermore, no difference in adverse events when comparing live vaccine preparation with placebo was reported. We downgraded the certainty of the evidence to very low due to unclear risk of bias, indirectness because the population of this study was only young men, and imprecision because confidence intervals were wide and the number of events was low. The included study did not assess vaccine-related or all-cause mortality.  AUTHORS' CONCLUSIONS: This Cochrane Review was based on one study with very low-certainty evidence, which showed that there may be no difference between the adenovirus vaccine and placebo in reducing the incidence of the common cold. We identified a need for well-designed, adequately powered RCTs to investigate vaccines for the common cold in healthy people. Future trials on interventions for preventing the common cold should assess a variety of virus vaccines for this condition, and should measure such outcomes as common cold incidence, vaccine safety, and mortality (all-cause and related to the vaccine)

Seroprevalence and risk factors associated with the presence of bovine leptospirosis in the municipality of Sotaquirá, Colombia

Background: Bovine leptospirosis is a zoonotic, infectious, and cosmopolitan disease of worldwide distribution, caused by the spirochete Leptospira spp., which has been diagnosed in humans; domestic mammals, such as dogs, sheep, goats, swine, horses and cattle; and wild animals. It is considered a significant cause of economic losses in livestock because it causes infertility, abortion and reduced milk production. Aim: To establish the prevalence and the main risk factors associated with Leptospira spp. in cattle in the municipality of Sotaquirá, Colombia. Methods: An observational, descriptive, cross-sectional study with simple random sampling was carried out. 1,000 cattle of Ayrshire, Holstein, Jersey, Normande, Zebu, and crossbreeds were sampled. Blood samples were taken by coccygeal venipuncture and processed by microscopic agglutination technique; animals were considered positive when titers were ≥1:100. The data obtained were processed with the statistical program EpiInfo®. Results: A general apparent prevalence (AP) of 16% (160/1,000) was established, where the crossbreeds (20.5% AP), the 2–4 years age group (17% AP), and the serovars Leptospira interrogans serogroup Pomona (5.1%) and L. interrogans serogroup Sjroe serovar Hardjo (3.4%) presented the highest seropositivity. The variables barnyard, artificial insemination, and use of certified semen were identified as protective factors against the disease, while diarrhea was considered a risk factor. Conclusion: The prevalence in this study is within the range of those reported at the national level; however, it is essential to establish plans to control and prevent the disease

Seroprevalence of bovine viral diarrhea virus (BVDV) in cattle from Sotaquirá, Colombia

Worldwide distributed Bovine Viral Diarrhea Virus (BVDV) represents a high risk of infection in most bovine farms, in which it is associated with gastrointestinal, respiratory, and reproductive diseases. The purpose of this research was to establish the seroprevalence and the main risk factors associated with the presentation of BVDV in the municipality of Sotaquirá, Colombia. Samples were taken from 1000 cattle of Holstein, Ayrshire, Jersey, Normande Gyr and Holstein x Gyr. Epidemiological surveys were implemented, reproductive and management variables were taken into consideration. Indirect ELISA was performed to detect specific antibodies against BVDV using the commercial kit SERELISA® BVD p80 Ab Mono Blocking. The overall seroprevalence of antibodies against BVDV was 42.5% (425/1000), where the Gyr breed (59.1% apparent prevalence (AP); 60.3% real prevalence (PR)) and the age group > 4 years (53.0% PA; 54.4% PR) presented the highest seroprevalences. A significant statistical association was found for the breed, age, management practices evaluated and the presentation of PI3 (p ≤ 0.05). Age group > 4 years, Normande breed, presentation of PI3 and grazing lease were established as risk factors associated with BVDV in the herds. These infections are mainly associated with dairy cattle and herds with many animals, so it is important to consider vaccination plans as a preventive system and follow up on the most common diseases

Seroprevalence and risk factors associated with bovine herpesvirus 1 in dairy herds of Colombia

BACKGROUND AND AIM: Infectious bovine rhinotracheitis (IBR) is an infectious disease widely distributed globally and is considered the main cause of various reproductive and respiratory tract diseases in cattle and buffaloes. This study aimed to estimate seroprevalence and determine risk factors associated with the presentation of IBR in the municipality of Sotaquirá, Boyacá (Colombia). MATERIALS AND METHODS: A descriptive cross-sectional study with simple random sampling was performed, and the sample size was 1,000 cattle. Blood samples were obtained by coccygeal venipuncture and processed through indirect enzyme-linked immunosorbent assay using the Synbiotics(®) kit (Zoetis, New Jersey, USA) with a sensitivity and specificity of 96% and 98%, respectively. Data were processed using the statistical program EpiInfo(®) (Centers for Disease Control and Prevention; Atlanta, Georgia). RESULTS: A high seroprevalence of 57.5% was established. Seroprevalence was the highest in cattle >4 years of age (65.0% apparent seroprevalence [AS]; 67% true seroprevalence [TS]) and in the Holstein breed (65.5% AS; 67.8% TS). The breed and age of the animals were significantly associated with each other. The Holstein breed, age group >4 years, uncertified semen, and fetal death were established as risk factors for IBR. In comparison, the age groups of <1 and 1–2 years and the Normande breed were established as protective factors against the bovine herpesvirus-1 virus. CONCLUSION: Management factors, such as livestock from other owners and animal purchases, which affect disease presentation, are evident. The implementation and development of novel prevention and control measures for IBR at the national level are necessary