Talking to the people that really matter about their participation in pandemic clinical research: a qualitative study in four European countries

Background Pandemics of new and emerging infectious diseases are unpredictable, recurrent events that rapidly threaten global health and security. We aimed to identify public views regarding provision of information and consent to participate in primary and critical care clinical research during a future influenza-like illness pandemic. Methods Descriptive-interpretive qualitative study, using focus groups (n = 10) and semi-structured interviews (n = 16), with 80 members of the public (>18 years) in Belgium, Spain, Poland and the UK. Local qualitative researchers followed a scenario-based topic guide to collect data. Data were transcribed verbatim, translated into English and subject to framework analysis. Results Public understandings of pandemics were shaped by personal factors (illness during the previous H1N1 pandemic, experience of life-threatening illness) and social factors (historical references, media, public health information). Informants appreciated safeguards provided by ethically robust research procedures, but current enrolment procedures were seen as a barrier. They proposed simplified enrolment processes for higher risk research and consent waiver for certain types of low-risk research. Decision making about research participation was influenced by contextual, research and personal factors. Informants generally either carefully weighed up various approaches to research participation or responded instinctively. They supported the principle of using routinely collected, anonymized clinical biological samples for research without explicit consent, but regarded this as less acceptable if researchers were motivated primarily by commercial gain. Conclusions This bottom-up approach to ascertaining public views on pandemic clinical research has identified support for more proportionate research protection procedures for publically funded, low-risk studies

Nivel de conocimientos de estudiantes de medicina sobre diagnóstico y manejo del infarto agudo del miocardio

Introduction: acute myocardial infarction is a disease with high morbidity and mortality.Objective: to determine the knowledge level of medical students about the diagnosis and management of acute myocardial infarction.Method: an observational, descriptive and cross-sectional study was carried out between January and February 2022 in medical students from the University of Medical Sciences of Pinar del Río who participated in the provincial update workshop on acute myocardial infarction. Through intentional sampling, a sample of 92 students was selected. To collect the information, a survey was used using Google Forms.Results: the female sex (65,21%), the age group from 21 to 22 years (65,21%) and the fourth-year students (50%) prevailed. Hypertension was the most identified risk factor (97,98%). 97,82% of the students identified precordial pain as the main clinical manifestation. 100% identified the presentation with complications, where sudden death was the most identified (81,52%). 100% point to the electrocardiogram as the main complementary, where ST alterations were the most identified (84,78%). 95,65% of the students indicated constant monitoring of vital parameters and cardiovascular function as the management measure.Conclusions: Medicine students belonging to the clinical area at the University of Medical Sciences of Pinar del Río have an adequate level of knowledge about the diagnosis and management of acute myocardial infarction.Introducción: el infarto agudo del miocardio constituye una enfermedad con elevada morbilidad y mortalidad.Objetivo: determinar el nivel de conocimientos de estudiantes de medicina sobre el diagnóstico y manejo del infarto agudo del miocardioMétodo: se realizó un estudio observacional, descriptivo y transversal entre enero y febrero de 2022 en estudiantes de Medicina de la Universidad de Ciencias Médicas de Pinar del Río del ciclo clínico que participaron en el Taller provincial de actualización sobre infarto agudo de miocardio. Mediante un muestreo intencional se seleccionó una muestra de 92 estudiantes. Para la recolección de la información se empleó una encuesta mediante Google Forms.Resultados: predominó el sexo femenino (65,21 %), el grupo etario de 21 a 22 años (65,21 %) y los estudiantes de cuarto año (50 %). La hipertensión fue el factor de riesgo más identificado (97,98 %). El 97,82 % de los estudiantes identificó el dolor precordial como principal manifestación clínica. El 100 % identificó la presentación con complicaciones, donde la muerte súbita fue la más identificada (81,52 %). El 100 % señala al electrocardiograma como principal complementario, donde las alteraciones del ST fueron las más identificada (84,78 %). El 95,65 % de los estudiantes indicaron la monitorización constante de los parámetros vitales y función cardiovascular como la medida de manejo.Conclusiones: los estudiantes de Medicina pertenecientes al área clínica en la Universidad de Ciencias Médicas de Pinar del Río poseen un adecuado nivel de conocimientos sobre el diagnóstico y manejo del infarto agudo del miocardio.  

Advancing Exposure Assessment for Food Contaminants through Probabilistic Modeling

Building from analysis of the current state of adoption of probabilistic exposure modeling by regulatory agencies to inform risk management decisions and regulation for food contaminants, this project will highlight the value of further integration of probabilistic exposure assessments into regulatory frameworks and discuss factors that hinder widespread adoption of probabilistic exposure models. This project will address: 1. When probabilistic exposure assessments are warranted for food contaminants. 2. The criteria for determining that the assessor has high quality distributions for input variables. 3. Review existing guidance on how to describe the model and present the results and underlying inputs so that the stakeholders who are evaluating the assessment have confidence to evaluate and decide. 4. Identify the primary barriers to more widespread adoption and provide discussion/critique around whether each of the identified deterrents/concerns are valid or based on misconceptions/resistance to change. If a barrier is valid, provide recommendations of what information is needed. If an existing barrier is more subjective or based on perception, provide a rationale, utilizing existing examples where possible, to counter the misperception

Prevalence of noncommunicable disease risk factors among the Kani tribe in Thiruvananthapuram district, Kerala

Background & objective: Noncommunicable Disease (NCD) risk factors are on the rise and often linked to the adoption of modern lifestyles. This study explores NCD risk factors in a rapidly modernising indigenous population in Kerala, the Kani tribe. Methods: A representative sample of 298 adults of the Kani tribe in Thiruvananthapuram district was studied using the WHO stepwise framework for surveillance of NCD risk factors. Descriptive, bivariate and multivariable analysis were done using the R statistical package. Results: Prevalence of hypertension (48.3%), use of tobacco (81.5%) and alcohol consumption (36.2%) were found to be higher in the Kani tribe compared to the general population in Kerala. Abdominal obesity (22.1%) is found to be higher in Kani tribes compared to other tribal groups in India. The physical inactivity level (9.7%) was similar to urban Kerala and higher than many other tribes in India. Hypertension was scientifically associated (p < 0.05) with higher age, male sex, low education levels, and tobacco intake among them. On multivariable analysis, age and alcohol consumption were found to be the prominent risk factors for hypertension and high education level was found to be a protective factor. Conclusion: The major modifiable NCD risk factors were found to be higher among the people of the Kani tribe compared to the general population in Kerala. Physical inactivity level was comparable to urban Kerala, and obesity rates were higher than many other tribal communities in India. The findings warrants targeted action in these vulnerable communities for effective control of the noncommunicable epidemic