What do we know about Immunity to SARS-CoV-2? Implications for Public Health Policies

Additional support from ISGlobal’s Antoni Plasència and Josep M. AntóAs the COVID-19 pandemic progresses, so does our knowledge of the magnitude, type and durability of the immune response to SARS-CoV-2 as a result of natural infection or vaccination. This information is crucial since it will largely define the strategies we need to implement in order to protect individuals and populations. With this in mind, the GCMSC presents its second report, where they review the current knowledge on immunity to SARS-CoV-2 and the implications in terms of public health policies

Post-Acute COVID Syndrome (PACS): Definition, Impact and Management

Additional support from ISGlobal’s Antoni Plasència and Josep M. AntóA variety of studies suggest that up to 10-15% of all patients with COVID-19 may present persistent symptomatology weeks or even months after the original infection. Given the accumulated burden of COVID-19 in Catalonia, Spain, we speculate that over 90,000 patients could have been or are currently affected by persistent symptoms or sequelae. The Multidisciplinary Collaborative Group for the Scientific Monitoring of COVID-19 (GCMSC) presents its third report where they propose a clear set of case definitions of Post-Acute COVID syndrome (PACS) and its sub-categories and recommend a comprehensive medical examination to characterise the clinical features and complications when assessing PACS

BA.5 Omicron subvariant in Catalonia: Current impact and recommendations for booster vaccination strategies

Additional support from ISGlobal’s Antoni Plasència and Josep M. AntóCirculation of the Omicron BA.5 subvariant has led to a considerable increase in cases and also in hospitalisations (but not severe cases or deaths) in recent weeks in Catalonia, the rest of Spain and many other countries. Based on scientific evidence and the current epidemiological situation, the Multidisciplinary Collaborative Group for the Scientific Monitoring of COVID-19 (GCMSC) has conducted an analysis of the impact of the BA-5 subvariant in Catalonia and, with the support of the COVID-19 Scientific Advisory Committee (CCAC) attached to the Department of Health of the Government of Catalonia, has issued a series of recommendations for booster vaccination strategies

COVID-19 Immunisation Strategy: Priority Populations

Additional support from ISGlobal’s Antoni Plasència and Josep M. AntóWith a limited initial supply of COVID-19 vaccines doses and an expected delay for the universal vaccination of those eligible to receive it, it is relevant to analyse how best to prioritise the first available doses to achieve the greatest impact, both in terms of protecting individuals and minimising community transmission. Ethical issues are key in guiding a fair distribution. Different scenarios on vaccine implementation are summarised in this report. After a critical review of the documents and considering that these criteria are applied to Spanish citizens, the members of theGCMSC establish a priority vaccination list based on ethical principles and adapted to our count

The breadth of primary care: a systematic literature review of its core dimensions

Background: Even though there is general agreement that primary care is the linchpin of effective health care delivery, to date no efforts have been made to systematically review the scientific evidence supporting this supposition. The aim of this study was to examine the breadth of primary care by identifying its core dimensions and to assess the evidence for their interrelations and their relevance to outcomes at (primary) health system level. Methods: A systematic review of the primary care literature was carried out, restricted to English language journals reporting original research or systematic reviews. Studies published between 2003 and July 2008 were searched in MEDLINE, Embase, Cochrane Library, CINAHL, King's Fund Database, IDEAS Database, and EconLit. Results: Eighty-five studies were identified. This review was able to provide insight in the complexity of primary care as a multidimensional system, by identifying ten core dimensions that constitute a primary care system. The structure of a primary care system consists of three dimensions: 1. governance; 2. economic conditions; and 3. workforce development. The primary care process is determined by four dimensions: 4. access; 5. continuity of care; 6. coordination of care; and 7. comprehensiveness of care. The outcome of a primary care system includes three dimensions: 8. quality of care; 9. efficiency care; and 10. equity in health. There is a considerable evidence base showing that primary care contributes through its dimensions to overall health system performance and health. Conclusions: A primary care system can be defined and approached as a multidimensional system contributing to overall health system performance and health

Characteristics of general practice care: What do senior citizens value? A qualitative study

<p>Abstract</p> <p>Background</p> <p>In view of the increasing number of senior citizens in our society who are likely to consult their GP with age-related health problems, it is important to identify and understand the preferences of this group in relation to the non-medical attributes of GP care. The aim of this study is to improve our understanding about preferences of this group of patients in relation to non-medical attributes of primary health care. This may help to develop strategies to improve the quality of care that senior citizens receive from their GP.</p> <p>Methods</p> <p>Semi-structured interviews (N = 13) with senior citizens (65-91 years) in a judgement sample were recorded and transcribed verbatim. The analysis was conducted according to qualitative research methodology and the frame work method.</p> <p>Results</p> <p>Continuity of care providers, i.e. GP and practice nurses, GPs' expertise, trust, free choice of GP and a kind open attitude were highly valued. Accessibility by phone did not meet the expectations of the interviewees. The interviewees had difficulties with the GP out-of-office hours services. Spontaneous home visits were appreciated by some, but rejected by others. They preferred to receive verbal information rather than collecting information from leaflets. Distance to the practice and continuity of caregiver seemed to conflict for respondents.</p> <p>Conclusions</p> <p>Preferences change in the process of ageing and growing health problems. GPs and their co-workers should be also aware of the changing needs of the elderly regarding non-medical attributes of GP care. Meeting their needs regarding non-medical attributes of primary health care is important to improve the quality of care.</p

X chromosome inactivation does not necessarily determine the severity of the phenotype in Rett syndrome patients

Rett syndrome (RTT) is a severe neurological disorder usually caused by mutations in the MECP2 gene. Since the MECP2 gene is located on the X chromosome, X chromosome inactivation (XCI) could play a role in the wide range of phenotypic variation of RTT patients; however, classical methylation-based protocols to evaluate XCI could not determine whether the preferentially inactivated X chromosome carried the mutant or the wild-type allele. Therefore, we developed an allele-specific methylation-based assay to evaluate methylation at the loci of several recurrent MECP2 mutations. We analyzed the XCI patterns in the blood of 174 RTT patients, but we did not find a clear correlation between XCI and the clinical presentation. We also compared XCI in blood and brain cortex samples of two patients and found differences between XCI patterns in these tissues. However, RTT mainly being a neurological disease complicates the establishment of a correlation between the XCI in blood and the clinical presentation of the patients. Furthermore, we analyzed MECP2 transcript levels and found differences from the expected levels according to XCI. Many factors other than XCI could affect the RTT phenotype, which in combination could influence the clinical presentation of RTT patients to a greater extent than slight variations in the XCI pattern