The aim of the research is to build a measure of some of the motivations of the players to practice wheelchair basketball, as well as to identify the most important motives for wheelchair basketball ...players, and to identify the differences between the motivations of the players to practice wheelchair basketball, and. The researcher adopted the descriptive approach in the survey method and case study. The research community was represented by wheelchair basketball players, whose number is (84) players, and the scale building sample of (40) players was randomly selected and the survey sample numbered (19) players, while the number of the main research sample (the application sample) was (25) players, The researcher used the questionnaire, tests and measurement as measuring tools, and the measure of the motivations of the players to practice wheelchair basketball was prepared, after determining some of its dimensions by presenting the special questionnaire to a group of experts and specialists, as four dimensions were identified (health and physical motives, and social motives. And personal motives, and psychological motives), and the scale paragraphs amounted to (28) paragraphs distributed on the four dimensions, and alternatives answered according to a triple scale (agree, hesitant, disagree). Treating the results by appropriate statistical means. According to the results, the researcher concluded several conclusions, the most important of which is that the members of the research sample have good grades in the scale of some of the motives of the players to practice wheelchair basketball, in addition to the presence of moral differences between some of the motives of the players to practice wheelchair basketball, and one of the most important recommendations is to emphasize the need for Interest in some of the motivations of players to play wheelchair basketball.
The impact of human papillomavirus (HPV) vaccination has been observed in the United States through declining cervical precancer incidence in young women. To further evaluate vaccine impact, we ...described trends in HPV vaccine types 16/18 in cervical precancers, 2008-2014.
We analyzed data from a 5-site, population-based surveillance system. Archived specimens from women age 18-39 years diagnosed with cervical intraepithelial neoplasia grades 2-3 or adenocarcinoma
(CIN2+) were tested for 37 HPV types. We described the proportion and estimated number of cases of CIN2+ by HPV-type groups over time. Trends in HPV16/18-positive CIN2+ were examined, overall and by vaccination status, age, histologic grade, and race/ethnicity, using Cochrane-Armitage tests.
In 10,206 cases, the proportion and estimated number of cases of HPV16/18-positive CIN2+ declined from 52.7% (1,235 cases) in 2008 to 44.1% (819 cases) in 2014 (
< 0.001). Declining trends in the proportion of HPV16/18-positive CIN2+ were observed among vaccinated (55.2%-33.3%,
< 0.001) and unvaccinated (51.0%-47.3%,
= 0.03) women; ages 18-20 (48.7%-18.8%,
= 0.02), 21-24 (53.8%-44.0%,
< 0.001), 25-29 (56.9%-42.4%,
< 0.001), and 30-34 (49.8%-45.8%,
= 0.04) years; CIN2 (40.8%-29.9%,
< 0.001) and CIN2/3 (61.8%-46.2%,
< 0.001); non-Hispanic white (59.5%-47.9%,
< 0.001) and non-Hispanic black (40.7%-26.5%,
< 0.001).
From 2008-2014, the proportion of HPV16/18-positive CIN2+ declined, with the greatest declines in vaccinated women; declines in unvaccinated women suggest herd protection.
The declining proportion of HPV16/18-positive CIN2+ provides additional evidence of vaccine impact in the United States.
Abstract Background Prevention of pre-invasive cervical lesions is an important benefit of HPV vaccines, but demonstrating impact on these lesions is impeded by changes in cervical cancer screening. ...Monitoring vaccine-types associated with lesions can help distinguish vaccine impact from screening effects. We examined trends in prevalence of HPV 16/18 types detected in cervical intraepithelial neoplasia 2, 3, and adenocarcinoma in situ (CIN2+) among women diagnosed with CIN2+ from 2008 to 2012 by vaccination status. We estimated vaccine effectiveness against HPV 16/18-attributable CIN2+ among women who received ≥1 dose by increasing time intervals between date of first vaccination and the screening test that led to detection of CIN2+ lesion. Methods Data are from a population-based sentinel surveillance system to monitor HPV vaccine impact on type-specific CIN2+ among adult female residents of five catchment areas in California, Connecticut, New York, Oregon, and Tennessee. Vaccination and cervical cancer screening information was retrieved. Archived diagnostic specimens were obtained from reporting laboratories for HPV DNA typing. Results From 2008 to 2012, prevalence of HPV 16/18 in CIN2+ lesions statistically significantly decreased from 53.6% to 28.4% among women who received at least one dose ( Ptrend < .001) but not among unvaccinated women (57.1% vs 52.5%; Ptrend = .08) or women with unknown vaccination status (55.0% vs 50.5%; Ptrend = .71). Estimated vaccine effectiveness for prevention of HPV 16/18-attributable CIN2+ was 21% (95% CI: 1–37), 49% (95% CI: 28–64), and 72% (95% CI: 45–86) in women who initiated vaccination 25–36 months, 37–48 months, and >48 months prior to the screening test that led to CIN2+ diagnosis. Conclusions Population-based data from the United States indicate significant reductions in CIN2+ lesions attributable to types targeted by the vaccines and increasing HPV vaccine effectiveness with increasing interval between first vaccination and earliest detection of cervical disease.
In 2007, five Emerging Infections Program (EIP) sites were funded to determine the feasibility of establishing a population-based surveillance system for monitoring the effect of human papillomavirus ...(HPV) vaccine on pre-invasive cervical lesions. The project involved active population-based surveillance of cervical intraepithelial neoplasia grades 2 and 3 and adenocarcinoma in situ as well as associated HPV types in women >18 years of age residing in defined catchment areas; collecting relevant clinical information and detailed HPV vaccination histories for women 18-39 years of age; and estimating the annual rate of cervical cancer screening among the catchment area population. The first few years of the project provided key information, including data on HPV type distribution, before expected effect of vaccine introduction. The project's success exemplifies the flexibility of EIP's network to expand core activities to include emerging surveillance needs beyond acute infectious diseases. Project results contribute key information regarding the impact of HPV vaccination in the United States.
COVID-19-associated hospitalization rates are highest among adults aged ≥65 years (1); however, COVID-19 can and does cause severe and fatal outcomes in children, including infants (2,3). After the ...emergence of the SARS-CoV-2 B.1.1.529 (Omicron) BA.1 variant in December 2021, hospitalizations among children aged <5 years, who were ineligible for vaccination, increased more rapidly than did those in other age groups (4). On June 18, 2022, CDC recommended COVID-19 vaccination for infants and children aged ≥6 months (5). Data from the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network (COVID-NET)* were analyzed to describe changes in the age distribution of COVID-19-associated hospitalizations since the Delta-predominant period (June 20-December 18, 2021)
with a focus on U.S. infants aged <6 months. During the Omicron BA.2/BA.5-predominant periods (December 19, 2021–August 31, 2022), weekly hospitalizations per 100,000 infants aged <6 months increased from a nadir of 2.2 (week ending April 9, 2022) to a peak of 26.0 (week ending July 23, 2022), and the average weekly hospitalization rate among these infants (13.7) was similar to that among adults aged 65-74 years (13.8). However, the prevalence of indicators of severe disease
among hospitalized infants did not increase since the B.1.617.2 (Delta)-predominant period. To help protect infants too young to be vaccinated, prevention should focus on nonpharmaceutical interventions and vaccination of pregnant women, which might provide protection through transplacental transfer of antibodies (6).
Abstract
Background/Aims
Coronavirus Disease 2019 (COVID-19) is a global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). International mass vaccination schemes ...are implemented to control the disease and reduce mortality. The data on serological immune response among rheumatology patients receiving immunosuppressive therapy following SARS-CoV-2 vaccines is very sparse. We present a case of a rheumatoid arthritis patient receiving rituximab (RTX) who developed fatal nosocomial COVID-19 infection despite receiving SARS-CoV-2 vaccine.
Methods
A 71-year-old Caucasian male with longstanding seropositive rheumatoid arthritis, interstitial lung disease with bullous emphysema, paraproteinemia, osteoporosis, anxiety, and depression. His treatment included hydroxychloroquine, sulfasalazine, oral prednisolone (2-5 mg), and RTX every 6 months. He received his last cycle of RTX almost 8 weeks before vaccination. This gentleman received two doses of COVID-19 mRNA Vaccine (BioNTech-Pfizer) eleven weeks apart. Nine weeks after the second vaccination he was admitted with supraventricular tachycardia and heart failure. This admission coincided with a COVID-19 outbreak in the ward. Eight patients and one staff member tested (PCR) positive during regular ward screening. All patients were initially asymptomatic, and six of them were fully vaccinated. He was allowed to go home with advice to self-isolate for 10 days. Two days after discharge, he presented to the emergency department with shortness of breath, lethargy, and cough. The diagnosis was COVID-19 pneumonitis and pre-renal acute kidney injury. He received supplemental oxygen, dexamethasone, and intravenous co-amoxiclav. Unfortunately, he died from COVID-19 pneumonitis on his sixth day of admission. Our patient was the only one among the nine SARS-CoV-2 positive individuals who developed symptomatic disease.
Results
It is known that RTX along with other immune modulatory drugs reduce the response to some vaccines such as the seasonal flu vaccine, and it is expected that the same effect could be seen after COVID-19 vaccination. Octave study is evaluating immune responses in patients with a range of chronic rheumatic conditions on specific immunomodulatory and biologic treatments. This has shown the response to vaccine was dependent on the disease cohort, with 90% of those with RTX-treated antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis and 54% of those with inflammatory arthritis responding less well than the baseline for healthy subjects. There is no evidence to suggest how long after RTX a patient should delay vaccination with a COVID-19 vaccine, but published consensus suggests 4-8 weeks.
Conclusion
More studies are needed to assess the response to SARS-COV-2 vaccines among immunocompromised patients and the need for a third vaccine dose if antibodies level were low. The first approved monoclonal antibody treatment—Ronapreve™ for treating and preventing acute covid-19 in adults, is a promising drug for poor vaccine responders who develop COVID-19 infection. This case also highlights the importance of infection control within hospital setting.
Disclosure
N. Abdullah: None. A. Kinder: None. D. Jenkins: None. V. Patel: None.
Abstract Background People with disabilities face a range of health disparities, including increased risk for preventable health problems. Thus, health promotion efforts addressing the reduction of ...risk factors are especially important for this population. Objective This study examined changes in health behaviors among adults with disabilities following participation in the Healthy Lifestyles for People with Disabilities health promotion program. It was hypothesized that intervention participants would demonstrate significant increases in healthy behaviors in areas such as health responsibility, physical activity, nutrition, stress management, interpersonal relationships, and spiritual growth while controls would not show significant change. Methods Participants (n = 95) were randomly assigned to the intervention or to a wait-list. After initially serving as controls, wait-list members later received the intervention as well. A measure of health behaviors was completed at baseline, 4 months, 7 months, and 10 months. Results Health behavior scores of immediate intervention participants increased significantly (p <.001) while the scores of wait-list members showed no significant change. After subsequently attending a Healthy Lifestyles workshop, scores of wait-list participants also increased significantly (p = .001). Conclusions The Healthy Lifestyles intervention appears to be successful in helping adults with disabilities increase healthy behaviors.
Understanding risk factors for hospitalization in vaccinated persons and the association of COVID-19 vaccines with hospitalization rates is critical for public health efforts to control COVID-19.
To ...determine characteristics of COVID-19-associated hospitalizations among vaccinated persons and comparative hospitalization rates in unvaccinated and vaccinated persons.
From January 1, 2021, to April 30, 2022, patients 18 years or older with laboratory-confirmed SARS-CoV-2 infection were identified from more than 250 hospitals in the population-based COVID-19-Associated Hospitalization Surveillance Network. State immunization information system data were linked to cases, and the vaccination coverage data of the defined catchment population were used to compare hospitalization rates in unvaccinated and vaccinated individuals. Vaccinated and unvaccinated patient characteristics were compared in a representative sample with detailed medical record review; unweighted case counts and weighted percentages were calculated.
Laboratory-confirmed COVID-19-associated hospitalization, defined as a positive SARS-CoV-2 test result within 14 days before or during hospitalization.
COVID-19-associated hospitalization rates among vaccinated vs unvaccinated persons and factors associated with COVID-19-associated hospitalization in vaccinated persons were assessed.
Using representative data from 192 509 hospitalizations (see Table 1 for demographic information), monthly COVID-19-associated hospitalization rates ranged from 3.5 times to 17.7 times higher in unvaccinated persons than vaccinated persons regardless of booster dose status. From January to April 2022, when the Omicron variant was predominant, hospitalization rates were 10.5 times higher in unvaccinated persons and 2.5 times higher in vaccinated persons with no booster dose, respectively, compared with those who had received a booster dose. Among sampled cases, vaccinated hospitalized patients with COVID-19 were older than those who were unvaccinated (median IQR age, 70 58-80 years vs 58 46-70 years, respectively; P < .001) and more likely to have 3 or more underlying medical conditions (1926 77.8% vs 4124 51.6%, respectively; P < .001).
In this cross-sectional study of US adults hospitalized with COVID-19, unvaccinated adults were more likely to be hospitalized compared with vaccinated adults; hospitalization rates were lowest in those who had received a booster dose. Hospitalized vaccinated persons were older and more likely to have 3 or more underlying medical conditions and be long-term care facility residents compared with hospitalized unvaccinated persons. The study results suggest that clinicians and public health practitioners should continue to promote vaccination with all recommended doses for eligible persons.
Importance Racial and ethnic minority groups are disproportionately affected by COVID-19. Objectives To evaluate whether rates of severe COVID-19, defined as hospitalization, intensive care unit ...(ICU) admission, or in-hospital death, are higher among racial and ethnic minority groups compared with non-Hispanic White persons. Design, Setting, and Participants This cross-sectional study included 99 counties within 14 US states participating in the COVID-19–Associated Hospitalization Surveillance Network. Participants were persons of all ages hospitalized with COVID-19 from March 1, 2020, to February 28, 2021. Exposures Laboratory-confirmed COVID-19–associated hospitalization, defined as a positive SARS-CoV-2 test within 14 days prior to or during hospitalization. Main Outcomes and Measures Cumulative age-adjusted rates (per 100 000 population) of hospitalization, ICU admission, and death by race and ethnicity. Rate ratios (RR) were calculated for each racial and ethnic group compared with White persons. Results Among 153 692 patients with COVID-19–associated hospitalizations, 143 342 (93.3%) with information on race and ethnicity were included in the analysis. Of these, 105 421 (73.5%) were 50 years or older, 72 159 (50.3%) were male, 28 762 (20.1%) were Hispanic or Latino, 2056 (1.4%) were non-Hispanic American Indian or Alaska Native, 7737 (5.4%) were non-Hispanic Asian or Pacific Islander, 40 806 (28.5%) were non-Hispanic Black, and 63 981 (44.6%) were White. Compared with White persons, American Indian or Alaska Native, Latino, Black, and Asian or Pacific Islander persons were more likely to have higher cumulative age-adjusted rates of hospitalization, ICU admission, and death as follows: American Indian or Alaska Native (hospitalization: RR, 3.70; 95% CI, 3.54-3.87; ICU admission: RR, 6.49; 95% CI, 6.01-7.01; death: RR, 7.19; 95% CI, 6.47-7.99); Latino (hospitalization: RR, 3.06; 95% CI, 3.01-3.10; ICU admission: RR, 4.20; 95% CI, 4.08-4.33; death: RR, 3.85; 95% CI, 3.68-4.01); Black (hospitalization: RR, 2.85; 95% CI, 2.81-2.89; ICU admission: RR, 3.17; 95% CI, 3.09-3.26; death: RR, 2.58; 95% CI, 2.48-2.69); and Asian or Pacific Islander (hospitalization: RR, 1.03; 95% CI, 1.01-1.06; ICU admission: RR, 1.91; 95% CI, 1.83-1.98; death: RR, 1.64; 95% CI, 1.55-1.74). Conclusions and Relevance In this cross-sectional analysis, American Indian or Alaska Native, Latino, Black, and Asian or Pacific Islander persons were more likely than White persons to have a COVID-19–associated hospitalization, ICU admission, or in-hospital death during the first year of the US COVID-19 pandemic. Equitable access to COVID-19 preventive measures, including vaccination, is needed to minimize the gap in racial and ethnic disparities of severe COVID-19.
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