In February, 2020, during the initial phase of the COVID-19 pandemic, the US Centers for Disease Control and Prevention (CDC) made recommendations to clean and disinfect frequently-handled objects, which triggered nationwide panic buying of disinfectant products such as Clorox and Lysol. Numerous regu latory agencies and public health organisations (eg, CDC, US Food and Drug Administration, US Consumer Product Safety Commission, and the American Association of Poison Control Centers [AAPCC]) have repeatedly advised against ingestion and other off-label use of disinfectants and cleaning products. However, during a White House press briefing on April 23, 2020, President Trump implied that the White House Coronavirus Task Force should investigate injections of disinfectant as a potential treatment for COVID-19. 1 Health communication research shows that ideological and political affiliations can widen the divide between acquired knowledge and an individual's beliefs regarding public health behaviours and outcomes. 2 Political leaders, especially the president of the USA, can command media attention and direct public health policy. 3 During public health emergencies, imprecise communication of emerging research by government leadership can cast doubt on reputable sources of scientific information. 2,3 Additionally, as the so-called Spiral of Silence theory purports, those in positions of authority can influence social dynamics and public opinion on controversial issues. 4 Government leaders who openly question scien tific consensus on an important issue can increase anxiety and perceptions of threat among the public, undermining the effect of accurate information and encouraging risky behaviours. 3 Rapidly evolving information related to the pandemic has led to confusion regarding appropriate public health measures and behaviours for stopping the spread of COVID-19. People tend to use motivated reasoning, such that new information consistent with their opinions is considered stronger than information inconsistent with previous beliefs (ie, confirmation bias) regardless of its objective accuracy, and individuals have little incentive to spend excessive time and effort in seeking and processing technical information. 3 During
Background: The adoption of a population-based human papilloma virus (HPV) vaccination programme is debated in Lebanon on epidemiological, sociocultural, logistical and economic grounds. Aims: This cost-benefit analysis contributes to generating quantitative evidence necessary for a decision regarding costs through locally available data. Methods: The 2 sides of the cost-benefit analysis equation are: estimation of the cost of HPV vaccination campaigns targeting 11 year-old girls, using the cheapest vaccine in 2016 and estimation of the management cost for treatment of a yearly average case-load for cervical cancer. Results: A Cervarix® only campaign would cost US$ 5 407 790 to vaccinate 38 083 11-year-old girls. The estimated cost of managing a mean annual mixed case-load of 100 incident cervical cancer cases would cost US$ 1 591 336. The nearest break-even point may occur 5 years after this current analysis. Conclusion: This cost-benefit analysis using limited available data indicates that massive HPV vaccination would not be cost-beneficial under the circumstances existing in 2016. Nevertheless, some indications point to the need for a re-assessment around 2020. This finding will inform public health decision-makers in Lebanon and similar neighbouring countries.
Introduction: Attention Deficit Hyperactivity Disorder (ADHD) has been mainly studied in children, even though it persists into adulthood; only recently has adult ADHD received the required attention. ADHD research in Arab speaking countries is relatively scarce.Objectives: This scoping review has as objectives to provide a comprehensive overview of adult ADHD research in the 22 Arab countries, to identify gaps in the literature and inform future research. Methods:The scoping review is underpinned by the five-stage framework of Arksey and O'Malley. Eight electronics databases were searched for published and unpublished literature as well as conference proceedings from conception date of databases until February 2018. Results:The literature search yielded 2,792 citations after removal of duplicates, out of which 11 articles and conference proceedings were included. Publications were concentrated in the 21 st century. ADHD diagnosis and sample differed between each study, where a variety of screening and diagnostic tools were used among clinical and community samples. National prevalence of adult ADHD only exists for Lebanon and Iraq as they are part of the World Mental Health (WMH) Surveys initiative. Also, adult ADHD is highly comorbid with bipolar andHayek et al.
BACKGROUND Throughout the COVID-19 pandemic, US Centers for Disease Control and Prevention policies on face mask use fluctuated. Understanding how public health communications evolve around key policy decisions may inform future decisions on preventative measures by aiding the design of communication strategies (eg, wording, timing, and channel) that ensure rapid dissemination and maximize both widespread adoption and sustained adherence. OBJECTIVE We aimed to assess how sentiment on masks evolved surrounding 2 changes to mask guidelines: (1) the recommendation for mask use on April 3, 2020, and (2) the relaxation of mask use on May 13, 2021. METHODS We applied an interrupted time series method to US Twitter data surrounding each guideline change. Outcomes were changes in the (1) proportion of positive, negative, and neutral tweets and (2) number of words within a tweet tagged with a given emotion (eg, trust). Results were compared to COVID-19 Twitter data without mask keywords for the same period. RESULTS There were fewer neutral mask-related tweets in 2020 (β=–3.94 percentage points, 95% CI –4.68 to –3.21; <i>P</i><.001) and 2021 (β=–8.74, 95% CI –9.31 to –8.17; <i>P</i><.001). Following the April 3 recommendation (β=.51, 95% CI .43-.59; <i>P</i><.001) and May 13 relaxation (β=3.43, 95% CI 1.61-5.26; <i>P</i><.001), the percent of negative mask-related tweets increased. The quantity of trust-related terms decreased following the policy change on April 3 (β=–.004, 95% CI –.004 to –.003; <i>P</i><.001) and May 13 (β=–.001, 95% CI –.002 to 0; <i>P</i>=.008). CONCLUSIONS The US Twitter population responded negatively and with less trust following guideline shifts related to masking, regardless of whether the guidelines recommended or relaxed mask usage. Federal agencies should ensure that changes in public health recommendations are communicated concisely and rapidly.
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