Search

Social distancing measures are typically recommended to contain the spread of infectious diseases. To improve the public's voluntary compliance, governments and health authorities seek to publicize timely information about the pandemic. Yet social planners may exaggerate or downplay their private information about the disease's severity to elicit their preferred level of social distancing. This is because the relative weight they assign to the costs of isolation over public health may be unbalanced, and people may not fully consider how their social distancing may influence others' infection risk. Consequently, messages and claims about the pandemic may be distrusted. The author investigates whether and when communication can be fully or partially credible despite apparent incentives for misrepresentation. The author finds that a government would communicate truthfully in equilibrium if and only if the disease severity levels are not too close to each other in the public's prior belief. Nevertheless, an increasing difference between the severity levels need not enhance the credibility of communication. Greater communication credibility may hurt social welfare. Moreover, as the government becomes more concerned about the costs of social distancing, its equilibrium messages may become more or less trustworthy. The article's results can benefit social planners and users of their messages (e.g., analysts, researchers, investors). [ABSTRACT FROM AUTHOR]

This study, which is based on actual events, presents a dynamic analysis of the development, implementation, and post-implementation review of establishing an enterprise risk management (ERM) system for a U.S. multinational nonprofit firm over a 5-year period, 2015–2020. Using the Risk and Insurance Management Society Risk Maturity Model (RIMS RMM), questionnaire-based risk data and multi-dimensional risk mapping indices are used to identify and prioritize the firm's key strategic risks leading to the development of mitigation strategies whose performance are reviewed post ERM implementation, including during the 2020 Coronavirus pandemic. The results reveal that the firm's risk management system has been ad hoc and uncoordinated. Post-implementation review of the ERM program shows improvements in financial and operating positions resulting from risk diversification, enhanced profitability, exploitation of natural hedges, and improved board governance. The results further show that the recommended mitigation strategies have been effective in managing the adverse impact of the pandemic. Overall, the evidence offered in this study provides further support on the valuation benefits of ERM maturity within a real-world environment. [ABSTRACT FROM AUTHOR]

Introduction: The United States lacks a national interfacility patient transfer coordination system. During the coronavirus 2019 (COVID-19) pandemic, many hospitals were overwhelmed and faced difficulties transferring sick patients, leading some states and cities to form transfer centers intended to assist sending facilities. In this study we aimed to explore clinician experiences with newly implemented transfer coordination centers.Methods: This mixed-methods study used a brief national survey along with in-depth interviews. The American College of Emergency Physicians Emergency Medicine Practice Research Network (EMPRN) administered the national survey in March 2021. From September–December 2021, semi-structured qualitative interviews were conducted with administrators and rural emergency clinicians in Arizona and New Mexico, two states that started transfer centers during COVID-19.Results: Among 141 respondents (of 765, 18.4% response rate) to the national EMPRN survey, only 30% reported implementation or expansion of a transfer coordination center during COVID-19. Those with new transfer centers reported no change in difficulty of patient transfers during COVID-19 while those without had increased difficulty. The 17 qualitative interviews expanded upon this, revealing four major themes: 1) limited resources for facilitating transfers even before COVID-19; 2) increased number of and distance to transfer partners during the COVID-19 pandemic; 3) generally positive impacts of transfer centers on workflow, and 4) the potential for continued use of centers to facilitate transfers.Conclusion: Transfer centers may have offset pandemic-related transfer challenges brought on by the COVID-19 pandemic. Clinicians who frequently need to transfer patients may particularly benefit from ongoing access to such transfer coordination services.

Science is humanity's best insurance against threats from nature, but it is a fragile enterprise that must be nourished and protected. The preponderance of scientific evidence indicates a natural origin for SARS-CoV-2. Yet, the theory that SARS-CoV-2 was engineered in and escaped from a lab dominates media attention, even in the absence of strong evidence. We discuss how the resulting anti-science movement puts the research community, scientific research, and pandemic preparedness at risk.

BACKGROUND:  Telemedicine expanded rapidly during the COVID-19 pandemic, as key policy changes, financial support, and pandemic fears tipped the balance toward internet-based care. Despite this increased support and benefits to patients and clinicians, telemedicine uptake was variable across clinicians and practices. Little is known regarding physician and institutional characteristics underlying this variability. OBJECTIVE:  This study aimed to evaluate factors influencing telemedicine uptake among frontline physicians in the early pandemic response. METHODS:  We surveyed a national stratified sample of frontline clinicians drawn from the American Medical Association Physician Professional Data in June or July 2020. The survey inquired about the first month and most recent month (June 2020) of pandemic telemedicine use; sample data included clinician gender, specialty, census region, and years in practice. Local pandemic conditions were estimated from county-level data on COVID-19 rates at the time of survey response. Data were analyzed in a weighted logistic regression, controlling for county-specific pandemic data, and weighted to account for survey data stratification and nonresponse. RESULTS:  Over the first 3-4 months of the pandemic, the proportion of physicians reporting use of telemedicine in >30% of visits increased from 29.2% (70/239) to 35.7% (85/238). Relative to primary care, odds of substantial telemedicine use (>30%) both during the first month of the pandemic and in June 2020 were increased among infectious disease and critical care physicians and decreased among hospitalists and emergency medicine physicians. At least minimal prepandemic telemedicine use (odds ratio [OR] 11.41, 95% CI 1.34-97.04) and a high 2-week moving average of local COVID-19 cases (OR 10.16, 95% CI 2.07-49.97) were also associated with substantial telemedicine use in June 2020. There were no significant differences according to clinician gender, census region, or years in practice. CONCLUSIONS:  Prepandemic telemedicine use, high local COVID-19 case counts, and clinician specialty were associated with higher levels of substantial telemedicine use during the early pandemic response. These results suggest that telemedicine uptake in the face of the pandemic may have been heavily influenced by the level of perceived threat and the resources available for implementation. Such understanding has important implications for reducing burnout and preparation for future public health emergencies.

Purpose: A decline in youth running was observed at the start of the COVID-19 pandemic. We investigated whether the resumption of organized running after social distancing restrictions changed running habits or injury frequency in adolescent runners. Methods: Adolescents (age = 16.1 [2.1] y) who participated in long-distance running activities completed an online survey in the Spring and Fall of 2020. Participants self-reported average weekly running habits and whether they sustained an injury during the Fall 2020 season. Poisson regression models and 1-way analysis of variance compared running habits while Fisher exact test compared differences in frequencies of injuries during Fall 2020 among season statuses (full, delayed, and canceled). Results: All runners, regardless of season status, increased weekly distance during Fall 2020. Only runners with a full Fall 2020 season ran more times per week and more high-intensity runs per week compared with their Spring 2020 running habits. There were no differences in running volume or running-related injury frequency among Fall 2020 season statuses. Conclusions: There were no significant differences in running-related injury (RRI) frequency among runners, regardless of season status, following the resumption of cross-country. Health care providers may need to prepare for runners to increase running volume and intensity following the resumption of organized team activities. [ABSTRACT FROM AUTHOR]

Introduction: Standard of care for patients with acute ischemic stroke from large vessel occlusion (AISLVO) includes prompt evaluation for urgent mechanical thrombectomy (MT) at a comprehensive stroke center (CSC). During the start of the coronavirus 2019 pandemic (COVID-19), there were reports about disruption to emergency department (ED) operations and delays in management of patients with AIS-LVO. In this study we investigate the outcome and operations for patients who were transferred from different EDs to an academic CSC’s critical care resuscitation unit (CCRU), which specializes in expeditious transfer of time-sensitive disease.Methods: This was a pre-post retrospective study using prospectively collected clinical data from our CSC’s stroke registry. Adult patientswho were transferred fromany ED to the CCRUand underwent MT were eligible. We compared time intervals in the pre-pandemic (PP) period between January 2018– February 2020, such as ED in-out and CCRU arrival-angiography, to those during the pandemic (DP) between March 2020–May 31, 2021. We used classification and regression tree (CART) analysis to identify which time intervals, besides clinical factors, were associated with good neurological outcome (90-day modified Rankin scale 0–2).Results: We analyzed 203 patients: 135 (66.5%) in the PP group and 68 (33.5%) in the DP group. Time from ED triage to computed tomography (difference 7 minutes, 95% confidence interval [CI] −12 to −1, P < 0.01) for the DP group was statistically longer, but ED in-out was similar for both groups. Time from CCRU arrival to angiography (difference 9 minutes, 95% CI 4–13, P < 0.01) for the DP group was shorter. Forty-nine percent of the DP group achieved mRS ≤ 2 vs 32% for the PP group (difference −17%, 95% CI −0.32 to −0.03, P < 0.01). The CART identified initial National Institutes of Health Stroke Scale, age, ED in-and-out time, and CCRU arrival-to-angiography time as important predictors of good outcome.Conclusion: Overall, the care process in EDs and at this single CSC for patients requiring MT were not heavily affected by the pandemic, as certain time metrics during the pandemic were statistically shorter than pre-pandemic intervals. Time intervals such as ED in-and-out and CCRU arrival-to-angiography were important factors in achieving good neurologic outcomes. Further study is necessary to confirm our observation and improve operational efficiency in the future.

INTRODUCTION: COVID-19 infection was accompanied by otologic symptoms, a pattern that was captured early by Google Trends. The objective of this study is to investigate searches for otologic symptoms and identify correlations with the pandemic onset. MATERIALS AND METHODS: Search interest for otologic symptoms was gathered using Google Trends from two years before and two years following the pandemic start date. A two-tailed Mann-Whitney U test was used to identify significant changes and effect size. RESULTS: In total, search interest for 14 terms was collected, with significant changes identified in 11. Six terms showed increased search interest, with the most significant rises observed for headache (r=0.589, p

The global COVID-19 pandemic made vulnerable work environments, and campus recreation departments could not avoid its influence. Previous studies focused on strategies and policies for reopening campus recreation facilities and the impacts of recreation programs on students and participants during the pandemic. Relatively little research has explored employees' perceptions about campus recreation departments' challenges and solutions, and employees' work experience during the pandemic has not been fully explored. This study explored employees' work experience related to burnout during the pandemic through semi-structured interviews with campus recreation employees (N = 10). The findings revealed stressors, including extra workload, and lack of interaction, and burnout symptoms, including exhaustion, and cynicism. The findings also revealed that employees utilized individual strategies to manage stressors, and the department made efforts to reduce employees' stress. The findings of this study will provide campus recreation practitioners with a better understanding of employees' experience related to burnout. [ABSTRACT FROM AUTHOR]

This article provides a polyvocal narrative of the development, initial assessment, and ongoing revision of an Informed Self-Placement (ISP) process initially implemented during the COVID pandemic. The authors intersperse collectively narrated description how the ISP unfolded in its first two years with individual reflections on those experiences from a variety of positions and identities. Data so far suggest that this ISP process has narrowed but not fully closed racial equity gaps in first-year writing placement while maintaining enrollments and academic performance in the first-year writing course sequence. Persistent equity issues reside not only in the ISP instrument itself but the systems by which students learn about the ISP and the opportunities they have to complete it.

In times of crises, public health leaders may claim that trials of public health interventions are unethical. One reason for this claim can be that equipoise-i.e. a situation of uncertainty and/or disagreement among experts about the evidence regarding an intervention-has been disturbed by a change of collective expert views. Some might claim that equipoise is disturbed if the majority of experts believe that emergency public health interventions are likely to be more beneficial than harmful. However, such beliefs are not always justified: where high quality research has not been conducted, there is often considerable residual uncertainty about whether interventions offer net benefits. In this essay we argue that high-quality research, namely by means of well-designed randomized trials, is ethically obligatory before, during, and after implementing policies in public health emergencies (PHEs). We contend that this standard applies to both pharmaceutical and non-pharmaceutical interventions, and we elaborate an account of equipoise that captures key features of debates in the recent pandemic. We build our case by analyzing research strategies employed during the COVID-19 pandemic regarding drugs, vaccines, and non-pharmaceutical interventions; and by providing responses to possible objections. Finally, we propose a public health policy reform: whenever a policy implemented during a PHE is not grounded in high-quality evidence that expected benefits outweigh harms, there should be a planned approach to generate high-quality evidence, with review of emerging data at preset time points. These preset timepoints guarantee that policymakers pause to review emerging evidence and consider ceasing ineffective or even harmful policies, thereby improving transparency and accountability, as well as permitting the redirection of resources to more effective or beneficial interventions.

BackgroundSocial distancing from the COVID-19 pandemic may have decreased engagement in cardiac rehabilitation (CR) and may have had possible consequences on post-CR exercise maintenance. The increased use of technology as an adaptation may benefit post-CR participants via wearables and social media. Thus, we sought to explore the possible relationships of both the pandemic and technology on post-CR exercise maintenance.ObjectiveThis study aimed to (1) understand CR participation during the COVID-19 pandemic, (2) identify perceived barriers and facilitators to physical activity after CR completion, and (3) assess willingness to use technology and social media to support physical activity needs among older adults with cardiovascular disease.MethodsWe recruited participants aged 55 years and older in 3 different CR programs offered at both public and private hospitals in Northern California. We conducted individual interviews on CR experiences, physical activity, and potential for using technology. We used thematic analysis to synthesize the data.ResultsIn total, 22 participants (n=9, 41% female participants; mean age 73, SD 8 years) completed in-depth interviews. Themes from participants' feedback included the following: (1) anxiety and frustration about the wait for CR caused by COVID-19 conditions, (2) positive and safe participant experience once in CR during the pandemic, (3) greater attention needed to patients after completion of CR, (4) notable demand for technology during the pandemic and after completion of CR, and (5) social media networking during the CR program considered valuable if training is provided.ConclusionsIndividuals who completed CR identified shared concerns about continuing physical activity despite having positive experiences during the CR program. There were significant challenges during the pandemic and heightened concerns for safety and health. The idea of providing support by leveraging digital technology (wearable devices and social media for social support) resonated as a potential solution to help bridge the gap from CR to more independent physical activity. More attention is needed to help individuals experience a tailored and safe transition to home to maintain physical activity among those who complete CR.

ContextTo facilitate the manufacturing of COVID-19 medical products, in October 2020 India and South Africa proposed a waiver of certain intellectual property (IP) provisions of a World Trade Organization (WTO) agreement. After nearly two years, a narrow waiver agreement that did little for vaccine access passed the ministerial despite the pandemic's impact on global trade, which the WTO is mandated to safeguard.MethodsThe authors conducted a content analysis of WTO legal texts, key-actor statements, media reporting, and the WTO's procedural framework to explore legal, institutional, and ideational explanations for the delay.FindingsIP waivers are neither legally complex nor unprecedented within WTO law, yet these waiver negotiations exceeded their mandated 90-day negotiation period by approximately 18 months. Waiver opponents and supporters engaged in escalating strategic framing that justified and eventually secured political attention at head-of-state level, sidelining other pandemic solutions. The frames deployed discouraged consensus on a meaningful waiver, which ultimately favored the status quo that opponents preferred. WTO institutional design encouraged drawn-out negotiation while limiting legitimate players in the debate to trade ministers, empowering narrow interest group politics.ConclusionsDespite global political attention, the WTO process contributed little to emergency vaccine production, suggesting a pressing need for reforms aimed at more efficient and equitable multilateral processes.

To support the ongoing management of viral respiratory diseases while transitioning out of the acute phase of the COVID-19 pandemic, many countries are moving toward an integrated model of surveillance for SARS-CoV-2, influenza virus, and other respiratory pathogens. Although many surveillance approaches catalyzed by the COVID-19 pandemic provide novel epidemiologic insight, continuing them as implemented during the pandemic is unlikely to be feasible for nonemergency surveillance, and many have already been scaled back. Furthermore, given anticipated cocirculation of SARS-CoV-2 and influenza virus, surveillance activities in place before the pandemic require review and adjustment to ensure their ongoing value for public health. In this report, we highlight key challenges for the development of integrated models of surveillance. We discuss the relative strengths and limitations of different surveillance practices and studies as well as their contribution to epidemiologic assessment, forecasting, and public health decision-making.

BACKGROUND: There are knowledge gaps about factors associated with acute kidney injury (AKI) among COVID-19 patients. To examine AKI predictors among COVID-19 patients, a retrospective longitudinal cohort study was conducted between January 2020 and December 2022. Logistic regression models were used to examine predictors of AKI, and survival analysis was performed to examine mortality in COVID-19 patients. RESULTS: A total of 742,799 veterans diagnosed with COVID-19 were included and 95,573 were hospitalized within 60 days following COVID-19 diagnosis. A total of 45,754 developed AKI and 28,573 AKI patients were hospitalized. Use of vasopressors (OR = 14.73; 95% CL 13.96-15.53), history of AKI (OR = 2.22; CL 2.15-2.29), male gender (OR = 1.90; CL 1.75-2.05), Black race (OR = 1.62; CL 1.57-1.65), and age 65+ (OR = 1.57; CL 1.50-1.63) were associated with AKI. Patients who were vaccinated twice and boosted were least likely to develop AKI (OR = 0.51; CL 0.49-0.53) compared to unvaccinated COVID-19 patients. Patients receiving two doses (OR = 0.77; CL = 0.72-0.81), or a single dose (OR = 0.88; CL = 0.81-0.95) were also less likely to develop AKI compared to the unvaccinated. AKI patients exhibited four times higher mortality compared to those without AKI (HR = 4.35; CL 4.23-4.50). Vaccinated and boosted patients had the lowest mortality risk compared to the unvaccinated (HR = 0.30; CL 0.28-0.31). CONCLUSION: Use of vasopressors, being unvaccinated, older age, male gender, and Black race were associated with post COVID-19 AKI. Whether COVID-19 vaccination, including boosters, decreases the risk of developing AKI warrants additional studies.

ImportanceIn Myanmar, amid political and civil unrest, droves of Burmese are displaced to neighboring countries including Thailand. Since the COVID-19 pandemic, little is known about the available healthcare services and health and well-being among refugees and migrant workers within resettlement areas along the Myanmar-Thailand border.ObjectiveTo explore the unmet needs of migrants along the Thailand-Myanmar border during the COVID-19 pandemic and their reasons for leaving Myanmar.DesignA qualitative study that used focus groups with migrant schoolteachers and school masters was undertaken. An interpretative analysis approach was used to analyze the data from the focus group sessions. The study followed the COREQ (COnsolidated criteria for REporting Qualitative) checklist.SettingIn July 2022, community stakeholders from migrant schools located in the vicinity of Mae Sot, Thailand were referred to the study team.ParticipantsA purposive sample of 17 adult participants was recruited from 4 migrant schools. The participants were schoolteachers and schoolmasters who had traveled from Myanmar to Thailand 1 to 20 years ago.Main outcomes and measuresThematic analysis was used to scrutinize qualitative data for the outcomes of health and well-being, barriers, and reasons for migration.ResultsThree main themes were identified: "issues related to the pandemic", "teenage marriage and pregnancies" and "migration decisions". The issues related to the pandemic included behavior changes in children, a diminished quality of education, and barriers to receiving COVID-19 vaccines and accessing other health care. There were more dropouts due to teenage pregnancy/marriage during the shelter in place mandate. Migration decisions were affected by concerns over health, civil unrest, and military harassment.Conclusions and relevanceThis study presented the difficulties experienced by Myanmar migrants currently living along the Thailand-Myanmar border. The reasons for leaving Myanmar included health and safety. Suspending education during the pandemic caused more school dropouts due to teenage pregnancy/marriage. Additionally, behavioral changes in children, a diminished quality of education, barriers to receiving COVID-19 vaccines and access to other health care services were reported. Future studies should focus on how migration stress and access to mental health care impact the migrant population.

BackgroundCannabis use before the COVID-19 pandemic for many involved sharing prepared cannabis for inhalation, practices that were less prevalent during the pandemic. State-level COVID-19 containment policies may have influenced this decrease. This study examined the extent to which the intensity of state-level COVID-19 policies were associated with individual-level cannabis sharing. Findings have the potential to guide harm reduction policies for future respiratory pandemics and seasonal respiratory virus waves.MethodsThis study used cross-sectional individual-level data from the COVID-19 Cannabis Study, an anonymous U.S.-based web survey on cannabis use disseminated during the early phase of the pandemic (Full sample N = 1,883). We combined individual-level data with state-level policy data from Kaiser Family Foundation's State COVID-19 Data and Policy Actions for three time-points from June to August 2020 that overlapped with the survey period. Cannabis sharing was dichotomized as any versus no sharing. We adapted a previously published coding framework to score the intensity of COVID-19 policies implemented in each U.S. state and averaged the policy score across the time period. We then used Poisson regression models to quantify the associations of the average state-level COVID-19 policy score with cannabis sharing during the pandemic.ResultsParticipants (n = 925) reporting using inhalation as a mode for cannabis use were included in this analysis. Most respondents were male (64.1%), non-Hispanic White (54.3%), with a mean age of 33.7 years (SD 8.8). A large proportion (74.9%) reported sharing cannabis during the pandemic. Those who shared cannabis more commonly lived in states with a lower average policy score (16.7, IQR 12.3-21.5) compared to those who did not share (18.6, IQR 15.3-25.3). In adjusted models, the prevalence ratio of any cannabis sharing per every 5-unit increase in the average COVID-19 policy score was 0.97 (95% CI 0.93, 1.01).ConclusionsFewer individuals shared cannabis in states with more intense COVID-19 containment policies compared to those in states with less intense policies. Individuals who use cannabis may be willing to make changes to their behavior and may further benefit from specific and directed public health messaging to avoid sharing during respiratory infection outbreaks.

Libraries play an essential role in fostering sustainable development by providing equal access to information. Since the beginning of the 1990s, libraries have engaged in various activities designed to reduce their environmental impact; these libraries are referred to as "green libraries. During the Covid Pandemic, authors are discussing establishing a green library in the Rajagiri Business School (RBS). This is a novel concept in a business school setting, because not much has been published in this area yet and will contribute to our commitment to achieving the United Nations Sustainable Development Goal initiative. In this paper, an attempt has been made to discuss the proposal and model for designing a green library with respect to the UN’s Sustainable Development Goal. RBS should pioneer in implementing green initiatives in business school libraries and serve as a model for other libraries in India and abroad. Researchers believe that this model will be an insightful document for decision-makers in setting a greener and more aesthetic library for the academic community.

The COVID-19 pandemic has had serious implications on the health and well-being of student-athletes. The present study explored the athletic experiences of NCAA Division II college athletes during the competitive hiatus caused by the pandemic, as well as in their return to sport participation. Twenty male and female student-athletes from a variety of sports (freshman = 2, sophomores = 4, seniors = 9, and graduate = 5) participated in semistructured interviews to explore how the pandemic affected their athletic identity, anxiety, and mental health. Through the use of thematic content analysis, the following major themes were identified: (a) influence of COVID on athletic identity, (b) increased anxiety during COVID, (c) social aspects of sport participation, and (d) factors that influence mental health. Findings indicated a combination of positive and negative effects on the athletic identity, anxiety, and mental health and well-being of student-athletes. [ABSTRACT FROM AUTHOR]

Business ethics researchers and practitioners are interested in understanding the temporal mechanisms of various managerial activities, processes, and policies. In this direction, I borrow notions of time from Virginia Woolf's Mrs. Dalloway to examine how social time intersperses with the paid and (unpaid) care work of female employees during the pandemic. I explore how discussions of social time in connection to care work appear in newspaper discourses of "shecession", i.e. the large-scale job/income losses experienced by women during the COVID-19 pandemic. Since shecession is a byproduct of the pandemic times, exploring the role of time in it is crucial. In fact, my findings show that the macro social time of the pandemic affects working women with care responsibilities who are situated at the intersection of multiple vulnerable social categories by simultaneously being a penalizer and a lost opportunity. Similarly, I also find that the micro social times of working women embed, stratify, and synchronize differently during the pandemic when compared to normal times. Working women with care responsibilities are thus adversely affected by both micro and macro social time changes. My findings, therefore, could be instrumental in developing and implementing inclusive policies and processes in business organizations and labor markets. In so doing, my study also indicates how a consideration of social time enriches the application of care ethics in work contexts. Ultimately, this article is also about developing caring organizations, societies, and families which care for the caregivers (working women), since receiving care is a precondition of giving care. [ABSTRACT FROM AUTHOR]

Related Articles Welfare programs in emerging economies are, in most cases, highly selective. This article illustrates this point by exploring Cambodia's emergency cash assistance scheme coverage for workers affected by the COVID‐19 pandemic. Drawing on policy analysis and interviews with government officials, industry representatives, and garment and tourism unions, it analyzes the level of benefit and efficacy of the initiative for different groups of workers. Based on this analysis, we find that garment factory and tourism workers received better support than workers in other sectors as a consequence of industry lobbying and strategic decision‐making on the part of the government designed to mitigate the impact of the pandemic on those sectors. Our analysis also reveals, however, that the relatively informal nature of even formal‐sector workplaces in Cambodia meant that the scheme's impact was highly varied even among these targeted groups of workers. We conclude with a discussion of the findings' broader implications.Asongu, Simplice, and Nicholas M. Odhiambo. 2023. “The Effect of Inequality on Poverty and Severity of Poverty in Sub‐Saharan Africa: The Role of Financial Development Institutions.” Politics & Policy 51(5): 898–918. https://doi.org/10.1111/polp.12558.Lachapelle, Erick, Thomas Bergeron, Richard Nadeau, Jean‐François Daoust, Ruth Dassonneville, and Éric Bélanger. 2021. “Citizens' Willingness to Support New Taxes for COVID‐19 Measures and the Role of Trust.” Politics & Policy 49(3): 534–65. https://doi.org/10.1111/polp.12404.Onyango, Gedion, and Japheth Otieno Ondiek. 2022. “Open Innovation during the COVID‐19 Pandemic Policy Responses in South Africa and Kenya.” Politics & Policy 50(5): 1008–31. https://doi.org/10.1111/polp.12490. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic and response severely impacted people living with non-communicable diseases (PLWNCDs) globally. It exacerbated pre-existing health inequalities, severely disrupted access to care, and worsened clinical outcomes for PLWNCDs, who were at higher risk of morbidity and mortality from the virus. The pandemic's effects were likely magnified in humanitarian settings, where there were pre-existing gaps in continuity of care for non-communicable diseases (NCDs). We sought to explore factors affecting implementation of NCD care in crisis settings during the COVID-19 pandemic and the adaptations made to support implementation. Methods: Guided by the Consolidated Framework for Implementation Research, we undertook an online survey of 98 humanitarian actors from multiple regions and organization types (March-July 2021), followed by in-depth interviews with 13 purposively selected survey respondents (October-December 2021). Survey data were analysed using descriptive statistics, while interview data were analysed thematically, using both deductive and inductive approaches. Results: Initially, humanitarian actors faced challenges influenced by external actors' priorities, such as de-prioritisation of NCD care by governments, travel restrictions and supply chain interruptions. With each infection wave and lockdown, humanitarian actors were better able to adapt and maintain NCD services. The availability of COVID-19 vaccines was a positive turning point, especially for the risk management of people with NCDs and protection of health workers. Key findings include that, despite pre-existing challenges, humanitarian actors largely continued NCD services during the crisis. Enabling factors that supported continuity of NCD services included the ability to quickly pivot to remote means of communication with PLWNCDs, flexibility in medicine dispensing, and successful advocacy to prioritize NCD management within health systems. Key lessons learned included the importance of partnerships and cooperation with other health actors, and the mobilisation or repurposing of community health workers/volunteer networks. Conclusions: The COVID-19 experience should prompt national and global health stakeholders to strengthen inclusion of NCDs in emergency preparedness, response, and resilience planning. Key lessons were learned around remote care provision, including adapting to NCD severity, integrating community health workers, providing context-adapted patient information, combating misinformation, and strengthening cross-sectoral partnerships. [ABSTRACT FROM AUTHOR]

Background: Despite the worldwide increasing incidence of Group A Streptococcus (GAS) infections reported since December 2022, data on noninvasive GAS (nGAS) infections in the post COVID-19 era are limited. By a self-reported survey performed in an outpatient setting, we investigated the number and clinical features of GAS infections, the diagnostic work-up and the type of treatment utilized. In addition, the rate of influenza vaccination was evaluated. Methods: In June 2023 family pediatricians involved in the study sent the survey to parents of patients aged 0–16 years. The survey included questions on GAS infections that occurred from January 1 to May 31, 2023. Results: Among 3580 children, 20.3% had a GAS infection (0,8% < 1 year, 16,4% 1–3 years, 42,3% 3–6 years, 26,5% 6–9 years, 11,4%, 9–12 years, and 2,6% 12–16 years). Symptoms reported were sore throat (76.9%), fever (75.2%), tonsillar exudate (25.2%), lymphadenopathy (21.8%), and scarlet fever (14.7%). A single patient was hospitalized due to GAS meningitis. Twenty four percent of children had more than one GAS infection. In this group, frequencies of symptoms reported in the first and in the following infection were similar, except for fever and scarlet fever which were less frequent during relapses. GAS was identified by rapid antigen detection test in 81.0% of children. Eighty-nine per cent of children were treated with antibiotics, mostly amoxicillin/clavulanate (40.4%) and amoxicillin (39.4%). Thirty four percent of children received influenza vaccine. No difference was observed among immunized and not immunized regarding the number and characteristics of GAS infection. Conclusions: We reported a certain prevalence of nGAS infections in children, mainly those aged 3–6 years age, who were mostly characterized by a low score of symptoms, and in most of the cases diagnosed and treated using a microbiological test as confirmatory tool. In this new clinical setting, a national study would be useful to reach more significant data for the definition of a correct diagnosis and clinical management of nGAS infections in children. Moreover, it is important to improve flu vaccination campaign and coverage to protect children from coinfections that could worsen the disease and misdiagnose the etiology of pharyngitis. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONThis study aims to explore the priorities, preferences, and feedback of multiple healthcare professionals to inform the future development of virtual clinics for community-dwelling adults with spinal cord injury (SCI) in Ontario, Canada.Interpretive description methodology was used to guide our exploration. Semi-structured interviews were conducted with 15 expert healthcare professionals (HCPs) involved in the care of patients with SCI. Interviews were recorded and transcribed verbatim. Interview transcripts were then analyzed using a six-phase thematic analysis approach.HCPs perceived virtual care to improve access to care over the long term, particularly to those living in rural areas, as well as increase connections between different providers. However, participants highlighted that in-person care is still required for management of severe SCI-related sequelae that can be life-threatening, such as pressure ulcers, spasticity, respiratory issues, and bowel and bladder complications.Our findings can be used to inform policymakers, HCPs, and stakeholders involved with SCI rehabilitation when establishing a virtual clinic for patients with SCI. Results of this study found that policymakers and HCPs should consider hybridized (blend of virtual and in-person) healthcare and uptake of multidisciplinary approaches within the virtual healthcare systems.Healthcare professionals (HCPs) perceived virtual care to be accessible, convenient, and a practical approach to enhance access to care over the long term, particularly for those persons with spinal cord injury (SCI) living in remote areas.Persons with SCI could benefit from hybridized healthcare models (blend of in-person and virtual care) as it offers efficient care pathways, leads to a continuum of care, and creates more accessible healthcare for those with limited SCI healthcare options.HCPs and policymakers should consider the uptake of multidisciplinary approaches within virtual healthcare systems to optimize care delivery by digitally connecting providers from multiple disciplines and team members involved in caring for persons with SCI.Healthcare professionals (HCPs) perceived virtual care to be accessible, convenient, and a practical approach to enhance access to care over the long term, particularly for those persons with spinal cord injury (SCI) living in remote areas.Persons with SCI could benefit from hybridized healthcare models (blend of in-person and virtual care) as it offers efficient care pathways, leads to a continuum of care, and creates more accessible healthcare for those with limited SCI healthcare options.HCPs and policymakers should consider the uptake of multidisciplinary approaches within virtual healthcare systems to optimize care delivery by digitally connecting providers from multiple disciplines and team members involved in caring for persons with SCI. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has contributed to significant societal challenges, including increased substance misuse. The COVID stress syndrome is a constellation of interrelated processes that occur in response to pandemics, including danger/contamination fears, fears concerning economic consequences, xenophobia, compulsive checking/reassurance-seeking, and pandemic-related traumatic stress symptoms. In the present study, using a sample of 812 adults collected during the early stages of the COVID-19 pandemic in May 2020, we examined the relations between identified profiles of the COVID Stress Scales (CSS) and behavioral and cognitive aspects of substance misuse. Using profile analysis via multidimensional scaling (PAMS), we identified two core profiles of the CSS, which explained 60 % of the variance in participant responding: 1) High compulsive checking & Low xenophobia and 2) High xenophobia & Low danger/contamination. The first profile is consistent with the COVID stress syndrome, while the second profile aligns with the COVID disregard syndrome, which is a constellation of interrelated processes distinguished by a denial or downplaying of the seriousness of the COVID-19 pandemic and lack of perceived vulnerability to disease. Both profiles demonstrated significant positive correlations with drug and alcohol misuse, respectively. However, only the High xenophobia & Low danger/contamination profile demonstrated relations with cognitive aspects of substance misuse via positive and negative correlations with positive and negative expectancies of alcohol use, respectively. These findings provide further support for the relationship between the COVID stress syndrome and substance misuse and offer insight into how unique profiles of this syndrome may impact pandemic-related mental and public health interventions. • COVID stress syndrome is a set of processes occurring in response to pandemics. • The COVID stress scales (CSS) was developed to measure the COVID stress syndrome. • Two distinct profiles were identified characterizing participant responding on CSS. • Both profiles were related to substance abuse-related outcomes. • Relationship between COVID stress syndrome and substance use warrants more research. [ABSTRACT FROM AUTHOR]

Objective Respiratory syncytial virus (RSV) is the most common viral respiratory infection in infants. This study aimed to establish the potential changes in the clinical course of RSV in the neonatal period with the onset of the coronavirus disease 2019(COVID-19) pandemic. Study Design During the observational study period, newborns diagnosed with community-acquired RSV infection and admitted to the neonatal intensive care unit (NICU) were evaluated. RSV-infected neonates before the COVID-19 pandemic were classified as Group 1 , those during the strict isolation period as Group 2 , and RSV-infected newborns after the removal of restrictions were classified as Group 3. Results A total of 208 community-acquired RSV-infected neonates were analyzed. The median age at admission to the NICU was 26 days, and the mean gestational week was 37.2 ± 2.7. The ratio of hospitalized babies with RSV infection to all hospitalized newborns rose after the pandemic significantly (1.9, 1.6, and 5.2%; p < 0.001). Following the pandemic, there was an increase in full-term, early-term, and late-preterm cases. Nevertheless, no change was observed in the number of preterm cases (p > 0.05). There was also a statistically significant increase in the need for intubation, noninvasive ventilation (NIV), supplemental oxygen, inhaled bronchodilator drugs, and length of hospital stay in Group 3 after the pandemic (p < 0.001). All these parameters related to more severe RSV infection when the precautions were removed, while there was a milder disease with restrictions during the pandemic in Group 2 (p < 0.001). However, none died due to RSV infection during the study because of timely supportive care. Conclusion Following the COVID-19 pandemic, the frequency and severity of RSV infection in newborns have increased, and it can result in a serious clinical picture even in full-term babies with no comorbidities. Attention to strict contact precautions, particularly in newborns, who are a more vulnerable population after the pandemic, may play an important role in any future outbreak. Key Points The course of neonatal RSV infection has changed after the pandemic. A statistically significant increase was observed in the need of intubation in newborns with RSV. The strict precautions during the pandemic also helped to prevent the transmission of RSV. [ABSTRACT FROM AUTHOR]

Purpose: A significant percentage of women experience psychopathological symptoms during the postpartum period, which can impact not only their mental health and well-being but also the relationship between mother and baby. However, studies investigating how specific psychological factors, such as self-compassion and self-criticism, contribute to the development and maintenance of these symptoms are scarce. Methods: This cross-sectional study aimed to examine the relationship among compassionate self-responding (CSR), uncompassionate self-responding (USR), maternal mental health indicators, mother-infant bonding, and the perceived impact of the COVID-19 pandemic. Data were collected online from 189 Brazilian women with infants aged 0 to 12 months. Participants completed measures of sociodemographic characteristics, Self-Compassion Scale (SCS), Edinburgh Postnatal Depression Scale (EPDS), Postpartum Specific Anxiety Scale (PSAS-BR-RSF-C), Postpartum Bonding Questionnaire (PBQ), and COVID-19–Impact on Quality of Life (COV19-QoL). Results: Through network analysis, our findings highlighted that postpartum depression played a central role in the structuring of variables in this system. Furthermore, USR, instead of CSR, emerged as the variable most strongly associated with levels of postpartum depression, which, in turn, was associated with mother-infant bonding. Conclusion: Mitigating levels of self-criticism in mothers may represent a pathway to prevent the development of postpartum depression, which, in turn, could impact the quality of the mother-infant relationship. Given the significance of the child's early years for their emotional development, intervening early in maternal mental health may be a means to prevent mental disorders in the child as well. [ABSTRACT FROM AUTHOR]

Background: SARS-CoV-2 (COVID-19) has disrupted lives worldwide, affecting individuals from all walks of life. Individuals who have a spinal cord injury (SCI) are also affected by this phenomenon. This survey compares the quality of life (QOL), depression, and anxiety of SCI patients before and during COVID-19 in Wuhan City, China. Methods: A cross-sectional survey utilized an online questionnaire to assess the QOL, levels of anxiety, and depression among 189 SCI patients admitted to Wuhan Tongji Hospital during pandemic from November 2020 to April 2021. Data before COVID-19 outbreak from November to December 2019 was retrieved from hospital records with the same assessment previously performed in-person or during a follow up visit. However, some participants were excluded for various reasons, such as declining to participate, not being admitted to a rehabilitation program due to the pandemic, or being under 18 years old. The World Health Organization's (WHO) QOL-Brief Version (BREF) and disability (DIS) modules, which focus on disability-related QOL, were used to assess the participants' QOL. Results: SCI patients had lower QOL scores during the pandemic compared to pre-pandemic times. Mean scores on the 12-item DIS module significantly differed before and during the COVID-19 period. Participants showed higher adherence to self-isolation and quarantine measures for high-risk encounters (64.94%), but lower compliance with home disinfection and proper rest practices (23.38%). Conclusions: The COVID-19 pandemic has had a detrimental effect on the QOL of SCI patients in China, highlighting the urgent requirement for telehealth-based rehabilitation to mitigate its impact. It is crucial to provide essential. [ABSTRACT FROM AUTHOR]

Related Articles This article aims to explain why participation in presidential elections increased among people who feared the risk of worsening COVID‐19 in Africa. The analysis is based on a sample of 16,890 people living in 34 African countries. Econometric results suggest that fear of the pandemic's escalation can reduce citizens' willingness to participate in presidential elections. However, this negative effect changes based on perceptions of government management of the pandemic. We show that the likelihood of voting in a presidential election increases significantly among those afraid of the pandemic's worsening with (i) a lack of confidence in government statistics on COVID‐19; (ii) perceived corruption related to the COVID‐19 pandemic; (iii) a lack of confidence in the government's ability to ensure the safety of COVID‐19 vaccines; (iv) perceived insufficient public investment in combating health emergencies; and (v) perceived insufficient intervention by law enforcement in enforcing COVID‐19 control measures.Onyango, Gedion, and Japheth Otieno Ondiek. 2022. “Open Innovation during the COVID‐19 Pandemic Policy Responses in South Africa and Kenya.” Politics & Policy 50(5): 1008–31. https://doi.org/10.1111/polp.12490.Stockemer, Daniel. 2016. “Is the Turnout Function in Democracies and Nondemocracies Alike or Different?” Politics & Policy 44(5): 889–915. https://doi.org/10.1111/polp.12174.Stockemer, Daniel, and Stephanie Parent. 2014. “The Inequality Turnout Nexus—New Evidence from Presidential Elections.” Politics & Policy 42(2): 221–45. https://doi.org/10.1111/polp.12067. [ABSTRACT FROM AUTHOR]

Background: Mpox, is a zoonosis that is known to be endemic in several Central and West African countries. Recently, in 2022, it has emerged in Europe and United States, what raised the alarm to be declared in late June 2024 as a public health event of international concern. This study aimed to give insight about the recent spread of mpox in Sudan, and documents the epidemiologic situation. Methods: Through a cross-sectional design, Sudan mpox data was extracted from the disease surveillance line-list at the national level at Sudan Federal Ministry of Health. the data was customized and then analyzed using Epi Info7 software. Analysis was done using frequencies and percentages and the results presented in tables and figures. Permission and ethical approval were obtained from the Health Emergency and Epidemic Control Directorate at the Federal Ministry of Health. Results: The outbreak of mpox was confirmed after testing of initial specimens outside Sudan with positivity rate of 72%. Later the cases continued to be reported based on the clinical diagnosis and standard case definition. Out of 375 reported cases, 54.4% were males, while 45.6% were females. The age of cases ranged from one month to 78 years with majority (41.1%) of the cases were children under 5 years of age. Regarding the reported symptoms, all cases had the characteristic skin rash and 74.1% of them had fever. Other symptoms included, headache (31.5%), sore throat (30.9%) and lymphadenopathy (26.1%). For occupation, 35.7% were preschool and 10.4% were school children, 9% of cases were prisoners. Around 22 (5.8%) reported contact history with a confirmed case, while (5.6%) of the cases were imported cases. Cases were reported from 17 states with 42 affected localities (districts) with an overall attack rate of 2.36/ 100,000. The highest number of cases was reported from Gadaref (45.3%), West Darfur (25.9%), Khartoum (13.3%) and north Darfur (3.5%). In Gadaref, 146 (85.8%) of the cases were from a refugees' camp. Started in epi week 19, the outbreak peaked in week 38 and last in week 42. Conclusion: Mpox was confirmed in the new Sudan for the first time with cases reported in most of states. Although importation of the virus is hypothesized, internal hidden circulation is possible and more in-depth investigation is highly recommended. The higher rate of infection among preschool, school children and refugees, highlights the need to strengthen the prevention and control measures in schools and camps. More focus on the data completeness is required for better understanding of the disease and can be ensured by the surveillance directorate through training of staff and updating of reporting forms. Strengthening the lab capacity inside the country is a necessity to ensure testing of all the clinically diagnosed cases. [ABSTRACT FROM AUTHOR]

Objective Setting Participants Design Results Conclusion To explore the impact of COVID‐19 pandemic disruptions on general practice trainees interdependent learning, from the perspectives of trainees and the whole of the practice team.Four rural general practices in Queensland that continued to supervise registrars, junior doctors and medical students through the pandemic.Twenty‐three members of the general practice teams, including general practitioners, practice managers, receptionists, practice nurses, registrars, junior doctors and medical students.Audio‐recorded semi‐structured interviews were conducted with all participants following an initial survey. Thematic analysis and the theory of interdependent learning were used to understand how supervision and training was both disrupted and sustained during the pandemic period. Reporting is informed by the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.Learning affordances were transformed by the rapid implementation of physical distancing and other infection control measures. Telehealth consultations and remote working impacted on the interdependent relationship between the work environment, supervision team and trainees.Practice staff identified new ways of working that arose through this period, including changes to practice team roles and the supervisory dynamic that enabled patient care and trainee learning to continue. Social connectedness was important to the trainees and the implications for future training need to be further evaluated. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has spurred the growth of a global infodemic. In order to combat the COVID-19 infodemic, it is necessary to understand what kinds of misinformation are spreading. Furthermore, various local factors influence how the infodemic manifests in different countries. Therefore, understanding how and why infodemics differ between countries is a matter of interest for public health. This study aims to elucidate and compare the types of COVID-19 misinformation produced from the infodemic in the US and Japan. Methods: COVID-19 fact-checking articles were obtained from the two largest publishers of fact-checking articles in each language. 1,743 US articles and 148 Japanese articles in their respective languages were gathered, with articles published between 23 January 2020 and 4 November 2022. Articles were analyzed using the free text mining software KH Coder. Exploration of frequently-occurring words and groups of related words was carried out. Based on agglomeration plots and prior research, eight categories of misinformation were created. Lastly, coding rules were created for these eight categories, and a chi-squared test was performed to compare the two datasets. Results: Overall, the most frequent words in both languages were related to health-related terms, but the Japan dataset had more words referring to foreign countries. Among the eight categories, differences with chi-squared p ≤ 0.01 were found after Holm-Bonferroni p value adjustment for the proportions of misinformation regarding statistics (US 40.0% vs. JP 25.7%, ϕ 0.0792); origin of the virus and resultant discrimination (US 7.0% vs. JP 20.3%, ϕ 0.1311); and COVID-19 disease severity, treatment, or testing (US 32.6% vs. JP 45.9%, ϕ 0.0756). Conclusions: Local contextual factors were found that likely influenced the infodemic in both countries; representations of these factors include societal polarization in the US and the HPV vaccine scare in Japan. It is possible that Japan's relative resistance to misinformation affects the kinds of misinformation consumed, directing attention away from conspiracy theories and towards health-related issues. However, more studies need to be done to verify whether misinformation resistance affects misinformation consumption patterns this way. [ABSTRACT FROM AUTHOR]

Background: While COVID-19 has been controlled and deaths have decreased, the long-term consequences of COVID-19 remain a challenge we face today. This study was conducted to determine the relationship between the apoptosis of lymphocyte cells with DNA damage and oxidative stress and the therapeutic and clinical outcomes of elderly patients with COVID-19. Methods: This study was conducted from April 2020 to May 2021 (the period of severe attacks of the epidemic peak of COVID-19) and September 2022 (the post-COVID-19 period). The study groups included elderly patients with COVID-19 hospitalized in the ICU and normal wards of the hospital as well as elderly patients with influenza. A polymerase chain reaction was used to check the validity of the studied diseases. The Annexin V/Propidium Iodide method was used to evaluate the level of apoptosis. Genotoxic effects and DNA damage were assessed by the comet assay method. Total antioxidant status (TAS), total oxidant status (TOS), and myeloperoxidase activity (MPO) were measured by photometric methods. Results: The highest level of apoptosis in peripheral blood lymphocytes and the highest level of DNA damage were observed at both times in the intubated-ICU and non-intubated-ICU groups. In all groups, there was a significant increase in peripheral blood lymphocyte apoptosis levels and DNA damage levels compared to the healthy control group (p < 0.01). The level of apoptosis and DNA damage decreased significantly in the post-COVID-19 period (p < 0.01). In the investigation of oxidative stress biomarkers, the oxidative stress index, including TOS and MPO levels, increased in patients (p < 0.01), and the TAS level decreased (p < 0.01). Conclusion: It shows that the apoptosis of lymphocyte cells, DNA damage, and oxidative stress can be effective in prognostic decisions and is a suitable predictor for diagnosing the condition of patients with viral infections such as COVID-19 and influenza. [ABSTRACT FROM AUTHOR]