Distance and grief: Optimising wellbeing for transnational migrants in Tasmania

End-of-life care, bereavement and grief involve significant challenges and impact our wellbeing in varied ways. For transnational migrants, geographical distance to a dying loved one, relatives, friends and meaningful locations can further complicate care, bereavement and grief. Our research aims to improve understandings of the role distance plays for transnational migrant wellbeing at these times. Using an instrumental, interpretative case study design we explored the experiences of five people with migration backgrounds with end-of-life care, bereavement and grief in Tasmania, Australia. Additional data sources included policies for end-of-life and bereavement care in Tasmania. In our study, participants tended to seek – and create – places and spaces of informal, rather than formal, support, both in their receiving society and country of origin. Online spaces played a key role: keeping people in touch with family members overseas, providing a means to care from a distance and ways to participate in grief rituals – albeit with mixed success. A lack of places to perform death and grief rituals, and inability to be physically present at a loved one's death (for some, due to COVID-19 travel restrictions) posed significant challenges to participants' wellbeing and impacted coping. We argue that if societies better understand the significances of places, spaces and distance during times of end-of-life, bereavement and grief, we can adjust policy and practice accordingly to collectively optimise wellbeing for transnational migrants. © 2023

The COVID-19 Pandemic and U.S. Aviation: System Adaptation and Performance Impact

The COVID-19 pandemic drastically impacted nearly all aspects of life throughout the world during 2020. It had a particularly severe impact on air transportation with U.S. demand initially dropping by over 90%. In this paper, we investigate the impact on the performance of the U.S. domestic air transportation system. We analyze both the changes in the volume and characteristics of flight operations and also changes in system performance metrics. We also discuss various adjustments made by the Federal Aviation Administration (FAA) both to take advantage of reduced system congestions and also to cope with COVID-19 infections among controllers. © ATM 2021. All rights reserved.

A faster diagnosis for mesothelioma and lung cancer with a one-stop shop clinic for suspected pleural malignancy

Introduction: We audited the effect of implementing a One-stop Shop (OSS) clinic for combined assessment/diagnostic pro ce dure for suspected pleural malignancy, mainly lung cancer and mesothelioma, on achieving the NHS 28-day Faster Diagnosis Standard in the context of the COVID pandemic. Method: We retrospectively collected data on all cases of suspected pleural malignancy undergoing an outpatient procedure after implementing the OSS over 16 weeks (10th March to 30th June 2021). We analysed a cohort seen in the OSS clinic (“OSS”) and a cohort seen via the original clinic pathway (“Non-OSS”). We also analysed an earlier control group during an 18-week period prior to the COVID pandemic from November 2019 to March 2020 (“Pre- OSS”). Results: 21 patients were seen in the OSS clinic compared to 20 non- OSS and 31 pre-OSS. Final diagnoses were 15% (n=11) lung cancer, 18% (n=13) mesothelioma, 22% (n=16) other malignancy and 44% (n=32) benign. The proportions of initial diagnostic procedure were 22% (n=16) diagnostic aspirate, 36% (n=26) therapeutic aspirate, 8% (n=6) chest drain, 1% (n=1) indwelling pleural catheter, 21% (n=15) medical thoracoscopy and 17% (n=12) ultrasound only. The mean time from referral to follow-up with diagnosis for OSS patients was 19 days which was less than both non-OSS patients (mean 30 days) and pre-OSS patients (mean 38 days). Conclusion: Patients seen in the One-Stop Shop clinic received a final diagnosis considerably quicker than those in the standard pathway. Interestingly, after implementing the OSS, patients seen via the standard pathway also received a final diagnosis faster after than before (pre-COVID). This suggests that even if there is not capacity to see all patients in the OSS, all may benefit, perhaps due an increase in efficiency across the service. Our model can be successfully applied to services in the post-COVID era to streamline the diagnostic pathway

Detroit City Mass Vaccination Site Template

Study Objective: In 2020, the city of Detroit was impacted by the COVID-19 pandemic, with over 162,000 reported diagnosed cases and 4,800 deaths. In response to anticipated availability of a vaccine, the Detroit Health Department developed plans for a drive-through mass vaccination site to help distribute the vaccine to the city’s population. We describe the Detroit City Mass Vaccination Site and its methods of recruitment, enrollment, site selection, and logistics. Discussion: Initial recruitment for vaccination was through traditional media means as well as the city of Detroit’s website. Interested individuals were instructed to call a dedicated scheduling line in addition to separate numbers for general inquiries and SMS based inquiries for vaccination sites. Individuals were provided appointments on the hour for both doses at the appropriate interval during the initial conversation. Methods: The TCF Conference Center was selected due to its central location, vicinity to the city’s vaccine storage site, capacity for large number of vehicles, protection from the elements, and availability. As vehicles arrived for appointments, they went through multiple checkpoints for confirmation of appointment and consent for treatment. Detroit police traffic control units aided with traffic-flow and vehicles were queued into two floors with a total of 27 lanes. On-site pharmacy was responsible for drawing, preparation, and delivery of vaccine doses to each lane. Once vehicles were confirmed for appointment and consent reviewed the vaccine was administered and vehicles remained in line for an observation period. Vaccine administration was documented on a CDC Vaccination Card and consent form was delivered to data entry workers from the Detroit Health Department for entry into the Michigan Care Improvement Registry (MCIR). On-site EMS supervisor, EMS teams, and an on-site physician and were available for medical response. After observation, vehicles were directed by security for egress. Results: To date, the TCF Center Mass Vaccination site accounts for over 220,000 doses administered with 62.0% of those doses given to individuals identifying as Black/African American, 31.9% identify as White and 6.0% identifying as another race. Conclusion: As vaccination studies showed promise for efficacy, the City of Detroit developed and implemented a mass vaccination site to help to mitigate the impact of COVID-19 on the city. Multiple public and private partners assisted in the effort. While only a piece of the necessary response, to date we have provided in excess of 250,000 doses of vaccine and this model has proven effective at providing mass vaccination while the population remains vaccine limited.

Locked Down with the Perpetrator: The Hidden Impacts of COVID-19 on Domestic and Family Violence in Australia

Prior to the COVID-19 global pandemic, domestic and family violence (DFV) had been recognised globally as an epidemic in its own right. Further, research has established that during times of crisis and/or after disasters, rates of DFV can escalate. The COVID-19 pandemic has been no exception, with emerging research from around the world confirming that the public health measures and social effects associated with COVID-19 have increased the frequency and severity of DFV in various countries. In contributing to this evolving body of literature, this paper reports on the findings of a national research project that examined the impact of the COVID-19 global pandemic on DFV in Australia. This nationwide survey of service providers indicates the public health responses to COVID-19 such as lockdowns and travel restrictions, while necessary to stem the pandemic, have had profound effects on increasing women's risk and vulnerability to domestic violence, while at the same time making it more difficult for women to leave violent relationships and access support. However, this vulnerability is not evenly distributed. The pandemic pushed marginalised voices further underground, with many unable to seek help, locked down with their abuser. Our survey sought to amplify the experiences of culturally and linguistically diverse (CALD) communities;Indigenous communities;lesbian, gay, bisexual, transgender, intersex, queer, + (LGBTIQ+) communities;women locked down with school-age children;those already in violent relationships;and those whose first experience of domestic violence coincided with the onset of the pandemic. For logistical and ethical reasons, we could only access their voices through the responses from the domestic violence sector.