How Deteriorating Conditions in Myanmar Affect Migrant Domestic Workers in Singapore: A Transnational Analysis of Migrant Labour Regulation

The COVID-19 pandemic and 2021 military coup in Myanmar have greatly exacerbated the existing economic distress of ordinary people across the country. Yet, what has been the impact of the pandemic and the coup on Myanmar migrant workers abroad? To address this question, we investigate the situation of Myanmar migrant domestic workers (MDWs) in Singapore. We find that pandemic-related economic contraction in Myanmar and heightened insecurity following the country's 2021 military coup have increased outmigration and intensified pressures on Myanmar domestic workers in Singapore to increase remittances and set aside aspirations of shortly returning home. These origin-country conditions, mediated through a transnational system of labour brokerage, have increased Myanmar MDWs' vulnerability to exploitation and abuse relative to MDWs of other nationalities. This article thus contributes to analysis of the transnational constitution of migrant labour regimes. © The Author(s) 2023.

The Long-Term Impact of COVID-19 on Presentations to a Specialist Child and Adolescent Eating Disorder Program.

Aim Explore the impact of COVID-19 on numbers and clinical profile of Eating Disorder (ED) presentations to a specialist ED program pre- and during COVID-19. Methods Retrospective chart review of referrals pre- COVID-19 (January 2018 - February 2020) and during COVID-19 (March 2020 - August 2021) were compared. Results 128 youth were assessed with significantly higher rates of referrals each month during COVID-19 compared to pre- COVID-19 (3.78 vs. 2.31, p = 0.02). Youth referred during COVID-19 showed a higher rate of % Ideal Body Weight (IBW) loss (4.8% = vs. 2.6%, p = < 0.001) and had a shorter duration of illness pre-referral (4.8 months vs. 7.4 months, p = 0.001). Fewer youth during COVID- 19 (19% vs. 43%, p = 0.011) were prescribed psychotropic medication. Many youth (80%), self-declared COVID-19 as a contributory factor in the development of their ED. Conclusion This study supports the growing consensus of a COVID-19 specific impact on ED services with higher rates of referrals, youth presenting with a faster pace of weight loss and earlier referral to specialist services. Whether this represents a true increase in EDs or an overall increase in CAMHS referrals with a faster transfer to ED services requires further exploration.

Mending Dispute Resolution under the International Health Regulations

International dispute resolution not only aims to redress wrongdoings, but also to deter states from violating obligations. Approaching the International Health Regulations (IHR) from this viewpoint and using recent global health crises as examples, this paper argues that dispute resolution must be strengthened in the IHR in order to protect global health security. While a diverse range of dispute resolution mechanisms exist in other legal regimes, this paper proposes that a three-pronged architecture consisting of a guidance mechanism, formal adjudicative mechanism, and recourse to the ICJ and binding arbitration would provide for the most efficient and timely response to a dispute between states parties. Importantly, this architecture can be used both prior to and during a global health crisis, and could incentivize states parties towards solidarity in the global public health response.

EXAMINING THE REFERRAL CHARACTERISTICS OF PAEDIATRIC EATING DISODER REFERRALS TO A SPECIALIST EATING DISORDER SERVICE PRE AND DURING COVID

Clinicians have noticed a significant increase in cases of youth with an eating disorder (ED) presenting since the beginning of the COVID-19 lockdown, with younger cases attending and presenting with atypical features. The overall aim of the study is to explore the effect of COVID-19 on presentations to an eating disorder team in a child and adolescent mental health service (CAMHS) setting. A retrospective chart review was completed of all initial multidisciplinary assessment notes of patients with ED referred to a CAMHS specialist ED service between 1st January 2018 and May 31st 2021. Data was compared over the study time periods pre-COVID and during- COVID. When comparing the pre-COVID cohort to the during-COVID cohort, there was a greater proportion of autism spectrum disorder (ASD) and other ED diagnoses than anorexia nervosa (AN) in the during-COVID cohort. Mention was made of COVID having had a significant negative effect on the young person in 80% of cases presenting during COVID. The mean duration of weight loss was 7.4 months pre-COVID and 4.4 months during-COVID (P value: <.001). The effects of lockdown restrictions during the pandemic have triggered EDs in some young people. Youth with EDs referred to specialist ED services during the COVID-19 pandemic exhibit a shorter duration of weight loss and are more likely to receive an ED diagnosis other than AN. Further research is required to better understand the effects of the COVID-19 pandemic on ED illness on a sample representative of youth with ED.

Implementation of Remote Supportive Care Programs to Women At-Risk for and Surviving with Breast and Ovarian Cancer during the COVID-19 Pandemic

Background/Purpose: The COVID-19 global pandemic created significant challenges in providing screening, treatment, and support services to women at-risk for and living with breast and ovarian cancer. These individuals have unique socio-emotional needs (e.g., stress, fear of recurrence, caregiving, employment, financial hardship) that preceded the pandemic, and intensified during COVID-19. Sharsheret, a national non-profit organization helping Jewish women with breast and ovarian cancer, provides informative and supportive programming to address these needs. In response to the pandemic, the organization implemented a range of programs specifically designed for this population during a time of crisis. Methods: Outcome data from N = 345 respondents were collected in early 2021, including data from a special COVID-19 impact survey evaluating remote programs offered during the pandemic. Results: Among respondents, 19% were most concerned about financial hardship during the pandemic due to loss of/changes in employment, insurance, or other income: 16% also expressed concern about obtaining care and support. Respondents expressed high satisfaction with the programs and services offered, as 64% highly valued online educational webinars, and 51% valued experiential workshops and essential connections with Sharsheret's clinical staff. The implementation of such programs supported women in maintaining their physical health, mental health, and overall wellbeing in the midst of a global pandemic. Conclusions and Implications: Success of these remote care services offered during COVID-19 highlights the necessity of implementing opportunities for continued psychosocial programming. Insights gleaned from this evaluation serve to inform on how to best educate and counsel women at-risk for and surviving with breast and ovarian cancer during times of crisis.

COVID-19 in health care workers, Australia 2020

Background: Health care workers are at increased risk of SARS-CoV-2 infection due to potential exposure to patients or staff in health care settings. Australian health care services and health care workers experienced intense pressure to prepare for and respond to SARS-CoV-2 infections. We summarise national data on health care worker infections and associated outbreaks during 2020.

Systemic Transformation of Education through Evidence-based Reform (STEER): Results and Lessons Learned

We report here on the implementation over five years of a comprehensive project to improve STEM education at the University of South Florida, a large, public university. The STEER project, funded by NSF-IUSE, seeks to achieve this improvement by (1) advocating and incentivizing the adoption of Evidenced Based Teaching (EBT) methods in STEM courses and (2) facilitating change to a culture in which student-centered learning is valued within research-driven STEM departments. A number of synergistic thrusts have been implemented to support these efforts and include: (1) Facilitating and Incentivizing Adoption of EBT Methods: Faculty can apply for development grants to incorporate EBT methods into their course. They can apply for travel grants to learn more about adopting EBT within their discipline. A peer observation program places STEM faculty from different disciplines into small groups where each member observes a class taught by the others and also a class taught by a separate faculty member versed in one or more EBT approaches. Teaching assistants for STEM laboratory courses are provided training in EBT methods. A new program developed during COVID solicited STEM faculty to produce videos in which they illustrate one or more methods useful in online teaching. (2) Retreats: STEER facilitates departmental retreats in which faculty are guided to fine- tune their curricula and align departmental courses. These retreats include an introduction to EBT methods. STEER also hosts interdisciplinary retreats, in which STEM faculty from various disciplines are grouped and encouraged to explore ways in which their courses can build upon each other. (3) Support for Transfer Students: Faculty from our campus and from our main feeder institution meet to align common courses at the two institutions. Students who have previously transferred from the feeder institution are hired as “STEER Peers”. They advise students who are in the process of transferring, participate in transfer student orientation, and design and deliver workshops on study skills and professional/career development. (4) Creating Momentum for Change: A seminar series attended by faculty, administrators, graduate assistants and advisors brings in nationally known presenters who speak on a variety of topics such as EBT methods, institutional change, and student retention (both overall and for under-represented groups). STEER members facilitate STEM Teaching Workshops sponsored by the university provost. Each year, STEM Scholar Awards are made to several faculty who have successfully applied EBT to their courses. We described many of these thrusts at the 2019 ASEE conference. In this paper, we will focus more on describing the thrusts that have been implemented, or have evolved, since then. Also, as this grant is in its no-cost extension year, we will present results and lessons learned. Specifically, we will address the number of faculty, graduate assistants and undergraduate students directly impacted by each thrust and will quantify, to the extent possible, the effect of that impact. Institutional data related to retention and graduation rates for STEM disciplines over the course of the project will also be presented. Finally, we will discuss lessons learned, with an eye towards helping institutions who are in the early stages of a program like. © American Society for Engineering Education, 2021

The impact of COVID-19 on research within the homeless services sector

Purpose: This paper aims to discuss the challenges of conducting research with homelessness services frontline workers during the COVID-19 pandemic. Design/methodology/approach: Between 2015 and 2019, the research team surveyed frontline staff in three cities about their psychosocial stressors and needs. In 2020, the authors replicated the previous study and expanded data collection to seven cities across Canada to determine the extent to which the COVID-19 pandemic impacted the well-being of frontline staff. This report describes how the authors adapted the research methodologies to continue work throughout the pandemic, despite various restrictions. Findings: The original studies had very high participation rates because of several methodological approaches that minimized barriers, especially in-person data collection. During the pandemic, distancing requirements precluded replication of these same methods. Research strategies that enabled staff participation during working hours, with designated time allotted for participation, was key for ensuring high participation rates, as access to technology, availability of free time and other factors frequently make online survey research a hardship for these staff. Restrictive interpretation and regional variations of COVID-19 guidelines by some research ethics boards were also a challenge to rapid and responsive data collection. Originality/value: Few studies describe the experiences of frontline workers in the homelessness sector, and quantitative reports of their experiences are particularly scant. Consequently, little is known about specific methodologies that facilitate large-scale data collection in the homelessness services sector. The present research advances the field by providing lessons learned about best practice approaches in pre and post COVID-19 front line worker contexts. A strength of this research is the well-controlled design. The authors collected data within several of the organizations that had previously participated. This fortunate baseline provided opportunity for comparison before and during the pandemic;the authors can highlight factors that might have had influence during the pandemic. © 2021, Jeannette Waegemakers Schiff, Eric Paul Weissman, Deborah Scharf, Rebecca Schiff, Stephanie Campbell, Jordan Knapp and Alana Jones.

Low SARS-CoV-2 seroprevalence and no active infections among dogs and cats in animal shelters with laboratory-confirmed COVID-19 human cases among employees

Human-to-animal and animal-to-animal transmission of SARS-CoV-2 has been documented;however, investigations into SARS-CoV-2 transmission in congregate animal settings are lacking. We investigated four animal shelters in the United States that had identified animals with exposure to shelter employees with laboratory-confirmed COVID-19. Of the 96 cats and dogs with specimens collected, only one dog had detectable SARS-CoV-2 neutralizing antibodies;no animal specimens had detectable viral RNA. These data indicate a low probability of human-to-animal transmission events in cats and dogs in shelter settings with early implementation of infection prevention interventions.

Factors that might affect SARS-CoV-2 transmission among foreign-born and U.S.-born poultry facility workers - Maryland, May 2020

The disproportionate number of foreign-born workers employed in meat and poultry processing reflects structural, social, and economic inequities that likely contribute to an increased COVID-19 incidence in this population. In May 2020, the Maryland Department of Health and CDC investigated factors that might affect person-to-person SARS-CoV-2 transmission among persons who worked at two poultry processing facilities. A survey administered to 359 workers identified differences in risk factors for SARS-CoV-2 infection between workers born outside the United States and U.S.-born workers. Compared with U.S.-born workers, foreign-born workers had higher odds of working in fixed locations on the production floor (odds ratio [OR] for cutup and packaging jobs = 4.8), of having shared commutes (OR = 1.9), and of living with other poultry workers (OR = 6.0). They had lower odds of participating in social gatherings (OR for visits to family = 0.2;OR for visits to friends = 0.4), and they visited fewer businesses in the week before the survey than did their U.S.-born coworkers. Some workplace risk factors can be mitigated through engineering and administrative controls focused on the production floor, and this will be of particular benefit to the foreign-born workers concentrated in these areas. Employers and health departments can also partner with local organizations to disseminate culturally and linguistically tailored messages about risk reduction behaviors in community settings, including shared transportation section and household members dwelling in close quarters.

Feasibility of Prospective Dietetic Assessment and Intervention of Patients Receiving Chemo-Radiotherapy for Lung Cancer

Introduction: Chemo-radiotherapy for lung cancer can be a morbid treatment, often in an older and co-morbid population. Our patients are not routinely seen by a dietitian. Methods: As a pilot project, all patients receiving either sequential or concurrent chemo-radiotherapy for lung cancer between May and November 2020, were identified by the lead lung radiographer and bookings team and referred to a specialist oncology dietitian. These patients were offered up to 3 routine fortnightly assessments on treatment. We recorded their symptoms (based on a standardised tool, PG-SGA) and weight during treatment. Results: 15 patients were referred to the dietitian: 7 male, 8 female. All patients accepted dietetic review. The median age was 64 years old;mean age 63 years old (range 50-79). The mean average number of cycles of chemotherapy was 3.4. Concurrent chemo-radiotherapy was given to 11 patients, with the remaining 4 having sequential treatment. Of all patients, 1 had small cell lung cancer, 1 had a mixed adenocarcinoma and small cell. The remaining 13 were non-small cell lung cancers, and of these 6 were adenocarcinomas and 6 were squamous cell carcinomas and 1 mixed histology. All patients were reviewed at least twice whilst on treatment. The most complete data was for the review in weeks 3/4 of radiotherapy. All 15 patients had scores for this time point. Mean number of symptoms was 5.5 (range 3-9). The commonest symptoms were fatigue (100%), loss of appetite (67%), pain (67%) and dysphagia (60%). For 12 patients receiving 6 weeks of radiotherapy median symptom number increased from 5 in 1st 2 weeks, to 5.5 in weeks 2nd 2 weeks, to 6.5 in final 2 weeks. All patients in this group lost weight. Median weight loss during treatment was 6.6% (range 1.8-15.9%). All patients received food fortification advice throughout their treatment and advice on symptom management. The symptom management advice for 12 of the 15 patients either reinforced advice, or, made adjustments to the timing of medications prescribed by medical or nursing staff. The other 3 patients did not have an existing prescription, and so recommendations were made of medications to manage symptoms, e.g. oxcetacaine, anti-emetics and laxatives. Oral nutritional supplements (ONS) were recommended if patients were not meeting their estimated nutritional requirements from dietary assessment. Seven patients received ONS prescription in addition to the food fortification advice. One patient declined an ONS prescription. Conclusion: 1. Routine dietetic review during radical chemo-radiotherapy is feasible and occurred successfully during the COVID-19 pandemic. It led to some simple, but vital changes in practice such as weekly weighing of patients on treatment 2. Patients undergoing chemo-radiotherapy have a high symptom burden. 3. All patients receiving 6 weeks of radiotherapy lost weight during treatment. 4. We received positive feedback from patients. Keywords: Dietitian, Dietician, radiotherapy

Improving frontline healthcare workers wellbeing during the COVID-19 pandemic through creative writing;a pilot study and a unique collaboration between the open university and an acute hospital trust

Aim: The COVID-19 pandemic has resulted in healthcare workers (HCW) with a wide breadth of previous experience caring for a vast number of dying patients;including many with distressing symptoms. Recent rapid review of the evidence has highlighted that HCWs responding to the pandemic are under significant physical and psychological stressors which may lead to ongoing mental health problems;with research yet to illicit the most effective way to provide support. Creative writing for wellbeing has previously been used to support war veterans and so a pilot study was developed to investigate if this method could potentially improve wellbeing for HCWs. Methods: All clinical staff at an acute hospital were invited to participate via e-mail. Written informed consent was sought from all participants and background data gathered including their role and specialty. All participants were provided with a Creative Writing for wellbeing workbook and invited to attend three virtual workshops, over 3 months. Participants were encouraged to continue therapeutic creative writing between sessions. After each workshop, participants were asked to anonymously complete a survey, ranking on a Likert scale multiple aspects relating to their perceived usefulness of the sessions in improving wellbeing. Results: 14 frontline hospital HCWs participated, from a range of specialties;included 7 nurses, 4 doctors and 2 other HCWs. Feedback was overwhelmingly positive with 100% of survey respondents agreeing that they had found it to be a positive experience and that they felt enabled to use the techniques learned for the future. Conclusion: This pilot shows creative writing workshops to be a feasible and welcome intervention, in providing support to healthcare workers facing the COVID-19 pandemic. Although numbers are small, a positive impact was felt by those who participated. The next step is a multi-site study to gather evidence of effectiveness of this intervention on a larger scale.

Causal Inference Using Global Forecasting Models for Counterfactual Prediction

This research proposes a global forecasting and inference method based on recurrent neural networks (RNN) to predict policy interventions’ causal effects on an outcome over time through the counterfactual approach. The traditional univariate methods that operate within the well-established synthetic control method have strong linearity assumptions in the covariates. This has recently been addressed by successfully using univariate RNNs for this task. We use an RNN trained not univariately per series but globally across all time series, which allows us to model treated and control time series simultaneously over the pre-treatment period. Therewith, we do not need to make equivalence assumptions between distributions of the control and treated outcomes in the pre-treatment period. This allows us to achieve better accuracy and precisely isolate the effect of an intervention. We compare our novel approach with local univariate approaches on two real-world datasets on 1) how policy changes in Alcohol outlet licensing affect emergency service calls, and 2) how COVID19 lockdown measures affect emergency services use. Our results show that our novel method can outperform the accuracy of state-of-the-art predictions, thereby estimating the size of a causal effect more accurately. The experimental results are statistically significant, indicating our framework generates better counterfactual predictions. © 2021, Springer Nature Switzerland AG.

Telehealth practice among health centers during the COVID-19 pandemic - United States, July 11-17, 2020

Telehealth is a promising approach to promoting access to care and can facilitate public health mitigation strategies and help prevent transmission of SARS-CoV-2 and other respiratory illnesses, while supporting continuity of care. Although CMS's change of its telehealth provisions enabled health centers to expand telehealth by aligning guidance and leveraging federal resources, sustaining expanded use of telehealth services might require additional policies and resources. During 11-17 July, 2020, 963 (95.4%) of 1,009 Health Resources and Services Administration-funded health centers that responded to a voluntary weekly survey reported providing telehealth services. Health centers in urban areas were more likely to provide >30% of visits virtually than were those in rural areas. Compared with health centers that reported full staffing capacity, the prevalence of reporting >30% telehealth visits was 22% higher among those reporting 5% staff absence and was 63% higher among health centers reporting 10% staff absence. No association was detected between the percentage of telehealth visits and PPE shortages for the week following the survey (the week ending July 24), nor was an association found between the percentage of telehealth visits and the change in the number of weekly visits from 2019.

Coronavirus in Scotland: The effect of COVID-19 lockdown on admissions with chronic liver disease

Background: COVID-19 lockdown began in Scotland on 23rd March 2020. This was followed by a significant reduction in unselected medical admissions to Scottish hospitals with increased illness severity and in-patient mortality This study aimed to investigate the specific effect of lockdown on admissions with liver disease in Scotland Methods: Patients admitted to 7 major Scottish hospitals with chronic liver disease in April 2020 were identified and compared with admissions in April 2017, 2018 and 2019 (n=459) Data was collected on patient demographics and disease characteristics Socioeconomic deprivation was derived from the Scottish Index of Multiple Deprivation (SIMD) in quintiles for analysis (1=most deprived;5=least deprived) Statistical analysis was done using SPSS version 22 Results: The median age of the whole cohort was 58 years (IQR: 49-66) They were predominantly male (n=267;58 2%) 204 (44 4%) were from the most deprived quintile of the population The median MELD was 16 (IQR: 12-21) 354 (77 1%) had alcoholic liver disease (ALD) as either the primary or a contributory factor to their disease Median length of stay was 7 days (IQR: 4-14) 46 patients died in hospital giving an inpatient mortality of 9 8% Table 1 outlines the comparisons between patients admitted in April 2020 (n=111) and the previous 3 years (n=348) No difference was seen in age (59 years vs 58;p=0 88) or gender (59 men (53 2%) vs 208 men (59 8%);p=0 22) Severity of liver disease on admission was similar (MELD 15 vs 16;p=0 68) Although serum sodium was reduced in the pre-COVID era group (135 (130-138), n=348) compared with the COVID-lockdown cohort (137 (132-140), n=111) (p=0.01) no significant differences were seen in other blood parameters Length of stay (7 days vs 8 days;p=0 093), inpatient mortality (8 3% vs 10 4%;p=0 51) and socioeconomic deprivation by SIMD (p=0 41) were not significantly different between the two cohorts. There was not a significant difference between the number of patients admitted in each year (poisson regression analysis p=0 37) Conclusion: The lockdown introduced to control the COVID pandemic in Scotland did not have a significant impact on the number, severity of liver disease at presentation or outcomes in patients admitted with chronic liver disease, in contrast with unselected medical admissions in the immediate post lockdown period(Table Presented).