Covid-19 and the 2020 presidential election

Whether deserved on not, US Presidents often receive the blame or the credit for the nature of the economy and direction of the country. Therefore, the status of the economy and the country in an election year can be a very important factor in election success for an incumbent President (or his party if an incumbent is not running). This is especially true in ‘battleground states' due to the presence of the Electoral College system where Presidential candidates need only win different combinations of states in order to become President. However, the 2020 Presidential election was vastly different from past election cycles in that an additional variable, COVID-19, was added to the decision calculus of voters. Eventually, the 2020 election came down to the extremely slim margins in three states (Arizona, Georgia, and Wisconsin) and thin margins in two others (Pennsylvania and Michigan). This paper shows that deaths from COVID-19 at the county level played a small role in demotivating voters to turnout in 2020 to cast their vote for Joe Biden as President. In other words, without Covid-19, President Trump's losses within these five states would have been even larger.

The psychological well-being of people in a COVID-19 supervised quarantine facility: A mixed methods study.

WHAT IS KNOWN ON THE SUBJECT?: Supervised Quarantine has been shown to impact the psychological well-being of those in quarantine both during the COVID-19 pandemic and in previous pandemics. There are few studies regarding the psychological impact of supervised quarantine for the purpose of COVID-19 mitigation. There is little research regarding the psychological well-being of professionals maintaining quarantine, despite the fact they risk potential psychological distress. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper addresses the paucity of knowledge regarding the psychological well-being of those undergoing quarantine in a purpose-built facility. The quarantined study population involved uniquely domestic arrivals and also professionals maintaining quarantine. Lack of control, isolation and miscommunication were perceived as challenging mental well-being. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Although psychological distress in Domestic arrivals appeared low, there are still identifiable stresses on mental well-being. Mental health workers need to be cognizant that point entry to COVID-19 quarantine (Domestic vs. International as well as specific regions) may influence risk of psychological distress. Mental Health nurses supporting those in quarantine should afford quarantined individuals a degree of choice, establish regular clear communication and consider how to establish peer support mechanisms within the quarantine environment. ABSTRACT: INTRODUCTION: Supervised quarantine may compromise psychological well-being. There is equivocal evidence regarding psychological distress in compulsory supervised quarantine facilities. AIMS: To evaluate the mental well-being of people undergoing and working in a supervised COVID-19 quarantine facility. METHOD: Mixed methodology was used, including a cross-sectional analysis of psychological distress (DASS-21) and individual semi-structured interviews (10 professionals maintaining quarantine and 10 quarantined persons). RESULTS: Overall levels of psychological distress were low. Those quarantining from Victoria had significantly lower depression scores compared to all other departure points. Qualitative analysis identified distress being linked to a lack of control, isolation and miscommunication. DISCUSSION: Quarantine was associated with low levels of psychological distress. This was lower in people travelling from Victoria, a state where there were higher rates of infections and restrictions. Interviews showed that psychological distress was conceptualized as being associated with supervised quarantine, but participants recognized the overall importance of quarantine. IMPLICATIONS FOR PRACTICE: Mental health professionals supporting quarantined people should consider original departure points may predict levels of psychological distress. Implementing ways of gaining control through affording choice, improving communication channels and establishing peer support networks within quarantine settings may help maintain mental well-being.

Understanding the Psychological Well-Being of International Arrivals in a Purpose-Designed Australian COVID-19 Quarantine Facility.

Equivocal evidence suggests that mandatory supervised quarantine can negatively affect psychological well-being in some settings. It was unclear if COVID-19 supervised quarantine was associated with psychological distress in Australia. The sociodemographic characteristics associated with distress and the lived experiences of quarantine are also poorly understood. Therefore, this study aimed to evaluate the mental well-being of international arrivals undergoing supervised COVID quarantine in a purpose designed facility in the Northern Territory, Australia. We conducted a concurrent triangulation mixed-methods study comprising of an observational cross-sectional survey (n = 117) and individual qualitative interviews (n = 26). The results revealed that several factors were associated with distress, including significantly higher levels of depression for those who smoked, drank alcohol, had pre-existing mental health conditions and had no social networks in quarantine. Levels of psychological distress were also related to waiting time for re-entry (the time between applying to repatriate and returning to Australia) and flight origin. Qualitative data showed that despite quarantine being viewed as necessary, unclear communication and a perception of lack of control were affecting emotional well-being. This information is useful to inform the further development of models to identify those at most risk and support psychological well-being in quarantine settings.

Covid-19 and the 2020 presidential election

Whether deserved on not, US Presidents often receive the blame or the credit for the nature of the economy and direction of the country. Therefore, the status of the economy and the country in an election year can be a very important factor in election success for an incumbent President (or his party if an incumbent is not running). This is especially true in 'battleground states' due to the presence of the Electoral College system where Presidential candidates need only win different combinations of states in order to become President. However, the 2020 Presidential election was vastly different from past election cycles in that an additional variable, COVID-19, was added to the decision calculus of voters. Eventually, the 2020 election came down to the extremely slim margins in three states (Arizona, Georgia, and Wisconsin) and thin margins in two others (Pennsylvania and Michigan). This paper shows that deaths from COVID-19 at the county level played a small role in demotivating voters to turnout in 2020 to cast their vote for Joe Biden as President. In other words, without Covid-19, President Trump's losses within these five states would have been even larger.

Assessment of the role of the Edinburgh dysphagia score in referral triage in a national service evaluation of the urgent suspected upper gastrointestinal cancer pathway.

BACKGROUND: The British Society of Gastroenterology has recommended the Edinburgh Dysphagia Score (EDS) to risk-stratify dysphagia referrals during the endoscopy COVID recovery phase. AIMS: External validation of the diagnostic accuracy of EDS and exploration of potential changes to improve its diagnostic performance. METHODS: A prospective multicentre study of consecutive patients referred with dysphagia on an urgent suspected upper gastrointestinal (UGI) cancer pathway between May 2020 and February 2021. The sensitivity and negative predictive value (NPV) of EDS were calculated. Variables associated with UGI cancer were identified by forward stepwise logistic regression and a modified Cancer Dysphagia Score (CDS) developed. RESULTS: 1301 patients were included from 19 endoscopy providers; 43% male; median age 62 (IQR 51-73) years. 91 (7%) UGI cancers were diagnosed, including 80 oesophageal, 10 gastric and one duodenal cancer. An EDS ≥3.5 had a sensitivity of 96.7 (95% CI 90.7-99.3)% and an NPV of 99.3 (97.8-99.8)%. Age, male sex, progressive dysphagia and unintentional weight loss >3 kg were positively associated and acid reflux and localisation to the neck were negatively associated with UGI cancer. Dysphagia duration <6 months utilised in EDS was replaced with progressive dysphagia in CDS. CDS ≥5.5 had a sensitivity of 97.8 (92.3-99.7)% and NPV of 99.5 (98.1-99.9)%. Area under receiver operating curve was 0.83 for CDS, compared to 0.81 for EDS. CONCLUSIONS: In a national cohort, the EDS has high sensitivity and NPV as a triage tool for UGI cancer. The CDS offers even higher diagnostic accuracy. The EDS or CDS should be incorporated into the urgent suspected UGI cancer pathway.

Was it Good for You? Gender Differences in Motives and Emotional Outcomes Following Casual Sex

Casual sex, also referred to as a hookup, has been associated with a range of negative emotional outcomes for women, including regret, anxiety, depression and social stigma. However, it has been argued that it is the nature of the sexual motivation, not gender that influences the emotional outcome. This study was designed to ascertain what motivates people to have casual sex, what emotional outcomes follow casual sex and whether there are gender differences among these variables. Seven hundred and one participants (47% men and 52.8% women) completed a 44-item online survey. Gender differences were found for both sexual motivations and emotional outcomes of casual sex, with women generally having more negative emotional outcomes than men. Additionally, a principal components analysis uncovered four reliable principal motivations underlying engagement in casual sex, and three principal emotional outcomes of casual sex. Predictors of negative emotional outcomes included being motivated to regulate negative emotions and to achieve positive emotions. No predictors (apart from being a man) were found for a positive emotional outcome. While the stigma surrounding female sexual agency is diminishing, results generally support the presence of a sexual double-standard which encourages male promiscuity but dissuades female sexual autonomy.

Incidence of childhood cancer in Canada during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has had a major impact on access to health care resources. Our objective was to estimate the impact of the COVID-19 pandemic on the incidence of childhood cancer in Canada. We also aimed to compare the proportion of patients who enrolled in clinical trials at diagnosis, presented with metastatic disease or had an early death during the first 9 months of the COVID-19 pandemic compared with previous years. METHODS: We conducted an observational study that included children younger than 15 years with a new diagnosis of cancer between March 2016 and November 2020 at 1 of 17 Canadian pediatric oncology centres. Our primary outcome was the monthly age-standardized incidence rates (ASIRs) of cancers. We evaluated level and trend changes using interventional autoregressive integrated moving average models. Secondary outcomes were the proportion of patients who were enrolled in a clinical trial, who had metastatic or advanced disease and who died within 30 days. We compared the baseline and pandemic periods using rate ratios (RRs) and 95% confidence intervals (CIs). RESULTS: Age-standardized incidence rates during COVID-19 quarters were 157.7, 164.6, and 148.0 per million, respectively, whereas quarterly baseline ASIRs ranged between 150.3 and 175.1 per million (incidence RR 0.93 [95% CI 0.78 to 1.12] to incidence RR 1.04 [95% CI 0.87 to 1.24]). We found no statistically significant level or slope changes between the projected and observed ASIRs for all new cancers (parameter estimate [ß], level 4.98, 95% CI -15.1 to 25.04, p = 0.25), or when stratified by cancer type or by geographic area. Clinical trial enrolment rate was stable or increased during the pandemic compared with baseline (RR 1.22 [95% CI 0.70 to 2.13] to RR 1.71 [95% CI 1.01 to 2.89]). There was no difference in the proportion of patients with metastatic disease (RR 0.84 [95% CI 0.55 to 1.29] to RR 1.22 [0.84 to 1.79]), or who died within 30 days (RR 0.16 [95% CI 0.01 to 3.04] to RR 1.73 [95% CI 0.38 to 15.2]). INTERPRETATION: We did not observe a statistically significant change in the incidence of childhood cancer, or in the proportion of children enrolling in a clinical trial, presenting with metastatic disease or who died early during the first 9 months of the COVID-19 pandemic, which suggests that access to health care in pediatric oncology was not reduced substantially in Canada.

National service evaluation of the two week wait upper GI cancer referral pathway

HTU-5 Figure 1The median interval from triage to endoscopy was: 12 days (IQR 8-18) for 2WW;14 days (10-26) for urgent (non-2WW);and 17 days (9-38) for routine endoscopy[Figure omitted. See PDF]ConclusionsTriage based on the BSG recovery guidance was 97% sensitive with a negative predictive value of 99% in diagnosing UGI cancer at 2WW or urgent endoscopy or CT scan. 6.6% of 2WW referrals were safely investigated routinely and over 9% of 2WW referrals required no investigation at all following triage. These findings should guide reform of the upper GI 2WW pathway to reduce the burden on endoscopy during and after the COVID pandemic.

The Benefits of Fit-for-Purpose Land Administration for Urban Community Resilience in a Time of Climate Change and COVID-19 Pandemic

The major global pressures of rapid urbanization and urban growth are being compounded by climate impacts, resulting in increased vulnerability for urban dwellers, with these vulnerabilities exacerbated during the COVID-19 pandemic. Much of this is concentrated in urban and peri-urban areas where urban development spreads into hazard-prone areas. Often, this development is dominated by poor-quality homes in informal settlements or slums with poor tenure security. Lessons from a resilience-building project in the Pacific shows that a fit-for-purpose (FFP) approach to land administration can provide solutions by increasing the number of households with security of tenure, and consequently, improving resilience outcomes as informal settlements grow. This paper specifically discusses the influence of FFP land administration on reducing vulnerabilities to external shocks, such as climate change and COVID-19. It proposes ways to be better manage urban growth through the responsible governance of land tenure rights and more effective land-use planning to improve resilience to multiple shocks and stresses, hence, delivering improved access to safe land and shelter. Land administration systems can contribute to enhanced resilience to the shocks of climate extremes and pandemics by improving tenure security and enhancing land-use planning controls. It is argued that climate change adaptation and disaster risk reduction need to be better mainstreamed into two major elements of land governance: (i) securing and safeguarding of land rights, and (ii) planning and control of land use.