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The importance of measuring trust in health systems has been accentuated due to its correlation with important health outcomes aimed at reducing COVID-19 transmission. A systematic review published almost a decade ago identified gaps in measures including the lack of focus on trust in systems, inconsistency regarding the dimensionality of trust and need for research to strengthen the validity of measures. Given developments in our understandings of trust since its publication, we sought to identify new scales developed, existing ones adapted in response to identified gaps, and agendas for future research. Using the PRISMA approach for systematic reviews, we conducted a search in four databases. A total of 26 articles were assessed. Twelve new scales were identified, while 14 were adapted for different settings and populations. Literature continues to focus on measuring trust in health professionals rather than systems. Various shortcomings were identified, including some articles not mentioning the dimensions included in the scale and suboptimal use of validity and reliability testing and/or reporting. Moreover, a variety of terms were used for dimensions. Future research is needed to address these gaps and consequently, to understand their correlation with health behaviors and outcomes more accurately. © 2023 The Authors. Sociology Compass published by John Wiley & Sons Ltd.
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This article explores adaptive capacity as a framework for understanding how South Australian women in midlife (aged 45-64) demonstrated resilience during the early phases of COVID-19. In-depth interviews were undertaken with 40 women mid-2020 as a follow-up study to interviews with the same women undertaken 2018-19 (before COVID-19 emerged). Transcripts were analysed following a critical realist approach using Grothmann and Patt's construct of adaptive capacity as a framework for analysis. This enabled authors to unpack the mechanisms of resilience that shaped women's experiences of appraising, and then showing an intention to adapt to COVID-19 adversity. Findings support the explanatory utility of adaptive capacity to understand resilience processes in the context of person-environment changes - the environment being the COVID-19 context - and women's capability to adapt to social distancing and lockdown conditions. With COVID-19 evoking health, social and economic challenges at incomparable scales, potentially fracturing mental stability, this article provides insight useful to policy makers and health professionals to support resilience as the pandemic continues.Copyright © 2022 The Authors
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Background: Evidence favouring the effectiveness of videolaryngoscopes over conventional direct laryngoscopy for facilitating successful tracheal intubation has been growing. However, to choose be-tween different devices, clinicians need to know how individual devices perform outside of carefully controlled clinical trials.Aim: To evaluate the effectiveness of the McGrath MAC videolaryngoscope as it was introduced into clinical practice. Methods: Cohort evaluation of McGrath MAC videolaryngoscope use in clinical practice by voluntary completion of an evaluation form over a two-year period.Results: In a total of 979 cases, tracheal intubation was successful in 955/979 (97.5%), with first pass success achieved in 785/955 (82.2%). Most tracheal intubations (964/979, 80.1%) were performed during 'office hours' (Monday to Friday 0800-1800). Senior anaesthetists conducted 423/970 (43.6%) of in-tubations. There were 24/979 (2.5%) failed intubations, with consultants or senior anaesthetists con-ducting laryngoscopy in the majority of these;in 16/22 failed intubations, a grade I or II glottic view was obtained on the videolaryngoscope screen. Of the 20 anaesthetists involved as intubators, 14 had used the device fewer than 50 times.Conclusion: Our historical results demonstrate the effectiveness and feasibility of using the McGrath MAC videolaryngoscope to facilitate tracheal intubation in clinical practice. However, we believe the most important finding was the number of "easy" grade I and II glottic views on videolaryngoscopy where tracheal intubation was not achieved. Our experience and the evidence suggest that in order to fully realise the numerous benefits of videolaryngoscopy, the introduction of formal teaching and in-struction by trained trainers is essential. (c) 2022 Elsevier Ltd. All rights reserved.
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SARS-CoV-2, the causative agent of COVID-19, typically manifests as a respiratory illness although extrapulmonary involvement, such as in the gastrointestinal tract and nervous system, are increasingly recognised. Through immunohistochemistry against the SARS-CoV-2 nucleocapsid protein (NP), we aimed to characterise the multisystem viral tropism of SARS-CoV-2. FFPE tissue was obtained from 16 PCR-confirmed post-mortem COVID cases. Of these cases, 10 were full-body, 5 were brain only and 1 was a brain biopsy. Brain regions studied included frontal cortex, medulla, cerebellum, pons and olfactory bulb. Neurological symptoms featured in the cohort included brainstem encephalitis, acute disseminated encephalomyelitis (ADEM) and brain infarction. Immunohistochemistry of digestive system tissues revealed presence of SARS-CoV-2 NP in neurons of the myenteric plexus, a site of high ACE-2 expression, the entry receptor for SARS-CoV-2 and one of the earliest affected cells in Parkinson's disease (PD). Within the brain, staining was widespread in all sampled regions but limited to endothelial cells only (including in the olfactory bulb). Furthermore, in the full-body post-mortem cases, positivity in brain endothelia was restricted to cases exhibiting multiorgan tissue positivity (3/9 cases). The average time from symptom onset to time of death was shorter in positively versus negatively stained postmortem cases (mean = 10.3 days vs mean = 20.3 days, p = 0.0416) suggesting NP detection was confined to the infectious period. Together, our findings provide evidence for enteric nervous system but not brain neuroinvasion of SARS-CoV-2 as well as potential insights into long-term complications of COVID-19 and PD pathogenesis.
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This article seeks to explain the dynamics of resource depletion in North Korea's fishery. We utilize insights from the common-pool resource (CPR) literature and show how theories from comparative politics that explain why states sometimes do not formalize property rights but prefer their informal exercise can be fruitfully applied to North Korea's fishery. Utilizing a process tracing methodology, we demonstrate that the North Korean state possesses the necessary capacity to limit resource depletion, but has largely failed to do so. We argue that broad access to the commons maintains relations of enmeshed dependence between the dictator and those utilizing the fishery, balancing regime social control concerns with the party-state's need for revenue. Further, in recent times, foreign actors have been allowed into the sector, providing a lucrative source of revenue without creating issues for internal control. We consider the alternative explanation that the North Korean state lacks the capacity to prevent CPR depletion, but demonstrate its implausibility given the preponderance of available evidence, not least the response of the regime in Pyongyang to the COVID-19 pandemic, where it has demonstrated considerable capacity to control the country's fishing fleet.
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Purpose: This study offers an understanding of vulnerable populations' experiences of actual use of mobile banking and their expectations of mobile banking (MB). Design/methodology/approach: Data were generated from MB customers and bankers using online reviews, focus groups and semi-structured interviews, as a mix of methods and sources can provide rich and in-depth understanding. Findings: The affordance of MB for vulnerable populations is explained in four concepts: meaning, material, competency and usability. Recommendations that could further engage and improve the service quality of MB apps for vulnerable populations include customization and personalization of services, access to the digital health data of members of vulnerable populations, audio-based option selection and touchscreen options, and enhancement of service and performance standards. Research limitations/implications: It is suggested that retail bankers should improve the service quality and performance of their MB apps by considering the recommendations drawn from vulnerable people's experiences. This study discusses implications for retailers. Originality/value: This study applied social practice theory and affordance of technology theory to understand how those in vulnerable populations experienced MB apps;the results could be used to improve the accessibility, performance and service quality of MB apps. © 2022, Emerald Publishing Limited.
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The development of a teacher educator requires a sustained, systematic, and critical inquiry into one's own practice. The purpose of this study was to explore how two doctoral students, in their first semester of doctoral study, understood how to do physical education teacher education in an introductory teaching method class, through the lens of socialization theory. This was a collaborative self-study using an interpretative phenomenological analysis. Three themes were identified. First, social justice and its sub-themes: (a) challenges in changing habited behaviors, (b) social justice issues embedded in the class material, and (c) understanding diversity, change, and the importance of adaptability. Second, practice-based teacher education and its two sub-themes: (a) alignment between theory and practice, and (b) core teaching practices. Third, adapting to the COVID-19 environment and sub-themes of: (a) environmental constraints, (b) improving while being online, and (c) creating a supportive and caring atmosphere in the breakout sessions. Our recommendations include using self-study as a tool to help doctoral students understand and do teacher education.
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AIMS: TeleCheck-AF is a multicentre international project initiated to maintain care delivery for patients with atrial fibrillation (AF) during COVID-19 through teleconsultations supported by an on-demand photoplethysmography-based heart rate and rhythm monitoring app (FibriCheck®). We describe the characteristics, inclusion rates, and experiences from participating centres according the TeleCheck-AF infrastructure as well as characteristics and experiences from recruited patients. METHODS AND RESULTS: Three surveys exploring centre characteristics (n = 25), centre experiences (n = 23), and patient experiences (n = 826) were completed. Self-reported patient characteristics were obtained from the app. Most centres were academic (64%) and specialized public cardiology/district hospitals (36%). Majority of the centres had AF outpatient clinics (64%) and only 36% had AF ablation clinics. The time required to start patient inclusion and total number of included patients in the project was comparable for centres experienced (56%) or inexperienced in mHealth use. Within 28 weeks, 1930 AF patients were recruited, mainly for remote AF control (31% of patients) and AF ablation follow-up (42%). Average inclusion rate was highest during the lockdown restrictions and reached a steady state at a lower level after easing the restrictions (188 vs. 52 weekly recruited patients). Majority (>80%) of the centres reported no problems during the implementation of the TeleCheck-AF approach. Recruited patients [median age 64 (55-71), 62% male] agreed that the FibriCheck® app was easy to use (94%). CONCLUSION: Despite different health care settings and mobile health experiences, the TeleCheck-AF approach could be set up within an extremely short time and easily used in different European centres during COVID-19.
Subject(s)
Atrial Fibrillation , COVID-19 , Mobile Applications , Atrial Fibrillation/diagnosis , Atrial Fibrillation/epidemiology , Atrial Fibrillation/therapy , Communicable Disease Control , Female , Humans , Male , Middle Aged , Pandemics , Patient Outcome Assessment , SARS-CoV-2ABSTRACT
OBJECTIVE: To investigate the impact of Dutch COVID-19 restrictions on sexual behavior and HIV/sexually transmitted infection (STI) acquisition among men who have sex with men (MSM) participating in the Amsterdam Cohort Studies (ACS) on HIV in Amsterdam. METHODS: ACS participants complete a questionnaire on sexual behavior and are tested for HIV/STI biannually. They may also be tested at the STI clinic in-between study visits. On May 29, 2020, ACS participants were invited to complete an online questionnaire on health, COVID-19 risk perceptions, and sexual behavior. Determinants of reporting casual sex partners (CSP) during COVID-19 restrictions were examined using logistic regression. RESULTS: Of 683 MSM, 353 (52%; median age, 47 years; interquartile range, 38-53 years) completed the questionnaire. Since COVID-19, 73% reported a reduction in the number of CSP. CSP during COVID-19 restrictions were reported by 133 MSM (38%) and, in multivariable analysis, was associated with not having a college/university degree, being single, lower perceived importance of avoiding COVID-19, number of CSP before COVID-19, and current preexposure prophylaxis use (P < 0.05 for all). During COVID-19 restrictions, no HIV infections were diagnosed, and the STI positivity rate was 8%. CONCLUSION: Since COVID-19, the number of CSP decreased among MSM, and there may have been a temporary reduction in HIV/STI transmission. Some MSM were not fully compliant to social distancing regulations and reported CSP, which was related to prior sexual behavior and low perceived importance of avoiding COVID-19. For these men, it is important to maintain accessible HIV/STI-related testing and care during times of lockdown.
Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Homosexuality, Male , SARS-CoV-2 , Adult , COVID-19/prevention & control , Cohort Studies , Data Collection , Humans , Logistic Models , Male , Middle Aged , Netherlands/epidemiology , Sexual Behavior , Surveys and QuestionnairesSubject(s)
Coronavirus Infections/therapy , Patient Safety/standards , Pneumonia, Viral/therapy , Tracheostomy/methods , Tracheostomy/standards , COVID-19 , Female , Humans , Male , Middle Aged , Pandemics , Safety , SurgeonsABSTRACT
BACKGROUND: Cancer diagnostics and surgery have been disrupted by the response of health care services to the coronavirus disease 2019 (COVID-19) pandemic. Progression of cancers during delay will impact on patients' long-term survival. PATIENTS AND METHODS: We generated per-day hazard ratios of cancer progression from observational studies and applied these to age-specific, stage-specific cancer survival for England 2013-2017. We modelled per-patient delay of 3 and 6 months and periods of disruption of 1 and 2 years. Using health care resource costing, we contextualise attributable lives saved and life-years gained (LYGs) from cancer surgery to equivalent volumes of COVID-19 hospitalisations. RESULTS: Per year, 94 912 resections for major cancers result in 80 406 long-term survivors and 1 717 051 LYGs. Per-patient delay of 3/6 months would cause attributable death of 4755/10 760 of these individuals with loss of 92 214/208 275 life-years, respectively. For cancer surgery, average LYGs per patient are 18.1 under standard conditions and 17.1/15.9 with a delay of 3/6 months (an average loss of 0.97/2.19 LYGs per patient), respectively. Taking into account health care resource units (HCRUs), surgery results on average per patient in 2.25 resource-adjusted life-years gained (RALYGs) under standard conditions and 2.12/1.97 RALYGs following delay of 3/6 months. For 94 912 hospital COVID-19 admissions, there are 482 022 LYGs requiring 1 052 949 HCRUs. Hospitalisation of community-acquired COVID-19 patients yields on average per patient 5.08 LYG and 0.46 RALYGs. CONCLUSIONS: Modest delays in surgery for cancer incur significant impact on survival. Delay of 3/6 months in surgery for incident cancers would mitigate 19%/43% of LYGs, respectively, by hospitalisation of an equivalent volume of admissions for community-acquired COVID-19. This rises to 26%/59%, respectively, when considering RALYGs. To avoid a downstream public health crisis of avoidable cancer deaths, cancer diagnostic and surgical pathways must be maintained at normal throughput, with rapid attention to any backlog already accrued.