The multi-method approach to analyzing motivations and perceived travel risks: impacts on domestic tourists' adaptive behaviors and tourism destination advocacy

The study investigated factors influencing tourists' adaptive behaviors and advocacy for domestic destinations during COVID-19 using a combination of integrated generalized structured component analysis (IGSCA) and fuzzy set qualitative comparative analysis (fsQCA). One thousand tourists from Thailand, South Korea, and China participated in the study. The results revealed that fsQCA's multiple configurations provided valuable insights into the antecedents affecting adaptive behavior and destination advocacy, which complemented IGSCA's symmetric results. The study affirmed the complexity of antecedents that impact outcomes and supported the notion of complexity theory in explaining tourists' destination supporting behavior. The study provided implications for future research in this area.

De Novo Experience of Individuals with Li-Fraumeni Syndrome: Sometimes the people in your family are never going to be the ones who understand best

Background/Objectives: Li-Fraumeni Syndrome (LFS) is a rare hereditary cancer predisposition syndrome characterized by high lifetime risks for multiple primary malignancies. Although most individuals with LFS inherit a pathogenic TP53 variant from a parent, approximately 20% have de novo variants with no suggestive family cancer history. This may result in an LFS experience distinct from individuals with affected relatives. This multi-case study report examines the unique psychosocial experiences of three young adults with de novo TP53 variants. Method(s): The National Cancer Institute's LFS study (NCT01443468) recruited adolescents and young adults (AYAs;aged 15-39 years) with LFS for qualitative interviews. Three participants had a de novo TP53 variant and a personal cancer history. An interprofessional team analyzed interview data using extended case study and narrative methods. Result(s): De novo participants lacked familiarity with LFS to situate a cancer diagnosis, interpret genetic test results, or adjust to chronic cancer risk. Communicating with and receiving support from family was challenged by their lack of common experience. De novo participants experienced socioemotional isolation, which was amplified during the COVID-19 pandemic. To cope, they sought support in online rare disease communities or through mental health providers. Conclusion(s): Individuals with de novo variants may lack familial guides and familiar providers to address disease management and uncertainty. Specialty health and mental health providers may support de novo patients across hereditary cancer syndromes by validating their uncertainties and connecting them with diseasespecific patient advocacy groups that support adjustment to chronic cancer risk.

Challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic

Objective: To analyze the challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic.Methods: This is an online descriptive-exploratory qualitative study. Participants were 28 nursing professionals enrolled in the subject Nursing in Health Care for Children and Adolescents in a graduate program at a federal university in northeastern Brazil. Data collection took place in June 2021 through a conversation wheel and press conference. As instruments, we used Google forms and a semi-structured script. The study was approved by the Research Ethics Committee. As an analysis method, Discursive Textual Analysis (DTA) was used. For data organization, Atlas.ti 8.4.15 software (Qualitative Research and Solutions) was used.Results: Two categories emerged: 1) Impacts of the pandemic on pediatric care and advocacy: child isolation and a health care scenario where children were placed in the background were observed. 2) Existing barriers that worsened with the health crisis: work overload, precarious structure and difficulty in working conditions were identified, which led to violations of children's rights and aggravated the overview of difficulties in the provision of pediatric services.Conclusion: The challenges for exercising health advocacy for hospitalized children during the pandemic, evidenced by the impacts and barriers to care, have expanded health teams' work, making the exercise of advocacy in pediatric care even more difficult. It is necessary to rethink and adjust access and care policies after the pandemic to ensure that child care is not restricted.

How to read a paper about inequality in respiratory disease: Basic epidemiological principles and how inequalities are measured

Health inequalities in respiratory disease are widespread, and monitoring them is important for advocacy, the design and delivery of health services, and informing wider health policy. In this chapter, we introduce the different ways in which health inequalities can be quantified, including measures that quantify absolute and relative inequalities, and those that measure gaps between groups or differences across the entire social gradient. We consider the strengths and limitations of these different approaches and highlight things to look out for when reading a paper on health inequalities in respiratory health. These include how common the outcome is and whether other factors have been adjusted for, as both can have a crucial impact on interpretation and can lead to misleading conclusions.Copyright © ERS 2023.

The establishment of a national federation representing health workers from ethnic minorities

ContextThe Federation of Ethnic Minority Healthcare Organisations (FEMHO) was established in 2022 in light of the disproportionate inequalities experienced by this group before, during and after the COVID-19 pandemic.The FEMHO is as a multidisciplinary consortium representing Ethic Minority organisations and individuals within the health and social care in the UK. At the time of writing, FEMHO represents over 55,000 individual members, covering various disciplines, specialisms and levels of seniority, spanning across 43 organisations and interest groups. As a self-governed union, FEMHO encourages organisations to collaborate and work collectively to achieve better outcomes through the implementation of improved policies and opinion formers as well regulators and commissioners both locally and nationally.Issue/ChallengeOf the 1.2 million staff employed by NHS, 20.7% belong to Black, Asian and minority ethnic (BAME) background. However, analysis of deaths of NHS Staff during the pandemic showed that 64% of those who died belonged to a BAME background. Such disproportionate impacts were seen when the number of deaths amongst doctors and nurses were further analysed, where 20% of nursing staff identified as BAME yet 64% of nurses who died were BAME and 44% of medical staff identified as BAME and 95% of doctors who died were BAME.Doctors from BAME backgrounds also reported:Feeling less confident that appropriate adjustments had been made to mitigate riskFeeling less confident about PPE provision and feeling safe to report PPE shortagesHigher rates of bullying and harassment during the pandemic periodSuch inequalities are believed to be as a result of a number of structural inequalities that existed well beyond the pandemic. it also hypothesised that several inequalities may persist well beyond the pandemic, such as the disproportionate impact of long-covid of health workers from an ethnic minority, which is currently being investigated by researchers at the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre.In view of these challenges, the FEMHO was established as a method of collaborating and co-ordinating the efforts of grassroots organisations, policy makers, regulators and commissioners to ensure that the lived experiences and potential solutions offered by organisations and individuals within this group can be better heard and acted upon.Assessment of issue and analysis of its causesThe FEMHO was established to promote a more concerted approach for the advocacy for health workers from ethnic minority backgrounds, with the aim of reducing the inequalities experienced by this group. A two pronged approach of galvanising grassroots organisations already working tirelessly to support ethnic minority health workers along with lobbying and collating interests amongst policy makers, commissioners and regulators was utilised.For grassroots organisations, a mixed methodology of targeted invitations and open advertisement of opportunities for membership was utilised. Several mediums were used to spread the word of such opportunities, including social media posts, word of mouth and email.For policy makers and systems leaders, a more targeted approach was adopted to acquire their support. A targeted email campaign was developed to raise awareness of FEMHO's work with the aim of acquiring their official support, particularly in the form of endorsing FEMHO's call for the inclusion of race inequality in the COVID-19 public enquiry.ImpactAt the time of writing, the FEMHO has been successful in galvanising the membership and support of both grassroots organisations and policy makers respectively at a national level.FEMHO now represents over 55,000 individual members, covering various disciplines, specialisms and levels of seniority, spanning across 43 organisations and interest groups.The targeted email campaign saw the achievement of 39 cross party MPs officially supporting FEMHO's call for inclusion of race inequality in the COVID-19 public enquiry.An inaugural meeting was also held within th Houses of Parliament, where grassroot organisation leads as well as MPs were invited to discuss the strategic priorities and direction of the organisation such as the organisations contribution to the COVID-19 public enquiry, to ensure that inequality is truly at the ‘forefront' of issues.Feedback acquired during the inaugural meeting from MPs and front-line workers was incredibly positive, with attendees welcoming this concerted approach to effect change.Challenges faced in this process largely themed around the limited time availability of the several individuals involved with this project. Executive members of the union as well as grassroots member leads largely worked full time in a variety of demanding healthcare professionals, making communication, organisation and prioritisation of voluntary roles such as contribution to FEMHO work difficult at times.InterventionThe intervention, being the development of a national union equipped with the lived experience and expertise of members who are able to effectively advocate for the interests for health workers from ethnic minority backgrounds, has had numerous positive outcomes:A shared space for grassroots organisations to share best practice for support of healthcare workers from ethnic minority backgroundsA concerted voice to contribute to policy change to address the structural inequalities that adversely impact healthcare workers from ethnic minority backgroundsFrom this experience thus far I have learnt that leadership, with regards to solving complex problems, can often be a journey of harnessing the voices, expertise and influence of several individuals and organisations to effect change. Such a journey can come with numerous hurdles: from stakeholder mapping to initiatives to promote cross-specialty, cross-seniority, cross-political party discussions. But I have learnt, particularly from the exec leadership team, made up Ade Adeyemi MBE (a Global Health Policy Expert) and Professor JS Bamrah CBE (Chair, British Association of Physicians of Indian Origin), and other notable individuals, that such efforts to galvanise individuals who have seemingly different priorities is often possible when you are able to see beyond this as a leader and define, clarify and communicate where such individuals share interests and focuses in common.Involvement of stakeholders, such as patients, carers or family members:As mentioned, the main stakeholders that had to be consulted within this process were front-line care workers from ethnic minority backgrounds and any relevant organisations who may work at a grassroots level to support them.Such stakeholders were involved through the establishment of communication channels as well as feedback sessions to ensure that the FEMHO was sufficiently and accurately representing the interests of the group in question.Key MessagesSolving complex problems as a leader requires the ability to create a collaborative environment that often sees the development, nurturing or new relationships at both an individuals and organisation levelLeaders are able to harness human energy through the development and forecast of a vision and mission that is inspiring and compelling, encouraging individuals to sacrifice their time for a matter bigger than themChange that is sustainable and impactful can often be slow, as seen with the policy changes we continue to advocate for as an organisation, but leaders must be patient.Lessons learntAs mentioned, I have learnt that to effect change, one must be patient as a leader. Our policy activities has taken a great deal of time to be heard and seen, and it can often be tempting to grow impatient and quit.Future barriers to our work include the degree to which can promote regular communication and collaboration amongst member organisations who are often time poor, competing with a number of other priorities such as a demanding full time career in healthcare. Other barriers include maintaining political interest from policy makers, commissioners, MPs, many of which may not hold positions for a long-term basis, as a r sult of the political nature of many of their positions.Measurement of improvementWe will measure the effect of our initiative through a series of feedback forms, particularly of member organisations and their members to assess the degree to which front-line care workers from ethnic minority backgrounds feel that progress in being made in the level of advocacy and campaigning on their behalf. Additionally, we will seek to gather feedback on our members perception of ways of working and any suggestions to ensure that all member organisations feel empowered to influence the direction of the federationStrategy for improvementAfter each feedback round, held on a quarterly basis, executive members of the FEMHO will analyse findings and implement changes accordingly where possible

Challenging the dominant path of forest policy? Bottom-up, citizen forest management initiatives in a top-down governance context in Poland

Forest governance in Poland is characterised by the dominance of public forest ownership and hierarchical, top-down policy-making. These governance arrangements, characteristic of post-socialist countries, have traditionally been challenged by environmental NGOs, advocating stronger protection of old-growths. Recently, institutional stability of the forest policy field has been increasingly influenced by numerous citizen initiatives responding to technocratic local forest management decisions. These initiatives, so far not analysed scientifically, vary in terms of the issues addressed, actions employed, and the local actors involved. In the paper we use a data base of 274 such initiatives to explore their manifestation, actors involved, main postulates, and the responses of forest managers. Based on this, we explored whether these initiatives pose challenges to the traditional forest management and, if so, what kind. We imply that the growth of bottom-up initiatives indicates a growing diversity of beliefs and values regarding forests and the increasing determination of local people to impact local environmental decisions. Furthermore, informed by the institutional theory, we argue that the growth of local initiatives, particularly during and after Covid-19 pandemics, suggests the eroding legitimacy of dominant rules and discourses. This process is particularly visible in sub-urban forests, which are increasingly seen through a ‘well-being discourse' that highlights cultural, regulative and supportive functions of forests, while putting less emphasis on provisioning functions. We also identify a networking trend among the initiatives that unifies their discursive background and enhances their influence at the national level. Therefore, local activists can be seen as a new advocacy group in the Polish forest policy subsystem. In response to local demands public forest administration has introduced institutional changes enhancing participation but their impact is still to be assessed. We recommend establishing a monitoring programme to track new participatory practices and to identify and promote best practices.

Virtual educational therapy: A case study of clinical supports and advocacy

A case study is a research approach that is used to generate an in-depth, multifaceted understanding of a complex issue in its real-life context. It is both time- and space-bound and is useful to explore, describe, and explain phenomena. It is an established research design that is used extensively in a wide variety of disciplines, particularly in the social sciences, including education. Many master's programs employ the case study methodology as the basis for the culminating project. The case study methodology is especially relevant to advancing "younger disciplines" such as educational therapy. Many do not understand the training and difference in approaches between an Educational Therapist and a tutor, so publishing case studies is crucial. This book presents a board-certified educational therapist's year-long case study of clinical supports and advocacy for a student with learning disabilities who is attending school remotely during the COVID-19 pandemic. With online and blended learning, now the norm in K-12 education, educational therapists need new models of intervention, treatment, and relationship-building for their child-age clients. The book offers detailed single-case research focused on a middle-school student who is learning virtually while challenged with attention-deficit/hyperactivity disorder as well as visual and verbal memory issues, but who is nonetheless found ineligible for special education services. Across eight chapters, the book describes the neuropsychological principles, research-based techniques, personal interactions, clinical approaches, and advocacy efforts that led to a vulnerable student's significant gains in academic skills and outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Understanding and Addressing the Well-Being of School Counselors

Diminished self-care practices and heightened stress of school counselors are continuing problems in education. With role ambiguity, high student-to-counselor ratios, emotional exhaustion, and other factors adding pressure to the roles and responsibilities of school counselors, this study investigated the well-being practiced of Missouri school counselors and the internal and external factors which influence them. Findings demonstrate several ways in which school counselors fail to meet basic well-being benchmarks, examples of positive school principal supports, and systemic counselor role ambiguity, mission creep, and high caseloads that contribute to stress and burnout. These results indicate three levels of decision-making that are paramount to school counselors achieving and sustaining healthy well-being practices--the individual counselor's role in self-care and professional advocacy;the school leader's approach to defining the counselor's role and promoting a healthy workplace culture;and the ways in which policymakers affect systemic change.

The Impact of Communicating Advocacy and Scientific Uncertainty on a Scientist's Trustworthiness

A central aspect of scientific knowledge is scientific uncertainty. When scientists touch upon political issues, there are two contrary expectations: One is that scientists communicate in a straightforward manner and give a direct, concrete suggestion. The other is that they communicate in a way that carefully considers the pros and cons as well as the current state of (non-) knowledge. This 2x2 experimental study investigated how disclosing scientific uncertainty affects the perceived trustworthiness of a scientist when they express either their motive to inform or their motive to advocate. All participants (N = 503) read an interview with a scientist about the usefulness of further vaccinations against COVID-19. In the interview, uncertainty was explicitly addressed (vs. not). Furthermore, the scientist either disclosed their motive to advocate or their motive to merely inform about research results. Results showed that the scientist was perceived as more trustworthy (i. e., having more expertise, integrity, and benevolence) when they communicated uncertainty than when they did not. However, contrary to our expectations, the effect of the scientist's expressed motive to advocate (vs. to inform) on trustworthiness did not depend on whether uncertainty was explicitly addressed or not.

Lesson Learned in Drug Development for Year Ahead

COVID-19 highlighted the value of remote approaches in many fields, but DCTs offered an opportunity beyond the needs of the pandemic: to make clinical research easier for patients to participate in and more accessible to a wider population not served by traditional study design. Partnership-driven approach to working with communities and patient advocacy groups As part of their efforts to increase diversity and equity in clinical research, organizations have changed how they work with patients by fostering closer partnerships with communities and patient advocacy groups. A 2021 survey by the Center for Information and Study on Clinical Research Participation found that, while overall awareness of research had increased, self-reported understanding of clinical trials and willingness to participate has decreased since 2019.

The Influence of Social Media and Sustainability Advocacy on the Purchase Intention of Filipino Consumers in Fast Fashion

The large consumption of fast fashion brings many negative environmental impacts. Filipino consumers love and buy fast fashion because it is relatively cheap but trendy, and there are lots of fashionable designs to choose from. Despite the shortage in water supply and disposal issues of fast fashion, people still continue to purchase. The lack of awareness of consumers on sustainable fashion consumption led the researchers to conduct a study that aims to identify factors affecting Filipino consumers' buying decisions on fast fashion using the combined theory of planned behavior, elaboration likelihood model, and hedonic motivation. A total of 407 participants were gathered through a convenience sampling approach, and the data collected were analyzed using structural equation modeling (SEM). The result shows that attitude towards fast fashion is the highest contributing factor to purchase intention. While social media positively affects purchase intention, sustainability advocacy negatively impacts the consumers' intention to buy fast fashion. The awareness of sustainability leads to consumption reduction of fast fashion garments. Surprisingly, perceived product price and quality do not show a significant influence on purchase intention. Incorporating sustainability advocacy on social media may be a great strategy to encourage the sustainable consumption of fashion garments. The findings of this study could be a great tool to influence fashion companies and government institutions to promote sustainability awareness and transition marketing strategies to the sustainable consumption of fashion.

Patient Centricity: Design and Conduct of Clinical Trials in Orphan Diseases: Third of Three Sets of Expanded Proceedings from the 2020 ISCTM Autumn Conference on Pediatric Drug Development

This article expands on a session, titled "Patient Centricity: Design and Conduct of Clinical Trials in Orphan Diseases," that was presented as part of a two-day meeting on Pediatric Drug Development at the International Society for Central Nervous System (CNS) Clinical Trials and Methodology (ISCTM) Autumn Conference in Boston, Massachusetts, in October 2020. Speakers from various areas of pediatric drug development addressed a variety of implications of including children in drug development programs, including implications for rare/orphan diseases. The speakers have written summaries of their talks. The session's lead Chair was Dr. Joan Busner, who wrote introductory and closing comments. Dr. Simon Day, regulatory consultant, outlined some of the past mistakes that have plagued trials that did not consult with patient groups in the early design phase. Dr. Atul Mahableshwarkar provided an industry perspective of a recent trial that benefited from the inclusion of patient input. Drs. Lucas Kempf and Maria Sheean provided regulatory input from the perspectives of the United States (US) Food and Drug Administration (FDA) and European Medicines Agency (EMA), respectively. Dr. Judith Dunn outlined a novel approach for assessing and rank ordering patient and clinician clinical meaningfulness and the disconnect that may occur. Dr. Busner provided closing comments, tied together the presented issues, and provided a synopsis of the lively discussion that followed the session. In addition to the speakers above, the discussion included two representatives from patient advocacy groups, as well as an additional speaker who described the challenges of conducting a pediatric trial in the US and European Union (EU), given the often competing regulatory requirements. This article should serve as an expert-informed reference to those interested and involved in CNS drug development programs that are aimed at children and rare diseases and seek to ensure a patient-centric approach.Copyright © 2023, Matrix Medical Communications. All rights reserved.

Topic Summary: Looking Back to Envision the Future: Nursing Now USA as a Vehicle for Advocacy and Change, Part 2

[...]prior to the COVID-19 pandemic, which could be described as a waning period, nurses expressed a high level of concern about safe nurse staffing levels, a shortage of nurses, and the quality and safety of patient care. The movement sought a new, more balanced view of nurses' impact on patients and healthcare by stimulating the shift to a state that considers the costs and quality of care simultaneously, and, relative to the nursing workforce, appreciates the value of nurses' contributions to and impact on healthcare and society. [...]these authors call for a realignment of systems and structures within nursing education, practice, and research to build competencies and confidence for nurses to advocate not only for patients, the profession, and the healthcare sector, but most importantly to serve as agents of change for better health of our nation and planet (Oiemeni et al„ 2023). Discussion To put the work of these commissioned papers in context, we draw on the work of Kellerman and Seligman (2023). who recently offered a new typology for creative thinking: * Integration to demonstrate the similarities of different objects or entities that appear different;* Splitting, or teasing apart objects or entities that appear similar to view the differences;* Figure-ground reversal, or appreciating that elements or components of objects or entities deemed essential actually may be hidden, or in the background, rather than superficial or in the foreground;and * Distal thinking, or the imagining of objects and entities as being very different from their present state.

Challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic / Challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic / Desafios para o exercício da advocacia em saúde à criança hospitalizada durante a pandemia COVID-19 / Desafíos para el ejercicio de la defensa en salud de niños hospitalizados durante la pandemia de COVID-19

Resumo Objetivo Analisar os desafios para o exercício da advocacia em saúde à criança hospitalizada durante a pandemia COVID-19. Métodos Estudo qualitativo descritivo-exploratório on-line. Participaram 28 profissionais de enfermagem matriculados na disciplina Enfermagem na Atenção à Saúde da Criança e do Adolescente em um Programa de pós-graduação de uma universidade federal do nordeste brasileiro. A coleta de dados ocorreu em junho de 2021 através de roda de conversa e entrevista coletiva. Como instrumentos utilizou-se: o formulário do google forms e roteiro semiestruturado. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Como método de análise, foi empregada a Análise Textual Discursiva (ATD). Para a organização dos dados, utilizou-se o software Atlas.ti 8.4.15 (Qualitative Research and Solutions). Resultados Emergiram duas categorias: 1) Impactos da pandemia para assistência e advocacia pediátrica, constatou-se o isolamento infantil e um cenário de atenção à saúde onde a criança foi colocada em segundo plano. 2) Barreiras existentes que se agravaram com a crise sanitária, identificou-se: sobrecarga de trabalho, precarização da estrutura e dificuldade nas condições de trabalho, que gerou violações nos direitos infantis e agravou o panorama de dificuldades na oferta de serviços pediátricos. Conclusão Os desafios para o exercício da advocacia em saúde à criança hospitalizada durante a pandemia, evidenciados pelos impactos e barreiras para a assistência, ampliaram o trabalho das equipes de saúde tornando o exercício da advocacia no cuidado pediátrico ainda mais dificultoso. Cabe repensar e ajustar políticas de acesso e atendimento após a pandemia para assegurar que o cuidado infantil não seja restringido.

Resumen Objetivo Analizar los desafíos para el ejercicio de la defensa en salud de niños hospitalizados durante la pandemia de COVID-19. Métodos Estudio cualitativo descriptivo exploratorio en línea. Participaron 28 profesionales de enfermería inscriptos en la asignatura Enfermería en Atención a la Salud del Niño y del Adolescente en un programa de posgrado de una universidad nacional del nordeste brasileño. La recopilación de datos ocurrió en junio de 2021 a través de rondas de conversación y entrevista colectiva. Como instrumentos se utilizaron: un formulario de google forms y un guion semiestructurado. El estudio fue aprobado por el Comité de Ética en Investigación. Como método de análisis, se utilizó el Análisis Textual Discursivo (ATD). Para la organización de los datos, se utilizó el software Atlas.ti 8.4.15 (Qualitative Research and Solutions). Resultados Surgieron dos categorías: 1) Impactos de la pandemia en la atención y en la defensa pediátrica, se verificó el aislamiento infantil y un escenario de atención en salud en la que el niño fue colocado en segundo plano. 2) Barreras existentes que se agravaron con la crisis sanitaria, se identificó: sobrecarga de trabajo, precarización de la estructura y dificultad en las condiciones de trabajo, lo que generó violaciones de los derechos infantiles y agravó el panorama de dificultades en la oferta de servicios pediátricos. Conclusión Los desafíos para el ejercicio de la defensa en salud de niños hospitalizados durante la pandemia, evidenciados por los impactos y barreras para la atención, ampliaron el trabajo de los equipos de salud, lo que dificultó aún más el ejercicio de la defensa del cuidado pediátrico. Cabe reflexionar y ajustar políticas de acceso y atención después de la pandemia para asegurar que no se restrinja el cuidado infantil.

Abstract Objective To analyze the challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic. Methods This is an online descriptive-exploratory qualitative study. Participants were 28 nursing professionals enrolled in the subject Nursing in Health Care for Children and Adolescents in a graduate program at a federal university in northeastern Brazil. Data collection took place in June 2021 through a conversation wheel and press conference. As instruments, we used Google forms and a semi-structured script. The study was approved by the Research Ethics Committee. As an analysis method, Discursive Textual Analysis (DTA) was used. For data organization, Atlas.ti 8.4.15 software (Qualitative Research and Solutions) was used. Results Two categories emerged: 1) Impacts of the pandemic on pediatric care and advocacy: child isolation and a health care scenario where children were placed in the background were observed. 2) Existing barriers that worsened with the health crisis: work overload, precarious structure and difficulty in working conditions were identified, which led to violations of children's rights and aggravated the overview of difficulties in the provision of pediatric services. Conclusion The challenges for exercising health advocacy for hospitalized children during the pandemic, evidenced by the impacts and barriers to care, have expanded health teams' work, making the exercise of advocacy in pediatric care even more difficult. It is necessary to rethink and adjust access and care policies after the pandemic to ensure that child care is not restricted.

Frontline Workers in the Backrooms of COVID-19.

OBJECTIVES: To review the response to the coronavirus disease 2019 (COVID-19) pandemic in a forensics center that integrates an academic department of pathology with multiple regional county medical examiners' offices. METHODS: Faculty and staff were asked to volunteer stories, data, and photographs describing their activities from March through May 2020. The information was assembled into a narrative summary. RESULTS: Increased deaths challenged capacity limits in a hospital morgue and a large urban medical examiner's office (MEO) successfully managed by forensic teams and monitored by an institutional command center. Autopsies of suspected and proven cases of COVID-19 were performed in both facilities. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing of decedents was performed in a MEO serving a large urban area. Scene investigators worked directly with families to meet needs unique to a pandemic. Artful photographs of decedent's hands and/or tattoos were offered to those unable to have in-person viewings. Pathologists and social workers were available to families of the deceased and created novel solutions to facilitate the grieving process. CONCLUSIONS: Forensic pathology is important to successfully navigating emerging diseases like the COVID-19 pandemic. Direct conversations with families are common in forensic pathology and serve as a model for patient- and family-centered care.

The 2022 ParticipACTION Report Card on Physical Activity for Children and Youth: Focus on the COVID-19 pandemic impact and equity-deserving groups.

Introduction: The ParticipACTION Report Card on Physical Activity for Children and Youth is the most comprehensive national assessment of physical activity and related behaviors, characteristics, and opportunities for children and youth. The 2022 Report Card assigned grades based on data gathered during the COVID-19 pandemic to reflect this extraordinary time-period in Canada. Further, while not graded, efforts were made to summarize key findings for early years children and those identifying as: having a disability, Indigenous, 2SLGBTQ+, newcomers to Canada, racialized, or girls. The purpose of this paper is to summarize the 2022 ParticipACTION Report Card on Physical Activity for Children and Youth. Methods: The best available physical activity data captured during the whole COVID-19 pandemic was synthesized across 14 different indicators in four categories. The 2022 Report Card Research Committee assigned letter grades (i.e., A-F) based on expert consensus of the evidence. Synthesis: Grades were assigned for: Daily Behaviors (Overall Physical Activity: D; Active Play: D-; Active Transportation: C-; Organized Sport: C+; Physical Education: Incomplete [INC]; Sedentary Behaviors: F; Sleep: B; 24-Hour Movement Behaviors: F), Individual Characteristics (Physical Literacy: INC; Physical Fitness: INC), Spaces and Places (Household: C, School: B-, Community and Environment: B), and Strategies and Investments (Government: B-). Compared to the 2020 Report Card, the COVID-19 specific grades increased for Active Play and Active Transportation; and decreased for Overall Physical Activity, Sedentary Behaviors, Organized Sport, and Community and Environment. There were many data gaps for equity-deserving groups. Conclusion: During the COVID-19 pandemic, the grade for Overall Physical Activity decreased from a D+ (2020) to a D, coinciding with decreases in grades reflecting fewer opportunities for sport and community/facility-based activities as well as higher levels of sedentary behaviors. Fortunately, improvements in Active Transportation and Active Play during COVID-19 prevented a worse shift in children's health behaviors. Efforts are needed to improve physical activity for children and youth during and post-pandemic, with a greater emphasis on equity-deserving groups.

Facilitators of a Campus Tobacco-free Policy: Navigating the Politics

Objective: In this paper, we discuss prioritization, formulation, and adoption of a comprehensive campus tobacco-free policy on a large, diverse campus at a public university in the United States. Methods: We examined the comprehensive campus tobacco-free policy experience through Kindgon's Multiple Streams Framework, which stipulates that policy change can happen when problem, policy, and politics align. We focus on the factors that led the political stream to align with the problem and policy streams to create a "window of opportunity" for adopting this policy. Results: The campus experience with COVID-19 helped spur policy adoption. Support from leadership, a committed faculty-administration team, engagement with stakeholders and community partners, knowledge of the policy adoption process, and sustained advocacy all contributed to policy adoption. Conclusions: Campus tobacco-free policy advocates can navigate the politics of prioritizing, formulating, and adopting a campus smoke-free policy by knowing the context and process, being comfortable with policy work, engaging with tobacco prevention stakeholders, sustaining their efforts and advocating in multiple ways, and considering implementation and evaluation early.

How did the COVID pandemic impact anxiety and health anxiety in women living with HIV?

Background: The Covid pandemic and subsequent lockdown had implications on the population's mental health, particularly amongst society's most vulnerable members. We looked at the impact of the Covid pandemic on both generalised anxiety and health anxiety in women living with HIV (WLHIV). This research aimed to examine any increases in anxiety, what caused these increases, and how WLHIV dealt with them. Method(s): 12 WLHIV, aged 31-62 years old, completed recognised anxiety questionnaires (General Anxiety Disorder (GAD-7) and Health Assessment Questionnaire (HAQ)) to ascertain levels of anxiety and health anxiety respectively. Participants also responded to two open-ended questions: what made you most anxious during Covid lockdown and how did you deal with it? Results: Pre-covid GAD-7 scores averaged 6.3 indicating mild anxiety throughout the sample compared to postcovid scores of 12.9, which indicated moderate anxiety. Average HAQ scores were 21.3 indicating moderate health anxiety throughout the sample. Lack of self-advocacy skills (in relation to health) and isolation were commonly reported as being causes of anxiety;additional reasons included preexisting health issues and inability to access medical appointments and support. Participants reported using exercise, watching TV, sleep and prayer as coping mechanisms. Conclusion(s): The results of this research demonstrated that the Covid pandemic played a major part in raising anxiety, health anxiety and health worries in our sample. This was largely caused by increased isolation and decreased self-advocacy skills. Participants used individualised tools to manage their anxiety. Isolation: Isolation increased women's anxiety and health anxiety as they had no one to talk issues through with and social and organisational support was reduced due to lockdown. Lack of self-advocacy: Many participants reported that during the lockdown they found it difficult to identify and communicate their health concerns, advocate for themselves medically and subsequently negotiate help and support. Recommendations include future programmes to assist WLHIV to improve their self-advocacy skills and increase their attendance at groups/be actively involved with peers to reduce isolation. Supporting and improving advocacy helps women to gain more knowledge about their rights in relation to health care and empowers them to seek answers and negotiate treatment for themselves.

National Campaigns and Organizations Focused on Gender Equity in Pediatrics

This chapter explores the organizations, campaigns, and movements that advocate for gender equity in medicine, equity in specialties with the highest percentages of individuals who identify as women, and those which support women in pediatrics such as the work of the Federation of Pediatric Organizations (FOPO). It discusses these in the context of disparities in compensation, promotions, and research, the disproportionate effects of COVID on women in medicine, as well as the compounded effects of intersectionality in pediatrics. It also reviews studies that raise awareness of gender-based concerns in pediatrics like the Pediatric Life and Career Experience Study (PLACES) study and delves into one of the most recently launched pediatric advocacy groups, ADVANCE PHM. Through these avenues, there has been an increase in the awareness of gender equity and humanization of a profession that has historically had standards that are difficult to live up to and do not reflect the full potential of women who enter the profession. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.