The impact of covid-19 on justice-involved african americans

Abstract This study aimed to explore the impact of COVID-19 on justice-involved African Americans during incarceration and post-release. The study population comprised 25 African American men and women recently released from prison. A qualitative phenomenological approach was employed, and the reflexive thematic analysis process was utilized. In addition, semi-structured interviews were conducted and imported into NVivo 11 qualitative research software. The analysis revealed four major themes: stress, reentry, substance use, and community adjustment. The findings implied a need for (1) policy creation and revision to prepare jails and prisons for public health crises;(2) more realistic post-release coping strategies to prepare individuals to face post-release obstacles, such as COVID-19, housing, employment, relapse, and social reintegration;(3) improvements in data collection and transparency in disseminating such data to enhance healthcare services in jails and prisons;and (4) additional evidence-based research to address current concerns with data availability, misreporting, reporting delays, testing rate differences, and inconsistencies in population estimates. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Changes in Community-Dwelling Elderly's Activity and Participation Affecting Depression during COVID-19 Pandemic: A Cross-Sectional Study.

We determined the changes in the activity or participation of the community-dwelling elderly in Japan during the COVID-19 pandemic and identified the activities leading to depression. This will allow us to evaluate rehabilitation interventions that can be used to minimize or eliminate the negative impact of COVID-19 on today's community-dwelling elderly. Herein, demographics, activity or participation (Activity Card Sort-Japan version: ACS-JPN), the number of social networks (Lubben Social Network Scale: LSNS), and depression (Geriatric Depression Scale: GDS) were examined in 74 community-dwelling elderly in Japan from August to October 2020. A statistical analysis was conducted to determine the effect of demographics on GDS, LSNS, and ACS-JPN, to compare the activity retention rates of the four domains using ACS-JPN, and to extract the activities that might affect depression using a generalized linear model. The results show that the retention of leisure activity with a high physical demand (H-leisure) and sociocultural activities was significantly lower than instrumental activities of daily living and leisure activity with a low physical demand (L-leisure). L-leisure and the number of social networks were possible risk factors for depression during the pandemic. This study highlighted the importance of maintaining the number of L-leisure and social networks at home to prevent depression in community-dwelling elderly when they could not perform outdoor activities and direct interpersonal interaction.

Association Between COVID-19 and Activities of Daily Living in Older Adults.

Older adults gradually decrease their independence with activities of daily living (ADL) due to aging. The coronavirus disease-19 (COVID-19), the recent pandemic, can accelerate the decline in functions, such as ADL. This study aimed to examine whether there is an association between positive COVID-19 results and decreased independence with ADL in older adults. Data for a total of 3,118 older adults were extracted from the 2020 National Health and Aging Trends Study-COVID-19. A total of 71 (2.29%) participants presented with positive COVID-19 tests. There was a significant association between a positive COVID-19 result and decreased independence with ADL (relative risk [RR] = 1.47, 95% confidence interval [CI] = [1.11, 1.96], p = .0079). The study findings revealed that COVID-19 survivors had a high risk of decreased independence with ADL. These findings indicate that COVID-19 survivors have residual functional deficits and would need comprehensive health care services.

Validity and feasibility of a seated push-up test to indicate skeletal muscle mass in well-functioning older adults.

INTRODUCTION: Skeletal muscle mass (SMM) is a major component of the human body (> 30% of the body-weight) and plays crucial role in many bodily functions. However, SMM assessments require a complex and costly machine, which delays the ability to detect abnormalities related to SMM decline and, subsequently, reduces the effectiveness of the clinical management of older adults. PURPOSE: This study aimed to: 1) assess the correlation between upper limb loading during a seated push-up test (ULL-SPUT) and SMM (concurrent validity); 2) compare the SMM of participants who passed and failed a seated push-up test (SPUT; discriminant validity); and 3) explore the ability of a failed SPUT to identify older individuals with low SMM. METHODS: Participants (n = 40, age approximately 73 years) were cross-sectionally assessed for their SMM using a portable bioelectrical impedance analysis, and SPUTs were evaluated using digital push-up loading devices that were the size of clinical push-up boards, in three starting positions: 1) high; 2) ring, and 3) long sitting positions. RESULTS: The ULL-SPUT, especially in a ring sitting position, was significantly correlated to SMM (rs = 0.457-0.608, p < .005). The SMM and ULL-SPUT were significantly different between participants who passed and failed the SPUT (p < .05). Failure to complete the SPUT - that is, being unable to lift the body up from the floor during the test - showed an excellent ability to indicate participants with an SMM of < 28% of their body-weight (sensitivity > 83%, specificity > 82%, area under the curve = 0.93). CONCLUSIONS: The inability to lift the body up from the floor during sitting using the upper limbs can be used as a screening tool to indicate those with low SMM. Such a simple screening measure may enhance the distribution of healthcare services across various community- and home-based settings, particularly during the coronavirus (COVID-19) pandemic, when hospital services are limited for many individuals, including older adults.

Impact of incentivizing ASHAs on the outcome of persons with severe mental illness in a rural South Indian community amidst the COVID-19 pandemic.

BACKGROUND & OBJECTIVES: Task shifting has been recommended as a strategy to reach out to persons with mental illness and bridge the treatment gap. There is a need to explore task-shifting using existing health staff like Accredited Social Health Activists (ASHAs). We examined the impact of incentivizing ASHAs on the outcome of persons with severe mental illness (SMI) amidst the pandemic. METHODS: One hundred eighty-four adults with SMI from Jagaluru taluk were enrolled and followed up for a year. They were assessed for disability, work performance, internalized stigma, and illness severity at baseline, six months, and 12 months follow-up. ASHA workers were incentivized to ensure follow-up consultations, address concerns regarding illness/ medication side effects and monitor medication adherence. RESULTS: Out of the 184 recruited patients, 7 died (non-COVID-19 causes), 22 stopped treatment and did not report for follow-up consultations, 11 shifted to treatment from other centers, and in 1 case, there was a change in diagnosis. 143 (78%) patients with SMI completed the study amidst the COVID-19 pandemic. At one year follow-up, there was a significant reduction in disability, illness severity, self-stigma, and improved work performance. CONCLUSION: Incentivization of ASHAs helped ensure continuity of care to persons with SMI despite lockdowns and COVID-19 exigencies. It is feasible to involve ASHAs in the treatment of persons with SMI.

Impact of community-based rehabilitation on attainment of sustainable development goals: The case of selected districts in Zimbabwe

Several factors including droughts, cyclones, COVID-19, and inconsistent economic policies contributed to the challenges faced by children and persons with disabilities (PwDs) in rural areas of Zimbabwe. Consequently, there was a higher risk of low quality of life, poverty, and limited access to basic services such as education and healthcare. Various community-based rehabilitation (CBR) programs were implemented to address the violation of rights and access to services and participation by PwDs in general. This study used a mixed method approach to analyze the impact of CBR programs taking into account the five themes of the United Nations Convention of Rights of Persons with Disabilities (UN-CRPD): education, health, livelihoods, social protection, and participation. Respondents included core beneficiaries, caregivers, teachers, community health workers, and other key stakeholders. Results indicated that 61% were female respondents and 39% were males. Approximately 84% of rural families survive on less than USD 20.00 per month with the modal household having 5 to 9 members per household. Approximately 81% have received at least secondary education although some did not complete Ordinary Level mostly due to lack of funding for registration fees at the time of writing. However, none had tertiary education. The reach of CBR was as high as 92% of respondents received training on disability management;71% on income generating projects (IGPs) and 84% on Internal Savings and Lending (ISAL) although only 32% received funding. The study recommends funding for self-help groups, increased technical support, functional disability-friendly toilets, and orthopedic centers, scaling up of programs at a national level and adoption by the relevant agencies, decentralization by government officials to reduce red tape and accelerate programs, and training of trainers for additional capacity building. Improved latitude for NGOs and consistent economic policies are also needed to sustain IGPs.

Supporting ultra-poor children with cerebral palsy and their families with integrated microfinance/livelihood and community-based rehabilitation program -a cluster randomized controlled trial

Introduction: This trial aimed to test the efficacy of an integrated microfinance/livelihood and community-based rehabilitation (CBR) (IMCBR) program in improving health-related quality of life (HRQoL) and motor function of children with cerebral palsy (CP) from ultra-poor families and social capital gain to those families from such intervention in rural Bangladesh. Patients and Methods: This was an open-label cluster randomized controlled trial among children with CP aged ≤5 years randomly allocated in three arms;Arm-A: livelihood support and CBR (IMCBR), Arm-B: CBR only and Arm-C: care-as- usual. The CBR was stopped 2.5 months post-enrollment due to the COVID-19 pandemic and was replaced with phone follow-up followed by home-based CBR. The primary outcome was HRQoL of children while Gross Motor Function Classification System (GMFCS) level of children and social capital of their families were the secondary outcomes. Intention-to- treat analysis was performed. Results: Twenty-four clusters including 251 children-primary caregivers' dyads were assigned to three arms;Arm-A = 80, Arm-B = 82 and Arm-C = 89. Between baseline and endline, the percentage change in mean HRQoL was highest in Arm-A (30.0%) with significant mean differences between Arm-A and Arm-B (p = 0.015). The GMFCS level significantly changed both in Arm-A (p = 0.007) and Arm-C (p = 0.011). Also, the improvement in mean total social capital score was significantly higher in Arm-A compared to Arm-B (p <0.001) and Arm-C (p <0.001). Conclusion: The findings suggest that IMCBR could improve HRQoL and motor functions of children with CP and social capital of their ultra-poor families. Long-term follow- up of the trial participants and/or future exploration of such interventions are essential.

Supporting ultra-poor children with cerebral palsy and their families with integrated microfinance/livelihood and community-based rehabilitation: A cluster randomized controlled trial

Objective: This study aimed to test the effectiveness of an 'integrated microfinance/livelihood and community-based rehabilitation (CBR)' (IMCBR) program in improving quality of life and physical ability of children with cerebral palsy (CP), mental health of primary caregivers and social/economic capital of ultra-poor families of children with CP in rural Bangladesh. Design: Open-label pragmatic randomized controlled trial (registration: ACTRN12619001750178). Method: Children with CP aged ≤5 years were recruited in three arms: Arm-A: IMCBR, Arm-B: CBR, and Arm-C: control (i.e. care as usual). Each arm had eight clusters of 10-14 child-caregiver dyads. Caregivers recruited in the Arm-A received livelihood support (e.g., goat/lamb/poultry) and their children with CP received CBR once a week. The child-caregiver dyads in Arm-B received CBR only. The control Arm did not receive any intervention. However, CBR was stopped at 2.5 months of intervention due to COVID-19 pandemic and weekly phone follow-up was completed for home-based CBR. TNO-AZL Preschool children Quality of Life (TAPQoL), Gross Motor Function Classification System (GMFCS) and Communication Function Classification System (CFCS) were used to assess quality of life, motor function and communication of children, respectively. Depression, Anxiety, Stress Scale-Short Form-21 (DASS-21) was used to assess depression, anxiety and stress of primary caregivers. Results: Out of 251 children with CP and their caregivers recruited at baseline, 233 children and primary caregivers (Arm-A: n = 74, Arm-B: n = 77, and Arm-C: n = 82 dyads) completed the 12 month trial. The mean values of livelihood items given per family in Arm A increased from ∼USD66 to ∼USD79 between 0month(m) and 12m (p = 0.066), respectively. The mean TAPQoL score for physical functioning significantly increased between 0m and 12m in all three Arms (p < 0.001, p = 0.017 and p < 0.001 in Arm A, Arm B and Arm C, respectively), however, the improvement in the score was highest in Arm A. Similarly, significant improvement in the GMFCS level was observed between 0m and 12m in all three Arms with the highest improvement in Arm A (p < 0.001). Children's CFCS levels deteriorated slightly at 12m follow up in all three Arms. The depression, anxiety and stress levels among primary caregivers of children reduced significantly between the 0m and 12m in all three Arms (p ≤ 0.001 for all). Conclusion: Our findings suggest that the IMCBR is effective in enhancing quality of life and motor functions of children with CP, mental health of primary caregivers and economic status of ultra-poor families.

Goal Attainment in an Individually Tailored and Home-Based Intervention in the Chronic Phase after Traumatic Brain Injury.

Traumatic brain injury (TBI) is a heterogeneous condition with long-term consequences for individuals and families. Goal-oriented rehabilitation is often applied, but there is scarce knowledge regarding types of goals and goal attainment. This study describes goal attainment in persons in the chronic phase of TBI who have received an individualized, SMART goal-oriented and home-based intervention, compares goal attainment in different functional domains, and examines indicators of goal attainment. Goal attainment scaling (GAS) was recorded in the intervention group (n = 59) at the final session. The goal attainment was high, with 93.3% increased goal attainment across all goals at the final session. The level of goal attainment was comparable across domains (cognitive, physical/somatic, emotional, social). Gender, anxiety symptoms, self-reported executive dysfunction, and therapy expectations were indicators of goal attainment. These results indicate a potential for the high level of goal attainment in the chronic phase of TBI. Tailoring of rehabilitation to address individual needs for home-dwelling persons with TBI in the chronic phase represents an important area of future research.

Continuity of Care for Persons With Serious Mental Illness in a Rural Rehabilitation Program During the COVID-19 Pandemic in India.

The COVID-19 pandemic has posed challenges to community-based rehabilitation (CBR) for persons with mental illness, especially in resource-constrained settings. This column discusses the pandemic-related challenges faced by a rural CBR program in Jagaluru taluk (a subdistrict) in Karnataka, India. Thanks to stakeholder collaboration, task shifting with lay health workers, and implementation of telepsychiatry, the authors' clinical team could ensure uninterrupted medical care for persons with serious mental illness. Other CBR components were reduced because of pandemic-imposed resource and logistic constraints.