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2.
Psychol Med ; : 1-11, 2020 Dec 03.
Article in English | MEDLINE | ID: covidwho-1972484

ABSTRACT

BACKGROUND: The Syrian crisis has entered its ninth year with many being affected by the war. This is the largest-scale study that aims to evaluate the psychological profile of secondary school students in Syria. METHODS: This is a cross-sectional study in schools in Damascus, Syria. The surveys assessed working habits, smoking, war exposure, grades, socioeconomic status (SES), social support, health-related quality of life (HRQL), post-traumatic stress disorder (PTSD), problematic anger, and other parameters. RESULTS: This study included 1369 students of which 53% suffered from PTSD and 62% from problematic anger. Around 46% declared a fair or worse general health and 61% had moderate or severe mental health. Only 9.3% did not report exposure to any war-related variable. War exposure had an impact on PTSD, anger, and HRQL, but not on students' grades. Smoking, having consanguineous parents, and working did not have a clear association with grades or anger. Social support weakly reduced PTSD and anger scores. Interestingly, working was associatedwith lowerPTSD scores but was associated with a worse physical component of HRQL. CONCLUSION: This is the largest study on school students in Syria that reports the psychological ramifications of war. Although the direct effects of war could not be precisely described, the high burden of PTSD and anger distress was a strong reflection of the chronic mental distress.

3.
Climate Change Economics ; 13(3), 2022.
Article in English | ProQuest Central | ID: covidwho-1973876

ABSTRACT

Focusing on raising climate concerns and sustaining a clean ecosystem, the current study strives to examine the connectedness of clean energy markets with conventional energy markets and four regional stock markets of Asia, Pacific, Europe, and America for the period spanning January 1, 2004 to August 31, 2021. We employed the volatility connectedness methodology using dynamic conditional correlation (DCC-GARCH) estimates for analysis purposes. There is pronounced within class connectedness of all markets except conventional energy markets, which showed strong disconnection from the network. However, strong inter-class spillovers are reported between clean energy and regional stock markets. Time-varying analysis revealed that intense spillovers are shaped during the Global Financial Crisis, Shale Oil Crisis, and COVID-19 pandemic. Meanwhile, time-varying net connectedness estimates illuminate that world renewable energy and American stock markets are net transmitters, whereas leftover markets are net recipients of spillovers. Further analysis of sub-sample periods during GFC, SOR, and COVID-19 validate that intense spillovers are formed when markets experience unexpected financial, economic, and global health turmoil. We proposed significant implications for regional stock markets of Asia, Pacific, Europe and America to concentrate on the climate-friendly energy markets than conventional energy markets as they service the clean ecosystem motives more specifically.

4.
BMJ Paediatrics Open ; 6(1), 2022.
Article in English | ProQuest Central | ID: covidwho-1973854

ABSTRACT

BackgroundThere are calls for research into the mental health consequences of living through the COVID-19 pandemic. Australia’s initial, effective suppression of COVID-19 offers insights into these indirect impacts in the relative absence of the disease. We aimed to describe the mental health experiences of Australian caregivers and children over 12 months, reporting differences related to demographic, socioeconomic and lockdown characteristics.MethodsData were from Australia’s only nationally representative, repeated cross-sectional survey of caregivers with children (0–17 years). N=2020 caregivers participated in June 2020, N=1434 in September 2020 and N=2508 in July 2021. Caregivers reported their mental health (poor vs not, Kessler-6), and perceived impacts of the pandemic on theirs and their children’s mental health (negative vs none/positive). Data were weighted to approximate population distributions of caregiver age, gender, sole caregiving, number and ages of children, state/territory and neighbourhood-level disadvantage.ResultsPerceived impacts on mental health were more frequently negative for female (vs male) caregivers and older (vs younger) children. Poor caregiver mental health (Kessler-6) was more common for families experiencing socioeconomic adversity (especially financial), while perceived impacts were more frequently negative for more socially advantaged groups. Caregivers who experienced the least total lockdown reported similar mental health over time. Otherwise, poor mental health and perceived negative impacts increased over time with increasing total length of lockdown.ConclusionDespite Australia’s low infection rates, the negative mental health experiences of the COVID-19 pandemic are real and concerning. Addressing poor mental health must be central to ongoing pandemic recovery efforts for families and children.

5.
BMJ : British Medical Journal (Online) ; 378, 2022.
Article in English | ProQuest Central | ID: covidwho-1973822

ABSTRACT

Doctors and other UK public sector workers have concluded that time is now, in a pay dispute that will turn a long hot summer into an autumn and winter of discontent (doi:10.1136/bmj.o1859, doi:10.1136/bmj.o1868, doi:10.1136/bmj.o1872, doi:10.1136/bmj.o1873).1234 Workforce pressures and staff burnout are at unprecedented levels (doi:10.1136/bmj.o1866, doi:10.1136/bmj.o1796).56 NHS restructuring is understandably met with “change fatigue” (doi:10.1136/bmj.o1765).7 The effect on staff manifests in worse outcomes and frustrating experiences for patients, the self evident logic of which seems to escape the people in power. The positive focus on health at the start of the covid pandemic is now replaced by policy makers telling us that covid is over when it isn’t (doi:10.1136/bmj.o1779, doi:10.1136/bmj-2021-069558).89 Or that it is just flu, even when new estimates suggest that, among the many non-flu-like sequelae of covid, long term smell and taste dysfunction may be affecting around 5% of people (doi:10.1136/bmj-2021-069503, doi:10.1136/bmj.o1653).1011 The war in Ukraine and the crisis in the cost of living are being used as a pretext to renege on climate commitments and boost fossil fuel extraction, when what is needed is a redoubling of effort on tackling the climate crisis and faster progress, such as on air pollution targets (doi:10.1136/bmj.o1664).12 The modern world is ruled by expediency and populist manifestos and soundbites. The first test of our new policy may be imminent now that the World Health Organization has declared monkeypox a public health emergency of international concern (doi:10.1136/bmj.o1874).19 The way to stop the boot stamping on our faces for ever, to change the daunting picture of our future, is to stand by our principles, and that begins by distinguishing between what is right and wrong. 1 Waters A Torjesen I. Doctors’ pay award: what have different groups been offered, and is industrial action “inevitable”?

6.
Disaster Prevention and Management ; 31(4):349-360, 2022.
Article in English | ProQuest Central | ID: covidwho-1973382

ABSTRACT

Purpose>This study explores the relationships between governance quality and disaster risk in respect to the pillar values of public administration. The objective is to strengthen the focus and resolve of bureaucratic institutions to engage with disaster risk management (DRM) as a core function.Design/methodology/approach>Multiple correlation analysis is conducted using data from global indices of disaster risk and governance quality. This is situated in the argument for the importance of public administration to conduct DRM under the auspices of core values for governance.Findings>There are strong relationships between measures of disaster risk and various qualities of governance that adhere to the administrative theories of public welfare management, particularly through measures for mitigation and preparedness.Research limitations/implications>This study is conducted at the national level and may obscure regional effects of governance quality and disaster risk that occur in larger and environmentally diverse countries.Originality/value>There are few studies that champion the value of public administration's qualities and values in the efforts of DRM. This research provides support for such a position by connecting governance quality to disaster risk and overlaying the influence of the core administrative values of efficiency, effectiveness, the economy and equity.

7.
Oncology Times ; 44(14):29-29, 2022.
Article in English | CINAHL | ID: covidwho-1973263
8.
The Law and Regulation of Medicines and Medical Devices, Second Edition ; : 411-422, 2021.
Article in English | Scopus | ID: covidwho-1973235

ABSTRACT

This chapter reveals some of the major changes in the European and UK regulatory framework following the UK leaving the EU (Brexit), public health consequences of the supply of infected blood products, and the Covid-19 pandemic. It covers issues that occurred after Brexit, the independent medicines and medical devices safety review, and the UK blood enquiry. It also mentions the Medicines and Healthcare products Regulatory Agency (MHRA) that became the UK’s standalone regulator of medicines and medical devices since 1 January 2021, acting independently in joint work with other international regulators. The chapter elaborates on the UK’s intention to develop a new regulatory framework for medical devices that reflect the Independent Medicines and Medical Devices Safety Review published in July 2020. It highlights the European Medicines Agency’s (EMA) cooperation with the World Health Organization (WHO) on developing potential Covid-19 treatments by facilitating large-scale clinical trials. © Oxford University Press 2021.

9.
European Legacy ; 27(6):640-642, 2022.
Article in English | Academic Search Complete | ID: covidwho-1972868

ABSTRACT

Second, in retrieving archival records of the activity of the civic offices responsible for maintenance, Geltner also joins the call of other medieval public health historians to expand the scope of health histories beyond the activity of medical personnel. I Roads to Health i was published just a few months before the outbreak of the Covid-19 pandemic and the subsequent re-emergence into public consciousness of how health issues may impact all of society. Third, Geltner demonstrates that public health has a longer history than claimed by much modern historiography and that the Black Death, the plague of 1348, was not the watershed of public health measures as it is often claimed to have been. [Extracted from the article] Copyright of European Legacy is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

10.
Ethics & International Affairs ; 36(2):125-134, 2022.
Article in English | ProQuest Central | ID: covidwho-1972489

ABSTRACT

The current debate over the global distribution of COVID-19 vaccines once again highlights the many shortcomings of the modern intellectual property (IP) system, especially when it comes to equitable access to medicines. This essay argues that the (unspoken) conceptual center of struggles over access to new pharmaceuticals rests in the IP system's colonial legacy, which perceives the world as uncharted territory that is ripe for discovery and ownership. This vision of the world as a blank canvas, or terra nullius, sets aside any other models of ownership and devalues other traditional modes of relating to territory and nature. Several examples show the long-lasting exclusionary effects of this hidden legacy of colonial conquest in the field of public health, ranging from the spiraling price of insulin to the distribution of COVID-19 vaccines to the negotiation of sharing mechanisms for virus samples. In all of these cases, the continuing marginalization of other interests by the IP system can lead to exploitation, without either the “sources” of materials, such as those from whom the samples were taken, or the recipients of the eventual product having any say in matters of price and access. This legacy of fundamental exclusion needs to be recognized and addressed in order to arrive at more equitable solutions to public health emergencies such as the current pandemic.

11.
Language in Society ; 51(3):549-550, 2022.
Article in English | ProQuest Central | ID: covidwho-1972486

ABSTRACT

Social inferences, cultural differences, and linguistic misconceptions. Cambridge: Cambridge University Press. Communicating COVID-19 and public health strategy. Cambridge: Cambridge University Press.

12.
15th International Conference on Knowledge Science, Engineering and Management, KSEM 2022 ; 13369 LNAI:417-428, 2022.
Article in English | Scopus | ID: covidwho-1971568

ABSTRACT

The rapid spread of the Coronavirus (COVID-19) poses an unprecedented threat to the public health system and social economy, with approximately 500 million confirmed cases worldwide. Policymakers confront with high-stakes to make a decision on interventions to prevent the pandemic from further spreading, which is a dilemma between public health and a steady economy. However, the epidemic control problem has vast solution space and its internal dynamic is driven by population mobility, which makes it difficult for policymakers to find the optimal intervention strategy based on rules-of-thumb. In this paper, we propose a Deep Reinforcement Learning enabled Epidemic Control framework (DRL-EC) to make a decision on intervention to effectively alleviate the impacts of the epidemic outbreaks. Specifically, it is driven by reinforcement learning to learn the intervention policy autonomously for the policymaker, which can be adaptive to the various epidemic situation. Furthermore, District-Coupled Susceptible-Exposed-Infected-Recovered (DC-SEIR) model is hired to simulate the pandemic transmission between inter-district, which characterize the spatial and temporal nature of infectious disease transmission simultaneously. Extensive experimental results on a real-world dataset, the Omicron local outbreaks in China, demonstrate the superiority of the DRL-EC compared with the strategy based on rules-of-thumb. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

13.
Lecture Notes on Data Engineering and Communications Technologies ; 145:715-728, 2022.
Article in English | Scopus | ID: covidwho-1971543

ABSTRACT

The COVID-19 broke out and spread rapidly, posing a great challenge to the emergency management capacity of various regions in China, especially in rural areas. This paper takes three communities in ShiYang town, Dujiangyan City, Sichuan Province as cases, to analyze the specific practice of rural response to public health emergencies, summarize different stages in epidemic prevention and control, and explore the difficulties and solutions in rural emergency management. Through the case analysis, it is found that the rural epidemic prevention and control in ShiYang Town have experienced four stages including exploration period, development period, improvement period, and maturity period. At the same time, there are some dilemmas in rural emergency management, such as the imperfect emergency management mechanism, insufficient resources guarantee, and villagers’ weak awareness of health and epidemic prevention. Therefore, the paper proposes such countermeasures suggestions as improving the emergency management mechanism of rural public health, optimizing the resources guarantee system for rural emergency management, strengthening the popularization of health education, providing theoretical and practical guidance for improving the level of rural emergency management, and then promoting the modernization of rural emergency management system and capacity. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

14.
BMJ Mil Health ; 2022 Aug 04.
Article in English | MEDLINE | ID: covidwho-1973862

ABSTRACT

The COVID-19 pandemic placed significant global pressure on public health, with the demand for specialist clinical input, equipment and therapeutics often outweighing supply in many well-established healthcare systems. The UK was no exception to this burden, resulting in unprecedented demands being placed on its NHS. Throughout the pandemic, the UK Defence Medical Services (DMS) aided the civilian healthcare sector, while concurrently adapting as an organisation to meet its enduring commitment in promoting the operational output of the wider UK Armed Forces. This paper serves to provide an overview of some of these key activities while offering proposed lessons which can be learnt, in order to promote the DMS' output in times of future crises. Of note, the DMS aided to mitigate surge demands placed on the NHS' supply chain, assisting in promoting its resilience to provide key materials to civilian clinical personnel. Adaptation of military policy generation mechanisms, together with adoption of novel technological approaches to promote remote working, empowered efficient DMS operational output throughout the pandemic. Direct provision of personnel to assist in the NHS' clinical output served to foster mutually beneficial interorganisational relationships, while providing objective benefit for the UK public.This paper was selected as the BMJ Military Health Royal Society of Medicine Colt Foundation National Essay Prize Winner 2021.

15.
BMJ Open ; 12(8): e063935, 2022 08 03.
Article in English | MEDLINE | ID: covidwho-1973851

ABSTRACT

OBJECTIVE: To estimate the effectiveness of messenger RNA (mRNA) booster doses during the period of Delta and Omicron variant dominance. DESIGN: We conducted a matched test-negative case-control study to estimate the vaccine effectiveness (VE) of three and two doses of mRNA vaccines against infection (regardless of symptoms) and against COVID-19-related hospitalisation and death. SETTING: Veterans Health Administration. PARTICIPANTS: We used electronic health record data from 114 640 veterans who had a SARS-CoV-2 test during November 2021-January 2022. Patients were largely 65 years or older (52%), male (88%) and non-Hispanic white (59%). MAIN OUTCOME MEASURES: First positive result for a SARS-CoV-2 PCR or antigen test. RESULTS: Against infection, booster doses had higher estimated VE (64%, 95% CI 63 to 65) than two-dose vaccination (12%, 95% CI 10 to 15) during the Omicron period. For the Delta period, the VE against infection was 90% (95% CI 88 to 92) among boosted vaccinees, higher than the VE among two-dose vaccinees (54%, 95% CI 50 to 57). Against hospitalisation, booster dose VE was 89% (95% CI 88 to 91) during Omicron and 94% (95% CI 90 to 96) during Delta; two-dose VE was 63% (95% CI 58 to 67) during Omicron and 75% (95% CI 69 to 80) during Delta. Against death, the VE with a booster dose was 94% (95% CI 90 to 96) during Omicron and 96% (95% CI 87 to 99) during Delta. CONCLUSIONS: Among an older, mostly male, population with comorbidities, we found that an mRNA vaccine booster was highly effective against infection, hospitalisation and death. Although the effectiveness of booster vaccination against infection was moderately higher against Delta than against the Omicron SARS-CoV-2 variant, effectiveness against severe disease and death was similarly high against both variants.


Subject(s)
COVID-19 , Veterans , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Case-Control Studies , Female , Humans , Male , RNA, Messenger , SARS-CoV-2/genetics , Vaccines, Synthetic , mRNA Vaccines
19.
Crit Care Explor ; 4(7): e0727, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1973281

ABSTRACT

OBJECTIVES: The COVID-19 pandemic was characterized by rapidly evolving evidence regarding the efficacy of different therapies, as well as rapidly evolving health policies in response to that evidence. Data on adoption and deadoption are essential as we learn from this pandemic and prepare for future public health emergencies. DESIGN: We conducted an observational cohort study in which we determined patterns in the use of multiple medications to treat COVID-19: remdesivir, hydroxychloroquine, IV corticosteroids, tocilizumab, heparin-based anticoagulants, and ivermectin. We analyzed changes both overall and within subgroups of critically ill versus Noncritically ill patients. SETTING: Data from Optum's deidentified Claims-Clinical Dataset, which contains multicenter electronic health record data from U.S. hospitals. PATIENTS: Adults hospitalized with COVID-19 from January 2020 to June 2021. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 141,533 eligible patients, 34,515 (24.4%) required admission to an ICU, 14,754 (10.4%) required mechanical ventilation, and 18,998 (13.4%) died during their hospitalization. Averaged over the entire time period, corticosteroid use was most common (47.0%), followed by remdesivir (33.2%), anticoagulants (19.3%), hydroxychloroquine (7.3%), and tocilizumab (3.4%). Usage patterns varied substantially across treatments. For example, hydroxychloroquine use peaked in March 2020 and leveled off to near zero by June 2020, whereas the use of remdesivir, corticosteroids, and tocilizumab all increased following press releases announcing positive results of large international trials. Ivermectin use increased slightly over the study period but was extremely rare overall (0.4%). CONCLUSIONS: During the COVID-19 pandemic, medication treatment patterns evolved reliably in response to emerging evidence and changes in policy. These findings may inform efforts to promote optimal adoption and deadoption of treatments for acute care conditions.

20.
PNAS Nexus ; 1(3): pgac100, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1973239

ABSTRACT

Quarantine and serial testing strategies for a disease depend principally on its incubation period and infectiousness profile. In the context of COVID-19, these primary public health tools must be modulated with successive SARS CoV-2 variants of concern that dominate transmission. Our analysis shows that (1) vaccination status of an individual makes little difference to the determination of the appropriate quarantine duration of an infected case, whereas vaccination coverage of the population can have a substantial effect on this duration, (2) successive variants can challenge disease control efforts by their earlier and increased transmission in the disease time course relative to prior variants, and (3) sufficient vaccine boosting of a population substantially aids the suppression of local transmission through frequent serial testing. For instance, with Omicron, increasing immunity through vaccination and boosters-for instance with 100% of the population is fully immunized and at least 24% having received a third dose-can reduce quarantine durations by up to 2 d, as well as substantially aid in the repression of outbreaks through serial testing. Our analysis highlights the paramount importance of maintaining high population immunity, preferably by booster uptake, and the role of quarantine and testing to control the spread of SARS CoV-2.

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