The Supreme Court Is Harming Public Health and the Environment.

This Viewpoint looks back at the US Supreme Court's 2021 and 2022 terms and forward to the 2023 term and beyond with a focus on decisions that affect health care, public health and safety, environmental policy, and social equity.

The Psychosocial Impact of Treating Patients with COVID-19 on Psychiatry Residents in a Community Hospital: a Qualitative Study.

OBJECTIVE: The authors explored the experiences of psychiatry residents caring for patients during the COVID-19 pandemic on a medical unit. METHODS: From June 2020 through December 2020, structured, individual interviews were conducted with psychiatry residents deployed to internal medicine wards in a community hospital to provide medical care to COVID-19 patients for greater than or equal to 1 week. Interviews were recorded, transcribed verbatim, and analyzed using thematic analytical methods. RESULTS: Psychiatry residents (n = 16) were interviewed individually for approximately 45 min each. During the interviews, many residents described emotions of fear, anxiety, uncertainty, lack of preparedness, and difficulty coping with high patient mortality rates. Many of the residents expressed concerns regarding insufficient personal protective equipment, with the subsequent worries of their own viral exposure and transmission to loved ones. Multiple residents expressed feeling ill-equipped to care for COVID-19 patients, in some cases stating that utilizing their expertise in mental health would have better addressed the mental health needs of colleagues and patients' families. Participants also described the benefits of processing emotions during supportive group sessions with their program director. CONCLUSIONS: The COVID-19 pandemic represents a public health crisis with potential negative impacts on patient care, professionalism, and physicians' well-being and safety. The psychiatry residents and fellows described the overwhelmingly negative impact on their training. The knowledge gained from this study will help establish the role of the psychiatrist not only in future crises but in healthcare as a whole.

Impact of COVID-19 on traffic safety from the "Lockdown" to the "New Normal": A case study of Utah.

During the past several years, the COVID-19 pandemic has had pronounced impacts on traffic safety. Existing studies found that the crash frequency was reduced and the severity level was increased during the earlier "Lockdown" period. However, there is a lack of studies investigating its impacts on traffic safety during the later stage of the pandemic. To bridge such a gap, this study selects Salt Lake County, Utah as the study area and employs statistical methods to investigate whether the impact of COVID-19 on traffic safety differs among different stages. Negative binomial models and binary logit models were utilized to study the effects of the pandemic on the crash frequency and severity respectively while accounting for the exposure, environmental, and human factors. Welch's t-test and Pairwise t-test are employed to investigate the possible indirect effect of the pandemic by influencing other non-pandemic-related factors in the statistical models. The results show that the crash frequency is significantly less than that of the pre-pandemic during the whole course of the pandemic. However, it significantly increases during the later stage due to the relaxed restrictions. Crash severity levels were increased during the earlier pandemic due to the increased traffic speed, the prevalence of DUI, reduced use of seat belts, and increased presence of commercial vehicles. It reduced to a level comparable to the pre-pandemic later, owing to the reduction of speed and increased seat-belt-used to the pre-pandemic level. As for the incoming "New Normal" stage, stakeholders may need to take actions to deter DUI and reduce commercial-vehicle-related crashes to improve traffic safety.

Expressions of engagement in the Peruvian vaccination program against SARS-CoV-2 / Expresiones del engagement en el programa peruano de vacunación contra SARS-CoV-2

La investigación estuvo enfocada en el estudio de las expresiones emergentes del engagement en el programa peruano de vacunación COVID-19. Es de tipo descriptiva, transversal y con combinación de aspectos cuantitativos y cualitativos, en sus dimensiones vigor, dedicación y absorción, medidos a través de una adaptación del cuestionario Utrecht Work Engagement Scale, validado por expertos y con una muy alta confiabilidad (0,903), realizada entre los meses de febrero a mayo de 2021, en las localidades de Huancayo y Lima. Las expresiones emergentes nacen del conocimiento adquirido de las acciones realizadas y los factores motivacionales que condujeron al desarrollo de un accionar que va más allá de lo que el ministerio pudo haber solicitado de sus trabajadores, quienes a pesar de poner en riesgo constante su salud y su vida, por ser la primera línea de contención en defensa de la enfermedad, contribuyen enormemente con la población del Perú, logrando en la actualidad un 87,3% de total aplicación de los esquemas de vacunación indicados por las autoridades sanitarias en sus pobladores, aunque ello conlleva a largas jornadas de trabajo, sin límites de horas, pero imprimiéndole altos niveles de energía, así como deseo de invertir esfuerzos en el desarrollo de la labor con una amplia resistencia mental, gran implicación al compromiso laboral y sentido de significación ante la acción realizada, lo que finalmente genera en el individuo un estado positivo en los aspectos emocional, cognitivo, afectivo, social e integral del trabajador del sistema peruano de salud(AU)

The research was focused on the study of the emerging expressions of engagement in the Peruvian COVID-19 vaccination program. It is descriptive, cross-sectional and with a combination of quantitative and qualitative aspects, in its vigor, dedication and absorption dimensions, measured through an adaptation of the Utrecht Work Engagement Scale questionnaire, validated by experts and with a very high reliability (0.903), carried out between the months of February to May 2021, in Huancayo and Lima towns. The emerging expressions are born from the knowledge acquired from the actions carried out and the motivational factors that led to the development of actions that go beyond what the ministry could have requested of its workers, who despite constantly putting their health and safety at risk life, for being the first line of containment in defense of the disease, contribute enormously to the population of Peru, currently achieving 87.3% of total application of the vaccination schemes indicated by the health authorities in its inhabitants, although this leads to long working hours, with no limits on hours, but imprinting high levels of energy, as well as the desire to invest efforts in the development of the work with a broad mental resistance, great involvement in work commitment and a sense of significance in the face of action carried out, which finally generates in the individual a positive state in the emotional, cognitive, affective, social and integral of the worker of the peruvian health system(AU)

Safety analytics at a granular level using a Gaussian process modulated renewal model: A case study of the COVID-19 pandemic.

With the advance of intelligent transportation system technologies, contributing factors to crashes can be obtained in real time. Analyzing these factors can be critical in improving traffic safety. Despite many crash models having been successfully developed for safety analytics, most models associate crash observations and contributing factors at the aggregate level, resulting in potential information loss. This study proposes an efficient Gaussian process modulated renewal process model for safety analytics that does not suffer from information loss due to data aggregations. The proposed model can infer crash intensities in the continuous-time dimension so that they can be better associated with contributing factors that change over time. Moreover, the model can infer non-homogeneous intensities by relaxing the independent and identically distributed (i.i.d.) exponential assumption of the crash intervals. To demonstrate the validity and advantages of this proposed model, an empirical study examining the impacts of the COVID-19 pandemic on traffic safety at six interstate highway sections is performed. The accuracy of our proposed renewal model is verified by comparing the areas under the curve (AUC) of the inferred crash intensity function with the actual crash counts. Residual box plot shows that our proposed models have lower biases and variances compared with Poisson and Negative binomial models. Counterfactual crash intensities are then predicted conditioned on exogenous variables at the crash time. Time-varying safety impacts such as bimodal, unimodal, and parabolic patterns are observed at the selected highways. The case study shows the proposed model enables safety analytics at a granular level and provides a more detailed insight into the time-varying safety risk in a changing environment.

Identifying research priorities for road safety in Nepal: a Delphi study.

OBJECTIVE: To identify and prioritise the research needed to help Nepali agencies develop an improved road safety system. DESIGN: Delphi study. SETTING: Nepal. PARTICIPANTS: Stakeholders from government institutions, academia, engineering, healthcare and civil society were interviewed to identify knowledge gaps and research questions. Participants then completed two rounds of ranking and a workshop. RESULTS: A total of 93 participants took part in interviews and two rounds of ranking. Participants were grouped with others sharing expertise relating to each of the five WHO 'pillars' of road safety: (1) road safety management; (2) safer roads; (3) safer vehicles; (4) safer road users and (5) effective postcrash response. Interviews yielded 1019 research suggestions across the five pillars. Two rounds of ranking within expert groups yielded consensus on the important questions for each pillar. A workshop involving all participants then led to the selection of 6 questions considered the most urgent: (1) How can implementing agencies be made more accountable? (2) How should different types of roads, and roads in different geographical locations, be designed to make them safer for all road users? (3) What vehicle fitness factors lead to road traffic crashes? (4) How can the driver licensing system be improved to ensure safer drivers? (5) What factors lead to public vehicle crashes and how can they be addressed? and (6) What factors affect emergency response services getting to the patient and then getting them to the right hospital in the best possible time? CONCLUSIONS: The application of the Delphi approach is useful to enable participants representing a range of institutions and expertise to contribute to the identification of road safety research priorities. Outcomes from this study provide Nepali researchers with a greater understanding of the necessary focus for future road safety research.