In-service training policy during the COVID-19 pandemic: The case of the agents of the farmers, rural people, and nomads social insurance fund.

Introduction: The COVID-19 pandemic has posed the in-service training of agents of the Farmers, Rural People, Nomads Social Insurance Fund (hereafter the Fund) to many problems. In-service training is one of the most effective development factors for organizational goals. This sort of training will increase employees' skills and subsequently improve their job performance. Accordingly, the present research mainly aimed to shed light on the effect of in-service training policy on employees' capabilities and job performance. Methods: The research was conducted among the agents of the Fund in Fars province, Iran (N = 197) out of whom 127 agents were sampled by simple randomization. The research instrument was a standard questionnaire whose face and content validity was confirmed by a panel of experts and its reliability was determined by calculating Cronbach's alpha in a pilot study. The results showed that the indicators used to measure the research variables were acceptably consistent with the factor structure and the theoretical framework of the research. Results and discussion: Based on the findings, in-service training in the Fund during the COVID-19 pandemic has had a positive and significant effect on the agents' capabilities (communication and team-working skills, creativity and problem-solving skills, commitment and responsibility, technical information and knowledge, and technical and practical skills) and job performance at the individual, technical, and general levels. Also, the agents' capabilities have had a positive and significant influence on their job performance. It can be concluded that in-service training can influence the agents' capabilities and job performance and improve organizational performance during the COVID-19 pandemic. Thus, the enhancement of in-service training courses' quantity and quality during the COVID-19 pandemic can influence the job performance of the agents at the individual, general, and technical performance levels.

One-Year Adverse Outcomes Among US Adults With Post-COVID-19 Condition vs Those Without COVID-19 in a Large Commercial Insurance Database.

Importance: Many individuals experience ongoing symptoms following the onset of COVID-19, characterized as postacute sequelae of SARS-CoV-2 or post-COVID-19 condition (PCC). Less is known about the long-term outcomes for these individuals. Objective: To quantify 1-year outcomes among individuals meeting a PCC definition compared with a control group of individuals without COVID-19. Design, Setting, and Participants: This case-control study with a propensity score-matched control group included members of commercial health plans and used national insurance claims data enhanced with laboratory results and mortality data from the Social Security Administration's Death Master File and Datavant Flatiron data. The study sample consisted of adults meeting a claims-based definition for PCC with a 2:1 matched control cohort of individuals with no evidence of COVID-19 during the time period of April 1, 2020, to July 31, 2021. Exposures: Individuals experiencing postacute sequelae of SARS-CoV-2 using a Centers for Disease Control and Prevention-based definition. Main Outcomes and Measures: Adverse outcomes, including cardiovascular and respiratory outcomes and mortality, for individuals with PCC and controls assessed over a 12-month period. Results: The study population included 13 435 individuals with PCC and 26 870 individuals with no evidence of COVID-19 (mean [SD] age, 51 [15.1] years; 58.4% female). During follow-up, the PCC cohort experienced increased health care utilization for a wide range of adverse outcomes: cardiac arrhythmias (relative risk [RR], 2.35; 95% CI, 2.26-2.45), pulmonary embolism (RR, 3.64; 95% CI, 3.23-3.92), ischemic stroke (RR, 2.17; 95% CI, 1.98-2.52), coronary artery disease (RR, 1.78; 95% CI, 1.70-1.88), heart failure (RR, 1.97; 95% CI, 1.84-2.10), chronic obstructive pulmonary disease (RR, 1.94; 95% CI, 1.88-2.00), and asthma (RR, 1.95; 95% CI, 1.86-2.03). The PCC cohort also experienced increased mortality, as 2.8% of individuals with PCC vs 1.2% of controls died, implying an excess death rate of 16.4 per 1000 individuals. Conclusions and Relevance: This case-control study leveraged a large commercial insurance database and found increased rates of adverse outcomes over a 1-year period for a PCC cohort surviving the acute phase of illness. The results indicate a need for continued monitoring for at-risk individuals, particularly in the area of cardiovascular and pulmonary management.

Evolution of differences in clinical presentation across epidemic waves among patients with COVID-like-symptoms who received care at the Mexican Social Security Institute.

Background: Timely monitoring of SARS-CoV-2 variants is crucial to effectively managing both prevention and treatment efforts. In this paper, we aim to describe demographic and clinical patterns of individuals with COVID-19-like symptoms during the first three epidemic waves in Mexico to identify changes in those patterns that may reflect differences determined by virus variants. Methods: We conducted a descriptive analysis of a large database containing records for all individuals who sought care at the Mexican Social Security Institute (IMSS) due to COVID-19-like symptoms from March 2020 to October 2021 (4.48 million records). We described the clinical and demographic profile of individuals tested (3.38 million, 32% with PCR and 68% with rapid test) by test result (positives and negatives) and untested, and among those tested, and the changes in those profiles across the first three epidemic waves. Results: Individuals with COVID-19-like symptoms were older in the first wave and younger in the third one (the mean age for those positive was 46.6 in the first wave and 36.1 in the third wave; for negatives and not-tested, the mean age was 41 and 38.5 in the first wave and 34.3 and 33.5 in the third wave). As the pandemic progressed, an increasing number of individuals sought care for suspected COVID-19. The positivity rate decreased over time but remained well over the recommended 5%. The pattern of presenting symptoms changed over time, with some of those symptoms decreasing over time (dyspnea 40.6 to 14.0%, cough 80.4 to 76.2%, fever 77.5 to 65.2%, headache 80.3 to 78.5%), and some increasing (odynophagia 48.7 to 58.5%, rhinorrhea 28.6 to 47.5%, anosmia 11.8 to 23.2%, dysgeusia 11.2 to 23.2%). Conclusion: During epidemic surges, the general consensus was that any individual presenting with respiratory symptoms was a suspected COVID-19 case. However, symptoms and signs are dynamic, with clinical patterns changing not only with the evolution of the virus but also with demographic changes in the affected population. A better understanding of these changing patterns is needed to improve preparedness for future surges and pandemics.

Impact on Public Health Nutrition Services Due to COVID-19 Pandemic in India: A Scoping Review of Primary Studies on Health and Social Security Determinants Affecting the First 1000 Days of Life.

CONTEXT: COVID-19 was declared 'a global pandemic' by the World Health Organization in March 2020. India's lockdown, one of the harshest in the world, came with additional challenges for women. This paper aims to assess the impact of COVID-19 pandemic-related pathways on the first thousand days of life in the Integrated Child Development Scheme and the public distribution ecosystem in India. DATA SOURCES: Using Cochrane guidelines, electronic databases, namely Google Scholar and PubMed-NCBI, were searched for evidence between 1 March 2020 and 1 May 2022. A total of 73 studies were identified in initial search; 20 met the inclusion criteria and, thus, were included in the research analysis. Primary studies were conducted throughout pan-India in rural, urban, and semi-urban areas to study the impact of COVID-19 pandemic-related pathways on the first 1000 days of life. The impact of social security, food insecurity, service delivery, nutrition of pregnant and nursing mothers (P&NMs), and infant and young child feeding (IYCF) varied between geographies and within geographies. Most of the primary studies were conducted at small scale, while only three studies were pan-Indian. The majority of studies were conducted on the mental health of P&NMs and pre-natal and post-natal service delivery disruption. The paucity of the available literature highlights the need to undertake research on the impact of the COVID-19 pandemic-related pathways on 1000 days of life in India and worldwide. The best implementation practices were observed where cross-sectional programs were carried out in relation to health services and social security for P&NMs and children.

A natural experiment in social security as public health measure: Experiences of international students as temporary migrant workers during two Covid-19 lockdowns.

What is the impact of social security on public health? And what mechanisms does it operate through? To answer these questions, we take advantage of the unique circumstances of temporary migrant workers two Covid-19 lockdowns in Australia - one in which they were provided with social security, and one in which they were not. We undertook 47 qualitative interviews with South Asian international students who had lost their jobs in two lockdowns in 2020-2021. In Australia, international students represent the largest group of a growing temporary migration program, with many working in low-skilled occupations, in conditions below legal minimum standards. We compare our findings to two models of social security: the self-insurance model and state-insurance model. In first lockdown, without social security, participants struggled to comply with public health orders because of the need to work for income, lack of housing suitable for isolation, and lack of medical leave. Participants tended to avoid testing, and to work while potentially contagious. Participants reported high levels of anxiety, depression and emotional distress caused by job loss and exclusion from an implicit social contract with the rest of Australian society. In contrast, during the second lockdown, where temporary migrants were provided social security payments, participants reported avoiding risky work, undertook Covid-19 testing many times, and self-isolated successfully. There was little evidence of emotional distress. Participants felt like a valued part of Australian society. These results suggest a self-insurance model of social security does not protect the physical and psychological health of vulnerable populations and can exacerbate the spread of communicable diseases. In contrast, state-insurance and social welfare payments to marginalised communities, particularly unemployment benefits and medical leave, are crucial public health policy levers for both protecting vulnerable populations and tackling outbreaks of communicable diseases such as Covid-19.

Hepatopancreatobiliary surgery in a Mexican social security hospital during the COVID-19 pandemic.

INTRODUCTION: Data on hepatopancreatobiliary (HPB) surgery and COVID-19 are scarce. The objective of the study was to determine the outcomes HPB procedures during the COVID-19 pandemic and compare results to the previous year. METHODS: IRB approved study of HPB procedures (April, 2020-November, 2020). Primary endpoints: Thirty-day surgical morbidity/mortality, including COVID-19 infection. Secondary endpoints: Comparison between 2019 and 2020 procedures. RESULTS: Twenty-five patients were included. In 2020, HPB procedures decreased 31.6%. About 60% developed complications (Clavien-Dindo Grade III, 20%). Three patients developed post-operative COVID-19 infection (two deaths: 66% COVID-19 mortality). When compared to the previous year, there were more emergency cases, ventilator-assisted patients (p < 0.05) and pre-operative acute renal failure (p = 0.06). Clavien-Dindo complication grades were higher in 2020. Thirty-day mortality was also higher (16% vs. 5.6%). CONCLUSION: HPB surgical activity was negatively influenced by COVID-19 on 30-day morbidity/mortality. HPB patients who developed post-operative COVID-19 infection had a complicated course with significant mortality.

OBJETIVO: Los datos sobre cirugía hepatopancreatobiliar (HPB) y COVID-19 son escasos. El objetivo del estudio fue determinar los resultados de procedimientos de HPB durante la pandemia COVID-19 y comparar resultados con el año anterior. MATERIAL-MÉTODOS: Estudio de procedimientos HPB aprobado por el IRB (04/2020-11/2020). Criterios de valoración principales: morbilidad/mortalidad quirúrgica a los 30 días, incluida la infección por COVID-19. Criterios de valoración secundarios: comparación entre los procedimientos de 2019 y 2020. RESULTADOS: Se incluyeron 25 pacientes. En 2020, los procedimientos de HPB disminuyeron 31.6%. El 60% desarrolló complicaciones (grado III de Clavien-Dindo, 20%). 3 pacientes desarrollaron infección posoperatoria por COVID-19, (2 muertes: 66% de mortalidad por COVID-19). En comparación con el año anterior, hubo más casos de emergencia, pacientes asistidos por ventilador (p < 0.05) e insuficiencia renal aguda preoperatoria (p = 0.06). Los grados de complicación de Clavien-Dindo fueron más altos en 2020. La mortalidad a 30 días también fue más alta (16% frente a 5.6%). CONCLUSIÓN: La actividad quirúrgica de HPB fue influenciada negativamente por COVID-19 en la morbilidad/mortalidad a 30 días. Los pacientes con HPB que desarrollaron infección posoperatoria por COVID-19 tuvieron un curso complicado con una mortalidad significativa.

Mental Distress during the COVID-19 Pandemic: A Cross-Sectional Study of Women Receiving the Comprehensive Social Security Allowance in Hong Kong.

Welfare recipients were often considered the least deserving of COVID-related support. Despite the recent attention paid to the impact of COVID-19 pandemic on mental health, few studies have explored the mental distress experienced by welfare recipients. This cross-sectional study on female Comprehensive Social Security Allowance recipients in Hong Kong aimed to explore their level of mental distress and its association with a range of risk factors specific to welfare recipients. Hence, 316 valid cases from a local community center responded to our online survey. We found that 52.3%, 23.4%, and 78% of the participants showed moderate to extremely severe depression, anxiety, and stress symptoms, respectively. A higher level of mental distress was associated with having a psychiatric diagnosis, poorer social, and greater concerns over disciplining children, the living environment, daily expenses and being infected by COVID-19. Unexpectedly, being married, having a permanent residence, and having a job were not significant protective factors for this group. The models explained 45.5%, 44.6%, and 52.5% of the overall variance in the level of depression, anxiety, and stress (p < 0.01), respectively. Our findings have important implications for supporting female welfare recipients during a public health crisis and may help frontline staff and professionals provide prompt assistance to this group in need.

Knowledge, attitudes and practices of pharmacovigilance in the context of COVID-19 in health professionals of the peruvian social insurance. / Conocimientos, actitudes y prácticas de farmacovigilancia en el contexto de la COVID-19 en profesionales de la salud del Seguro Social del Perú.

The study aimed to evaluate a group of health professionals' knowledge, attitudes, and practices on pharmacovigilance in the context of COVID-19 in the Peruvian Social Health Insurance (EsSalud). A descriptive secondary analysis was carried out on a database that included responses from an online survey conducted by the Institutional Referral Center for Pharmacovigilance and Technovigilance of EsSalud. Of 144 participants, 66% showed a high level of knowledge and 81.2% had a positive attitude; however, 71.5% had an inadequate level of pharmacovigilance practice. Although EsSalud professionals demonstrated a high level of knowledge and positive attitude to implement pharmacovigilance, this is not reflected in the practice of this activity during the SARS-CoV-2 pandemic. Strategies should be implemented to integrate pharmacovigilance into healthcare activities to benefit patient safety.

El estudio tuvo como objetivo evaluar el conocimiento, las actitudes y prácticas de un grupo de profesionales de la salud sobre la farmacovigilancia en el contexto de la COVID-19 en el Seguro Social de Salud del Perú (EsSalud). Se realizó un análisis secundario descriptivo de una base de datos que incluía las respuestas de una encuesta en línea realizada por el Centro de Referencia Institucional de Farmacovigilancia y Tecnovigilancia de EsSalud. De 144 participantes, el 66% mostró alto nivel de conocimiento y el 81,2%, actitud positiva; sin embargo, el 71,5% tuvo un inadecuado nivel de práctica de farmacovigilancia. Si bien los profesionales de EsSalud demostraron tener alto conocimiento y actitud positiva para implementar farmacovigilancia, esto no se ve reflejado en la práctica de esta actividad en la época de pandemia por el SARS-CoV-2. Se deben emplear estrategias para integrar a la farmacovigilancia en las actividades asistenciales en beneficio de la seguridad del paciente.

How Does Social Security Fairness Predict Trust in Government? The Serial Mediation Effects of Social Security Satisfaction and Life Satisfaction.

Several studies have found that trust in government is associated with social fairness, citizens' satisfaction with public service, and life satisfaction. This study aimed to investigate the serial mediation effects of social security satisfaction and life satisfaction on the association between social security fairness and trust in government. We analyzed the data from the Chinese Social Survey in 2019 (n = 7403) to examine the serial mediation effects. The findings showed that the higher the level of government, the greater the trust it enjoyed from its citizens. The direct prediction of trust by social security fairness was stronger at the county and township levels than at the central government level. Both social security satisfaction and life satisfaction partially mediated the relationship between social security fairness and overall trust in government. Social security fairness indirectly positively predicted trust in local government at the county and township levels through social security satisfaction, life satisfaction, and their serial mediation. While social security fairness could only indirectly predict trust in central government through social security satisfaction, the prediction of trust in central government via life satisfaction (mediator) was not significant. We observed a serial mediation model in which social security fairness positively predicted trust in government directly and indirectly through social security satisfaction and life satisfaction. The finding that social security satisfaction partially mediates the relationship between perceptions of fairness in the social security system and trust in government has implications for improving policies and the functioning of the system at all levels of the government.

Comportamiento epidemiológico de SARS-CoV-2 en población trabajadora afiliada al Instituto Mexicano del Seguro Social.

Objetivo. Describir el comportamiento de la epidemia de SARS-CoV-2 entre los trabajadores afiliados al Instituto Mexicano del Seguro Social (IMSS). Material y métodos. Se analizaron las incapacidades temporales para el trabajo por enfermedades respiratorias (ITT-ER), las hospitalizaciones y defunciones asociadas durante el periodo del 1 marzo al 31 diciembre 2020. Se estimó la tasa de ataque (TA) por SARS-CoV-2, así como los riesgos relativos (RR) de ITT-ER, hos-pitalización y defunción. Resultados. De los trabajadores afiliados al IMSS, 8.8% (n=1 730 334) recibió al menos una ITT-ER. La TA fue mayor en mujeres y en ambos sexos fue menor en el grupo de >60 años. Los RR de hospitalización y defunción fueron mayores en hombres y aumentaron con la edad. Comparado con las ITT-ER de 2015-2019, Durango, Tamaulipas y Nuevo León tuvieron un RR mayor de ITT-ER que el resto del país. Conclusiones. La epidemia de SARS-CoV-2 tuvo repercusiones importantes en los trabajadores afiliados al IMSS; se observó un exceso de ITT-ER de 4.6 veces respecto a la frecuencia esperada y cerca de un millón de casos de SARS-CoV-2. Los datos sugieren que el sistema de ITT-ER puede ser utilizado como elemento adicional para la vigilancia epidemiológica de enfermedades emergentes.

Tackling the COVID-19 pandemic: Initial responses in 2020 in selected social health insurance countries in Europe☆.

Countries with social health insurance (SHI) systems display some common defining characteristics - pluralism of actors and strong medical associations - that, in dealing with crisis times, may allow for common learnings. This paper analyses health system responses during the COVID-19 pandemic in eight countries representative of SHI systems in Europe (Austria, Belgium, France, Germany, Luxembourg, the Netherlands, Slovenia and Switzerland). Data collection and analysis builds on the methodology and content in the COVID-19 Health System Response Monitor (HSRM) up to November 2020. We find that SHI funds were, in general, neither foreseen as major stakeholders in crisis management, nor were they represented in crisis management teams. Further, responsibilities in some countries shifted from SHI funds to federal governments. The overall organisation and governance of SHI systems shaped how countries responded to the challenges of the pandemic. For instance, coordinated ambulatory care often helped avoid overburdening hospitals. Decentralisation among local authorities may however represent challenges with the coordination of policies, i.e. coordination costs. At the same time, bottom-up self-organisation of ambulatory care providers is supported by decentralised structures. Providers also increasingly used teleconsultations, which may remain part of standard practice. It is recommended to involve SHI funds actively in crisis management and in preparing for future crisis to increase health system resilience.

Exploring the risk-taking tendency among migrant workers in the COVID-19 pandemic: The role of ontological security.

BACKGROUND: The COVID-19 pandemic has changed the social environment of most laborers around the world and has profoundly affected people's ontological security and behavior choices. Among them, the migrant workers are one of the groups most affected by the pandemic. OBJECTIVE: This study explored the mechanism of the impact of the scarcity of ontological security caused by the pandemic on the risk-taking tendency of migrant workers in China through two studies. METHODS: This study adopts two experimental method, with 514 participants in the first study and 357 participants in the second study. RESULTS: The results show that the pandemic-induced scarcity perception of ontological security promotes their risk-taking tendency, and the migrant workers' cognitive reflection ability, sense of unfairness and expected benefits play a significant mediating role in this process. The scarcity perception of ontological security promotes migrant workers' risk-taking tendency by reducing the cognitive reflection ability, triggering the sense of unfairness and overstating expected benefits. CONCLUSIONS: The conclusion of this study can help migrant workers, enterprises and government to avoid potential workplace and social bad behavior.

Migrant workers, essential work, and COVID-19.

Globally, migrant and immigrant workers have borne the brunt of the COVID-19 pandemic as essential workers. They might be a Bulgarian worker at a meat processing plant in Germany, a Central American farmworker in the fields of California, or a Filipino worker at an aged-care facility in Australia. What they have in common is they are all essential workers who have worked throughout the coronavirus pandemic and have been infected with coronavirus at work. COVID-19 has highlighted the inequitable working conditions of these workers. In many instances, they are employed precariously, and so are ineligible for sick leave or social security, or COVID-19 special payments. If these are essential workers, they should get at least the same health and safety benefits of all nonessential workers. Improving the working and living conditions of migrant workers can and should be a positive outcome of the coronavirus pandemic.

Social Policy Responses to the Covid-19 Crisis in China in 2020.

The 2020 coronavirus pandemic has catapulted China into a serious social and political crisis. This article focuses upon how Chinese social policy has responded to the Covid-19 crisis. It reveals that the Chinese welfare state has woven a comprehensive social safety net to mitigate the social suffering of Chinese society in the mid- and post-crisis periods. Different types of social policy programs have been combined and synthesized, including social insurance, social assistance, and social welfare arrangements. Facing the challenges of the new risks caused by the pandemic, the collaboration of the Chinese state and intermediary social welfare organizations has played a crucial role in providing both cash benefits and social services (benefits in kind). For the first time, social policy in China has acted as a major player for coping with the negative outcomes of a pandemic. This article concludes that the pandemic-related crisis has justified an interventionist approach and logic, driven by the state's welfare system, which favors a model of "big government". However, this model also requires justification and legitimation.

Income security during periods of ill health: a scoping review of policies, practice and coverage in low-income and middle-income countries.

The COVID-19 pandemic is a reminder that insufficient income security in periods of ill health leads to economic hardship for individuals and hampers disease control efforts as people struggle to stay home when sick or advised to observe quarantine. Evidence on income security during periods of ill health is growing but has not previously been reviewed as a full body of work concerning low-income and middle-income countries (LMICs). We performed a scoping review to map the range, features, coverage, protective effects and equity of policies that aim to provide income security for adults whose ill health prevents them from participating in gainful work. A total of 134 studies were included, providing data from 95% of LMICs. However, data across the majority of these countries were severely limited. Collectively the included studies demonstrate that coverage of contributory income-security schemes is low, especially for informal and low-income workers. Meanwhile, non-contributory schemes targeting low-income groups are often not explicitly designed to provide income support in periods of ill health, they can be difficult to access and rarely provide sufficient income support to cover the needs of eligible recipients. While identifying an urgent need for more research on illness-related income security in LMICs, this review concludes that scaling up and diversifying the range of income security interventions is crucial for improving coverage and equity. To achieve these outcomes, illness-related income protection must receive greater recognition in health policy and health financing circles, expanding our understanding of financial hardship beyond direct medical costs.

Older Adults and the Economic Impact of the COVID-19 Pandemic.

The COVID-19 pandemic has impacted communities throughout the United States and worldwide. While the implications of the concomitant economic downturn for older adults are just beginning to be recognized, past experience suggests that the consequences could be devastating for many. Analyses indicate that more than one out of five Americans aged 65 years or older live in counties where high infection rates and high economic insecurity risks occur simultaneously. These findings highlight the overlap between current infection patterns and subsequent challenges to economic security that are impacting older people. Strategies and supports for getting people back to work must take into account the large segment of older people who rely on earnings well into later life. Social Security serves as the foundation of economic security for older adults across the income continuum, but it is frequently insufficient in and of itself, let alone during a crisis. Recognizing the importance of cost of living in shaping economic security highlights the need for the federal and state governments and municipalities to take older people into account in the economic recovery effort.

Unclaimed Defined Benefit Pensions Can Help COVID-19 Economic Recovery.

The COVID-19 economic crisis makes it vitally important that workers who earned defined benefit pensions receive them at retirement. Unfortunately, billions of dollars that could help cushion the financial shock are sitting unclaimed, because the people who they belong to cannot locate the company responsible for paying them. As defined benefit pension plans have been terminated, merged and moved over the years, large numbers of deferred vested participants have not been notified about their benefits. The widespread and growing practice of insurance company pension buy-outs can be especially problematic for participants without notice. Broader use of electronic disclosures for pensions also threatens to make the situation worse. In the wake of COVID-19, policy makers should take steps to ensure that pension benefits are part of the economic recovery.