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1.
Health Res Policy Syst ; 20(1): 9, 2022 Jan 15.
Article in English | MEDLINE | ID: covidwho-1639041

ABSTRACT

BACKGROUND: Adaptive models of healthcare delivery, such as telehealth consultations, have rapidly been adopted to ensure ongoing delivery of essential healthcare services during the COVID-19 pandemic. However, there remain gaps in our understanding of how clinicians have adapted to telehealth. This study aims to explore the telehealth experiences of specialists, based at a tertiary hospital in the Hunter Region, and general practitioners (GP), including barriers, enablers and opportunities. METHODS: An interpretative qualitative study involving in-depth interviews explored the telehealth experiences of specialists, based at a tertiary hospital in the Hunter Region of Australia, and GPs, including barriers, enablers and opportunities. Data were analysed using an inductive thematic approach with constant comparison. RESULTS: Individual interviews were conducted with 10 specialists and five GPs. Key themes were identified: (1) transition to telehealth has been valuable but challenging; (2) persisting telehealth process barriers need to be addressed; (3) establishing when face-to-face consults are essential; (4) changes in workload pressures and potential for double-up; (5) essential modification of work practices; and (6) exploring what is needed going forward. CONCLUSIONS: While there is a need to rationalize and optimize health access during a pandemic, we suggest that more needs to be done to improve telehealth going forward. Our results have important policy implications. Specifically, there is a need to effectively train clinicians to competently utilize and be confident using this telehealth and to educate patients on necessary skills and etiquette.


Subject(s)
COVID-19 , Telemedicine , Australia , Delivery of Health Care , Humans , Pandemics , Policy , SARS-CoV-2
2.
J Bioeth Inq ; 18(4): 609-619, 2021 12.
Article in English | MEDLINE | ID: covidwho-1632687

ABSTRACT

We discuss whether and under what conditions people should be allowed to choose which COVID-19 vaccine to receive on the basis of personal ethical views. The problem arises primarily with regard to some religious groups' concerns about the connection between certain COVID-19 vaccines and abortion. Vaccines currently approved in Western countries make use of foetal cell lines obtained from aborted foetuses either at the testing stage (Pfizer/BioNTech and Moderna vaccines) or at the development stage (Oxford/AstraZeneca vaccine). The Catholic Church's position is that, if there are alternatives, Catholic people have a moral obligation to request the vaccine whose link with abortion is more remote, which at present means that they should refuse the Oxford/AstraZeneca vaccine. We argue that any consideration regarding free choice of the vaccine should apply to religious and non-religious claims alike, in order to avoid religion-based discrimination. However, we also argue that, in a context of limited availability, considering the significant differences in costs and effectiveness profile of the vaccines available, people should only be allowed to choose the preferred vaccine if: 1) this does not risk compromising vaccination strategies; and 2) they internalize any additional cost that their choice might entail. The State should only subsidize the vaccine that is more cost-effective for any demographic group from the point of view of public health strategies.


Subject(s)
COVID-19 , Vaccines , COVID-19 Vaccines , Female , Freedom of Religion , Humans , Policy , Pregnancy , SARS-CoV-2 , Vaccination
3.
Nurs Leadersh (Tor Ont) ; 34(4): 11-18, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1630585

ABSTRACT

The COVID-19 pandemic has laid bare the underlying vulnerabilities of the Canadian nursing workforce more clearly than ever before. In this commentary, I highlight how the roots of the present vulnerabilities of the nursing workforce lie in part with the complex and adaptive nature of the nursing workforce system. I also propose systemic solutions to address these vulnerabilities through enhanced foundational data on the nursing workforce. These data can be adopted across the range of Canadian nursing workforce stakeholders to create high-quality, interactive and iterative planning, policy and management processes.


Subject(s)
COVID-19 , Pandemics , Canada , Humans , Policy , SARS-CoV-2 , Workforce
4.
J Health Organ Manag ; ahead-of-print(ahead-of-print)2022 Jan 18.
Article in English | MEDLINE | ID: covidwho-1626719

ABSTRACT

PURPOSE: This illustrative case study describes and evaluates drivers of effective inter-organizational collaboration to mitigate the impact and spread of COVID-19 among homeless people in two cities in the Netherlands. The aims of this study are: (1) to explore the strategic and operational policy responses in two local integrated care settings at the start of the crisis, (2) to identify best policy practices and lessons learned. The authors interpret and evaluate the findings by combining insights from the population health management (PHM) and collaborative governance literature. DESIGN/METHODOLOGY/APPROACH: The authors describe and illustrate the experiences of two Dutch municipalities, Rotterdam and The Hague, in the early policy responses to sudden operational challenges around the impact of COVID-19 on homeless people as experienced by local decision-makers, medical doctors and clients. FINDINGS: The authors show that best policy practices revolve around (1) using data and risk stratification methods for identifying and targeting populations at-risk in local policy making, and (2) having an inter-organizational data sharing architecture in place ex ante. These two factors were clear prerequisites for tailor-made policy responses for newly-defined groups at risk with the existing and well-documented vulnerable population, and executing crisis-induced tasks efficiently. ORIGINALITY/VALUE: This paper is among the first to illustrate the potential of combining collaborative governance and PHM perspectives to identify key drivers of effective local governance responses to a healthcare crisis in an integrated care setting.


Subject(s)
COVID-19 , Delivery of Health Care, Integrated , Health Policy , Humans , Policy , Policy Making , SARS-CoV-2
5.
Int J Public Health ; 66: 1604236, 2021.
Article in English | MEDLINE | ID: covidwho-1626621

ABSTRACT

Objectives: We face the impossibility of having enough COVID-19 vaccines for everyone in the near future. This study aims to contribute to the debate on equitable global access to COVID-19 vaccines, tackling key ethical discussions and policy challenges regarding early phases of COVAX, the global cooperation mechanism for supporting fair vaccine allocation. Methods: We conducted in-depth interviews with twelve experts and a literature research on academic articles, media sources and public statements. We built a data analysis matrix and conducted a thematic analysis. Results: Our findings show, first, that interviewed experts who hold different views on vaccine allocation, including moderate nationalist perspectives, agree on joining a global cooperation mechanism. Second, incentives to join COVAX vary greatly among countries. Third, specific barriers to COVAX emerged in the early implementation phase. And fourth, countries might be trapped in a zero-sum game regarding the global vaccine supply. Conclusion: We present findings that enrich analyses of early phases of COVAX (April 2020-21), we introduce three ethical discussions that provide a common ground for equitable access to COVID-19 vaccines, and we highlight policy challenges.


Subject(s)
COVID-19 , Vaccines , COVID-19 Vaccines , Humans , Policy , SARS-CoV-2
6.
PLoS One ; 17(1): e0261929, 2022.
Article in English | MEDLINE | ID: covidwho-1622348

ABSTRACT

OBJECTIVES: The purpose of this study was to identify predictors of COVID-19 vaccine intention among Bangladeshi adults. METHODS: Secondary data from the COVID-19 Beliefs, Behaviors & Norms Survey conducted by the Massachusetts Institute of Technology (MIT) and Facebook were analyzed. Data were collected from 2,669 adult Facebook users in Bangladesh and was collected between February 15 and February 28, 2021. Binomial logistic regression examined the relationship between COVID-19 vaccination intent and demographic variables, risk perception, preventive behaviors, COVID-19 knowledge, and likelihood of future actions. RESULTS: Seventy-nine percent of respondents reported intent to get the COVID-19 vaccine when it becomes available. Intent to get vaccinated was highest among females, adults aged 71-80, individuals with college or graduate-level degrees, city dwellers, and individuals who perceived that they were in excellent health. Results of the binomial logistic regression indicated that predictors of vaccination intent include age (OR = 1.39), high risk perception of COVID-19 (OR = 1.47), and intent to practice social distancing (OR = 1.22). DISCUSSION: Findings suggest that age, perceived COVID-19 risk, and non-pharmaceutical COVID-19 interventions may predict COVID-19 vaccination intent among Bangladeshi adults. Findings can be used to create targeted messaging to increase demand for and uptake of COVID-19 vaccines in Bangladesh.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/immunology , Vaccination/legislation & jurisprudence , Adult , Aged , Aged, 80 and over , Bangladesh , Female , Humans , Intention , Male , Middle Aged , Policy , Young Adult
7.
Adv Exp Med Biol ; 1337: 127-135, 2021.
Article in English | MEDLINE | ID: covidwho-1596047

ABSTRACT

Social distancing and the recent lock down due to COVID-19 has increased the feeling of disconnection, isolation, and suffering in vulnerable individuals and has brought forward questions regarding open acute care psychiatric units that cannot be answered by the literature. In Greece, there is no available research on how open ward environments are perceived and experienced by mental health professionals. The aim of the present study was to illuminate nurses' experiences of working in a public psychiatric hospital which traditionally operates with open doors. Eleven nursing care providers were interviewed, and thematic analysis was employed to explore their experiences of working in locked psychiatric acute care units. Participants described nursing care in units with an open door policy as "acceptance," "availability of staff," "real respect for the person," "ensuring patients' rights," "listening to the person," and "negotiation and not imposition." Trust in therapeutic relationships was perceived as greatly dependent on the trust being given to patients indirectly by the open door policy. Being trusted enhanced patients' self-determination and self-confidence leading to their empowerment. Containment of an acute mental health crisis took place through medication and meaningful discussions with patients and significant others rather than locking the door of the unit. Overall, meaningful care led to professional emancipation, but compassion fatigue narratives emphasized the need for continuous education, support and clinical supervision as necessary support for mental health nurses in a system of mental health provision often reduced to the point of crisis.


Subject(s)
COVID-19 , Nurses , Communicable Disease Control , Humans , Policy , SARS-CoV-2
8.
Ann Agric Environ Med ; 28(4): 551-557, 2021 Dec 29.
Article in English | MEDLINE | ID: covidwho-1595556

ABSTRACT

INTRODUCTION AND OBJECTIVE: Poland is engaged in the implementation of activation programmes for seniors at governmental as well as non-governmental levels. Among these programmes may be mentioned, 'Active+', 'Senior+', 'Care 75+', and 'Senior Caritas'. The COVID-19 pandemic highlighted the need for the inclusion of seniors into social life, and concern about their health. An important challenge for social and ageing policy is the provision of proper standards of care and health protection, especially during an increased sanitary regime. The aim of the study was analysis of the ageing policy strategy and the quality of life of seniors before and during the COVID-19 pandemic. REVIEW METHODS: The study was conducted by the method of analysis of data in the area of national initiatives concerning activation programmes for seniors implemented during 2020-2021. The starting point was the well-established definition of the quality of life by the WHO. ABBREVIATED DESCRIPTION OF THE STATE OF KNOWLEDGE: The analysis performed showed a multitude of factors determining the needs of seniors at the time of the pandemic, which often differed from those observed earlier. The latest studies of the quality of life of the elderly in Poland demonstrated that nearly 60% of respondents assessed their psychological condition as worse than before the pandemic. Another problem was the issue of physical activity, which was limited by more than 62% of seniors, and difficulties with access to health care system services. SUMMARY: It seems necessary to implement forms of assistance which could be adjusted to the changing epidemiological conditions, in order to improve the quality of life of persons who, in the near future, will constitute a considerable percentage of Polish society.


Subject(s)
COVID-19 , Pandemics , Aged , Aging , Humans , Poland/epidemiology , Policy , Quality of Life , SARS-CoV-2
9.
Front Public Health ; 9: 785679, 2021.
Article in English | MEDLINE | ID: covidwho-1581104

ABSTRACT

Background: The negative impact of isolation, confinement, and physical (in)activity due to pandemic movement restriction has been well-documented over the past year, but less is known on the impact of these policies on children's physical fitness. This study was designed to determine the effects of pandemic movement restriction policies on the 24-hour movement behavior (24-HMB) of children, and whether any alterations are reflected in worsening physical fitness outcomes determined via direct testing. Methods: A two-phase, repeated-measures study with matched controls was conducted. Phase One: N = 62 schoolchildren (N = 31 female) completed self-assessment questionnaires on 24-HMB in October 2018 (pre-pandemic) and again in April 2020, at the height of movement restrictions enacted in response to the COVID-19 pandemic first wave. Phase Two: physical fitness of the original N = 62 children were determined directly pre- and post-isolation using an eight-component standardized fitness test battery and compared to N = 62 control children who were matched for age, sex, school region, and fitness centile scores. Results: During lockdown (total duration: 63 days), moderate-to-vigorous physical activity (MVPA) decreased by ~46 min per day, screen time demonstrated a significant interaction effect, such that kids reported spending less recreational screen time on weekends during lockdown compared to no restriction, and sleep duration was consistently lower (95% CI: -104.1 to -45.5 min, p < 0.001). No interaction effect was present for direct fitness indicators, including: hand tapping (reaction time), standing broad jump, polygon backward obstacle course (coordination), sit-ups, stand-and-reach, bent-arm hang, 60-m, and 600-m run (p ≥ 0.05) although significant main effects are noted for both sexes. Conclusion: Initial changes in 24-HMB did not translate to reductions in physical fitness per se, likely due to the high initial fitness levels of the children. Further work is needed to confirm whether longer or repeated movement restrictions exacerbate initial negative 24-HMB trends, especially for children who are less fit when restrictions are initiated, prolonged, or repeated.


Subject(s)
COVID-19 , Pandemics , Child , Communicable Disease Control , Female , Humans , Male , Physical Fitness , Policy , SARS-CoV-2 , Screen Time , Sleep
10.
Int J Environ Res Public Health ; 19(1)2021 12 28.
Article in English | MEDLINE | ID: covidwho-1576991

ABSTRACT

This study examined pre-pandemic (2017-early March 2020) to early-pandemic (Spring 2020) changes in moderate-to-vigorous PA (MVPA), light PA (LPA), and sedentary behavior/sleep (SS), by weekday/weekend, and age (preschool, elementary, middle school). We re-enrolled children from two pre-pandemic obesity prevention trials and examined differences in accelerometer-measured PA from pre-pandemic to early-pandemic across age groups using linear mixed models. Children (n = 75) were 51% multiple race/ethnicities, 29% preschool, 28% elementary, 43% middle school, 65% suburban, 21% rural, and 13% urban. Pre-pandemic to early-pandemic changes in weekday MVPA (p = 0.006), LPA (p = 0.018), and SS (p = 0.003) differed by age. On weekdays, middle schoolers' MVPA decreased 15.36 min/day (p = 0.002) and SS increased 94.36 min/day (p < 0.001) with non-significant changes among preschoolers and elementary schoolers. Compared to elementary schoolers, middle schoolers' changes in weekday MVPA (b = -16.34, p = 0.036) and SS (b = 63.28, p = 0.039) significantly differed. Declines in weekday MVPA and increases in SS among middle schoolers suggest that, compared with younger children, middle schoolers are dependent on school and recreational facilities for PA, and in their absence engage in more sedentary activities and sleep.


Subject(s)
Accelerometry , Pandemics , Child , Child, Preschool , Exercise , Humans , Policy , Sleep
11.
Gac Sanit ; 35 Suppl 2: S103-S106, 2021.
Article in English | MEDLINE | ID: covidwho-1587741

ABSTRACT

OBJECTIVE: The COVID-19 pandemic has disrupted people's normal life as a result of strict policies applied to slow down the pandemic. To find out how extensive the virus spread is, most countries increase their daily testing rates. METHOD: This simple modelling work uses stringency index and daily testing (including the lagged version up to the previous 14 days) to predict daily COVID-19 cases in India and Indonesia. A Stepwise Multiple Regression (SWMR) subroutine is used in this modelling to select factors based on a 0.01 significant level affecting daily COVID-19 cases before the epidemic peaks. RESULT: The models have high predictability close to 94% (Indonesia) and 99% (India). Increasing number of daily COVID-19 cases in Indonesia is associated with the country's increased testing capacity. On the other hand, stringency indices play more important role in determining India's daily COVID-19 cases. CLOCLUSION: Our finding shows that one question remains to be answered as to why testing and strict policy differ in determining daily cases in both Asian countries.


Subject(s)
COVID-19 , Asia , Humans , Pandemics , Policy , SARS-CoV-2
12.
NASN Sch Nurse ; 37(1_suppl): 3S-14S, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1582809

ABSTRACT

For decades, school-located vaccinations clinics (SLVs) have successfully offered influenza and routine childhood immunizations that have contributed to lowering the morbidity and mortality of vaccine-preventable diseases. These SLVs laid the foundation for state and local health departments and school districts to quickly implement SLVs in response to COVID-19. To support school nurses and immunization programs in implementing future SLVs during the COVID-19 pandemic, we explored the landscape of SLVs between August 2019 and late summer 2021 using publicly available information from school and health department websites, news articles reporting on SLVs, and internal documents provided by school nurses and immunization programs who hosted SLVs. Our scan identified variability in the reach, scope, and approach to SLVs, but consistent themes persist such as the importance of partnerships and SLVs as an opportunity to promote equitable access to vaccinations. Useful documents and resources for planning and hosting SLV clinics were compiled into a table. With COVID-19 vaccines now available to all school-age children, SLVs provide an even greater opportunity to improve school and community health. The included resources are designed to provide support for those interested in SLV implementation.


Subject(s)
COVID-19 , School Nursing , COVID-19 Vaccines , Child , Humans , Immunization Programs , Pandemics , Policy , SARS-CoV-2 , School Health Services , Schools , Vaccination
13.
Front Public Health ; 9: 754696, 2021.
Article in English | MEDLINE | ID: covidwho-1575228

ABSTRACT

Background: Attempts to quantify effect sizes of non-pharmaceutical interventions (NPI) to control COVID-19 in the US have not accounted for heterogeneity in social or environmental factors that may influence NPI effectiveness. This study quantifies national and sub-national effect sizes of NPIs during the early months of the pandemic in the US. Methods: Daily county-level COVID-19 cases and deaths during the first wave (January 2020 through phased removal of interventions) were obtained. County-level cases, doubling times, and death rates were compared to four increasingly restrictive NPI levels. Socio-demographic, climate and mobility factors were analyzed to explain and evaluate NPI heterogeneity, with mobility used to approximate NPI compliance. Analyses were conducted separately for the US and for each Census regions (Pacific, Mountain, east/West North Central, East/West South Central, South Atlantic, Middle Atlantic and New England). A stepped-wedge cluster-randomized trial analysis was used, leveraging the phased implementation of policies. Results: Aggressive (level 4) NPIs were associated with slower COVID-19 propagation, particularly in high compliance counties. Longer duration of level 4 NPIs was associated with lower case rates (log beta -0.028, 95% CI -0.04 to -0.02) and longer doubling times (log beta 0.02, 95% CI 0.01-0.03). Effects varied by Census region, for example, level 4 effects on doubling time in Pacific states were opposite to those in Middle Atlantic and New England states. NPI heterogeneity can be explained by differential timing of policy initiation and by variable socio-demographic county characteristics that predict compliance, particularly poverty and racial/ethnic population. Climate exhibits relatively consistent relationships across Census regions, for example, higher minimum temperature and specific humidity were associated with lower doubling times and higher death rates for this period of analysis in South Central, South Atlantic, Middle Atlantic, and New England states. Conclusion and Relevance: Heterogeneity exists in both the effectiveness of NPIs across US Census regions and policy compliance. This county-level variability indicates that control strategies are best designed at community-levels where policies can be tuned based on knowledge of local disparities and compliance with public health ordinances.


Subject(s)
COVID-19 , RNA, Viral , Humans , Pandemics , Policy , SARS-CoV-2 , United States/epidemiology
14.
Health Soc Care Community ; 30(1): 353-359, 2022 01.
Article in English | MEDLINE | ID: covidwho-1574075

ABSTRACT

Vaccination is a vital health care initiative to prevent individual and population infection. To increase vaccination rates the federal government implemented the 'No Jab, No Pay' policy, where eligibility for several government benefits required children to be fully vaccinated by removing 'conscientious objections' and expanding the age range of children whose families receive benefits. This study assesses the impact of this policy at a local area within a single medical practice community in NSW, Australia. A retrospective clinical audit was performed between 2012 and 2017 on a single general practice's vaccination records for children ≤19 years. Catch-up vaccinations were assessed based on age at vaccination. Incidence of catch-up vaccinations was assessed for each of four years before and two years after the implementation of the 'No Jab, No Pay' policy in January 2016, along with the age of children and vaccination(s) given. Catch-up vaccinations were assessed temporally either side of implementation of 'No Jab, No Pay'. Comparing the average annual vaccination catch-up incidence rate of 6.2% pre-implementation (2012-2015), there was an increase to 9.2% in 2016 (p < .001) and 7.8% in 2017 (p = .027). Secondary outcome measurement of catch-up vaccination incidence rates before (2012-2015) and after (2016-2017) 'No Jab, No Pay' implementation showed statistically significant increases for children aged 8-11 years (3.2%-5.6%, p = .038), 12-15 years (7.5%-14.7%, p < .001) and 16-19 years (3.3%-10.2%, p < .001) along with a statistically significant reduction in children aged 1-3 years (11.4%-6.2%, p = .015). Also, catch-up rates for DTPa significantly increased after program implementation. This study demonstrates that the Australian federal government vaccination policy 'No Jab, No Pay' was coincident with an increase in catch-up vaccinations within a rural NSW community served by one medical practice, especially for older children.


Subject(s)
Policy , Vaccination , Adolescent , Australia , Child , Clinical Audit , Humans , Incidence , Retrospective Studies
15.
Front Public Health ; 9: 795481, 2021.
Article in English | MEDLINE | ID: covidwho-1572346

ABSTRACT

The outbreak of a sudden infectious epidemic often causes serious casualties and property losses to the whole society. The COVID-19 epidemic that broke out in China at the end of December 2019, spread rapidly, resulting in large groups of confirmed diagnoses, and causing severe damage to China's society. This epidemic even now encompasses the globe. This paper takes the COVID-19 epidemic that has occurred in China as an example, the original data of this paper is derived from 20 Chinese media reports on COVID-19, and the grounded theory is used to analyze the original data to find the risk transmission rules of a sudden infectious epidemic. The results show that in the risk transmission of a sudden infectious epidemic, there are six basic elements: the risk source, the risk early warning, the risk transmission path, the risk transmission victims, the risk transmission inflection point, and the end of risk transmission. After a sudden infectious epidemic breaks out, there are three risk transmission paths, namely, a medical system risk transmission path, a social system risk transmission path, and a psychological risk transmission path, and these three paths present a coupling structure. These findings in this paper suggest that people should strengthen the emergency management of a sudden infectious epidemic by controlling of the risk source, establishing an efficient and scientific risk early warning mechanism and blocking of the risk transmission paths. The results of this study can provide corresponding policy implications for the emergency management of sudden public health events.


Subject(s)
COVID-19 , China/epidemiology , Grounded Theory , Humans , Policy , SARS-CoV-2
16.
Addict Sci Clin Pract ; 16(1): 72, 2021 12 11.
Article in English | MEDLINE | ID: covidwho-1571935

ABSTRACT

BACKGROUND: In the United States, methadone for opioid use disorder (OUD) is highly regulated. Federal agencies announced guidelines in March 2020 allowing for relaxation of take-home methadone dispensing at opioid treatment programs (OTPs) to improve treatment access and reduce COVID-19 transmission risk during the public health emergency. We explored patient perspectives at three OTPs serving rural communities on how take-home policy changes were received and implemented and how these changes impacted their addiction treatment and recovery. METHODS: We completed semi-structured individual qualitative interviews in 2 phases: (1) August-October 2020 and (2) November 2020-January 2021 (total n = 46), anticipating possible policy changes as the pandemic progressed. We interviewed patients with OUD enrolled at 3 rural OTPs in Oregon. Participants received varying take-home methadone allowances following the COVID-19-related policy changes. All interviews were conducted via phone, audio-recorded, and transcribed. We conducted a thematic analysis, iteratively coding transcripts, and deductively and inductively generating codes. RESULTS: The 46 participants included 50% women and 89% had Medicaid insurance. Three main themes emerged in the analysis, with no differences between study phases: (1) Adapting to changing OTP policies throughout the pandemic; (2) Recognizing the benefits, and occasional struggles, with increased take-home methadone dosing; and (3) Continuing policies and procedures post-pandemic. Participants described fears and anxieties around ongoing methadone access and safety concerns prior to OTP policy changes, but quickly adapted as protocols soon seemed "natural." The majority of participants acknowledged significant benefits to increased take-homes independent of reducing COVID-19 infection risk including feeling "more like a normal person," improved recovery support, reduced time traveling, and having more time with family and for work. Looking to a post-pandemic future, participants thought some COVID-19-related safety protocols should continue that would reduce risk of other infections, make OTP settings less stressful, and result in more individualized care. CONCLUSIONS: As the pandemic progressed, study participants adapted to rapidly changing OTP policies. Participants noted many unanticipated benefits to increased take-home methadone and other COVID-19 protocols including strengthened self-efficacy and recovery and reduced interpersonal conflict, with limited evidence of diversion. Patient perspectives should inform future policies to better address the ongoing overdose epidemic.


Subject(s)
Analgesics, Opioid , COVID-19 , Humans , Methadone/therapeutic use , Policy , Rural Population , SARS-CoV-2 , United States
17.
Obes Rev ; 22 Suppl 6: e13222, 2021 11.
Article in English | MEDLINE | ID: covidwho-1546396

ABSTRACT

Childhood obesity is a public health concern globally, with generally higher prevalence rates in boys compared to girls. Although biological sex is an important determinant, gender roles and norms influence the exposure and vulnerability to risk factors for noncommunicable diseases. Norms and roles might be reinforced or change due to coronavirus disease 2019 (COVID-19) related measures as well as the exposure to risk factors for childhood obesity. COVID-19 related changes, such as home confinement, influence a child's risk of obesity. Using Dahlgren and Whitehead's model of the main determinants of health, this paper aims to provide a roadmap for future research on sex, gender, and childhood obesity during the time of COVID-19. It examines how COVID-19 has led to important changes in children's general socioeconomic, cultural, and environmental conditions, social and community networks, and individual lifestyle factors and how these may affect a child's risk for obesity. It focuses on the influence of gender and sex and outlines key considerations and indicators to examine in future studies concerned with promoting health and gender equity and equality. We need to understand the differential impact of COVID-19 related measures on girls' and boys' risk for obesity to adequately react with preventive measures, policies, and programs.


Subject(s)
COVID-19 , Pediatric Obesity , Child , Female , Humans , Male , Pandemics , Pediatric Obesity/epidemiology , Pediatric Obesity/prevention & control , Policy , SARS-CoV-2 , Sex Characteristics , Sex Factors
18.
JAAPA ; 34(8): 15, 2021 Aug 01.
Article in English | MEDLINE | ID: covidwho-1532550
19.
J Child Psychol Psychiatry ; 62(12): 1375-1378, 2021 12.
Article in English | MEDLINE | ID: covidwho-1526376

ABSTRACT

The use of lockdown to slow the spread of COVID-19 has been unprecedented in its scale, scope and duration despite early predictions that such a measure would have a negative impact on the mental health and well-being of many young people and their families. From a developmental psychopathology perspective both direct and indirect effects of lockdown-related harms to young people's mental health were predictable: Direct effects, for instance, being due to the negative psychological impact of social isolation and confinement on children; Indirect effects being exerted via negative impacts on family and parent mental health and wellbeing. That these effects would vary from person-to-person was also predicted from this perspective; with vulnerable individuals with pre-existing conditions and those living in high-risk settings being at particular risk. The presumption has been that such negative effects, if they do occur, would be time limited and that everything would return to normal once lockdowns ended. But this is not necessarily the case. In this editorial we ask whether lockdowns could have long-term effects on young people's mental health and then briefly outline three putative mechanisms through which such long-term effects might occur.


Subject(s)
COVID-19 , Mental Health , Adolescent , Child , Cicatrix , Communicable Disease Control , Humans , Policy , SARS-CoV-2
20.
PLoS One ; 16(11): e0260015, 2021.
Article in English | MEDLINE | ID: covidwho-1523446

ABSTRACT

State governments in the U.S. have been facing difficult decisions involving tradeoffs between economic and health-related outcomes during the COVID-19 pandemic. Despite evidence of the effectiveness of government-mandated restrictions mitigating the spread of contagion, these orders are stigmatized due to undesirable economic consequences. This tradeoff resulted in state governments employing mandates at widely different ways. We compare the different policies states implemented during periods of restriction ("lockdown") and reopening with indicators of COVID-19 spread and consumer card spending at each state during the first "wave" of the pandemic in the U.S. between March and August 2020. We find that while some states enacted reopening decisions when the incidence rate of COVID-19 was minimal or sustained in its relative decline, other states relaxed socioeconomic restrictions near their highest incidence and prevalence rates experienced so far. Nevertheless, all states experienced similar trends in consumer card spending recovery, which was strongly correlated with reopening policies following the lockdowns and relatively independent from COVID-19 incidence rates at the time. Our findings suggest that consumer card spending patterns can be attributed to government mandates rather than COVID-19 incidence in the states. We estimate the recovery in states that reopened in late April was more than the recovery in states that did not reopen in the same period- 15% for consumer card spending and 18% for spending by high income households. This result highlights the important role of state policies in minimizing health impacts while promoting economic recovery and helps planning effective interventions in subsequent waves and immunization efforts.


Subject(s)
COVID-19/economics , Pandemics/economics , Policy , COVID-19/epidemiology , Humans , United States/epidemiology
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