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1.
Am J Nurs ; 122(1): 12-13, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1584036

ABSTRACT

As some states approach endemic status, others face more misery.


Subject(s)
COVID-19/therapy , Public Health/standards , COVID-19/epidemiology , Humans , Public Health/trends , United States
2.
5.
Sci Rep ; 11(1): 21700, 2021 11 04.
Article in English | MEDLINE | ID: covidwho-1504478

ABSTRACT

With recurring waves of the Covid-19 pandemic, a dilemma facing public health leadership is whether to provide public advice that is medically optimal (e.g., most protective against infection if followed), but unlikely to be adhered to, or advice that is less protective but is more likely to be followed. To provide insight about this dilemma, we examined and quantified public perceptions about the tradeoff between (a) the stand-alone value of health behavior advice, and (b) the advice's adherence likelihood. In a series of studies about preference for public health leadership advice, we asked 1061 participants to choose between (5) strict advice that is medically optimal if adhered to but which is less likely to be broadly followed, and (2) relaxed advice, which is less medically effective but more likely to gain adherence-given varying infection expectancies. Participants' preference was consistent with risk aversion. Offering an informed choice alternative that shifts volition to advice recipients only strengthened risk aversion, but also demonstrated that informed choice was preferred as much or more than the risk-averse strict advice.


Subject(s)
COVID-19/psychology , Guideline Adherence/trends , Information Dissemination/methods , Adolescent , Adult , Aged , Female , Health Behavior , Humans , Male , Middle Aged , Pandemics/prevention & control , Public Health/trends , Public Policy/trends , Risk Reduction Behavior , SARS-CoV-2/pathogenicity
6.
PLoS One ; 16(10): e0258781, 2021.
Article in English | MEDLINE | ID: covidwho-1496514

ABSTRACT

BACKGROUND: Novel viral pandemics present significant challenges to global public health. Non-pharmaceutical interventions (e.g. social distancing) are an important means through which to control the transmission of such viruses. One of the key factors determining the effectiveness of such measures is the level of public adherence to them. Research to date has focused on quantitative exploration of adherence and non-adherence, with a relative lack of qualitative exploration of the reasons for non-adherence. OBJECTIVE: To explore participants' perceptions of non-adherence to COVID-19 policy measures by self and others in the UK, focusing on perceived reasons for non-adherence. METHODS: Qualitative study comprising 12 focus groups conducted via video-conferencing between 25th September and 13th November 2020. Participants were 51 UK residents aged 18 and above, reflecting a range of ages, genders and race/ethnicities. Data were analysed using a thematic approach. RESULTS: Participants reported seeing an increase in non-adherence in others over the course of the pandemic. Reports of non-adherence in self were lower than reports of non-adherence in others. Analysis revealed six main themes related to participants' reported reasons for non-adherence in self and others: (1) 'Alert fatigue' (where people find it difficult to follow, or switch off from, information about frequently changing rules or advice) (2) Inconsistent rules (3) Lack of trust in government (4) Learned Helplessness (5) Resistance and rebelliousness (6)The impact of vaccines on risk perception. Participants perceived a number of systemic failures (e.g. unclear policy, untrustworthy policymakers) to strongly contribute to two forms non-adherence-violations and errors. CONCLUSION: Findings suggest that latent and systemic failures-in the form of policy decisions that are commonly experienced as too changeable, inconsistent and confusing, and policy makers that are commonly perceived as untrustworthy-may play a significant role in creating the conditions that enable or encourage non-adherence.


Subject(s)
COVID-19/psychology , Patient Compliance/psychology , Public Health/trends , Adult , Aged , Aged, 80 and over , COVID-19/prevention & control , Female , Focus Groups , Humans , Male , Middle Aged , Pandemics/prevention & control , Physical Distancing , Public Health/methods , Public Opinion , SARS-CoV-2/pathogenicity , Surveys and Questionnaires , United Kingdom
7.
Int J Behav Nutr Phys Act ; 17(1): 51, 2020 04 15.
Article in English | MEDLINE | ID: covidwho-1455978

ABSTRACT

BACKGROUND: Understanding how to create and deliver effective physical activity (PA) messages for and to various population subgroups may play a role in increasing population PA levels. This scoping review aimed to provide an overview of what is known about PA messaging and highlight key research gaps. METHODS: We followed a 5-stage protocol proposed by Arksey & O'Malley and the Preferred Reporting Items For Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews checklist. Stage 1: research questions were identified. Stage 2: we identified relevant studies by searching electronic databases, contacting existing networks and hand searching reference lists. Stage 3: studies were screened in Covidence™ software. Stage 4: study data were extracted and charted. Stage 5: findings from included studies were collated, summarised and reported in two ways: (1) a descriptive numerical analysis providing insight into extent, nature and distribution of the included studies, and (2) a narrative summary summarizing the evidence reviewed organised by messaging concepts and by population subgroup. RESULTS: A total of 9525 references were imported into Covidence™ for screening. Of these, 123 studies were included in final analysis. We found that PA messaging evidence is complex and multidimensional in nature, with numerous concepts to consider when creating or evaluating messages. The extent to which these different PA messaging concepts have been researched is variable. Where research has accumulated and evidence is consistent, it supports the following: (1) PA messages should be framed positively and highlight short-term outcomes specifically relating to social and mental health, (2) message content should be tailored or targeted to intended recipient(s), and (3) when developing messages, formative research, psychological theory and/or social marketing principles should be used. CONCLUSION: While it is unlikely to address global inactivity on its own, PA messaging may play a valuable role improving population PA levels. However, it is a complex and multidimensional concept and greater understanding is still needed. We present a synthesis of the existing evidence, highlighting key areas where evidence has accumulated and where gaps lie, as well as recommendations for PA messaging to different population subgroups.


Subject(s)
Exercise/psychology , Health Communication , Health Promotion/methods , Communications Media , Humans , Public Health/trends
9.
JMIR Public Health Surveill ; 7(9): e30460, 2021 09 20.
Article in English | MEDLINE | ID: covidwho-1430621

ABSTRACT

BACKGROUND: The UK National Health Service (NHS) classified 2.2 million people as clinically extremely vulnerable (CEV) during the first wave of the 2020 COVID-19 pandemic, advising them to "shield" (to not leave home for any reason). OBJECTIVE: The aim of this study was to measure the determinants of shielding behavior and associations with well-being in a large NHS patient population for informing future health policy. METHODS: Patients contributing to an ongoing longitudinal participatory epidemiology study (Longitudinal Effects on Wellbeing of the COVID-19 Pandemic [LoC-19], n=42,924) received weekly email invitations to complete questionnaires (17-week shielding period starting April 9, 2020) within their NHS personal electronic health record. Question items focused on well-being. Participants were stratified into four groups by self-reported CEV status (qualifying condition) and adoption of shielding behavior (baselined at week 1 or 2). The distribution of CEV criteria was reported alongside situational variables and univariable and multivariable logistic regression. Longitudinal trends in physical and mental well-being were displayed graphically. Free-text responses reporting variables impacting well-being were semiquantified using natural language processing. In the lead up to a second national lockdown (October 23, 2020), a follow-up questionnaire evaluated subjective concern if further shielding was advised. RESULTS: The study included 7240 participants. In the CEV group (n=2391), 1133 (47.3%) assumed shielding behavior at baseline, compared with 633 (13.0%) in the non-CEV group (n=4849). CEV participants who shielded were more likely to be Asian (odds ratio [OR] 2.02, 95% CI 1.49-2.76), female (OR 1.24, 95% CI 1.05-1.45), older (OR per year increase 1.01, 95% CI 1.00-1.02), living in a home with an outdoor space (OR 1.34, 95% CI 1.06-1.70) or three to four other inhabitants (three: OR 1.49, 95% CI 1.15-1.94; four: OR 1.49, 95% CI 1.10-2.01), or solid organ transplant recipients (OR 2.85, 95% CI 2.18-3.77), or have severe chronic lung disease (OR 1.63, 95% CI 1.30-2.04). Receipt of a government letter advising shielding was reported in 1115 (46.6%) CEV participants and 180 (3.7%) non-CEV participants, and was associated with adopting shielding behavior (OR 3.34, 95% CI 2.82-3.95 and OR 2.88, 95% CI 2.04-3.99, respectively). In CEV participants, shielding at baseline was associated with a lower rating of mental well-being and physical well-being. Similar results were found for non-CEV participants. Concern for well-being if future shielding was required was most prevalent among CEV participants who had originally shielded. CONCLUSIONS: Future health policy must balance the potential protection from COVID-19 against our findings that shielding negatively impacted well-being and was adopted in many in whom it was not indicated and variably in whom it was indicated. This therefore also requires clearer public health messaging and support for well-being if shielding is to be advised in future pandemic scenarios.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/methods , Mental Health/trends , Public Health/trends , Quarantine/psychology , Adult , Female , Health Policy , Humans , Longitudinal Studies , Male , Mental Health/legislation & jurisprudence , Middle Aged , Public Health/legislation & jurisprudence , SARS-CoV-2 , State Medicine , Surveys and Questionnaires , United Kingdom
10.
Global Health ; 17(1): 111, 2021 09 19.
Article in English | MEDLINE | ID: covidwho-1430460

ABSTRACT

Ten years of the Syrian war had a devastating effect on Syrian lives, including millions of refugees and displaced people, enormous destruction in the infrastructure, and the worst economic crisis Syria has ever faced. The health sector was hit hard by this war, up to 50% of the health facilities have been destroyed and up to 70% of the healthcare providers fled the country seeking safety, which increased the workload and mental pressure for the remaining medical staff. Five databases were searched and 438 articles were included according to the inclusion criteria, the articles were divided into categories according to the topic of the article.Through this review, the current health status of the Syrian population living inside Syria, whether under governmental or opposition control, was reviewed, and also, the health status of the Syrian refugees was examined according to each host country. Public health indicators were used to summarize and categorize the information. This research reviewed mental health, children and maternal health, oral health, non-communicable diseases, infectious diseases, occupational health, and the effect of the COVID - 19 pandemic on the Syrian healthcare system. The results of the review are irritating, as still after ten years of war and millions of refugees there is an enormous need for healthcare services, and international organization has failed to respond to those needs. The review ended with the current and future challenges facing the healthcare system, and suggestions about rebuilding the healthcare system.Through this review, the major consequences of the Syrian war on the health of the Syrian population have been reviewed and highlighted. Considerable challenges will face the future of health in Syria which require the collaboration of the health authorities to respond to the growing needs of the Syrian population. This article draws an overview about how the Syrian war affected health sector for Syrian population inside and outside Syria after ten years of war which makes it an important reference for future researchers to get the main highlight of the health sector during the Syrian crisis.


Subject(s)
Public Health/standards , Refugees/statistics & numerical data , Warfare/statistics & numerical data , Altruism , Developing Countries/statistics & numerical data , Health Resources/supply & distribution , Health Resources/trends , Health Services Accessibility/standards , Humans , Public Health/statistics & numerical data , Public Health/trends , Syria
12.
PLoS One ; 16(9): e0257291, 2021.
Article in English | MEDLINE | ID: covidwho-1416893

ABSTRACT

The outbreak of a novel coronavirus pneumonia (COVID-19), wherein more than 200 million people have been infected and millions have died, poses a great threat to achieving the United Nations 2030 sustainable development goal (SDGs). Based on the Baidu index of 'novel coronavirus', this paper analyses the spatial and temporal characteristics of and factors that influenced the attention network for COVID-19 from January 9, 2020, to April 15, 2020. The study found that (1) Temporally, the attention in the new coronavirus network showed an upward trend from January 9 to January 29, with the largest increase from January 23 to January 29 and a peak on January 29, and then a slow downward trend. The level of attention in the new coronavirus network was basically flat when comparing January 22 and March 4. (2) Spatially, first, from the perspective of regional differences, the network attention in the eastern and central regions decreased in turn. The network users in the eastern region exhibited the highest attention to the new coronavirus, especially in Guangdong, Shandong, Jiangsu and other provinces and cities. The network attention in Tibet, Xinjiang, Qinghai and Ningxia in the western region was the lowest in terms of the national network attention. Second, from the perspective of interprovincial differences, the attention in the new coronavirus network was highly consistent with the Hu Huanyong line of China's population boundary. The east of the Hu Huanyong line is densely populated, and the network showed high concern, mostly ranking at the third to fifth levels. (3) The number of Internet users in the information technology field, the population, and the culture and age characteristics of individuals are important factors that influence the novel coronavirus attention network.


Subject(s)
COVID-19/prevention & control , Information Dissemination/methods , Internet/statistics & numerical data , Online Social Networking , Spatio-Temporal Analysis , Algorithms , COVID-19/epidemiology , COVID-19/virology , China/epidemiology , Epidemics , Geography , Humans , Internet/trends , Models, Theoretical , Public Health/methods , Public Health/statistics & numerical data , Public Health/trends , SARS-CoV-2/physiology , Time Factors
13.
Commun Biol ; 4(1): 489, 2021 04 21.
Article in English | MEDLINE | ID: covidwho-1387493

ABSTRACT

We investigated SARS-CoV-2 transmission dynamics in Italy, one of the countries hit hardest by the pandemic, using phylodynamic analysis of viral genetic and epidemiological data. We observed the co-circulation of multiple SARS-CoV-2 lineages over time, which were linked to multiple importations and characterized by large transmission clusters concomitant with a high number of infections. Subsequent implementation of a three-phase nationwide lockdown strategy greatly reduced infection numbers and hospitalizations. Yet we present evidence of sustained viral spread among sporadic clusters acting as "hidden reservoirs" during summer 2020. Mathematical modelling shows that increased mobility among residents eventually catalyzed the coalescence of such clusters, thus driving up the number of infections and initiating a new epidemic wave. Our results suggest that the efficacy of public health interventions is, ultimately, limited by the size and structure of epidemic reservoirs, which may warrant prioritization during vaccine deployment.


Subject(s)
COVID-19/transmission , Communicable Disease Control/methods , Genome, Viral/genetics , Mutation , Public Health/methods , SARS-CoV-2/genetics , COVID-19/epidemiology , COVID-19/virology , Geography , Humans , Italy/epidemiology , Pandemics , Phylogeny , Public Health/trends , SARS-CoV-2/classification , SARS-CoV-2/physiology
14.
Acad Med ; 95(11): 1631-1633, 2020 11.
Article in English | MEDLINE | ID: covidwho-1373678

ABSTRACT

COVID-19 has disrupted every aspect of the U.S. health care and health professions education systems, creating anxiety, suffering, and chaos and exposing many of the flaws in the nation's public health, medical education, and political systems. The pandemic has starkly revealed the need for a better public health infrastructure and a health system with incentives for population health and prevention of disease as well as outstanding personalized curative health. It has also provided opportunities for innovations in health care and has inspired courageous actions of residents, who have responded to the needs of their patients despite risk to themselves. In this Invited Commentary, the author shares lessons he learned from 3 earlier disasters and discusses needed changes in medical education, health care, and health policy that the COVID-19 pandemic has revealed. He encourages health professions educators to use the experiences of this pandemic to reexamine the current curricular emphasis on the bioscientific model of health and to broaden the educational approach to incorporate the behavioral, social, and environmental factors that influence health. Surveillance for disease, investment in disease and injury prevention, and disaster planning should be basic elements of health professions education. Incorporating innovations such as telemedicine, used under duress during the pandemic, could alter educational and clinical approaches to create something better for students, residents, and patients. He explains that journals such as Academic Medicine can provide rapid, curated, expert advice that can be an important counterweight to the misinformation that circulates during disasters. Such journals can also inform their readers about new training in skills needed to mitigate the ongoing effects of the disaster and prepare the workforce for future disasters.


Subject(s)
Coronavirus Infections/prevention & control , Delivery of Health Care/organization & administration , Disaster Planning/organization & administration , Education, Medical/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Public Health/education , Public Health/trends , Adult , Betacoronavirus , COVID-19 , Female , Forecasting , Humans , Male , Middle Aged , SARS-CoV-2 , United States
15.
J Public Health Manag Pract ; 26(4): 301-303, 2020.
Article in English | MEDLINE | ID: covidwho-1343734
19.
Nat Med ; 27(3): 396-400, 2021 03.
Article in English | MEDLINE | ID: covidwho-1319038

ABSTRACT

Fourteen months into the SARS-CoV-2 pandemic, we identify key lessons in the global and national responses to the pandemic. The World Health Organization has played a pivotal technical, normative and coordinating role, but has been constrained by its lack of authority over sovereign member states. Many governments also mistakenly attempted to manage COVID-19 like influenza, resulting in repeated lockdowns, high excess morbidity and mortality, and poor economic recovery. Despite the incredible speed of the development and approval of effective and safe vaccines, the emergence of new SARS-CoV-2 variants means that all countries will have to rely on a globally coordinated public health effort for several years to defeat this pandemic.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control , Global Health , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communicable Disease Control/trends , Global Health/history , Global Health/trends , Government , History, 21st Century , Humans , Pandemics/history , Public Health/history , Public Health/methods , Public Health/trends , Public Health Administration/methods , Public Health Administration/standards , Public Health Administration/trends , SARS-CoV-2/physiology
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