Public alert and warning system literature review in the USA: identifying research gaps and lessons for practice.

As emergencies continue to impact communities in the USA on an unprecedented scale, it is imperative for communities to look for effective ways to keep people safe and reduce future impacts. Public alert and warning systems are an effective means of accomplishing these goals. As such, researchers have studied public alert and warning systems extensively in the USA. Due to the plethora of studies on public alert and warning systems, a systematic and comprehensive synthesize is needed to understand what has been studied and their major findings and identify practical lessons that can be used to further improve public alert and warning systems. Hence, the goal of this study is to answer the following two questions: (1) What are the major findings from public alert and warning system research? (2) What policy and practical lessons can be gleaned from public alert and warning system research to improve public alert and warning system research and practice? We answer these questions by conducting a systematic and comprehensive review of the public alert and warning system literature, starting with a keyword search. The search produced 1737 studies, and we applied six criteria (e.g., the study has to be a peer-reviewed article, dissertation, or conference paper), which narrowed the number of studies to 100. After a reverse citation search, that number increased to 156 studies. Analysis of the 156 studies, the results reveal 12 emergent themes regarding the major findings from public alert and warning system research. The results also reveal eight emergent themes related to the policy and practical lessons. We then offer recommended topics for future research as well as outline some policy and practical recommendations. We conclude by summarizing the findings and discussing the limitations of the study.

Systematic review and meta-analysis of changes in quality of life following initiation of buprenorphine for opioid use disorder.

BACKGROUND: People with opioid use disorder (OUD) experience lower quality of life (QoL) than the general population, but buprenorphine treatment for OUD could help improve QoL of individuals with OUD. Thus, we conducted a systematic review and meta-analysis of the impact of buprenorphine on QoL among people with OUD. METHODS: Seven databases were searched through August 2020. We included English-language studies with pre- and post- QoL assessments internationally. Standardized mean differences were calculated for five domains of QoL measures using a random effects model for correlated effect sizes with robust variance estimation. Meta-regression was used to assess variation in effect sizes based on QoL domain, treatment, and patient factors. RESULTS: Twenty-one peer-reviewed studies from twelve countries were included. Only three studies included a no-treatment control group and five studies assigned groups using randomization. Improvements between baseline and follow-up were observed across all five domains of QoL measures (overall, physical, psychological, social, and environmental). The certainty of evidence was low for all domains of QoL, and very low for environmental QoL. We did not observe differences in the effect of buprenorphine on QoL by QoL domain, duration, dose, participant characteristics, or adjunctive counseling services. CONCLUSIONS: Buprenorphine treatment likely improves overall, physical, psychological, and social QoL, and may improve environmental QoL, for individuals with OUD. Findings are limited by study quality, including lack of control groups and incomplete reporting. Future studies with more rigorous methods and comprehensive reporting are needed.

Exploring the relationship between super bowls and potential online sex trafficking.

Sex trafficking is one type of human trafficking, which involves scenarios where individuals are not paid and are forced to engage in forced sex, forced prostitution, and sexual slavery. Online advertising is increasingly used by traffickers as an anonymous and efficient method to exploit victims. Large sporting events have been linked to increases in sex trafficking, although there is limited empirical evidence to support this claim. The goal of this study is to answer the following question: What is the relationship between Super Bowls and potential online sex trafficking? Using time series Poisson analysis of secondary data on online sexual service advertisements in Florida during the 2020 and 2021 Super Bowls, which took place in Miami and Tampa, Florida, respectively, the result indicates an increase in online advertisements that exhibit indicators of sex trafficking during the two Super Bowls. The paper concludes by providing recommendations for federal, state, and local law enforcement for improving sex trafficking responses during large sporting events and outlines a future research agenda on the relationship between large sporting events and sex trafficking.

Inequity after death: Exploring the equitable utilization of FEMA's COVID-19 funeral assistance funds.

As of March 2021, the United States had nearly 1 million COVID-19 deaths. To aid families, the Federal Emergency Management Agency (FEMA) established the Funeral Assistance Program. Using publicly available data, we examine the equitable utilization of FEMA's COVID-19 Funeral Assistance Program funding. Results show a significant relationship between FEMA COVID-19 Funeral Assistance Program funding and some, but not all, social vulnerability components. Specifically, counties with higher percentages of the population with disabilities and higher percentages of minorities receive lower amounts of funding per 100,000 residents. These findings suggest that FEMA's equity efforts are not fully materializing regarding the utilization of the FEMA COVID-19 Funeral Assistance Program funding among socially vulnerable groups. FEMA should broaden its social equity outreach and priorities for those not traditionally considered in social equity discussions, such as people with disabilities while continuing efforts toward traditional social equity.

The intersection of race and opioid use disorder treatment: A quantitative analysis.

INTRODUCTION: Racial health inequities exist in the United States. Racial minorities and whites have different health care experiences and health outcomes. Past studies examined this relationship for health care treatment, but additional research on whether and how race affects treatment for opioid use disorder (OUD) is needed. Based on systematic racism theory, this study examines the relationship between race and OUD treatment in three ways, representing three different phases in the treatment process: referral source for treatment, whether the treatment plan includes medications for OUD (MOUD), and reason for discharge. METHODS: This study examines the relationship between race and treatment for OUD. The study uses data from the 2013 and 2017 Treatment Episode Data Set Discharges (TEDS-D) dataset to run logistical and multinomial regression models. RESULTS: This study found that a relationship between race and treatment for OUD exists in all three areas that we examined. Specifically, this study found that being a minority was associated with a decreased likelihood of being referred to treatment by a medical professional, a decreased likelihood of having MOUD as part of the treatment plan (although the opposite was true in 2013), and a decreased likelihood of leaving treatment because the treatment episode was complete. CONCLUSION: Policymakers should use these findings to develop policy interventions for OUD that recognize the systematic racism that exists rather than our current colorblind policies.

Managing Mass Fatalities during COVID-19: Lessons for Promoting Community Resilience during Global Pandemics.

In the United States and around the world, COVID-19 represents a mass fatality incident, as there are more bodies than can be handled using existing resources. Although the management and disposition of bodies is distressing and heartrending, it is a task that local, state, and federal governments must plan for and respond to collaboratively with the private sector and faith-based community. When mass fatalities are mismanaged, there are grave emotional and mental health consequences that can delay recovery and undermine community resilience. Using insights from one author's mass fatality management research during the 2010 Haiti earthquake, this Viewpoint essay explores how mass fatalities are being managed in response to COVID-19. Based on the researcher's findings a decade ago, it is apparent that many lessons have not been learned. The essay concludes by providing governments with practical lessons on how to manage mass fatalities to facilitate and promote community resilience.

The Politics of Health Care: Health Disparities, the Affordable Care Act, and Solutions for Success.

This article explores why racial and income health disparities continue to exist in the United States. Poverty and racism are the primary drivers of the social problem which impact social determinants of health for vulnerable populations. The theoretical frameworks of conflict theory and critical race theory contextualize the causes and provide direction for overhauling public health policy in general and the Patient Protection and Affordable Care Act (Affordable Care Act) in particular. Although the Affordable Care Act was implemented to increase health coverage, economic and racial health inequities still exist in the United States. Policy recommendations for improving the health and welfare of low-income minorities include: 1) impacting poverty itself by desegregating urban areas of concentrated poverty, and 2) impacting racial discrimination in health care by putting the voices of African-American patients in the forefront to inform culturally relevant policy and practice.