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2.
Glob Health Res Policy ; 9(1): 18, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38822437

RESUMO

BACKGROUND: The COVID-19 pandemic demonstrated the vital need for research to inform policy decision-making and save lives. The Wales COVID-19 Evidence Centre (WCEC) was established in March 2021 and funded for two years, to make evidence about the impact of the pandemic and ongoing research priorities for Wales available and actionable to policy decision-makers, service leads and the public. OBJECTIVES: We describe the approaches we developed and our experiences, challenges and future vision. PROGRAM IMPLEMENTATION: The centre operated with a core team, including a public partnership group, and six experienced research groups as collaborating partners. Our rapid evidence delivery process had five stages: 1. Stakeholder engagement (continued throughout all stages); 2. Research question prioritisation; 3. Bespoke rapid evidence review methodology in a phased approach; 4. Rapid primary research; and 5. Knowledge Mobilisation to ensure the evidence was available for decision-makers. MAIN ACHIEVEMENTS: Between March 2021-23 we engaged with 44 stakeholder groups, completed 35 Rapid Evidence Reviews, six Rapid Evidence Maps and 10 Rapid Evidence Summaries. We completed four primary research studies, with three published in peer reviewed journals, and seven ongoing. Our evidence informed policy decision-making and was cited in 19 Welsh Government papers. These included pandemic infection control measures, the Action Plan to tackle gender inequalities, and Education Renew and Reform policy. We conducted 24 Welsh Government evidence briefings and three public facing symposia. POLICY IMPLICATIONS: Strong engagement with stakeholder groups, a phased rapid evidence review approach, and primary research to address key gaps in current knowledge enabled high-quality efficient, evidence outputs to be delivered to help inform Welsh policy decision-making during the pandemic. We learn from these processes to continue to deliver evidence from March 2023 as the Health and Care Research Wales Evidence Centre, with a broader remit of health and social care, to help inform policy and practice decisions during the recovery phase and beyond.


Assuntos
COVID-19 , Política de Saúde , Formulação de Políticas , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , País de Gales , Pandemias/prevenção & controle , Tomada de Decisões , Prática Clínica Baseada em Evidências , Medicina Baseada em Evidências
3.
Sante Publique ; 36(2): 133-141, 2024.
Artigo em Francês | MEDLINE | ID: mdl-38834520

RESUMO

INTRODUCTION: Older adults were among those who suffered most from the COVID-19 pandemic. In Morocco, where 64.4 percent of older adults suffer from a form of chronic illness, the main challenge facing local authorities was how to maintain essential care for this population group in the context of the pandemic. PURPOSE OF THE RESEARCH: The aim of the study was to determine the effects of the COVID-19 pandemic on older adults’ access to primary healthcare in the Essaouira Province (Morocco), with a view to ensuring the ongoing provision of healthcare for older adults during health emergencies. A longitudinal retrospective survey was conducted from October to December 2021 based on a structured questionnaire with a sample of 196 people aged sixty and above. The data obtained were compiled and analyzed using SPSS software (version 20.0). RESULTS: The COVID-19 pandemic has adversely affected older adults’ access to primary healthcare. Older adults’ use of primary healthcare services fell by 51.6 percent during the pandemic compared with the same periods in previous years. In addition, the measures taken to control the pandemic have had a negative impact on the quality of services offered to the survey participants. CONCLUSION: The COVID-19 pandemic resulted in significant changes in the operation of primary healthcare for older populations. The findings of this study provide a basis for anticipatory actions to improve the ongoing provision of healthcare for older adults in the context of health emergencies.


Assuntos
COVID-19 , Acessibilidade aos Serviços de Saúde , Atenção Primária à Saúde , Humanos , Marrocos/epidemiologia , COVID-19/epidemiologia , Atenção Primária à Saúde/estatística & dados numéricos , Idoso , Feminino , Masculino , Estudos Retrospectivos , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Estudos Longitudinais , Pandemias , Inquéritos e Questionários
4.
Ann Glob Health ; 90(1): 35, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827539

RESUMO

Many low- and middle-income countries (LMICs) grapple with shortages of health workers, a crucial component of robust health systems. The COVID-19 pandemic underscored the imperative for appropriate staffing of health systems and the occupational health (OH) threats to health workers. Issues related to accessibility, coverage, and utilization of OH services in public sector health facilities within LMICs were particularly accentuated during the pandemic. This paper draws on the observations and experiences of researchers engaged in an international collaboration to consider how the South African concept of Ubuntu provides a promising way to understand and address the challenges encountered in establishing and sustaining OH services in public sector health facilities. Throughout the COVID-19 pandemic, the collaborators actively participated in implementing and studying OH and infection prevention and control measures for health workers in South Africa and internationally as part of the World Health Organizations' Collaborating Centres for Occupational Health. The study identified obstacles in establishing, providing, maintaining and sustaining such measures during the pandemic. These challenges were attributed to lack of leadership/stewardship, inadequate use of intelligence systems for decision-making, ineffective health and safety committees, inactive trade unions, and the strain on occupational health professionals who were incapacitated and overworked. These shortcomings are, in part, linked to the absence of the Ubuntu philosophy in implementation and sustenance of OH services in LMICs.


Assuntos
COVID-19 , Saúde Ocupacional , SARS-CoV-2 , Humanos , África do Sul/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pessoal de Saúde , Serviços de Saúde do Trabalhador/organização & administração , Países em Desenvolvimento , Acessibilidade aos Serviços de Saúde , Pandemias
5.
Front Public Health ; 12: 1105518, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827622

RESUMO

The COVID-19 pandemic had a strong territorial dimension, with a highly asymmetric impact among Romanian counties, depending on pre-existing vulnerabilities, regions' economic structure, exposure to global value chains, specialization, and overall ability to shift a large share of employees to remote working. The aim of this paper is to assess the role of Romanian local authorities during this unprecedented global medical emergency by capturing the changes of public spending at the local level between 2010 and 2021 and amid the COVID-19 pandemic, and to identify clusters of Romanian counties that shared similar characteristics in this period, using a panel data quantitative model and hierarchical cluster analysis. Our empirical analysis shows that between 2010-2021, the impact of social assistance expenditures was higher than public investment (capital spending and EU funds) on the GDP per capita at county level. Additionally, based on various macroeconomic and structural indicators (health, labour market performance, economic development, entrepreneurship, and both local public revenues and several types of expenditures), we determined seven clusters of counties. The research contributes to the discussion regarding the increase of economic resilience but also to the evidence-based public policies implementation at local level.


Assuntos
COVID-19 , Romênia/epidemiologia , COVID-19/epidemiologia , COVID-19/economia , Humanos , SARS-CoV-2 , Pandemias/economia , Política Pública , Análise por Conglomerados , Governo Local
6.
Health Aff (Millwood) ; 43(6): 846-855, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38830150

RESUMO

Revenue diversification may be a synergistic strategy for transforming public health, yet few national or trend data are available. This study quantified and identified patterns in revenue diversification in public health before and during the COVID-19 pandemic. We used National Association of County and City Health Officials' National Profile of Local Health Departments study data for 2013, 2016, 2019, and 2022 to calculate a yearly diversification index for local health departments. Respondents' revenue portfolios changed fairly little between 2016 and 2022. Compared with less-diversified local health departments, well-diversified departments reported a balanced portfolio with local, state, federal, and clinical sources of revenue and higher per capita revenues. Less-diversified local health departments relied heavily on local sources and saw lower revenues. The COVID-19 period exacerbated these differences, with less-diversified departments seeing little revenue growth from 2019 to 2022. Revenue portfolios are an underexamined aspect of the public health system, and this study suggests that some organizations may be under financial strain by not having diverse revenue portfolios. Practitioners have ways of enhancing diversification, and policy attention is needed to incentivize and support revenue diversification to enhance the financial resilience and sustainability of local health departments.


Assuntos
COVID-19 , Saúde Pública , COVID-19/economia , Humanos , Estados Unidos , Saúde Pública/economia , SARS-CoV-2 , Pandemias , Governo Local , Financiamento Governamental/economia , Administração em Saúde Pública/economia
7.
Health Aff (Millwood) ; 43(6): 768-775, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38830152

RESUMO

The absence of a comprehensive national playbook for developing and deploying testing has hindered the United States' ability to rapidly suppress recent biological emergencies (for example, the COVID-19 pandemic and outbreaks of mpox). We describe here the Testing Playbook for Biological Emergencies, a national testing playbook we developed. It includes a set of decisions and actions for US officials to take at specific times during infectious disease emergencies to implement testing rapidly and to ensure that available testing meets clinical and public health needs. Although the United States had multiple plans at the federal level for responding to pandemic threats, US leaders were unable to quickly and efficiently operationalize those plans to deploy different types of tests during the COVID-19 pandemic in 2020-21, and again during the US mpox outbreak in 2022. The playbook fills a critical gap by providing the necessary specific and adaptable guidance for decision makers to meet this need.


Assuntos
COVID-19 , Saúde Pública , Humanos , COVID-19/epidemiologia , Estados Unidos , Emergências , Teste para COVID-19/métodos , SARS-CoV-2 , Pandemias , Surtos de Doenças/prevenção & controle
8.
Health Aff (Millwood) ; 43(6): 791-797, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38830148

RESUMO

A narrative has taken hold that public health has failed the US. We argue instead that the US has chronically failed public health, and nowhere have these failures been more apparent than in rural regions. Decades of underinvestment in rural communities, health care, and public health institutions left rural America uniquely vulnerable to the COVID-19 pandemic. Rural communities outpaced urban ones in deaths, and many rural institutions and communities sustained significant impacts. At the same time, the pandemic prompted creative actions to meet urgent health and social needs, and it illuminated opportunities to address long-standing rural challenges. This article draws on our cross-disciplinary expertise in public health and medical anthropology, as well as our research on COVID-19 and rural health equity in northern New England. In this Commentary, we articulate five principles to inform research, practice, and policy efforts in rural America. We contend that advancing rural health equity beyond the pandemic requires understanding the forces that generate rural disparities and designing policies and practices that account for rural disadvantage.


Assuntos
COVID-19 , Equidade em Saúde , Saúde da População Rural , População Rural , Humanos , COVID-19/epidemiologia , Política de Saúde , Estados Unidos , Disparidades em Assistência à Saúde , Pandemias , SARS-CoV-2 , Serviços de Saúde Rural , Saúde Pública , Disparidades nos Níveis de Saúde
9.
Sci Rep ; 14(1): 12702, 2024 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-38830982

RESUMO

This paper analyzes the determinants of COVID-19 mortality across over 140 countries in 2020, with a focus on healthcare expenditure and corruption. It finds a positive association between COVID-19 deaths and aging populations, obesity rates, and healthcare expenditure while noting a negative association with rural residency and corruption perception. The study further reveals that mortality is positively associated with aging populations in high-income countries and positively associated with obesity in upper-middle to high-income countries. Mortality is positively associated with healthcare expenditure, which likely reflects a country's preparedness and ability to better track, document, and report COVID-19 deaths. On the other hand, mortality is negatively associated with corruption perception in upper-middle-income countries. Further analyses based on 2021 data reveal COVID-19 deaths are positively associated with the proportion of the population aged 65 and older in low to lower-middle-income countries, with obesity in high-income countries, and with tobacco use across most countries. Interestingly, there is no evidence linking COVID-19 deaths to healthcare expenditure and corruption perception, suggesting a post-2020 convergence in preparedness likely due to proactive pandemic responses, which might have also mitigated corruption's impact. Policy recommendations are proposed to aid the elderly, address obesity, and combat tobacco use.


Assuntos
COVID-19 , Gastos em Saúde , COVID-19/mortalidade , COVID-19/epidemiologia , COVID-19/economia , Humanos , Idoso , SARS-CoV-2 , Obesidade/mortalidade , Obesidade/economia , Pandemias/economia
10.
BMC Public Health ; 24(1): 1501, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840230

RESUMO

BACKGROUND: This study aims to evaluate healthcare systems and pandemic responses in relation to marginalized and vulnerable groups, identify populations requiring urgent care, and assess the differential impacts on their health during the pandemic. METHODS: Data were collected by the Asia-Pacific Observatory on Health Systems and Policies (APO)-National University of Singapore and APO-International Health Policy Program consortium members: Korea, Indonesia, Philippines, and Singapore. Data were collected through a combination of semi-structured interviews, policy document reviews, and analysis of secondary data. RESULTS: Our findings reveal that the pandemic exacerbated existing health disparities, particularly affecting older adults, women, and children. Additionally, the study identified LGBTI individuals, healthcare workers, slum dwellers, and migrant workers as groups that faced particularly severe challenges during the pandemic. LGBTI individuals encountered heightened discrimination and limited access to health services tailored to their needs. Healthcare workers suffered from immense stress and risk due to prolonged exposure to the virus and critical working conditions. Slum dwellers struggled with healthcare access and social distancing due to high population density and inadequate sanitation. Migrant workers were particularly hard hit by high risks of virus transmission and stringent, often discriminatory, isolation measures that compounded their vulnerability. The study highlights the variation in the extent and nature of vulnerabilities, which were influenced by each country's specific social environment and healthcare infrastructure. It was observed that public health interventions often lacked the specificity required to effectively address the needs of all vulnerable groups, suggesting a gap in policy and implementation. CONCLUSIONS: The study underscores that vulnerabilities vary greatly depending on the social environment and context of each country, affecting the degree and types of vulnerable groups. It is critical that measures to ensure universal health coverage and equal accessibility to healthcare are specifically designed to address the needs of the most vulnerable. Despite commonalities among groups across different societies, these interventions must be adapted to reflect the unique characteristics of each group within their specific social contexts to effectively mitigate the impact of health disparities.


Assuntos
COVID-19 , Populações Vulneráveis , Humanos , COVID-19/epidemiologia , Feminino , Masculino , Adulto , Filipinas/epidemiologia , Pessoa de Meia-Idade , Acessibilidade aos Serviços de Saúde , Atenção à Saúde/organização & administração , Singapura/epidemiologia , Pandemias , República da Coreia/epidemiologia , Disparidades nos Níveis de Saúde , Indonésia/epidemiologia , Idoso , Meio Social , Adulto Jovem , Disparidades em Assistência à Saúde
11.
J Coll Physicians Surg Pak ; 34(6): 732-736, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38840361

RESUMO

OBJECTIVE: To explore the impact of COVID-19 among both the newly diagnosed patients and patients under follow-up for breast cancer by focusing on patients' accessibility to management and comparing the distribution of them before and during pandemic. STUDY DESIGN: Single-centric retrospective study. Place and Duration of the Study: Department of General Surgery and Department of Physical Medicine and Rehabilitation, Atilim University, Medicana International Ankara Hospital, Ankara, Turkiye, from March 2018 to 2022. METHODOLOGY: The data were collected to analyse numbers and distributions of physician visits regarding breast cancer. RESULTS: The mean age of patients was 55.98 ± 12.60 years. The percentages of newly diagnosed cases showed similarity (7.37% vs. 9.79%) before and during the pandemic (p = 0.18).  The number of imaging studies decreased by 53.33% in patients under follow-up (p = 0.006), despite screening tests showed a similar trend (p = 0.145). General surgery visits marked up (+44.6%), in contrast to plastic surgery visits (-42.04%, p <0.001). Patients' admissions decreased in many COVID-19 related clinics (pulmonology, emergency, internal medicine, and intensive care), but cardiology (+96.59%) and rehabilitation (+75%) admissions increased during the pandemic (p <0.001). The number of medical oncology and radiation oncology visits did not change (p >0.05). CONCLUSION: Total number of physician visits was similar before and during the pandemic despite the changing distribution. While COVID-19 led to markedly rising trends of surgical, cardiological, and rehabilitative management in patients with breast cancer, falling trends were seen in other specialities except oncology which showed a plateau during two years. The falling trends of visits to pulmonology, emergency, internal medicine, and intensive care clinics may be explained by crowded COVID-19 cases. KEY WORDS: Breast cancer, COVID-19, Surgery, Oncology, Rehabilitation.


Assuntos
Neoplasias da Mama , COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , Neoplasias da Mama/terapia , Neoplasias da Mama/epidemiologia , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Turquia/epidemiologia , Adulto , Idoso , Pandemias , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos
12.
BMJ Open ; 14(6): e082757, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38839384

RESUMO

INTRODUCTION: The surge of public health emergencies over the past decade has disproportionately affected sub-Saharan Africa. These include outbreaks of infectious diseases such as Ebola, Monkeypox and COVID-19. Experience has shown that community participation is key to the successful implementation of infection control activities. Despite the pivotal role community engagement plays in epidemic and pandemic preparedness and response activities, strategies to engage communities have been underexplored to date, particularly in sub-Sahara Africa. Furthermore, reviews conducted have not included evidence from the latest pandemic, COVID-19. This scoping review aims to address these gaps by documenting through available literature, the strategies for community engagement for epidemic and pandemic preparedness and response in sub-Sahara Africa. METHODS AND ANALYSIS: We will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and the methodological framework for scoping reviews from Arksey and O'Malley to guide the review. Two reviewers will develop a systematic search strategy to identify articles published from January 2014 to date. We will retrieve peer-reviewed research published in the English language from databases including Embase, EBSCO-host, PubMed, Global Health, CINAHL, Google Scholar and Web of Science. Additionally, we will search for relevant grey literature from the websites of specific international organisations, public health institutes and Government Ministries of Health in African countries. After the removal of duplicates, the two reviewers will independently screen all titles, abstracts and full articles to establish the relevance of each study for inclusion in the review. We will extract data from the included articles using a data extraction tool and present the findings in tabular form with an accompanying narrative to aid comprehension. ETHICS AND DISSEMINATION: Ethical approval is not required for the conduct of scoping reviews. We plan to disseminate the findings from this review through publications in a peer-reviewed journal, presentations at conferences and meetings with policy-makers.


Assuntos
COVID-19 , Participação da Comunidade , Pandemias , Humanos , África Subsaariana/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Participação da Comunidade/métodos , SARS-CoV-2 , Projetos de Pesquisa , Saúde Pública , Epidemias/prevenção & controle , Literatura de Revisão como Assunto , Preparação para Pandemia
13.
BMJ Open ; 14(6): e078850, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38839393

RESUMO

OBJECTIVES: This study aimed to identify factors that shaped working parents (WPs') experiences of COVID-19-related social restrictions and analyse the relationships between those factors. DESIGN: A qualitative descriptive design was used to collect five time points of data including two online questionnaires and three telephone or online interviews between March 2021 and August 2021 with some follow-up interviews in December 2022. SETTING: The COVID-19 pandemic led to social restrictions which greatly impacted WPs who had to both work and look after their children within their home space without any formal childcare. PARTICIPANTS: 19 participants living in Scotland who had at least one child of primary school age and who had been working in March 2020. RESULTS: All parents were affected by social restrictions during the COVID-19 pandemic, with the flexibility of employers, their socioeconomic situation and the amount of space in their home environment being particularly influential. The impact of social restrictions was greater for lone parents (LPs) due to the inability to share childcare with another adult in the home. Parents in low-income households were affected due to pre-existing inequalities of resources. CONCLUSIONS: These findings indicate several policy options that could mitigate negative outcomes for parents in the case of a future pandemic, including options to lessen inequities experienced by LPs. These include priority access to school places (particularly for children with underlying chronic medical conditions), the ability to establish a 'support bubble' at the beginning of social restrictions and being given access to safe outside places for children without a garden.


Assuntos
COVID-19 , Pais , Pesquisa Qualitativa , Humanos , COVID-19/epidemiologia , COVID-19/psicologia , Escócia/epidemiologia , Feminino , Masculino , Pais/psicologia , Criança , Adulto , SARS-CoV-2 , Instituições Acadêmicas , Fatores Socioeconômicos , Emprego , Pessoa de Meia-Idade , Pandemias
14.
BMJ Open Qual ; 13(2)2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38830729

RESUMO

BACKGROUND: The demand for healthcare services during the COVID-19 pandemic was excessive for less-resourced settings, with intensive care units (ICUs) taking the heaviest toll. OBJECTIVE: The aim was to achieve adequate personal protective equipment (PPE) use in 90% of patient encounters, to reach 90% compliance with objectives of patient flow (OPF) and to provide emotional support tools to 90% of healthcare workers (HCWs). METHODS: We conducted a quasi-experimental study with an interrupted time-series design in 14 ICUs in Argentina. We randomly selected adult critically ill patients admitted from July 2020 to July 2021 and active HCWs in the same period. We implemented a quality improvement collaborative (QIC) with a baseline phase (BP) and an intervention phase (IP). The QIC included learning sessions, periods of action and improvement cycles (plan-do-study-act) virtually coached by experts via platform web-based activities. The main study outcomes encompassed the following elements: proper utilisation of PPE, compliance with nine specific OPF using daily goal sheets through direct observations and utilisation of a web-based tool for tracking emotional well-being among HCWs. RESULTS: We collected 7341 observations of PPE use (977 in BP and 6364 in IP) with an improvement in adequate use from 58.4% to 71.9% (RR 1.2, 95% CI 1.17 to 1.29, p<0.001). We observed 7428 patient encounters to evaluate compliance with 9 OPF (879 in BP and 6549 in IP) with an improvement in compliance from 53.9% to 67% (RR 1.24, 95% CI 1.17 to 1.32, p<0.001). The results showed that HCWs did not use the support tool for self-mental health evaluation as much as expected. CONCLUSION: A QIC was effective in improving healthcare processes and adequate PPE use, even in the context of a pandemic, indicating the possibility of expanding QIC networks nationwide to improve overall healthcare delivery. The limited reception of emotional support tools requires further analyses.


Assuntos
COVID-19 , Unidades de Terapia Intensiva , Melhoria de Qualidade , SARS-CoV-2 , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Argentina , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Feminino , Equipamento de Proteção Individual/estatística & dados numéricos , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Atenção à Saúde/normas , Adulto , Saúde Pública/métodos , Pessoal de Saúde/estatística & dados numéricos , Pessoal de Saúde/psicologia , Análise de Séries Temporais Interrompida/métodos
15.
BMC Public Health ; 24(1): 1268, 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38720254

RESUMO

BACKGROUND: In Africa, approx. 675 million people were at risk of food insecurity. COVID-19 pandemic is likely to have exacerbated this situation, by damaging populations' access to and affordability of foods. This study is aimed at estimating the impacts of the COVID-19 pandemic on availability and prices of essential food commodities at 20 large markets in Ghana. METHODS: Data on food availability and food retail prices collected through weekly market-level data during the period from July 2017 to September 2020 were used in this study. We performed interrupted time-series analyses and estimated the percentage increases between the observed and predicted food prices by food group and by region to assess the impact of COVID-19 pandemic on food prices. RESULTS: As a result, the impact of COVID-19 on food availability was limited. However, the results of interrupted time-series analyses indicate a significant increase in overall mean food prices in Greater Accra, Eastern and Upper East regions. It was also found that mean price of starchy roots, tubers and plantains significantly increased across regions. DISCUSSION: The impact of COVID-19 pandemic on food availability and prices was significant but varied by food type and regions in Ghana. Continuous monitoring and responses are critical to maintain food availability and affordability.


Assuntos
COVID-19 , Comércio , Abastecimento de Alimentos , Análise de Séries Temporais Interrompida , Gana/epidemiologia , Humanos , COVID-19/epidemiologia , Abastecimento de Alimentos/estatística & dados numéricos , Abastecimento de Alimentos/economia , Comércio/estatística & dados numéricos , Comércio/economia , Insegurança Alimentar/economia , Pandemias/economia
16.
Aust J Gen Pract ; 53(5): 327-331, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38697067

RESUMO

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic catalysed unprecedented changes to healthcare delivery in Australia, leading to a rapid transformation of asthma management, to which healthcare providers and patients have had to adapt. Understanding the impact of these changes is critical as we emerge from pandemic-affected workflows. METHOD: A qualitative study using semistructured interviews was conducted with 19 general practitioners across Sydney and regional New South Wales. Reflexive thematic analysis of interview data was undertaken. RESULTS: Four key themes were identified: disorganised asthma care before COVID­19; chaotic asthma care during the pandemic; adapting to non-guideline-driven telehealth asthma care; and widening health agenda misalignment. DISCUSSION: This study highlights the triumphs and gaps in asthma management during the pandemic and the vulnerability of existing asthma care systems to disruption. These lessons can be used to re-evaluate how we deliver asthma care and inform future models of care as we transition towards a 'post-COVID' landscape.


Assuntos
Asma , COVID-19 , Medicina Geral , Pesquisa Qualitativa , Humanos , Asma/terapia , COVID-19/terapia , Medicina Geral/métodos , Telemedicina/métodos , SARS-CoV-2 , New South Wales , Entrevistas como Assunto/métodos , Feminino , Masculino , Austrália , Pandemias , Atenção à Saúde/métodos
17.
PLoS One ; 19(5): e0303043, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38722835

RESUMO

INTRODUCTION: The COVID-19 pandemic posed significant risks to children worldwide. This study aimed to assess the COVID-19 protection status of children and explored the relationship between household socio-economic status and COVID-19 morbidity and preventive measures, including vaccination and mask-wearing, in two cities in Iran. METHOD: A population-based cross-sectional study was conducted from July to October 2022 among 7 to 18-year-old children and their families in Tehran and Karaj. A total of 3,022 samples were selected using stratified multistage cluster sampling. Data were collected through interviews with children and adults, using questionnaires and was analyzed with Stata software version 14. RESULTS: The analysis focused on 2,878 children with a median age of 12. Over half (54%) reported that the pandemic negatively affected their family's financial status, with 45% describing its impact on children's needs as negative or very negative. Just under 50% of respondents consistently wore masks during the study period, and around 54% had received at least one dose of the COVID-19 vaccine. Reasons for not getting vaccinated included concerns about side effects, ineligibility for the target age group, and overcrowding at vaccination sites. The odds of not getting vaccinated were significantly lower for children aged 15-18, with boys more likely to refuse vaccination than girls. CONCLUSION: The financial impact of the pandemic in Iran affected families' ability to meet their children's needs. Moreover, low vaccination acceptance rates increased children's vulnerability to health problems and contributed to COVID-19 infections. Efforts should be made to increase vaccination acceptance, particularly among immigrant populations.


Assuntos
Vacinas contra COVID-19 , COVID-19 , SARS-CoV-2 , Vacinação , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Irã (Geográfico)/epidemiologia , Adolescente , Criança , Masculino , Feminino , Estudos Transversais , Vacinação/estatística & dados numéricos , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/uso terapêutico , Prevalência , Fatores Socioeconômicos , Pandemias/prevenção & controle , Inquéritos e Questionários
18.
PLoS One ; 19(5): e0303061, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38722879

RESUMO

Understanding digital exclusion in older adults during the COVID-19 pandemic could help tailor responses to future outbreaks. This cohort study used data from older adults aged 60+ years in England who participated in wave nine (2018/2019) of the main English Longitudinal Study of Ageing (ELSA) survey, and/or wave one of the ELSA COVID-19 sub-study (June/July 2020). Using latent class analysis and latent transition analysis, we aimed to identify distinct subgroups of older adults characterised by different patterns of internet use pre- and intra-pandemic, explore the extent to which individuals remained in the same subgroup or transitioned to a different subgroup during the COVID-19 pandemic, and examine longitudinal associations of socio-economic factors (education, occupational class, and wealth) with latent class membership. Preliminary tests showed that the types of internet activities differed between men and women; therefore, subsequent analyses were stratified by biological sex. Three clusters (low, medium, and high) were identified in male participants at both timepoints. Among female participants, three clusters were distinguished pre-pandemic and two (low versus high) during the pandemic. The latent classes were characterised by participants' breadth of internet use. Higher education, occupational class, and wealth were associated with greater odds of membership in the medium and/or high classes, versus the low class, in men and women. A high degree of stability in latent class membership was observed over time. However, men experienced a stark decrease in online health information-seeking. Our results highlight that inequality regarding the range of functional and social opportunities provided by the internet prevailed during the pandemic. Policymakers should ensure that digital access and upskilling initiatives are equitable for all.


Assuntos
COVID-19 , Uso da Internet , Fatores Socioeconômicos , Humanos , COVID-19/epidemiologia , Masculino , Feminino , Inglaterra/epidemiologia , Idoso , Pessoa de Meia-Idade , Uso da Internet/estatística & dados numéricos , Estudos Longitudinais , Pandemias , SARS-CoV-2 , Idoso de 80 Anos ou mais
19.
PLoS One ; 19(5): e0302995, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38722991

RESUMO

In the earlier phases of the COVID-19 pandemic, studies in Germany and elsewhere found an overall reduction in health-related quality of life (HRQoL) among students. However, there is little evidence on later pandemic stages as well as socioeconomic influencing factors. We aimed to (1) describe HRQoL in a Berlin student cohort at two time points in mid-2021, and to (2) analyze the effects of household income and education. We assessed HRQoL of students from 24 randomly selected primary and secondary schools in Berlin, Germany, with the KIDSCREEN-10 index in June and September 2021. To adjust for non-response bias, inverse probability weighting was applied. The potential effects of both household income and education (lower vs. higher) were estimated in generalized linear mixed models, based on prior assumptions presented in directed acyclic graphs. Our cohort comprised 660 students aged 7-19 years. In June 2021, 11.3% [95% CI = 9.0% - 14.0%] reported low HRQoL, whereas in September 2021, this increased to 13.7% [95% CI = 11.1% - 16.5%], with adolescent girls more frequently reporting low HRQoL at both time points (20% [95% CI = 17.1% - 23.3%] and 29% [95% CI = 25.5% - 32.5%]) compared to boys and younger children. While there was no statistically significant total effect of lower household income on HRQoL, a negative effect of lower household education was statistically significant (ß = -2.15, SE 0.95, 95% CI = -4.01 to -0.29, p = 0.024). In summary, students' HRQoL in mid-2021 was better than that documented in other studies conducted at pandemic onset using KIDSCREEN-10. Female adolescents reported low HRQoL more often, and lower household education significantly reduced children's HRQoL. Support strategies for psychosocial wellbeing should consider socioeconomically disadvantaged children as important target groups.


Assuntos
COVID-19 , Qualidade de Vida , Instituições Acadêmicas , Classe Social , Estudantes , Humanos , COVID-19/epidemiologia , COVID-19/psicologia , Adolescente , Feminino , Masculino , Estudantes/psicologia , Criança , Adulto Jovem , Berlim/epidemiologia , SARS-CoV-2/isolamento & purificação , Alemanha/epidemiologia , Pandemias , Renda , Fatores Socioeconômicos
20.
PLoS One ; 19(5): e0297694, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38728255

RESUMO

BACKGROUND: The COVID-19 pandemic has not only caused tremendous loss of life and health but has also greatly disrupted the world economy. The impact of this disruption has been especially harsh in urban settings of developing countries. We estimated the impact of the pandemic on the occurrence of food insecurity in a cohort of women living in Mexico City, and the socioeconomic characteristics associated with food insecurity severity. METHODS: We analyzed data longitudinally from 685 women in the Mexico City-based ELEMENT cohort. Food insecurity at the household level was gathered using the Latin American and Caribbean Food Security Scale and measured in-person during 2015 to 2019 before the pandemic and by telephone during 2020-2021, in the midst of the pandemic. Fluctuations in the average of food insecurity as a function of calendar time were modeled using kernel-weighted local polynomial regression. Fixed and random-effects ordinal logistic regression models of food insecurity were fitted, with timing of data collection (pre-pandemic vs. during pandemic) as the main predictor. RESULTS: Food insecurity (at any level) increased from 41.6% during the pre-pandemic period to 53.8% in the pandemic stage. This increase was higher in the combined severe-moderate food insecurity levels: from 1.6% pre-pandemic to 16.8% during the pandemic. The odds of severe food insecurity were 3.4 times higher during the pandemic relative to pre-pandemic levels (p<0.01). Socioeconomic status quintile (Q) was significantly related to food insecurity (Q2 OR = 0.35 p<0.1, Q3 OR = 0.48 p = 0.014, Q4 OR = 0.24 p<0.01, and Q5 OR = 0.17 p<0.01), as well as lack of access to social security (OR = 1.69, p = 0.01), and schooling (OR = 0.37, p<0.01). CONCLUSIONS: Food insecurity increased in Mexico City households in the ELEMENT cohort as a result of the COVID-19 pandemic. These results contribute to the body of evidence suggesting that governments should implement well-designed, focalized programs in the context of economic crisis such as the one caused by COVID-19 to prevent families from the expected adverse health and well-being consequences associated to food insecurity, especially for the most vulnerable.


Assuntos
COVID-19 , Insegurança Alimentar , Pandemias , Humanos , COVID-19/epidemiologia , México/epidemiologia , Feminino , Adulto , Fatores Socioeconômicos , Pessoa de Meia-Idade , SARS-CoV-2/isolamento & purificação , Estudos de Coortes , Abastecimento de Alimentos/estatística & dados numéricos , Estudos Longitudinais
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