Designing Dynamic Interventions to Improve Adherence in Pediatric Long-Term Treatment - The Role of Perceived Value of the Physician by Primary Caregivers.

Primary Caregivers are the fulcrum in the physician-caregiver-child triad. Existing literature discusses static multi-component interventions in detail. In long-term treatments, dynamic intervention design is needed as the environment and situations of the families are dynamic. The objectives of this study are (a) to identify the components of the primary caregiver's perception of the physician's value with reference to the effectiveness of consultation and relationships with the former and with the child; (b) to establish the role of this perception in designing dynamic interventions, and (c) to describe the perception's potential influence on adherence. A PRISMA, chronological, and morphological analysis of the literature is carried out about caregivers' adherence in the pediatric long-term treatment context. We define communication and consultation as the functional, whereas relationship as the emotional component of the caregiver's perception of the physician. We propose a theoretical model that incorporates intervention as an integral component of care. Adherence happens as a response to changing situations and hence fluctuates. Hence, a dynamic intervention design to benefit the child should be incorporated into care through the caregiver-physician bridge. Future research should explore how intervention needs change and the driving reasons for understanding the static and dynamic components of interventions.

Impact of COVID-19 pandemic on road safety in Tamil Nadu, India.

This study uses structured literature mapping to review worldwide trends in traffic safety following the phenomenon of the COVID-19 pandemic. Motivated by dissimilar findings globally and a lack of evidence from emerging nations which have been significantly more affected by road traffic crashes, the study examines the impact of the pandemic-induced lockdown on road traffic deaths and injuries in Tamil Nadu, India. Using a holistic approach, methods such as ARIMA, Holt-Winters, Bayesian Structural Time Series, and Generalized Additive Model are employed for counterfactual prediction, to draw a causal inference of lockdown on traffic safety. In line with global studies, a substantial reduction in traffic crashes, injuries, and fatalities during lockdowns has been found. However, the comparison of relative differences shows that the number of grievous injuries reduced more than minor injuries, crashes, or fatalities. Furthermore, these relative differences were sustained even when metrics returned to normalcy in the post-lockdown phases. Further spatial stratification at two levels (cities and districts) shows that the macroscopic state-level trends are also broadly seen in the sub-units. This validates the consistency of trends across rural-urban differences and shows that, despite variations in the degree of enforcement of the lockdown within Chennai city, contrary to expectation, increased police presence did not have a differential impact on road crashes.

Relationship between mobility and road traffic injuries during COVID-19 pandemic-The role of attendant factors.

This study investigates the important role of attendant factors, such as road traffic victims' access to trauma centres, the robustness of health infrastructure, and the responsiveness of police and emergency services in the incidence of Road Traffic Injuries (RTI) during the pandemic-induced COVID-19 lockdowns. The differential effects of the first and second waves of the pandemic concerning perceived health risk and legal restrictions provide us with a natural experiment that helps us differentiate between the impact of attendant factors and the standard relationship between mobility and Road Traffic Injuries. The authors use the auto-regressive recurrent neural network method on two population levels-Tamil Nadu (TN), a predominantly rural state, and Chennai, the most significant metropolitan city of the state, to draw causal inference through counterfactual predictions on daily counts of road traffic deaths and Road Traffic Injuries. During the first wave of the pandemic, which was less severe than the second wave, the traffic flow was correlated to Road Traffic Death/Road Traffic Injury. In the second wave's partial and post lockdown phases, an unprecedented fall of over 70% in Road Traffic Injury-Grievous as against Road Traffic Injury-Minor was recorded. Attendant factors, such as the ability of the victim to approach relief centres, the capability of health and other allied infrastructures, transportation and medical treatment of road traffic crash victims, and minimal access to other emergency services, including police, assumed greater significance than overall traffic flow in the incidence of Road Traffic Injury in the more severe second wave. These findings highlight the significant role these attendant factors play in producing the discrepancy between the actual road traffic incident rate and the officially registered rate. Thus, our study enables practitioners to observe the mobility-adjusted actual incidence rate devoid of factors related to reporting and registration of accidents.

Empirical evidence of the impact of mobility on property crimes during the first two waves of the COVID-19 pandemic.

This paper seeks to evaluate the impact of the removal of restrictions (partial and complete) imposed during COVID-19-induced lockdowns on property offences such as robbery, burglary, and theft during the milder wave one and the more severe wave two of the pandemic in 2020 and 2021, respectively. Using 10-year data of the daily counts of crimes, the authors adopt an auto-regressive neural networks method to make counterfactual predictions of crimes, representing a scenario without the pandemic-induced lockdowns. The difference between the actual and forecast is the causal impact of the lockdown in all phases. Further, the research uses Google Mobility Community Reports to measure mobility. The analysis has been done at two levels: first, for the state of Tamil Nadu, which has a sizeable rural landscape, and second for Chennai, the largest metropolitan city with an urban populace. During the pandemic-induced lockdown in wave one, there was a steep decline in the incidence of property offences. On removing restrictions, the cases soared above the counterfactual predicted counts. In wave two, despite the higher severity and fatality in the COVID-19 pandemic, a similar trend of fall and rise in property cases was observed. However, the drop in mobility was less substantial, and the increase in the magnitude of property offences was more significant in wave two than in wave one. The overall trend of fluctuations is related to mobility during various phases of restrictions in the pandemic. When most curbs were removed, there was a surge in robberies in Tamil Nadu and Chennai after adjusting for mobility. This trend highlights the effective increase in crime due to pandemic-related economic and social consequences. Further, the research enables law enforcement to strengthen preventive crime work in similar situations, when most curbs are removed after a pandemic or other unanticipated scenarios.

Counterfactual analysis of the impact of the first two waves of the COVID-19 pandemic on the reporting and registration of missing people in India.

The primary duty of law enforcement agencies is to ensure that a victim has the necessary information and access to the relevant tools required to seek justice. In India, complex cases such as bodily offences and property crimes capture the work and efforts of many agencies involved; however, cases related to missing persons are not often accorded similar priority or seriousness. The COVID-19 pandemic and subsequent lockdowns have added further challenges to this scenario. The government-mandated lockdowns in Tamil Nadu generally exacerbated difficult socio-economic and living conditions, thereby directly or indirectly contributing to an increased load of missing person cases. This study aims to assess and identify the impact of mobility on reporting and registration of missing persons. By adopting an auto-regressive neural networks method, this study uses a counterfactual analysis of registered missing person cases during the government-mandated lockdowns in response to the global pandemic in 2020 and 2021. The registered cases are calculated based on the daily count of cases for eleven years in Tamil Nadu, India. The lockdowns identify eight different time windows to determine the impact of mobility on the registration of cases. While there has been no significant or drastic change over the pre-pandemic period, during the pandemic, especially during the restrictive phases of the pandemic, there was a sharp fall in cases compared to the counterfactual predicted (effect sizes: -0.981 and -0.74 in 2020 and 2021), signalling towards a choked mechanism of reporting. In contrast, when most mobility restrictions were removed, an increase in cases (effect sizes of +0.931 and 0.834 in 2020 and 2021) pointed to restored and enabled reporting channels. The research findings emphasise the significance of mobility as a factor in influencing the reporting and registration of missing persons and the need to ensure this continues to help families find redress.