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1.
Chiropr Man Therap ; 28(1): 44, 2020 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-32631385

RESUMO

INTRODUCTION: The COVID-19 pandemic led to unprecedented changes, as many state and local governments enacted stay-at-home orders and non-essential businesses were closed. State chiropractic licensing boards play an important role in protecting the public via regulation of licensure and provision of guidance regarding standards of practice, especially during times of change or uncertainty. OBJECTIVE: The purpose of this study was to summarize the guidance provided in each of the 50 United States, related to chiropractic practice during the COVID-19 pandemic. METHODS: A review of the public facing websites of governors and state chiropractic licensing boards was conducted in the United States. Data were collected regarding the official guidance provided by each state's chiropractic licensing board as well as the issuance of stay-at-home orders and designations of essential personnel by state governors. Descriptive statistics were used to report the findings from this project. RESULTS: Each of the 50 state governor's websites and individual state chiropractic licensing board's websites were surveyed. Stay-at-home or shelter-in-place orders were issued in 86% of all states. Chiropractors were classified as essential providers in 54% of states, non-essential in one state (2%), and no guidance was provided in the remaining 44% of all states. Fourteen states (28%) recommended restricting visits to only urgent cases and the remaining states (72%) provided no guidance. Twenty-seven states (54%) provided information regarding protecting against infectious disease and the remaining states (46%) provided no guidance. Twenty-two states (44%) provided recommendations regarding chiropractic telehealth and the remaining states (56%) provided no guidance. Seventeen states (34%) altered license renewal requirements and eight states (16%) issued warnings against advertising misleading or false information regarding spinal manipulation and protection from COVID-19. CONCLUSION: State guidance during the COVID-19 pandemic was heterogenous, widely variability in accessibility, and often no guidance was provided by state chiropractic licensing boards. Some state chiropractic licensing boards chose to assemble guidance for licensees into a single location, which we identified as a best practice for future situations where changes in chiropractic practice must be quickly communicated.


Assuntos
Betacoronavirus , Quiroprática/legislação & jurisprudência , Comércio/legislação & jurisprudência , Pandemias/legislação & jurisprudência , Governo Estadual , Quiroprática/normas , Infecções por Coronavirus , Humanos , Pneumonia Viral , Guias de Prática Clínica como Assunto , Estados Unidos
2.
Rev Saude Publica ; 54: 65, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32609277

RESUMO

OBJECTIVE: To point out challenges and opportunities for the Brazilian Unified Health System (SUS) with the use of telemonitoring to face the increasing costs of non-communicable chronic diseases, based on its general panorama in Brazil, business dynamics and reapplication of data from American studies. METHODS: Quali-quantitative approach with exploratory research. The field work focused on the analysis of the national market from private companies, since no experiences or studies related to this theme were identified in the SUS. To analyze the panorama and market dynamics, we investigated the offer of this technology based on the products and services available and their demand by reference hospitals the ten largest private health plan companies. To support the central discussion, we analyzed the reduction of costs with hospital admissions by the SUS due to chronic non-communicable diseases sensitive to telemonitoring (HCDST), using data from Datasus and some American studies from the MEDLINE/PubMed database. RESULTS: Although in the embryonic phase, business agents search for new business opportunities, whereas public initiatives for the use of telemonitoring in collective health seem inexistent. The reapplication of U.S. data would reduce spending on HCDST and provide benefits, such as the reduction in emergency room care, acute hospitalizations, readmissions and home care time, among others, which point to even greater economic gains. CONCLUSIONS: The development of a major project to reduce HCDST using this technology has the potential to advance in a comprehensive network of primary care, contribute to a greater dynamism of the national productive and innovative base and induce innovations along the chain of this emerging industry.


Assuntos
Assistência à Saúde , Custos de Cuidados de Saúde/estatística & dados numéricos , Hospitalização , Telemedicina/economia , Brasil , Comércio , Serviço Hospitalar de Emergência , Humanos , Doenças não Transmissíveis , Telemedicina/estatística & dados numéricos
4.
PLoS One ; 15(7): e0235654, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645023

RESUMO

On 3 April 2020, the Director-General of the WHO stated: "[COVID-19] is much more than a health crisis. We are all aware of the profound social and economic consequences of the pandemic (WHO, 2020)". Such consequences are the result of counter-measures such as lockdowns, and world-wide reductions in production and consumption, amplified by cascading impacts through international supply chains. Using a global multi-regional macro-economic model, we capture direct and indirect spill-over effects in terms of social and economic losses, as well as environmental effects of the pandemic. Based on information as of May 2020, we show that global consumption losses amount to 3.8$tr, triggering significant job (147 million full-time equivalent) and income (2.1$tr) losses. Global atmospheric emissions are reduced by 2.5Gt of greenhouse gases, 0.6Mt of PM2.5, and 5.1Mt of SO2 and NOx. While Asia, Europe and the USA have been the most directly impacted regions, and transport and tourism the immediately hit sectors, the indirect effects transmitted along international supply chains are being felt across the entire world economy. These ripple effects highlight the intrinsic link between socio-economic and environmental dimensions, and emphasise the challenge of addressing unsustainable global patterns. How humanity reacts to this crisis will define the post-pandemic world.


Assuntos
Infecções por Coronavirus/economia , Pandemias/economia , Pneumonia Viral/economia , Comércio , Conservação dos Recursos Naturais , Gases de Efeito Estufa , Humanos , Fatores Socioeconômicos
5.
Global Health ; 16(1): 51, 2020 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-32580728

RESUMO

The COVID-19 pandemic has ushered in a new climate of uncertainty which is fuelling protectionism and playing into nationalist narratives. Globalisation is under significant threat as governments scramble to reduce their vulnerability to the virus by limiting global trade and flows of people. With the imposition of border closures and strict migration measures, there have been major disruptions in Africa's global supply chains with adverse impacts on employment and poverty. The African economies overly reliant on single export-orientated industries, such as oil and gas, are expected to be severely hit. This situation is further aggravated by tumbling oil prices and a lowered global demand for African non-oil products. The agricultural sector, which should buffer these shocks, is also being affected by the enforcement of lockdowns which threaten people's livelihoods and food security. Lockdowns may not be the answer in Africa and the issue of public health pandemic response will need to be addressed by enacting context-specific policies which should be implemented in a humane way. In addressing the socioeconomic impact of COVID-19 on African nations, we argue that governments should prioritize social protection programmes to provide people with resources to maintain economic productivity while limiting job losses. International funders are committing assistance to Africa for this purpose, but generally as loans (adding to debt burdens) rather than as grants. G20 agreement so suspend debt payments for a year will help, but is insufficient to fiscal need. Maintaining cross-border trade and cooperation to continue generating public revenues is desirable. New strategies for diversifying African economies and limiting their dependence on external funding by promoting trade with a more regionalised (continental) focus as promoted by the African Continental Free Trade Agreement, while not without limitations, should be explored. While it is premature to judge the final economic and death toll of COVID-19, African leaders' response to the pandemic, and the support they receive from wealthier nations, will determine its eventual outcomes.


Assuntos
Comércio/organização & administração , Infecções por Coronavirus/prevenção & controle , Internacionalidade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , África/epidemiologia , Comércio/economia , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
8.
ScientificWorldJournal ; 2020: 8923036, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32528234

RESUMO

Background: The reports and information on coronavirus are not conspicuously emphasising the possible impact of population density on the explanation of difference in rapid spread and fatality due to the disease and not much has been done on bicountry comparisons. Objective: The study examined the impact of population density on the spread of COVID-19 pandemic in two sociodemographic divergent countries. Methods: The study conducted a scoping review of published and unpublished articles including blogs on incidences and fatalities of COVID-19. The analysis followed qualitative description and quantitative presentation of the findings using only frequency distribution, percentages, and graphs. Results: The two countries shared similar experience of "importation" of COVID-19, but while different states ordered partial lockdown in Nigeria, it was an immediate total lockdown in Italy. The physician/patient ratio is high in Italy (1 : 328) but low in Nigeria (1 : 2500), while population density is 221 in Nigeria and 206 in Italy. Daily change in incidence rate reduced to below 20% after 51 and 30 days of COVID-19 first incidence in Italy and Nigeria, respectively. Fatality rate has plummeted to below 10% after the 66th day in Italy but has not been stabilised in Nigeria. Conclusion: The authors upheld both governments' recommending measures that tilted towards personal hand-hygienic practices and social distancing. Authors suggested that if Italy with its high physician/patient ratio and lower population density compared to Nigeria could suffer high fatality from COVID-19 pandemic under four weeks, then Nigeria with its low physician/patient ratio and higher population density should prepare to face harder time if the pandemic persists.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/transmissão , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Pneumonia Viral/transmissão , Densidade Demográfica , Betacoronavirus , Comércio , Planejamento em Desastres , Política de Saúde , Acesso aos Serviços de Saúde , Humanos , Incidência , Cooperação Internacional , Itália/epidemiologia , Nigéria/epidemiologia , Pandemias , Saúde Pública , Quarentena , Classe Social
9.
MMWR Morb Mortal Wkly Rep ; 69(24): 751-758, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32555138

RESUMO

SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is thought to be transmitted mainly by person-to-person contact (1). Implementation of nationwide public health orders to limit person-to-person interaction and of guidance on personal protective practices can slow transmission (2,3). Such strategies can include stay-at-home orders, business closures, prohibitions against mass gatherings, use of cloth face coverings, and maintenance of a physical distance between persons (2,3). To assess and understand public attitudes, behaviors, and beliefs related to this guidance and COVID-19, representative panel surveys were conducted among adults aged ≥18 years in New York City (NYC) and Los Angeles, and broadly across the United States during May 5-12, 2020. Most respondents in the three cohorts supported stay-at-home orders and nonessential business closures* (United States, 79.5%; New York City, 86.7%; and Los Angeles, 81.5%), reported always or often wearing cloth face coverings in public areas (United States, 74.1%, New York City, 89.6%; and Los Angeles 89.8%), and believed that their state's restrictions were the right balance or not restrictive enough (United States, 84.3%; New York City, 89.7%; and Los Angeles, 79.7%). Periodic assessments of public attitudes, behaviors, and beliefs can guide evidence-based public health decision-making and related prevention messaging about mitigation strategies needed as the COVID-19 pandemic evolves.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Saúde Pública/legislação & jurisprudência , Adolescente , Adulto , Idoso , Comércio/legislação & jurisprudência , Feminino , Humanos , Los Angeles/epidemiologia , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Isolamento Social , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
12.
F1000Res ; 9: 225, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32566139

RESUMO

While the world is facing the urgency of the COVID-19 pandemic, policymakers must plan for the direct response to the outbreak while minimising its collateral impact. Maintaining the supply chain of pharmaceutical products is not only paramount to cover the immediate medical response but will be fundamental to reducing disruption of the healthcare delivery system, which requires constant medicines, diagnostic tools and vaccines for smooth functioning. In this equation, the role of the Indian pharmaceutical industry will not only be critical to meet the domestic need of over 1.3 billion inhabitants but will equally be important for the rest of the world, including wealthy economies. Preventing a significant disruption of the Indian pharmaceutical supply chain during the outbreak and preparing it for large scale production for COVID-19 therapeutic or preventive medical products will not only help India but will assist the global response to this outbreak.


Assuntos
Infecções por Coronavirus , Medicamentos Genéricos/provisão & distribução , Pandemias , Preparações Farmacêuticas/provisão & distribução , Pneumonia Viral , Betacoronavirus , Comércio , Indústria Farmacêutica , Humanos , Índia
13.
Proc Natl Acad Sci U S A ; 117(24): 13596-13602, 2020 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-32482862

RESUMO

The ongoing sixth mass species extinction is the result of the destruction of component populations leading to eventual extirpation of entire species. Populations and species extinctions have severe implications for society through the degradation of ecosystem services. Here we assess the extinction crisis from a different perspective. We examine 29,400 species of terrestrial vertebrates, and determine which are on the brink of extinction because they have fewer than 1,000 individuals. There are 515 species on the brink (1.7% of the evaluated vertebrates). Around 94% of the populations of 77 mammal and bird species on the brink have been lost in the last century. Assuming all species on the brink have similar trends, more than 237,000 populations of those species have vanished since 1900. We conclude the human-caused sixth mass extinction is likely accelerating for several reasons. First, many of the species that have been driven to the brink will likely become extinct soon. Second, the distribution of those species highly coincides with hundreds of other endangered species, surviving in regions with high human impacts, suggesting ongoing regional biodiversity collapses. Third, close ecological interactions of species on the brink tend to move other species toward annihilation when they disappear-extinction breeds extinctions. Finally, human pressures on the biosphere are growing rapidly, and a recent example is the current coronavirus disease 2019 (Covid-19) pandemic, linked to wildlife trade. Our results reemphasize the extreme urgency of taking much-expanded worldwide actions to save wild species and humanity's crucial life-support systems from this existential threat.


Assuntos
Infecções por Coronavirus/epidemiologia , Ecossistema , Extinção Biológica , Pneumonia Viral/epidemiologia , Vertebrados , Animais , Animais Selvagens , Mudança Climática , Comércio , Conservação dos Recursos Naturais , Espécies em Perigo de Extinção , Atividades Humanas , Pandemias , Densidade Demográfica , Vertebrados/classificação
16.
Med Leg J ; 88(2): 57-64, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32515258

RESUMO

This is a personal view from London as the Covid-19 pandemic continues to spread here and the situation changes from day to day. As such it can only be a snapshot caught in time; it is not a diary of events. The Coronavirus Act 2020 gives Government enormous powers and was passed by Parliament in one day of debate immediately before it closed early for the Easter break. In March, the government imposed a "lockdown: the closure of all" but "essential" businesses and people other than essential workers must work from home but are allowed out for exercise and food shopping but must maintain 2 m apart, the "social distancing rule". The aim is to suppress the spread of the virus, reduce the death toll and "protect the National Health Service (NHS)" which needed time to empty wards and expand its intensive care unit (ICU) capability to deal with an expected influx of thousands of very sick patients. I discuss whether this strategy is working, how and why it has rapidly been altered to respond to criticism. Why was the Government so slow to seek the help of private laboratories to assist with testing? Why was the personal protective equipment (PPE) guidance altered only after criticism? I look at the impact of the lockdown on the UK economy, the changes to practice of medicine and speeding of scientific research. Cooperating with the lockdown has its price; is it harming the health and mental health of children, people living in households with potentially abusive partners or parents and those who are disabled or financially desperate? Is the cure worse than the disease? The Economy is being devastated by the lockdown and each day of lockdown it is worse. Is litigation being seeded even now by the pandemic? Notwithstanding unprecedented Government financial help many businesses are on the edge of collapse, people will lose their jobs and pensioners income. The winners include pharmacies, supermarkets, online food retailers, Amazon, online apps, providers of video games, services, streaming and scientific research laboratories, manufacturers of testing kits, ventilators, hand sanitisers, coffins, undertakers, etc. The British public is cooperating with lockdown but are we less productive at home? Parents with babies and children often child minders, school, grandparents or paid help which is not now available. Will current reliance on video-conferencing and video calls permanently change the way we work and will we need smaller city offices? Will we travel less? Will medical and legal practice and civil and criminal trials be generally carried out remotely? Will social distancing with self-isolation and job losses and business failures fuel depression? Is Covid-19 comparable to past epidemics like the Plague and Spanish flu?


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Ansiedade/epidemiologia , Comércio/legislação & jurisprudência , Controle de Doenças Transmissíveis , Infecções por Coronavirus/transmissão , Direito Penal , Depressão/epidemiologia , Economia , Previsões , Liberdade , Regulamentação Governamental , Habitação/economia , Humanos , Internet , Londres/epidemiologia , Corpo Clínico Hospitalar/provisão & distribução , Recursos Humanos de Enfermagem no Hospital/provisão & distribução , Pandemias , Pânico , Autonomia Pessoal , Pneumonia Viral/transmissão , Administração em Saúde Pública , Quarentena , Instituições Acadêmicas , Políticas de Controle Social , Isolamento Social , Telemedicina , Viagem , Triagem
17.
J Environ Manage ; 269: 110774, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32560995

RESUMO

Following the adaptation of the Paris Agreement at COP21, it was noted that the traditional measures of carbon emissions have several limitations; and a reliable and relevant carbon emissions measurement is important to formulate a response to the challenge of climate change. This study, therefore, explores the relationship between international trade and consumption-based carbon emissions, which is a trade adjusted indicator; and measures the outflow and the inflow of emissions through exports and imports separately. We also include technological innovation in the model to understand its impact on consumption-based carbon emissions. The results show that exports and consumption-based carbon emissions are negatively associated, and technological innovation helps reducing the adverse effect of CO2 growth. In contrast, Imports and gross domestic product are positively linked with consumption-based carbon emissions. The findings also suggest the countries which embraced the Paris Climate Agreement must focus on consumption-based carbon emissions rather than the production-based carbon emissions.


Assuntos
Mudança Climática , Comércio , Carbono , Dióxido de Carbono , Internacionalidade
20.
Am J Clin Nutr ; 111(6): 1278-1285, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32412583

RESUMO

BACKGROUND: Many lower-income communities in the United States lack a full-line grocery store. There is evidence that the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) increases the availability of healthy foods in stores. One national discount variety store chain (DVS) that is often located in low-income neighborhoods became an authorized WIC vendor in 8 pilot stores. OBJECTIVES: The objective of this study was to evaluate how implementing WIC in DVS pilot stores affected sales of healthy, WIC-eligible foods. METHODS: We used DVS sales data and difference-in-differences regression to evaluate how WIC authorization affected sales of WIC-eligible foods in 8 DVS pilot stores, compared with 8 matched comparison stores. RESULTS: DVS added 18 new WIC-approved foods to become an authorized vendor. Results indicate that becoming a WIC vendor significantly increased sales of healthy, WIC-eligible foods that DVS carried before authorization. WIC implementation in DVS led to a 31-unit increase in sales of the original WIC foods per week on average (P < 0.01). Lower socioeconomic status, assessed using a summary measure, is associated with increased sales of WIC foods. Yet sales of non-WIC eligible foods (e.g., salty snack foods, candy bars, soda, and processed meats) were not affected by WIC authorization. CONCLUSIONS: Encouraging DVS stores to become WIC-authorized vendors has the potential to modestly increase DVS sales and the availability of healthy foods in low-income neighborhoods. If WIC authorization is financially viable for small-format variety stores, encouraging similar small-format variety stores to become WIC-authorized has the potential to improve food access.


Assuntos
Assistência Alimentar/economia , Abastecimento de Alimentos/economia , Alimentos/economia , Setor Privado/economia , Comércio/legislação & jurisprudência , Feminino , Assistência Alimentar/legislação & jurisprudência , Abastecimento de Alimentos/legislação & jurisprudência , Promoção da Saúde/economia , Humanos , Masculino , Pobreza , Autorização Prévia , Setor Privado/legislação & jurisprudência , Estados Unidos
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