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3.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 29(Special Issue): 713-719, 2021 Jun.
Artigo em Russo | MEDLINE | ID: mdl-34327950

RESUMO

The objectives of this research are to explore foreign experience of interaction of various levels of public authority in federal states in the context of the COVID-19 pandemic, to determine the prospects for the development and improvement of the activities of the public authority system in Russia in this part. MATERIALS AND METHODS: The regulatory legal acts and the practice of interaction of various levels of public authority during the COVID-19 pandemic in federations (Australia, India, Canada, USA) were research. RESULTS: It has been established that a dual federal system with strict rules for the distribution of powers and responsibilities between the federation and its regions impedes a coordinated national response in the fight against the COVID-19 pandemic, while various forms of executive federalism serve as the key to successfully countering this threat. The latter can be based on historically strong centralist tendencies, the existing negotiating practices of interaction between the executive branch at all levels, the experience of implementing federal programs and the work of emergency intergovernmental mechanisms. CONCLUSIONS: It has been substantiated that the optimal organization of managerial decision-making in the context of countering a pandemic presupposes a complex interagency approach with a strong federal presence.


Assuntos
COVID-19 , Governo Federal , Pandemias , Governo Estadual , Austrália , Canadá , Política de Saúde , Humanos , Índia , Administração em Saúde Pública , Federação Russa , Estados Unidos
6.
Am J Public Health ; 111(7): 1273-1280, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34111376

RESUMO

Objectives. To assess state policy environments and the relationship between state gun-control, gun-rights, and preemptive firearm-related laws in the United States. Methods. In 2019 through 2020, we evaluated substantive firearm laws and preemptive firearm laws across 50 US states for 2009 through 2018. For each state, we compared substantive measures with preemptive measures on the same policy topic for 2018. Results. The presence of state firearm-related laws varied across states, but with the exception of "punitive preemption" the number of gun-control, gun-rights, and preemptive measures remained unchanged in most states from 2009 through 2018. As of 2018, a majority of states had preemptive measures on almost all gun-control policy topics without enacting substantive gun-control measures. Several states had a combination of gun-control and preemptive measures. Only a small number of states had gun-control measures with few to no preemptive measures. Conclusions. Even where state legislators were unable to pass statewide gun-rights measures, they succeeded in passing preemption, preserving state authority over a wide range of gun-control and gun-rights policy topics. The majority of states used preemption as a tool to support policy frameworks favoring gun rights.


Assuntos
Armas de Fogo/legislação & jurisprudência , Governo Estadual , Homicídio/estatística & dados numéricos , Humanos , Suicídio/estatística & dados numéricos , Estados Unidos , Violência/estatística & dados numéricos , Ferimentos por Arma de Fogo/epidemiologia
7.
J Safety Res ; 77: 324-327, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34092324

RESUMO

INTRODUCTION: As part of scaling up the response to the opioid overdose epidemic, there is an opportunity to examine how state public health departments addressed workforce and other infrastructure needs to implement a large-scale opioid overdose prevention program. Understanding how this was done-and any lessons learned from the process-can inform future workforce development and capital improvement efforts. METHODS: Administrative data from the Centers for Disease Control and Prevention (CDC) Prescription Drug Overdose Prevention for States (PfS) program were analyzed to understand how states adapted to this emerging public health priority. RESULTS: Six months into the first year of funding, 6 of the 16 state health departments had filled all anticipated staffing positions. States faced challenges obtaining timely expenditure authority and hiring staff. However, states were able to overcome these challenges by strategically reassigning staff, hiring from within, and utilizing existing contract mechanisms. CONCLUSION: Our analysis revealed how planning, using existing infrastructure, and maintaining a prepared workforce are critical to ensure that public health agencies have the ability to surge to meet emerging challenges and effectively utilize resources to achieve program goals. practical applications: Greater attention should be directed toward strategically addressing known barriers and timelines in work plans and budgets during the application and selection process to ensure implementation readiness.


Assuntos
Epidemia de Opioides , Administração em Saúde Pública , Governo Estadual , Recursos Humanos/organização & administração , Centers for Disease Control and Prevention, U.S. , Overdose de Drogas/prevenção & controle , Humanos , Seleção de Pessoal , Admissão e Escalonamento de Pessoal , Saúde Pública , Estados Unidos/epidemiologia
9.
BMJ Glob Health ; 6(6)2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34083242

RESUMO

INTRODUCTION: To present an analysis of the Brazilian health system and subnational (state) variation in response to the COVID-19 pandemic, based on 10 non-pharmaceutical interventions (NPIs). MATERIALS AND METHODS: We collected daily information on implementation of 10 NPI designed to inform the public of health risks and promote distancing and mask use at the national level for eight countries across the Americas. We then analyse the adoption of the 10 policies across Brazil's 27 states over time, individually and using a composite index. We draw on this index to assess the timeliness and rigour of NPI implementation across the country, from the date of the first case, 26 February 2020. We also compile Google data on population mobility by state to describe changes in mobility throughout the COVID-19 pandemic. RESULTS: Brazil's national NPI response was the least stringent among countries analysed. In the absence of a unified federal response to the pandemic, Brazilian state policy implementation was neither homogenous nor synchronised. The median NPI was no stay-at-home order, a recommendation to wear masks in public space but not a requirement, a full school closure and partial restrictions on businesses, public transportation, intrastate travel, interstate travel and international travel. These restrictions were implemented 45 days after the first case in each state, on average. Rondônia implemented the earliest and most rigorous policies, with school closures, business closures, information campaigns and restrictions on movement 24 days after the first case; Mato Grosso do Sul had the fewest, least stringent restrictions on movement, business operations and no mask recommendation. CONCLUSIONS: The study identifies wide variation in national-level NPI responses to the COVID-19 pandemic. Our focus on Brazil identifies subsequent variability in how and when states implemented NPI to contain COVID-19. States' NPIs and their scores on the composite policy index both align with the governors' political affiliations: opposition governors implemented earlier, more stringent sanitary measures than those supporting the Bolsonaro administration. A strong, unified national response to a pandemic is essential for keeping the population safe and disease-free, both at the outset of an outbreak and as communities begin to reopen. This national response should be aligned with state and municipal implementation of NPI, which we show is not the case in Brazil.


Assuntos
COVID-19 , Pandemias , Política Pública , Governo Estadual , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Pandemias/prevenção & controle
11.
J Appl Psychol ; 106(4): 518-529, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34014707

RESUMO

The purpose of this article is to simultaneously advance theory and practice by understanding how the Coronavirus disease 2019 (COVID-19) pandemic relates to new hire engagement. Prior research suggests starting a new job is an uncertain experience; we theorize that the COVID-19 pandemic creates additional environmental stressors that affect new hire engagement. First, we hypothesize that the occurrence of COVID-19 and unemployment rates relate negatively to engagement. Second, we theorize that the effects of the pandemic become more disruptive on new hire engagement as they gain tenure within the organization. Third, drawing from strategic management theory, we test whether States that introduce stronger COVID-19 policies help enhance the engagement of new hires. Examining a U.S. national sample of 12,577 newly hired (90 days or less) quick service restaurant employees across 9 months (January-September, 2020), we find support for these hypotheses. Subsequent model comparisons suggest there may be health stressors that shape engagement more strongly than purely economic stressors. These findings may be important because they highlight the experiences of workers more likely to be exposed to the pandemic and affected by COVID-related policies. Should the results generalize to other samples and jobs, this study offers potentially new research directions for understanding relationships between macro stressors and new hire perceptions and socialization. It also offers practical implications by helping organizations understand the importance of explicitly managing job insecurity, particularly in terms of COVID-19 policy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
COVID-19/psicologia , Pandemias/legislação & jurisprudência , Governo Estadual , Desemprego/estatística & dados numéricos , Engajamento no Trabalho , Local de Trabalho/legislação & jurisprudência , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pessoal/estatística & dados numéricos , SARS-CoV-2 , Fatores de Tempo , Desemprego/psicologia , Estados Unidos , Adulto Jovem
12.
Online braz. j. nurs. (Online) ; 20: e20216486, 05 maio 2021.
Artigo em Inglês, Espanhol, Português | LILACS, BDENF - Enfermagem | ID: biblio-1224136

RESUMO

OBJETIVO: Analisar o processo de seleção da primeira turma de Oficiais Enfermeiros do Corpo de Bombeiros do Estado do Rio de Janeiro, realizado no período de 1992 a 1993. MÉTODO: Trata-se de uma pesquisa histórica, do tipo documental, cujas fontes históricas diretas foram documentos escritos relativos ao tema. RESULTADOS: Foram oito vagas para oficiais enfermeiros, que se submeteram a um processo seletivo rigoroso, sendo selecionados cinco homens e três mulheres, após aprovação nas quatro etapas do concurso. DISCUSSÃO: Integrar o Corpo de Bombeiros significava submeter-se às regras que o estruturavam, e para lograr êxito era necessária a atualização do habitus dos postulantes à patente de oficiais na Corporação. CONCLUSÃO: Enfermeiros foram selecionados dentro do rigor exigido pela Instituição, cujo domínio do conhecimento na área de enfermagem deveria caminhar pari passu com boas condições de saúde e condicionamento físico, atributos fundamentais no desempenho de um bombeiro militar.


OBJECTIVE: To analyze the selective process of the first class of Nursing Officers of the Fire Department of the State of Rio de Janeiro, carried out from 1992 to 1993. METHOD: This is a historical research, a documental one, which used as direct historical sources written documents concerning the theme. OUTCOMES: There were eight vacancies for nursing officers, who were submitted to a rigorous selective process that approved five men and three women after four stages along the contest. DISCUSSION: Making part of the Fire Department meant to accept being submitted to its structural rules, and succeeding required updating the habitus of the candidates according to the ranking of the Corporation's officers. CONCLUSION: Nurses were selected under the rigorous criteria as required by the Institution. Their knowledge abilities in the nursing area should come at equal pace as good health conditions and physical fitness, fundamental performance attributes of a military officer of the Fire Department.


OBJETIVO: Analizar el proceso de selección del primer grupo de Oficiales Enfermeros del Cuerpo de Bomberos del estado de Rio de Janeiro, realizado en el período de 1992 a 1993. MÉTODO: Se trata de una investigación histórica, del tipo documental, cuyas fuentes históricas directas han sido los documentos escritos relativos al tema. RESULTADOS: Fueron ocho vacantes para oficiales enfermeros, que se sometieron a un riguroso proceso de selección. Tras aprobar en las cuatro etapas del concurso, se seleccionaron a cinco hombres y a tres mujeres. DISCUSIÓN: Formar parte del Cuerpo de Bomberos significaba someterse a las reglas que lo estructuraban, y para lograr éxito se hacía necesaria una actualización del habitus de los postulantes al rango de oficiales en la Corporación. CONCLUSIÓN: Los enfermeros se seleccionaron dentro del rigor exigido por la Institución, y su dominio del conocimiento en el área de enfermería debería caminar pari passu con las buenas condiciones de salud y acondicionamiento físico, atributos fundamentales en el desempeño de un bombero militar.


Assuntos
História do Século XX , Seleção de Pessoal , Governo Estadual , Brasil , Bombeiros/história , Enfermagem Militar/história
13.
Am J Drug Alcohol Abuse ; 47(4): 486-496, 2021 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-33909518

RESUMO

Background: Limited research has examined how states have changed policies for treatment of substance use disorder (SUD) during the COVID-19 pandemic.Objectives: We aimed to identify themes in state policy responses to the pandemic in the context of SUD treatment. Identifying themes in policy responses provides a framework for subsequent evaluations of the relationship between state policies and health service utilization.Methods: Between May and June 2020, we searched all Single State Agencies for Substance Abuse Services (SSA) websites for statements of SUD treatment policy responses to the pandemic. We conducted Iterative Categorization of policies for outpatient programs, opioid treatment programs, and other treatment settings to identify themes in policy responses.Results: We collected 220 documents from SSA websites from 45 states and Washington D.C. Eight specific themes emerged from our content analysis: delivery of pharmacological and non-pharmacological services, obtaining informed consent and documentation for remote services, conducting health assessments, facility operating procedures and staffing requirements, and permissible telehealth technology and billing protocols. Policy changes often mirrored federal guidance, for instance, by expanding methadone take-home options for opioid treatment programs. The extent and nature of policy changes varied across jurisdictions, including telehealth technology requirements and staffing flexibility.Conclusion: States have made significant policy changes to SUD treatment policies during COVID-19, particularly regarding telehealth and facilitation of remote care. Understanding these changes could help policymakers prioritize guidance during the pandemic and for future health crises. Impacts of policies on disparate treatment populations, including those with limited technological access, should be considered.


Assuntos
COVID-19 , Controle de Medicamentos e Entorpecentes , Política de Saúde , Serviços de Saúde Mental , Tratamento de Substituição de Opiáceos , Governo Estadual , Transtornos Relacionados ao Uso de Substâncias/terapia , Governo Federal , Acesso aos Serviços de Saúde , Humanos , SARS-CoV-2 , Telemedicina
14.
Contraception ; 104(1): 111-116, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33930382

RESUMO

OBJECTIVES: We aimed to characterize the combined impact of federal, state, and institutional policies on barriers to expanding medication and telemedicine abortion care delivery during the COVID-19 pandemic in the abortion-restrictive states of Ohio, Kentucky, and West Virginia. STUDY DESIGN: We analyzed 4 state policies, 2 COVID-related state executive orders, and clinic-level survey data on medication abortion provision from fourteen abortion facilities in Ohio, Kentucky, and West Virginia from December 2019 to December 2020. We calculated the percent of medication abortions provided at these facilities during the study period by state, to assess changes in medication abortion use during the pandemic. RESULTS: We ascertained that COVID-19-executive orders in Ohio and West Virginia that limited procedural abortion in Spring 2020 coincided with an increase in the overall number and proportion of medication abortions in this region, peaking at 1613 medication abortions (70%) in April 2020. Ohio and West Virginia, which had executive orders limiting procedural abortion, saw relatively greater increases in April compared to Kentucky. Despite temporary lifting of the mifepristone REMS, prepandemic regulations banning telemedicine abortion in Kentucky and West Virginia and requiring in-person clinic visits for medication abortion distribution in Ohio limited clinics' ability to adapt to offer medication abortion by mail. CONCLUSIONS: Our findings illustrate how restrictive medication and telemedicine abortion policies in Ohio, Kentucky, and West Virginia created additional obstacles for patients seeking medication abortion during the pandemic. Permanently lifting federal regulations on in-clinic distribution of mifepristone would only advantage abortion seekers in states without restrictive telehealth and medication abortion policies. State policies that limit access to comprehensive abortion services should be central in larger efforts toward dismantling barriers that impinge upon reproductive autonomy. IMPLICATION STATEMENT: We find that abolishing the REMS on mifepristone would not be enough to expand access to patients in abortion-restrictive states with telemedicine and medication abortion laws. While the REMS is a barrier, it represents one of several hindrances to the expansion of telemedicine abortion distribution across the United States.


Assuntos
Abortivos/uso terapêutico , Aborto Induzido/legislação & jurisprudência , COVID-19 , Serviços Postais , Telemedicina/legislação & jurisprudência , Aborto Induzido/métodos , Controle de Medicamentos e Entorpecentes , Procedimentos Cirúrgicos Eletivos , Governo Federal , Acesso aos Serviços de Saúde , Humanos , Kentucky , Ohio , Política Pública , Avaliação de Risco e Mitigação , SARS-CoV-2 , Governo Estadual , Telemedicina/organização & administração , West Virginia
15.
Healthc Q ; 24(1): 28-35, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33864438

RESUMO

Provincial health systems have been challenged by the surge in healthcare demands caused by the COVID-19 pandemic; the COVID-19 vaccine rollout across the country has further added to these challenges. A successful vaccination campaign is widely viewed as the only way to overcome the COVID-19 pandemic, placing greater urgency on the need for a rapid vaccination strategy. In this paper, we present emerging findings, from a national research study, that document the key challenges faced by current vaccine rollout strategies, which include procurement and leadership strategies, citizen engagement and limitations in supply chain capacity. These findings are used to inform a scalable vaccine strategy comprising collaborative leadership, mobilization of an integrated workforce and a digitally enabled supply chain strategy. The goal of vaccinating the entire Canadian population in the next few months can be achieved when supported by such a strategy.


Assuntos
Vacinas contra COVID-19/uso terapêutico , COVID-19/prevenção & controle , Prática Clínica Baseada em Evidências/métodos , Programas de Imunização/organização & administração , Capacidade de Resposta ante Emergências/organização & administração , Vacinas contra COVID-19/provisão & distribuição , Canadá , Humanos , Liderança , Governo Estadual
16.
Healthc Q ; 24(1): 36-43, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33864439

RESUMO

The COVID-19 pandemic has highlighted the many challenges that provincial health systems have experienced while scaling health services to protect Canadians from viral transmission and support care for those who get infected. Supply chain capacity makes it possible for health systems to deliver care and implement public health initiatives safely. In this paper, we present emerging findings from a national research study that documents the key features of the fragility of the health supply chain evident across the seven Canadian provinces. Results suggest that the fragility of the health supply chain contributes to substantive challenges across health systems, thus limiting or precluding proactive and comprehensive responses to pandemic management. These findings inform strategies to strengthen supply chain capacity and performance in order to enable health systems to effectively respond to pandemic events.


Assuntos
COVID-19/epidemiologia , Atenção à Saúde/organização & administração , COVID-19/terapia , Canadá , Equipamentos e Provisões Hospitalares/provisão & distribuição , Humanos , Administração de Materiais no Hospital/organização & administração , Política , Governo Estadual
17.
JAMA ; 325(16): 1631-1639, 2021 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-33904868

RESUMO

Importance: Safe reduction of the cesarean delivery rate is a national priority. Objective: To evaluate the rates of cesarean delivery for nulliparous, term, singleton, vertex (NTSV) births in California in the context of a statewide multifaceted intervention designed to reduce the rates of cesarean delivery. Design, Setting, and Participants: Observational study of cesarean delivery rates from 2014 to 2019 among 7 574 889 NTSV births in the US and at 238 nonmilitary hospitals providing maternity services in California. From 2016 to 2019, California Maternal Quality Care Collaborative partnered with Smart Care California to implement multiple approaches to decrease the rates of cesarean delivery. Hospitals with rates of cesarean delivery greater than 23.9% for NTSV births were invited to join 1 of 3 cohorts for an 18-month quality improvement collaborative between July 2016 and June 2019. Exposures: Within the collaborative, multidisciplinary teams implemented multiple strategies supported by mentorship, shared learning, and rapid-cycle data feedback. Partnerships among nonprofit organizations, state governmental agencies, purchasers, and health plans addressed the external environment through transparency, award programs, and incentives. Main Outcomes and Measures: The primary outcome was the change in cesarean delivery rates for NTSV births in California and a difference-in-differences analysis was performed to compare cesarean delivery rates for NTSV births in California vs the rates in the rest of the US. A mixed multivariable logistic regression model that adjusted for patient-level and hospital-level confounders also was used to assess the collaborative and the external statewide actions. The cesarean delivery rates for NTSV births at hospitals participating in the collaborative were compared with the rates from the nonparticipating hospitals and the rates in the participating hospitals prior to participation in the collaborative. Results: A total of 7 574 889 NTSV births occurred in the US from 2014 to 2019, of which 914 283 were at 238 hospitals in California. All California hospitals were exposed to the statewide actions to reduce the rates of cesarean delivery, including the 149 hospitals that had baseline rates of cesarean delivery greater than 23.9% for NTSV births, of which 91 (61%) participated in the quality improvement collaborative. The rate of cesarean delivery for NTSV births in California decreased from 26.0% (95% CI, 25.8%-26.2%) in 2014 to 22.8% (95% CI, 22.6%-23.1%) in 2019 (relative risk, 0.88; 95% CI, 0.87-0.89). The rate of cesarean delivery for NTSV births in the US (excluding California births) was 26.0% in both 2014 and 2019 (relative risk, 1.00; 95% CI, 0.996-1.005). The difference-in-differences analysis revealed that the reduction in the rate of cesarean delivery for NTSV births in California was 3.2% (95% CI, 1.7%-3.5%) higher than in the US (excluding California). Compared with the hospitals and the periods not exposed to the collaborative activities, and after adjusting for patient characteristics and time using a modified stepped-wedge analysis, exposure to collaborative activities was associated with a lower odds of cesarean delivery for NTSV births (24.4% vs 24.6%; adjusted odds ratio, 0.87 [95% CI, 0.85-0.89]). Conclusions and Relevance: In this observational study of NTSV births in California from 2014 to 2019, the rates of cesarean delivery decreased over time in the setting of the implementation of a coordinated hospital-level collaborative and statewide initiatives designed to support vaginal birth.


Assuntos
Cesárea/estatística & dados numéricos , Política de Saúde , Hospitais/estatística & dados numéricos , Melhoria de Qualidade , California , Feminino , Administração Hospitalar , Humanos , Recém-Nascido , Doenças do Recém-Nascido/epidemiologia , Modelos Logísticos , Análise Multivariada , Paridade , Gravidez , Governo Estadual
19.
Appl Clin Inform ; 12(2): 208-221, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33853140

RESUMO

BACKGROUND: In the United States, all 50 state governments deployed publicly viewable dashboards regarding the novel coronavirus disease 2019 (COVID-19) to track and respond to the pandemic. States dashboards, however, reflect idiosyncratic design practices based on their content, function, and visual design and platform. There has been little guidance for what state dashboards should look like or contain, leading to significant variation. OBJECTIVES: The primary objective of our study was to catalog how information, system function, and user interface were deployed across the COVID-19 state dashboards. Our secondary objective was to group and characterize the dashboards based on the information we collected using clustering analysis. METHODS: For preliminary data collection, we developed a framework to first analyze two dashboards as a group and reach agreement on coding. We subsequently doubled coded the remaining 48 dashboards using the framework and reviewed the coding to reach total consensus. RESULTS: All state dashboards included maps and graphs, most frequently line charts, bar charts, and histograms. The most represented metrics were total deaths, total cases, new cases, laboratory tests, and hospitalization. Decisions on how metrics were aggregated and stratified greatly varied across dashboards. Overall, the dashboards were very interactive with 96% having at least some functionality including tooltips, zooming, or exporting capabilities. For visual design and platform, we noted that the software was dominated by a few major organizations. Our cluster analysis yielded a six-cluster solution, and each cluster provided additional insights about how groups of states engaged in specific practices in dashboard design. CONCLUSION: Our study indicates that states engaged in dashboard practices that generally aligned with many of the goals set forth by the Centers for Disease Control and Prevention, Essential Public Health Services. We highlight areas where states fall short of these expectations and provide specific design recommendations to address these gaps.


Assuntos
COVID-19/epidemiologia , COVID-19/virologia , SARS-CoV-2/fisiologia , Governo Estadual , Análise por Conglomerados , Humanos , Estados Unidos/epidemiologia
20.
J Prev Interv Community ; 49(2): 119-126, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33843499

RESUMO

Crisis communication is most effective when it takes into consideration the emotional reactions of those involved. Messages pertaining to pandemic illness such as COVID-19 should thus include the most effective types of words, given the goal of crisis management. This study investigated hypothesized word categories (e.g., reward/risk, focus on present versus past) related to superordinate categories of positive and negative emotional tone in COVID-19 fact sheets from each of the fifty states in the U.S. The relation of six word types to the superordinate categories and a health outcome variable (the rate of deaths per positive virus cases) was also tested. Results indicated that each of the six word types mapped on to either the positive or negative emotion word category. Furthermore, messages that included more reward and uncertainty words were associated with lower deaths per positive virus cases. Implications for future pandemic crisis messages are discussed.


Assuntos
COVID-19/psicologia , Emoções , Comunicação em Saúde , Idioma , Avaliação de Resultados em Cuidados de Saúde , Governo Estadual , Humanos , Armazenamento e Recuperação da Informação , Pandemias , SARS-CoV-2 , Estados Unidos
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