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1.
Epidemiol Prev ; 45(3): 189-195, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34212700

RESUMO

OBJECTIVES: to analyse the association between smoking behaviour and economic crises in Italy between 1993 and 2015. DESIGN: ecological study, carried out on data of the Italian National Institute of Statistics, by means of fixed-effect panel regressions. SETTING AND PARTICIPANTS: the rate of smoking prevalence (disaggregated by gender and age) and the unemployment rate (disaggregated by gender and referring to individuals aged 15 or more) were collected for each of the twenty Italian regions. Also, percentage fluctuations of the national real gross domestic product (GDP) were collected to identify the years of severe economic crisis. MAIN OUTCOME MEASURES: number of people who smoke per 100 people with the same features. RESULTS: among men, increased regional unemployment rate was associated with increased smoking behaviour only in the group aged 25-34 years. Differently, severe economic crises were associated with increased smoking in almost all age groups, except for men aged 15-24 years. A 1-point decrease in GDP was associated with 0.75 more smokers aged 15 years or more. The highest coefficient was reported among men aged 35-44 years, where a 1-point decrease in GDP was associated with 1.16 more smokers (every 100 men). This age group is also featured by the second highest prevalence of tobacco smoking (36.8%). Among women, a 1-point increase in the regional unemployment rate was associated with 0.08 less smokers every 100 women. Similarly, periods of severe economic crisis at national level were associated with reduced smoking behaviour among women aged 15 years or more, specifically those aged 15-24 years. Differently, women aged 25-34 and 65 years or more showed an association similar to that reported among men. In these groups, a 1-point decrease in GDP was associated with 0.67 and 1.08 more smokers every 100 women. While among the latter the prevalence of tobacco smoking is the lowest, among the former it is the third highest prevalence (21.69%). Therefore, increased smoking behaviour due to economic crises seems to occur especially among women aged 25-35 years old, as happens among men. CONCLUSIONS: men in almost all age groups and women aged 25-34 and 65 years or more represent vulnerable groups in which smoking behaviour may increase in times of economic hardship. Therefore, specific policies should be implemented to prevent this occurrence, as well as the negative health outcomes of tobacco smoking.


Assuntos
Recessão Econômica , Fumar , Desemprego , Adolescente , Adulto , Feminino , Humanos , Itália/epidemiologia , Masculino , Prevalência , Fumar/epidemiologia , Desemprego/estatística & dados numéricos , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-34265874

RESUMO

Objective: To measure the mental health effects (perceived stress, anxiety, and depression) among health care workers and medical students in Lebanon during the coronavirus disease 2019 (COVID-19) pandemic and subsequent to the Beirut blast.Methods: In this cross-sectional study, a self-administered online questionnaire was developed and distributed between late December 2020 and early February 2021 among health care workers and medical students via social media. The 10-item Perceived Stress Scale (PSS-10) and the 4-item Patient Health Questionnaire for Depression and Anxiety (PHQ-4) were administered. P values between variables were calculated using χ2 test.Results: Overall, 98% of the respondents had a low PSS-10 score and 89% had a low PHQ-4 score. About 58.1% of health care workers and 69.0% of student respondents had moderate to severe stress on the PSS-10, and 48.7% and 46.8%, respectively, reported moderate to severe anxiety and depression on the PHQ-4. Prevalence of depression and anxiety was relatively higher among health care workers with monthly incomes < LBP 4 million (57.1%) and higher in women (39.9%) compared to men (17.2%). Furthermore, the prevalence of depression and anxiety was higher among health care workers traveling between different districts (63.0%) compared to those with residence and work location within the same district and was higher among females (65.4%) compared to males (34.6%).Conclusions: The resilience of the Lebanese people as well as their ability to adapt in the face of trauma, tragedy, threats, or any significant source of stress is remarkable and seen in their everyday lives, especially subsequent to the Beirut blast. However, the psychological well-being and mental health of health care workers and medical students in Lebanon should be carefully surveilled and recorded during the COVID-19 pandemic, especially within the ongoing socioeconomic crisis.


Assuntos
COVID-19 , Desastres , Pessoal de Saúde/psicologia , Saúde Mental , Pandemias , Estudantes de Medicina/psicologia , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Recessão Econômica , Feminino , Humanos , Líbano , Masculino , Pessoa de Meia-Idade , Prevalência , Resiliência Psicológica , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
3.
Rev Esp Salud Publica ; 952021 Jun 03.
Artigo em Espanhol | MEDLINE | ID: mdl-34078851

RESUMO

OBJECTIVE: Homelessness, which is a severe social problem across Europe and on the rise over the past decade, is closely linked to organic and mental health problems. In front of the lack of diagnostic analysis studies in the Spanish territory, this research aimed to determine the sociodemographic characteristics of a sample of individuals experiencing homelessness (IEH), to determine the prevalence of diagnoses of substance use disorders, dual pathology and other mental disorders and to analyze the existence of diagnostic differences between IEH born in the country and immigrant IEH. METHODS: A transversal and observational study was carried out, based on the analysis of mental health diagnostics of the medical histories of a sample of 1,072 IEH (453 locals and 619 immigrants) assisted between 2008 and 2017 in mental health services in Girona, northeastern Spain. For the statistical analysis, Student's t test was used to compare means and the chi-squared test was used for the analysis of qualitative variables. A binary logistic regression analysis was carried out to establish the predictor variables for the diagnosis of drug addiction and dual pathology. RESULTS: IEH showed high rates of mental disorders, especially psychoactive substances (82.6% of diagnosed people). 43.9% of IEH showed alcohol dependence as the reason for their diagnosis, followed by cocaine addiction and opiates. Foreign born IEH had more diagnoses for alcohol dependence and less for opiates or dual pathology than spanish born IEH. IEH born in Spain showed a higher vulnerability and received more mental health diagnoses than immigrant IEH. CONCLUSIONS: Even though immigrant PESS show more diagnoses for alcohol dependence, PESS born in Spain show a higher vulnerability and receive more mental health diagnoses than immigrant PESS. The process of migrating seems to establish a difference in the kind of mental disorders and addictions the PESS collective is prone to.


Assuntos
Recessão Econômica , Emigrantes e Imigrantes/psicologia , Pessoas em Situação de Rua/psicologia , Transtornos Mentais/diagnóstico , Adulto , Emigrantes e Imigrantes/estatística & dados numéricos , Emigração e Imigração/estatística & dados numéricos , Feminino , Pessoas em Situação de Rua/estatística & dados numéricos , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Espanha/epidemiologia
4.
JCO Glob Oncol ; 7: 694-703, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33999696

RESUMO

Since December 2019, the world has been mired in an infectious pandemic that has displaced other health priorities for 21st century populations. Concerned about this situation, Latin American experts on cancer decided to evaluate the impact of the pandemic on cancer control in the region. The analysis was based on information obtained from public sources and scientific publications and included the characteristics of the health care and cancer control prior to the pandemic, the COVID-19 pandemic and measures implemented by the governments of the region, and the regional impact of the pandemic on cancer control together with the costs of cancer care and possible impact of the pandemic on cancer expense. We compared 2019 and 2020 data corresponding to the period March 16-June 30 and found a significant reduction in the number of first-time visits to oncology services (variable depending on the country between -28% and -38%) and a corresponding reduction in pathology (between -6% and -50%), cancer surgery (between -28% and -70%), and chemotherapy (between -2% and -54%). Furthermore, a significant reduction in cancer screening tests was found (PAP smear test studies: between -46% and -100%, mammography: between -32% and -100%, and fecal occult blood test: -73%). If this situation becomes a trend, the health and economic impact will be compounded in the postpandemic period, with an overload of demand on health services to ensure diagnostic tests and consequent treatments. On the basis of this information, a set of prevention and mitigation measures to be immediately implemented and also actions to progressively strengthen health systems are proposed.


Assuntos
COVID-19/prevenção & controle , Recessão Econômica , Oncologia/tendências , Neoplasias/terapia , Distanciamento Físico , COVID-19/economia , Feminino , Humanos , América Latina/epidemiologia , Pandemias/prevenção & controle
6.
Int Nurs Rev ; 68(1): 1-8, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33891770

RESUMO

The World Health Organization designated last year as the International Year of the Nurse and the Midwife. And as we know worldwide, 2020 became an unforgettable year as nurses and midwives everywhere confronted the COVID-19 pandemic. To be a nurse in 2020 was challenging and heroic, but being a nurse in 2020 in Beirut, Lebanon was so extraordinarily charged with adversity. The country witnessed in a one-year series of tragedies of epic dimensions - laying a heavy toll on front-line nurses. We present our stories as eight Lebanese nurses, giving voice to our incredible experiences and our ongoing resilience in the face of these adversities. We served in the emergency department of a Beirut city hospital after a catastrophic explosion occurred in the capital on the 4th of August 2020. We reported for duty during a disaster of immense magnitude and are now coping with the aftermath of trauma. As nurses, we have faced many traumas in our country that has experienced through war and terrorism for decades. Arising from this disaster and challenges of the pandemic, we give policy recommendations that deserve urgent attention in Lebanon and underscore the need for disaster preparation, funding, education and importantly mental health care for nurses and other health professionals with help and support of the international community.


Assuntos
COVID-19/epidemiologia , Recessão Econômica , Explosões , Papel do Profissional de Enfermagem , Atitude do Pessoal de Saúde , Planejamento em Desastres , Humanos , Líbano/epidemiologia , Incidentes com Feridos em Massa , Pandemias , SARS-CoV-2
7.
Artigo em Inglês | MEDLINE | ID: mdl-33920282

RESUMO

Considering the constant increase in breast cancer patients, identifying factors that influence the moment of diagnosis is essential for optimizing therapeutic management and associated cost. The purpose of the study is to evaluate the impact of the economic crisis on the moment of a breast cancer diagnosis. This retrospective observational study analyzed a cohort of 4929 patients diagnosed with breast cancer over the course of 19 years in the Western region of Romania. The time interval was divided based on the onset of the economic crisis into 3 periods: pre-crisis (2001-2006), crisis (2007-2012), and post-crisis (2013-2019). The disease stage at the moment of diagnosis was considered either early (stages 0, I, II) or advanced (stages III, IV). Although recording a similar mean number of patients diagnosed per year during the pre- and crisis periods, a significantly higher percentage of patients were diagnosed with late-stage breast cancer during the economic crisis period compared to the previous interval (46.9% vs. 56.3%, p < 0.01). This difference was further accentuated when accounting for environmental setting, with 65.2% of patients from a rural setting being diagnosed with advanced disease during the crisis interval. An overall improvement of 12% in early-stage breast cancer diagnosis was recorded in the post-crisis period (55.7%, p < 0.001). The findings of this study support periods of economic instability as potential factors for a delay in breast cancer diagnosis and highlight the need for the development of specific strategies aimed at reducing cancer healthcare and associated financial burden in times of economic crisis.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Diagnóstico Tardio , Recessão Econômica , Humanos , Estudos Retrospectivos , Romênia
9.
Int J Behav Nutr Phys Act ; 18(1): 57, 2021 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-33926455

RESUMO

BACKGROUND: The 2008 Great Recession significantly impacted economies and individuals globally, with potential impacts on food systems and dietary intake. We systematically reviewed evidence on the impact of the Great Recession on individuals' dietary intake globally and whether disadvantaged individuals were disproportionately affected. METHODS: We searched seven databases and relevant grey literature through June 2020. Longitudinal quantitative studies with the 2008 recession as the exposure and any measure of dietary intake (energy intake, dietary quality, and food/macronutrient consumption) as the outcome were eligible for inclusion. Eligibility was independently assessed by two reviewers. The Newcastle Ottawa Scale was used for quality and risk of bias assessment. We undertook a random effects meta-analysis for changes in energy intake. Harvest plots were used to display and summarise study results for other outcomes. The study was registered with PROSPERO (CRD42019135864). RESULTS: Forty-one studies including 2.6 million people met our inclusion criteria and were heterogenous in both methods and results. Ten studies reported energy intake, 11 dietary quality, 34 food intake, and 13 macronutrient consumption. The Great Recession was associated with a mean reduction of 103.0 cal per adult equivalent per day (95% Confidence Interval: - 132.1, - 73.9) in high-income countries (5 studies) and an increase of 105.5 cal per adult per day (95% Confidence Interval: 72.8, 138.2) in middle-income countries (2 studies) following random effects meta-analysis. We found reductions in fruit and vegetable intake. We also found reductions in intake of fast food, sugary products, and soft drinks. Impacts on macronutrients and dietary quality were inconclusive, though suggestive of a decrease in dietary quality. The Great Recession had greater impacts on dietary intake for disadvantaged individuals. CONCLUSIONS: The 2008 recession was associated with diverse impacts on diets. Calorie intake decreased in high income countries but increased in middle income countries. Fruit and vegetable consumption reduced, especially for more disadvantaged individuals, which may negatively affect health. Fast food, sugary products, and soft drink consumption also decreased which may confer health benefits. Implementing effective policies to mitigate adverse nutritional changes and encourage positive changes during the COVID-19 pandemic and other major economic shocks should be prioritised.


Assuntos
Dieta/estatística & dados numéricos , Recessão Econômica , COVID-19 , Bebidas Gaseificadas/estatística & dados numéricos , Ingestão de Alimentos , Recessão Econômica/história , Recessão Econômica/estatística & dados numéricos , Frutas , História do Século XXI , Humanos , Pandemias , Verduras
10.
Rev Saude Publica ; 55: 3, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33825798

RESUMO

OBJECTIVE: To estimate the impact of the 2015-2018 economic crisis on tobacco consumption in Brazil. METHODS: This is an interrupted time series analysis conducted with data from 27 cities collected by VIGITEL, using linear regression models to account for first-order autocorrelation. Analyses were conducted based on gender, age group, and education level. RESULTS: Smoking rates decreased between 2006 and 2018, decelerating after the crisis onset. Differently than women, men showed an immediate but transient increase in smoking, followed by a decelerated decrease. Those over 65 also showed increased smoking rates immediately after the economic crisis onset, but decline accelerated later on. In turn, we found a trend reversal among those aged 31-44. Rates also decreased among those with lower education levels, but decelerated among those with more years of schooling. CONCLUSION: An economic crisis have varied impacts on the smoking habits of different population groups. Tobacco control policies should entail a detailed understanding of smoking epidemiology, especially during an economic crisis.


Assuntos
Recessão Econômica , Fumar , Adulto , Brasil/epidemiologia , Cidades/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Fumar/epidemiologia
11.
Glob Heart ; 16(1): 18, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33833942

RESUMO

The current pandemic of SARS-COV 2 infection (Covid-19) is challenging health systems and communities worldwide. At the individual level, the main biological system involved in Covid-19 is the respiratory system. Respiratory complications range from mild flu-like illness symptoms to a fatal respiratory distress syndrome or a severe and fulminant pneumonia. Critically, the presence of a pre-existing cardiovascular disease or its risk factors, such as hypertension or type II diabetes mellitus, increases the chance of having severe complications (including death) if infected by the virus. In addition, the infection can worsen an existing cardiovascular disease or precipitate new ones. This paper presents a contemporary review of cardiovascular complications of Covid-19. It also specifically examines the impact of the disease on those already vulnerable and on the poorly resourced health systems of Africa as well as the potential broader consequences on the socio-economic health of this region.


Assuntos
COVID-19/fisiopatologia , Doenças Cardiovasculares/fisiopatologia , Síndrome Coronariana Aguda/economia , Síndrome Coronariana Aguda/etiologia , Síndrome Coronariana Aguda/fisiopatologia , África , Antimaláricos/efeitos adversos , Arritmias Cardíacas/economia , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/fisiopatologia , COVID-19/complicações , COVID-19/economia , Doenças Cardiovasculares/economia , Doenças Cardiovasculares/etiologia , Cloroquina/efeitos adversos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Atenção à Saúde/economia , Fatores Econômicos , Recessão Econômica , Produto Interno Bruto , Recursos em Saúde/economia , Recursos em Saúde/provisão & distribuição , Insuficiência Cardíaca/economia , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/fisiopatologia , Humanos , Hidroxicloroquina/efeitos adversos , Inflamação , Isquemia Miocárdica/economia , Isquemia Miocárdica/etiologia , Isquemia Miocárdica/fisiopatologia , Miocardite/economia , Miocardite/etiologia , Miocardite/fisiopatologia , SARS-CoV-2 , Síndrome Respiratória Aguda Grave/complicações , Síndrome Respiratória Aguda Grave/fisiopatologia , Fatores Socioeconômicos , Cardiomiopatia de Takotsubo/economia , Cardiomiopatia de Takotsubo/etiologia , Cardiomiopatia de Takotsubo/fisiopatologia
12.
J Ment Health Policy Econ ; 24(1): 13-30, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33739933

RESUMO

BACKGROUND: Research examining mental health outcomes following economic downturns finds both pro-cyclic and counter-cyclic associations. Pro-cyclic findings (i.e. economic downturns correspond with decline in illnesses) invoke increase in leisure time and risk-averse behavior as underlying drivers of reduction in harmful consumption during economic recessions. By contrast, counter-cyclic evidence (i.e. economic downturns correspond with increase in illnesses) suggests increase in mental illness with economic decline owing to heightened stress and loss of resources, particularly among certain age and socioeconomic groups. AIM OF THE STUDY: To examine the relation between monthly aggregate employment decline and psychiatric emergency department visits across 96 counties within 49 Metropolitan Statistical Areas in the United States. METHODS: For this study, data on all psychiatric outpatient Emergency Department (ED) visits for 4 US states (Arizona, California, New Jersey and New York) were retrieved from the State Emergency Department Database (SEDD) and aggregated by county-month, for the time period of 2006 to 2011. Exposure to recession was operationalized as population-level employment change in a Metropolitan Statistical Area (MSA). This information was obtained from MSA-level employment provided by the US Bureau of Labor Statistics. Brief exposure time lags of 0 to 3 months were specified to estimate proximate responses to MSA-level economic decline. Income level was approximated based on insurance status (private insurance= high-income, public insurance = low-income). Linear regression analysis was used to test whether monthly decline in aggregate employment in an MSA corresponds with (i) changes in population rates of psychiatric ED visits and (ii) whether the relation between the outcome and exposure varies by insurance status (private, public) and age group (children, age < 20 years; working-age adults, age 20 to 64 years; elderly adults, age > 64 years). Regression methods controlled for region, year and month fixed effects, and state-specific linear time trends. RESULTS: Linear regression results indicate that overall, psychiatric ED visits (per 100,000 population) decline with decline in monthly employment at exposure lag 0 (coefficient: 0.54, p < 0.001) and lag 2 (coefficient: 0.52, p < 0.001). Privately insured (high-income) groups also show a decline in psychiatric ED visits following decline in aggregate employment. Conversely, publicly insured children show an increase in psychiatric ED visit rates one month (i.e. lag 1) following employment decline (coefficient: -0.35, p value < 0.01). Exploratory analyses by disorder groups show that the population-level decline in psychiatric ED visits concentrates among visits for alcohol use disorders at 0, 1 and 2 month lags of employment decline. DISCUSSION: This study's findings provide evidence of pro- as well as counter-cyclic trends in psychiatric emergency visits following aggregate employment decline in an MSA. Whereas declines in psychiatric emergencies support a risk-averse response to economic recessions, these aggregate trends may mask countervailing trends among vulnerable groups. Limitations of this study include the absence of sex-specific analyses and lack of information on emergent or non-emergent nature of psychiatric ED visits. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: Psychiatric ED visits during recessions may vary by age and income groups. IMPLICATIONS FOR HEALTH POLICIES: Findings from this study may serve to develop targeted policies for low-income groups during macroeconomic downturns. IMPLICATIONS FOR FURTHER RESEARCH: Future research may examine trends in emergent versus non-emergent psychiatric ED visits following economic recessions.


Assuntos
Alcoolismo/psicologia , Recessão Econômica , Serviço Hospitalar de Emergência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Alcoolismo/epidemiologia , Alcoolismo/terapia , Arizona , Criança , Emergências , Emprego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New Jersey/epidemiologia , New York , Estados Unidos/epidemiologia , Adulto Jovem
13.
Am J Prev Med ; 60(6): 802-811, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33653647

RESUMO

INTRODUCTION: This study examines the distribution and trends in suicide death rates among male adults aged ≥65 years in the U.S. from 1999 to 2018. METHODS: Suicide mortality data were derived from Multiple Cause of Death from the Center for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research database. Suicides were identified from the underlying causes of death. Joinpoint regression examined the distribution and shift in suicide age-adjusted death rates overall and by age groups, race/ethnicity, method of suicide, and urbanicity. Analyses were conducted in 2020. RESULTS: Between 1999 and 2018, a total of 106,861 male adults aged ≥65 years died of suicide (age-adjusted rate=31.4 per 100,000 population, 95% CI=31.2, 31.6). Suicide rates showed a V-shaped trend. They were declining annually by 1.8% (95% CI= -2.4, -1.2); however, starting in 2007, there was a shift upward, increasing significantly by 1.7% per year for the next decade (95% CI=1.0, 1.6). Suicide rates were highest among those aged ≥85 years (48.8 per 100,000 population with an upward shift in 2008), Whites (35.3 per 100,000 population with an upward shift in trend in 2007), and the most rural communities (39.0 per 100,000 population). Most suicides were due to firearms (78.3% at a rate of 24.7 per 100,000 population), especially in rural areas, and shifted upward after 2007. CONCLUSIONS: Increases in suicide rates among male older adults in the U.S., particularly after the 2007-2008 economic recession, are concerning. Tailored suicide prevention intervention strategies are needed to address suicide-related risk factors.


Assuntos
Armas de Fogo , Suicídio , Distribuição por Idade , Idoso , Recessão Econômica , Grupos Étnicos , Grupo com Ancestrais do Continente Europeu , Humanos , Masculino , Distribuição por Sexo
14.
J Insur Med ; 49(1): 1-8, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33784745

RESUMO

Disability due to mental health disorders has been increasing in many countries over the past years. The COVID-19 pandemic may worsen this trend because of 3 different, and at times overlapping, pathways. This article describes each pathway, and by drawing on the experience of previous coronavirus epidemics and recent recessions, attempts to estimate the likelihood that claims due to mental health disorders will increase.


Assuntos
COVID-19/epidemiologia , COVID-19/psicologia , Seguro por Invalidez/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Pessoas com Deficiência Mental/estatística & dados numéricos , Recessão Econômica , Humanos , Pandemias , Distanciamento Físico , Quarentena/psicologia , SARS-CoV-2
15.
Hum Resour Health ; 19(1): 29, 2021 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-33658051

RESUMO

BACKGROUND: Since the 2008 recession, Ireland has experienced large-scale doctor emigration. This paper seeks to ascertain whether (and how) the COVID-19 pandemic might disrupt or reinforce existing patterns of doctor emigration. METHOD: This paper draws on qualitative interviews with 31 hospital doctors in Ireland, undertaken in June-July 2020. As the researchers were subject to a government mandated work-from-home order at that time, they utilised Twitter™ to contact potential respondents (snowball sampling); and conducted interviews via Zoom™ or telephone. FINDINGS: Two cohorts of doctors were identified; COVID Returners (N = 12) and COVID Would-be Emigrants (N = 19). COVID Returners are Irish-trained emigrant doctors who returned to Ireland in March 2020, just as global travel ground to a halt. They returned to be closer to home and in response to a pandemic-related recruitment call issued by the Irish government. COVID Would-be Emigrants are hospital doctors considering emigration. Some had experienced pandemic-related disruptions to their emigration plans as a result of travel restrictions and border closures. However, most of the drivers of emigration mentioned by respondents related to underlying problems in the Irish health system rather than to the pandemic, i.e. a culture of medical emigration, poor working conditions and the limited availability of posts in the Irish health system. DISCUSSION/CONCLUSION: This paper illustrates how the pandemic intensified and reinforced, rather than radically altered, the dynamics of doctor emigration from Ireland. Ireland must begin to prioritise doctor retention and return by developing a coherent policy response to the underlying drivers of doctor emigration.


Assuntos
Atitude do Pessoal de Saúde , COVID-19 , Emigração e Imigração , Satisfação no Emprego , Pandemias , Médicos , Área de Atuação Profissional , Adulto , Recessão Econômica , Emigrantes e Imigrantes , Médicos Graduados Estrangeiros , Humanos , Irlanda , Motivação , Pesquisa Qualitativa , SARS-CoV-2 , Viagem
16.
Artigo em Inglês | MEDLINE | ID: mdl-33669703

RESUMO

The financial crisis of 2008 precipitated the "Great Recession". In this scenario, we took Spain as a country of study, because although it experienced significant negative shocks associated with macroeconomic variables (GDP or unemployment), its welfare indicators have been marked by limited changes. This study used data from waves 2 and 4 (years 2006-2007 and 2010-2012, respectively) of the Survey on Health, Aging and Retirement in Europe (SHARE). Specifically, through logistic regressions we have analysed the effects of socioeconomic, demographic, health and "Great Recession" factors on the quality of life (QoL) of elders in Spain. Although QoL did not change too much during the "Great Recession", the results confirmed the importance of several factors (such as chronicity) that affect the satisfaction with the QoL among the older people. In this regard, statistically significant effects were obtained for individual exposure to recession. Therefore, a decrease in household income in the crisis period with respect to the pre-crisis period would increase by 44% the probability of reporting a low QoL (OR = 1.44; 95% CI: 1.00-2.07). Furthermore, gender differences were observed. Health and socioeconomic variables are the most significant when determining individual QoL. Therefore, when creating policies, establishing multidisciplinary collaborations is essential.


Assuntos
Recessão Econômica , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Europa (Continente) , Humanos , Fatores Socioeconômicos , Espanha/epidemiologia , Desemprego
17.
Sci Adv ; 7(6)2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33547077

RESUMO

Despite numerous journalistic accounts, systematic quantitative evidence on economic conditions during the ongoing COVID-19 pandemic remains scarce for most low- and middle-income countries, partly due to limitations of official economic statistics in environments with large informal sectors and subsistence agriculture. We assemble evidence from over 30,000 respondents in 16 original household surveys from nine countries in Africa (Burkina Faso, Ghana, Kenya, Rwanda, Sierra Leone), Asia (Bangladesh, Nepal, Philippines), and Latin America (Colombia). We document declines in employment and income in all settings beginning March 2020. The share of households experiencing an income drop ranges from 8 to 87% (median, 68%). Household coping strategies and government assistance were insufficient to sustain precrisis living standards, resulting in widespread food insecurity and dire economic conditions even 3 months into the crisis. We discuss promising policy responses and speculate about the risk of persistent adverse effects, especially among children and other vulnerable groups.


Assuntos
COVID-19/economia , COVID-19/epidemiologia , Países em Desenvolvimento/economia , Emprego/tendências , Renda/tendências , Pandemias/economia , SARS-CoV-2 , Adulto , África/epidemiologia , Agricultura/economia , Ásia/epidemiologia , COVID-19/virologia , Criança , Colômbia/epidemiologia , Violência Doméstica , Recessão Econômica , Características da Família , Feminino , Insegurança Alimentar/economia , Programas Governamentais/economia , Humanos , Masculino , Estações do Ano , Inquéritos e Questionários
18.
BMC Public Health ; 21(1): 334, 2021 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-33573632

RESUMO

BACKGROUND: The outbreak of COVID-19 has caused mental health problems and increased unemployment due to the economic recession. This survey aimed to assess the psychological impact of the state of emergency. We estimated changes in mental health, quality of life, and unemployment experience for general workers during the first COVID-19 outbreak in Japan. METHODS: We conducted a nationwide follow-up study. During the periods of March 26 to April 6, 2020 and June 26 to July 2, 2020, we used the internet to survey general workers aged 15 to 59 years in Japan. The questionnaire items covered employment status and socioeconomic factors, and we used the Center for Epidemiologic Studies Depression Scale (CES-D) and EQ-5D-5L to assess depression and health-related quality of life (HR-QOL), respectively. The differences in outcomes of permanent and non-permanent workers were analyzed using propensity score analysis. A multiple linear regression analysis was performed to examine the relationship between unemployment and CES-D scores. RESULTS: We included 2351 subjects in the analysis. Changes in both CES-D scores and utility were not significantly different between the two groups. However, a significant difference was found regarding the rate of unemployment, which was associated with higher CES-D scores. CONCLUSIONS: The present study demonstrated that the mental health of non-permanent workers was not negatively affected following the state of emergency due to COVID-19 in Japan. Unemployment is an important factor that influences the mental health of general workers.


Assuntos
COVID-19/epidemiologia , Surtos de Doenças , Transtornos Mentais/epidemiologia , Desemprego/psicologia , Adolescente , Adulto , Recessão Econômica , Feminino , Seguimentos , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Fatores Socioeconômicos , Inquéritos e Questionários , Desemprego/estatística & dados numéricos , Adulto Jovem
19.
Nutr Metab Cardiovasc Dis ; 31(4): 1053-1062, 2021 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-33549444

RESUMO

BACKGROUND AND AIMS: The CASSIOPEA Study was designed to evaluate whether the economic downturn during the late 2000s was a contributing factor to the observed decrease in adherence to Mediterranean diet (MD). METHODS AND RESULTS: The study protocol consists of two steps: A) recall of 7406 men and women who, between 2005 and 2006, had been randomly recruited in the Moli-sani Study from the general population of Molise, to assess possible economic hardship (EH) related to the economic crisis initiated in 2007; B) re-examination, between 2017 and 2020, of available subjects identified in Step 1 as poorly or harder hit by EH to test the hypothesis that EH is associated with a decrease in MD adherence, possibly resulting in increased inflammation. The results of Step 1 are reported here. From the initial sample of individuals re-examined after 12.6 years (median; IQR = 12.1-13.0 y), 3646 were finally analysed. An Economic Hardship Score (EHS; range 0-14) was obtained by scoring three domains: 1) change in employment status; 2) financial hardship and 3) financial hardship for health expenditures. Overall, 37.8% of the sample reported high EHS (≥3), whilst 32% scored 0 (no EH). Those with high EHS were prevalently women and younger, with low socioeconomic status. CONCLUSIONS: High economic hardship was prevalently reported by weaker socioeconomic groups. Longitudinal analysis (step 2) will examine whether the economic crisis had an effect on adherence to Mediterranean diet with consequent potential impact on inflammation, one of the main biological pathways linking MD to health outcomes. CLINICALTRIALS. GOV IDENTIFIER: NCT03119142.


Assuntos
Dieta Saudável/economia , Dieta Mediterrânea/economia , Recessão Econômica , Inflamação/prevenção & controle , Síndrome Metabólica/prevenção & controle , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Adulto , Idoso , Biomarcadores/sangue , Emprego/economia , Comportamento Alimentar , Feminino , Estresse Financeiro/economia , Estresse Financeiro/epidemiologia , Gastos em Saúde , Humanos , Renda , Inflamação/sangue , Inflamação/economia , Inflamação/epidemiologia , Itália/epidemiologia , Estudos Longitudinais , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/economia , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Proteção , Projetos de Pesquisa , Medição de Risco , Fatores de Risco , Comportamento de Redução do Risco
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