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1.
Infectio ; 25(4): 205-206, oct.-dic. 2021.
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286714

RESUMO

La pandemia por COVID-19 ha obligado a los gobiernos de todo el mundo a la toma de decisiones con información preliminar, insuficiente o discutible en argumentos científicos, algo que como académicos debemos entender y acompañar y se convierte en un reto mayor: ¿cómo dar recomendaciones con información limitada y reducir las incertidumbres? Para ello, primero que todo, se debe reconocer que estos procesos están sometidos a cambios según la evolución del conocimiento y la comunicación de la información se vuelve crucial para evitar minar la confianza pública ante los cambios. Es así como muchas recomendaciones para el manejo de COVID 19 han venido evolucionando a medida que se conoce mejor la patogénesis, sus mecanismos de transmisión y las particularidades en la respuesta inmune y, por ejemplo, pasamos de una recomendación inicial de medidas de prevención que incluía limpieza de superficies a una en la cual el énfasis es la limitación en número de personas en reunión. La Asociación Colombiana de infectología junto con otras 27 sociedades científicas lleva tres diferentes actualizaciones de recomendaciones basadas en evidencia en los primeros 12 meses de pandemia, es decir cada tres meses se han venido revisando las más de 250 recomendaciones, lo cual ha significado un trabajo enorme de revisión, discusión y presentación final las cuales, afortunadamente, han sido acogidas y tomadas como base de las decisiones gubernamentales.


The COVID-19 pandemic has forced governments around the world to take decisions on preliminary, insufficient The COVID-19 pandemic has forced governments around the world to make decisions with preliminary, insufficient or debatable information on scientific grounds, something that as academics we must understand and accompany and which becomes a major challenge: how to give recommendations with limited information and reduce uncertainties? To do this, first of all, it must be recognised that these processes are subject to change as knowledge evolves and the communication of information becomes crucial to avoid undermining public confidence in the face of change. Thus, many recommendations for the management of COVID 19 have evolved as the pathogenesis, transmission mechanisms and particularities of the immune response have become better understood and, for example, we have gone from an initial recommendation of measures to be taken in response to COVID 19 to a recommendation of measures to be taken in response to COVID 19, we have moved from an initial recommendation for prevention measures that included surface cleaning to one in which the emphasis is on limiting the number of people at a meeting. The Colombian Association of Infectious Diseases, together with 27 other scientific societies, has scientific societies has three different updates of evidence-based evidence-based recommendations in the first 12 months of a pandemic, i.e. every months of the pandemic, i.e. every three months, the more than 250 recommendations have been This has meant an enormous work of review, discussion and final presentation which, fortunately, have been accepted and taken as a basis for governmental decisions. and taken as a basis for governmental decisions.


Assuntos
Humanos , Masculino , Feminino , Comunicação , Informação , Ciência , Sociedades Científicas , Tomada de Decisões , Decisões , Pandemias , Governo
2.
Front Public Health ; 9: 741525, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34604164

RESUMO

The outbreak of COVID-19 pandemic has caused profound consequences on world economy. In order to explore the long-term impact of the pandemic on economic growth and the effects of different policy responses, this paper combines economic theory with epidemiological model to construct an interdisciplinary model, in which labor supply is dynamically constrained by pandemic conditions. Analysis of model equilibrium suggests that outbreaks of infectious disease reduce labor supply and negatively affect economic output. The accumulation of health capital can suppress the spread of disease and improve the recovery rate of infected individuals, which will alleviate the labor supply constraint caused by the pandemic and lead to an increase in output and consumption. The model is then calibrated to Chinese economy. The simulation results imply that government's public health policy can enhance the role of health capital in promoting economic growth. But the marginal effect of certain policies is diminishing. Therefore, the government needs to balance pandemic prevention and control costs and marginal benefits when formulating public health policies. When the pandemic is under control, the resumption of production is feasible and the economic stimulus package could lead to economic recovery.


Assuntos
COVID-19 , Pandemias , Desenvolvimento Econômico , Governo , Humanos , Pandemias/prevenção & controle , SARS-CoV-2
3.
Artigo em Inglês | MEDLINE | ID: mdl-34639813

RESUMO

The Australian Institute of Health and Welfare (AIHW) has been providing support to the Australian Government Department of Health to report on mental health-related data to Australian governments on a frequent basis since April 2020 in the form of COVID-19 mental health services data dashboards. These dashboards feature extensive use of data visualizations which illustrate the change in mental health service use over time as well as comparisons with pre-pandemic levels of service use. Data are included from the Medicare Benefits Schedule (MBS), Pharmaceutical Benefits Scheme (PBS/RPBS), Australian Government-funded crisis and support organizations, and key findings from emerging research. Demand for telehealth, crisis and support organizations and online mental health information services, in particular, have increased during the pandemic. The dashboards incorporate both new and existing data sources and represent an innovative way of reporting mental health services data to Australian governments. The reporting has enabled timely, targeted adjustments to mental health service delivery during the pandemic with improved cooperative data sharing arrangements having the potential to yield ongoing benefits.


Assuntos
COVID-19 , Serviços de Saúde Mental , Idoso , Austrália , Governo , Humanos , Medicare , SARS-CoV-2 , Estados Unidos
5.
PLoS One ; 16(10): e0258132, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34597334

RESUMO

This confirmatory research investigates the influence of risk framing of COVID-19 on support for restrictive government policy based on two web survey experiments in Russia. Using 2x2 factorial design, we estimated two main effects-factors of risk severity (low vs. high) and object at risk (individual losses vs. losses to others). First, focusing on higher risks had a positive effect on support for the government's restrictive policy. Second, focusing on the losses for others did not produce stronger support for the restrictive policy compared to focusing on personal losses. However, we found a positive moderation effect of such prosocial values as universalism and benevolence. We found that those with prosocial values had a stronger positive effect in the "losses for others" condition and were more willing to support government restrictive policy when others were included. The effects found in our experimental study reveal both positive and negative aspects in risk communication during the pandemic, which may have a great and long-term impact on trust, attitudes, and behavior.


Assuntos
COVID-19/patologia , Política de Saúde , Apoio Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/virologia , Surtos de Doenças , Feminino , Governo , Humanos , Masculino , Pessoa de Meia-Idade , Risco , Federação Russa/epidemiologia , SARS-CoV-2/isolamento & purificação , Inquéritos e Questionários , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-34615649

RESUMO

INTRODUCTION: Insulin pump access in type 1 diabetes may be inequitable. We studied the association between government funding programs for insulin pumps and rates of insulin pump use and disparities between pump users and non-users. RESEARCH DESIGN AND METHODS: Adults with type 1 diabetes were identified in the National Diabetes Repository, a primary care electronic medical record database of individuals with diabetes from five Canadian provinces. Proportions of individuals using insulin pumps were compared between provinces with and without pump funding programs. Multivariable logistic regression models were used to estimate the odds of insulin pump use adjusting for confounders. Univariate logistic regression models were used to estimate the odds of insulin pump use according to each predictor, according to pump funding program status. RESULTS: Of 1559 adults with type 1 diabetes, proportions using insulin pumps were 47.8% (95% CI 45.1% to 50.5%) and 37.7% (95% CI 31.5% to 44.1%) in provinces with and without pump funding programs (p=0.0038). Adjusting for age, sex, HbA1c, income quintile, and rural/urban location, the OR for insulin pump use was 1.45 (1.08-1.94) for provinces with pump funding programs compared with provinces without. Higher income was associated with a greater odds of insulin pump use in provinces with pump funding programs, and rural/urban location was not associated with insulin pump use. CONCLUSIONS: Insulin pump use is more common in regions with government funding programs. Further research is required to best understand and comprehensively address persistent income disparities between pump users and non-users despite the availability of reimbursement programs.


Assuntos
Diabetes Mellitus Tipo 1 , Insulina , Adulto , Canadá/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/epidemiologia , Governo , Humanos
7.
Front Public Health ; 9: 716333, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34650948

RESUMO

During the COVID-19 pandemic, information is being rapidly shared by public health experts and researchers through social media platforms. Whilst government policies were disseminated and discussed, fake news and misinformation simultaneously created a corresponding wave of "infodemics." This study analyzed the discourse on Twitter in several languages, investigating the reactions to government and public health agency social media accounts that share policy decisions and official messages. The study collected messages from 21 official Twitter accounts of governments and public health authorities in the UK, US, Mexico, Canada, Brazil, Spain, and Nigeria, from 15 March to 29 May 2020. Over 2 million tweets in various languages were analyzed using a mixed-methods approach to understand the messages both quantitatively and qualitatively. Using automatic, text-based clustering, five topics were identified for each account and then categorized into 10 emerging themes. Identified themes include political, socio-economic, and population-protection issues, encompassing global, national, and individual levels. A comparison was performed amongst the seven countries analyzed and the United Kingdom (Scotland, Northern Ireland, and England) to find similarities and differences between countries and government agencies. Despite the difference in language, country of origin, epidemiological contexts within the countries, significant similarities emerged. Our results suggest that other than general announcement and reportage messages, the most-discussed topic is evidence-based leadership and policymaking, followed by how to manage socio-economic consequences.


Assuntos
COVID-19 , Mídias Sociais , Governo , Humanos , Pandemias , Saúde Pública , SARS-CoV-2
8.
BMC Health Serv Res ; 21(1): 1088, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34645430

RESUMO

BACKGROUND: Low- and middle-income countries bear the highest burden of non-communicable diseases (NCDs) mortality and morbidity. Syria has undergone an epidemiological transition from infectious diseases to NCDs in the past decades. Despite the high prevalence of cardiovascular diseases (CVDs) and diabetes in Syria, little is known about medicines utilization or prescriptions for these diseases. The aims of this study are to present the patterns and rates of dispensing medicines used for CVDs and diabetes among patients with government health insurance in Syria and examine age, sex, and regional variation in the dispensing of these medicines. METHODS: Outpatient data from June 2018 to May 2019 on dispensed medicines for 81,314 adults with government health insurance were obtained. The dispensing rate was expressed as the number of defined daily doses (DDDs) per 1000 beneficiaries per day (DID). The DID is a measurement that is used in drug utilization research to control for differences or changes in population size between or within countries. The number of DIDs was adjusted according to beneficiaries' sex, age, and governorate. RESULTS: Beneficiaries received 302.09 DIDs of CVDs medicines and 35.66 DIDs of diabetes medicines, including 0.96 DID of insulin (2.99% of the total of diabetes medicines). CVDs and diabetes medicine dispensing rates were low during the study period and included very low rates of insulin dispensing compared to the dispensing rates of these medicines in other countries in East Mediterranean Region or in Europe. We found lower dispensing rates of CVDs medicines among female beneficiaries (249.59 DIDs) than male beneficiaries (388.80 DIDs). Similarly, the dispensing rates of diabetes medicines among female beneficiaries (29.42 DIDs) were lower than those among male beneficiaries (45.98 DIDs). In addition, there were lower rates of CVDs and diabetes medicines and very low to no dispensing of insulin in some governorates that were partly controlled by the Syrian government compared to other governorates that were completely or mostly controlled by the Syrian government. CONCLUSIONS: Additional efforts are needed to raise awareness about the prevention and management of CVDs and diabetes especially among females in Syria and consider cultural issues that might influence access to healthcare services. There is a crucial need to address the political and geographical challenges caused by the conflict which have limited access to CVDs and diabetes medicines in some regions in Syria.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Adulto , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/epidemiologia , Feminino , Governo , Humanos , Seguro Saúde , Masculino , Pacientes Ambulatoriais , Estudos Retrospectivos , Síria/epidemiologia
9.
Nat Commun ; 12(1): 5820, 2021 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-34611158

RESUMO

European governments use non-pharmaceutical interventions (NPIs) to control resurging waves of COVID-19. However, they only have outdated estimates for how effective individual NPIs were in the first wave. We estimate the effectiveness of 17 NPIs in Europe's second wave from subnational case and death data by introducing a flexible hierarchical Bayesian transmission model and collecting the largest dataset of NPI implementation dates across Europe. Business closures, educational institution closures, and gathering bans reduced transmission, but reduced it less than they did in the first wave. This difference is likely due to organisational safety measures and individual protective behaviours-such as distancing-which made various areas of public life safer and thereby reduced the effect of closing them. Specifically, we find smaller effects for closing educational institutions, suggesting that stringent safety measures made schools safer compared to the first wave. Second-wave estimates outperform previous estimates at predicting transmission in Europe's third wave.


Assuntos
COVID-19/epidemiologia , Governo , Número Básico de Reprodução , COVID-19/virologia , Europa (Continente)/epidemiologia , Humanos , Modelos Teóricos , SARS-CoV-2/fisiologia , Fatores de Tempo
10.
Emerg Infect Dis ; 27(10): 1-9, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34546168

RESUMO

To deal with the risk of emerging diseases with many unknowns, close and timely collaboration and communication between science experts and policymakers are crucial to developing and implementing an effective science-based intervention strategy. The Expert Meeting, an ad hoc medical advisory body, was established in February 2020 to advise Japan's COVID-19 Response Headquarters. The group played an important role in the policymaking process, promoting timely situation awareness and developing science-based proposals on interventions that were promptly reflected in government actions. However, this expert group may have been overly proactive in taking on the government's role in crisis management. For the next stage of managing the coronavirus disease pandemic and future pandemics, the respective roles of the government and its advisory bodies need to be clearly defined. Leadership and strategic risk communication by the government are key.


Assuntos
COVID-19 , Governo , Humanos , Japão/epidemiologia , Pandemias , SARS-CoV-2
11.
Vaccine ; 39(42): 6183-6185, 2021 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-34535316

RESUMO

In the United States, clinical trials of COVID-19 vaccines and therapeutics quickly exhausted available clinical research capacity at large medical centers. The NIAID Division of Clinical Research tapped community hospitals to help fill the gap.


Assuntos
COVID-19 , Emergências , Vacinas contra COVID-19 , Governo , Hospitais Comunitários , Humanos , Saúde Pública , SARS-CoV-2 , Estados Unidos
12.
Kennedy Inst Ethics J ; 31(3): 247-270, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34565744

RESUMO

Legal standards of disclosure in a variety of jurisdictions require physicians to inform patients about the likely consequences of treatment, as a condition for obtaining the patient's consent. Such a duty to inform is special insofar as extensive disclosure of risks and potential benefits is not usually a condition for obtaining consent in non-medical transactions.What could morally justify the physician's special legal duty to inform? I argue that existing justifications have tried but failed to ground such special duties directly in basic and general rights, such as autonomy rights. As an alternative to such direct justifications, I develop an indirect justification of physicians' special duties from an argument in Kant's political philosophy. Kant argues that pre-legal rights to freedom are the source of a duty to form a state. The state has the authority to conclusively determine what counts as "consent" in various kinds of transactions. The Kantian account can subsequently indirectly justify at least one legal standard imposing a duty to inform, the reasonable person standard, but rules out one interpretation of a competitor, the subjective standard.


Assuntos
Revelação/ética , Consentimento Livre e Esclarecido/ética , Obrigações Morais , Direitos do Paciente , Filosofia , Relações Médico-Paciente/ética , Médicos/ética , Revelação/legislação & jurisprudência , Ética Médica , Liberdade , Governo , Humanos , Médicos/legislação & jurisprudência , Política , Risco
16.
J Environ Manage ; 300: 113685, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34517232

RESUMO

The effect of environmental regulations on the nexus between financial development and biased technological innovation is a prerequisite for optimizing systems of environmental and financial policies to gain sustainable development goals (SDGs) in emerging markets. Drawing on China's city-level data from 2003 to 2018, we established econometric models and obtained the following empirical results. Financial development (FD) can promote energy- and environmental-biased technological progress, but, owing to the inverted U-shaped relationship, economic development, and resource endowment, the impact that FD has on biased technological progress is heterogeneous; unreasonable FD will also hinder green technological progress. Threshold model shows that with the improvement of environmental regulation, the impact of energy- and environmental-biased technological progress is also increasing. The development of green finance under SDGs is an important driving force in green technological progress. Finally, we offer suggestions to optimize environmental and financial policymaking and implementation from a government intervention perspective.


Assuntos
Desenvolvimento Econômico , Invenções , China , Governo , Modelos Econométricos , Tecnologia
17.
J Environ Manage ; 300: 113686, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34521008

RESUMO

Due to global warming and increasingly severe resource and environmental constraints, the role of renewable energy in reducing pollutant emissions and mitigating environmental degradation has gradually attracted the attention of all countries. This study examines the relationship between government corruption, market segmentation, and renewable energy technology innovation. The regression results show that government corruption can increase the degree of market segmentation, and both government corruption and market segmentation can significantly reduce regional renewable energy technology innovation. Further analysis shows that the improvement in market segmentation can lead to a negative moderating effect of corruption on renewable energy technology innovation. In addition, corruption and market segmentation have complementary effects on the impact of renewable energy technology innovation. The improvement of corruption level can increase the negative influences of market segmentation on renewable energy technology innovation. Similarly, the higher degree of market segmentation can increase the restraining effect of corruption on renewable energy technology innovation. Therefore, this study provides a valuable reference for all countries to accelerate the construction of regional market integration, break through interprovincial barriers, and improve renewable energy technology innovation.


Assuntos
Dióxido de Carbono , Desenvolvimento Econômico , Dióxido de Carbono/análise , China , Governo , Invenções , Energia Renovável
18.
J Environ Manage ; 300: 113749, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34547569

RESUMO

Public trust in water managers is often considered an important precondition for the effective implementation of sustainable water-management practices. Although it is well known that general public trust in government institutions is under pressure, much less is known in the literature on water governance whether such distrust also affects general and task-specific trust of the wider public in water managers. In addition, empirical studies on the determinants of such trust seem to be scarce. To fill those gaps, this study aims to measure general and task-specific public trust in water managers in the Netherlands and to assess how a selected group of potential determinants is related to general- and task-specific trust in water managers. To this end, we employ an original survey among a representative sample of the Dutch population (N = 2262). We find that trust in water managers in the Netherlands is generally high, but that it also comes with some task-specific variations. People have more trust in the flood-protection capacities of the water managers than in the capacities to successfully manage surface-water quality, nature conservation, and drought management. Using linear regression models, we subsequently find that individual-level variations in trust in water managers are best explained by one's general level of political trust. Additionally, we also show that both risk perceptions and self-evaluations of how informed people feel themselves about water management are important factors with (curvilinear) relations with trust in water managers. Overall, we conclude that water managers are under specific conditions able to build themselves well-established reputations and relatively high trust levels based on their performances. Nevertheless, trust development is far from entirely in the hands of the water managers themselves as we also conclude that trust evaluations of water managers are not immune from negative generalized political evaluations and public perceptions on water related risks.


Assuntos
Confiança , Água , Inundações , Governo , Humanos , Países Baixos
19.
PLoS One ; 16(9): e0256159, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34495998

RESUMO

What influences the adoption of SARS-CoV-2 mitigation behaviors-both personal, such as mask wearing and frequent handwashing, and social, such as avoiding large gatherings and physical contact-across countries? Understanding why some individuals are more willing to change their behavior to mitigate the spread of a pandemic will not only help us to address the current SARS-CoV-2 pandemic but also to respond to future ones. Researchers have pointed to a variety of factors that may influence individual adoption of personal and social mitigation behaviors, including social inequality, risk perception, personality traits, and government policies. While not denying the importance of these factors, we argue that the role of trust and confidence has received insufficient attention to date. Our study explores whether there is a difference in the way trust and confidence in particular leaders and organizations affect individual compliance and whether this effect is consistent across different types of mitigation behaviors. Specifically, we utilize an original cross-national survey conducted during the first wave of the SARS-CoV-2 pandemic (May-June 2020) to investigate how trust in scientists, medical professionals, politicians, and religious leaders and confidence in global, national, and local health organizations affects individual compliance in 16 countries/territories across five world regions. Our analyses, which control for the aforementioned factors as well as several others, suggest that trust in politicians and confidence in national health ministries have the most consistent influence on whether individuals adopt both personal and social mitigation behaviors. Across our sample, we find that greater trust in politicians is associated with lower levels of individual compliance with public health directives, whereas greater confidence in the national health ministry is associated with higher levels of individual compliance. Our findings suggest the need to understand trust and confidence as among the most important individual level characteristics driving compliance when developing and delivering messaging about the adoption of mitigation behaviors. The content of the message, it seems, will be most effective when citizens across countries trust its source. Trusted sources, such as politicians and the national health ministry, should thus consider working closely together when determining and communicating recommended health behaviors to avoid contradicting one another.


Assuntos
COVID-19/prevenção & controle , COVID-19/psicologia , Comportamentos Relacionados com a Saúde/fisiologia , Pandemias/prevenção & controle , Confiança/psicologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Governo , Desinfecção das Mãos/métodos , Humanos , Masculino , Máscaras , Pessoa de Meia-Idade , SARS-CoV-2/patogenicidade , Comportamento Social , Inquéritos e Questionários , Adulto Jovem
20.
BMJ Glob Health ; 6(9)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34580072

RESUMO

INTRODUCTION: In order to tackle the pandemic, governments have established various types of advisory boards to provide evidence and recommendations to policy makers. Scientists working on these boards have faced many challenges, including working under significant time constraints to produce 'evidence' as quickly as possible. However, their voices are still largely missing in the discussion. This study explores the views and experiences of scientists working on government advisory boards during the COVID-19 pandemic, with the aim to learn lessons for future pandemic management and preparedness. METHODS: We conducted online video or telephone semi-structured interviews between December 2020 and April 2021 with 21 scientists with an official government advisory role during the COVID-19 pandemic in Belgium, the Netherlands, UK, Sweden and Germany. The interviews were audio-recorded and transcribed and analysed using a combination of inductive and deductive thematic analysis techniques. RESULTS: Scientists viewed the initial focus on biomedically oriented work during the pandemic as somewhat one-dimensional, but also highlighted difficulties of working in an interdisciplinary way. They found it difficult at times to ensure that the evidence is understood and taken on board by governments. They found themselves taking on new roles, the boundaries of which were not clearly defined. Consequently, they were often perceived and treated as a public figure. CONCLUSION: Scientists working on advisory boards in European countries faced similar challenges, highlighting key lessons to be learnt. Future pandemic preparedness efforts should focus on building interdisciplinary collaboration through development of scientists' skills and appropriate infrastructure; ensuring transparency in how boards operate; defining and protecting the boundaries of the scientific advisor role; and supporting scientists to inform the public in the fight against disinformation, while dealing with potential hostile reactions.


Assuntos
COVID-19 , Pandemias , Europa (Continente) , Governo , Humanos , Pandemias/prevenção & controle , SARS-CoV-2
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