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Daly F, O'Riordan J. Assessing care deficits in Ireland's international protection accommodation system: Lessons learned in COVID-19 and beyond. J Migr Health 2024; 10:100255. [PMID: 39193010 PMCID: PMC11347839 DOI: 10.1016/j.jmh.2024.100255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 07/12/2024] [Accepted: 07/24/2024] [Indexed: 08/29/2024] Open
Abstract
Responding to the need for qualitative research that reveals the lived reality of how forced migrants endured the COVID-19 pandemic this paper presents findings from eleven interviews with asylum seekers residing in Ireland's Direct Provision (DP) accommodation system that detail care deficits before, during and after COVID-19 along with analysis of how care is discussed within Irish policy documents concerned with the health and wellbeing of asylum seekers. The research contributes personal testimony and documentary evidence of the inability of DP to properly adapt to the pandemic and its failure to protect the health and wellbeing of asylum seekers given pre-existing care deficits. The paper argues that an ethic of care practiced for and with asylum seekers must ensure they are not re-traumatised, and their health disparities are not exacerbated during public health crises and beyond. The findings are relevant to efforts to reform how international protection responsibilities are enacted in Ireland and other destinations of forced migrants, including EU member states.
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Affiliation(s)
- Felicity Daly
- Assistant Professor Global Health (2023 – Present), Trinity Centre for Global Health, Trinity College Dublin, the University of Dublin, 7-9 Leinster Street South, Dublin D02 K104, Ireland
- Postdoctoral Researcher (2020-2033), Institute for Social Science in the 21st Century (ISS21), University College Cork, Top Floor Carrigbawn Building, Donovan Road, Cork T12 YE30, Ireland
| | - Jacqui O'Riordan
- Lecturer (Retired), School of Applied Social Studies, University College Cork, Ground Floor Carrigbawn Building, Donovan Road, Cork T12 YE30, Ireland
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Rossoni I, Chollier M, Dudushi R, Ghigo J, Padovese V. A scoping review of sexual and reproductive health recommendations in the context of migration to Europe. J Eur Acad Dermatol Venereol 2023; 37:2450-2461. [PMID: 37591613 DOI: 10.1111/jdv.19428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 07/21/2023] [Indexed: 08/19/2023]
Abstract
In recent years, growing instability and conflict around the world have continued to fuel outward migration, including migration to the EU/EEA. Many migrants hail from countries and regions with a higher burden of STIs-including HIV-and are exposed to enhanced risks of sexual and gender-based violence leading to sexual health issues during their journeys. This scoping review aims to identify existing sexual health recommendations for non-European migrants in the EU/EEA and identify gaps in their implementation. Sexual health recommendations formulated in relation to the migrant population in peer- reviewed journals or by expert consensus, between 2010 and 2021, were included. A keyword search was used to retrieve relevant publications on PubMed, ScienceDirect, the Cochrane Library databases, WHO and ECDC websites. The search strategy employed was charted in a dedicated Prisma Chart. Overall, 180 publications were retrieved. Based on the abstract and after eliminating duplicates, 33 publications were included for full-text reading. The references of these publications were screened. In total, 19 publications met the inclusion criteria. Evidence-based sexual health recommendations target only newly arrived migrants and migrant children (at arrival and during stay in the country). Screening practices are mostly informed by the country of origin and related prevalence, which remains a limitation; challenges faced during migration should also be considered. Implementation and compliance with these recommendations remain uncertain, as sexual health is not funded and addressed in a uniform manner across Europe.
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Affiliation(s)
- I Rossoni
- Van Vollenhoven Institute for Law, Governance and Society, Leiden University, Leiden, The Netherlands
| | - M Chollier
- CRIR-AVS PACA, APHM, Marseille, France
- UNESCO Chair for Sexual Health and Human Rights, Paris, France
| | - R Dudushi
- Faculty of Social Sciences, University of Tirana, Tirana, Albania
| | - J Ghigo
- Department of Obstetrics and Gynecology, Mater Dei Hospital, Msida, Malta
| | - V Padovese
- Genitourinary Clinic, Department of Dermatology and Venereology, Mater Dei Hospital, Msida, Malta
- International Foundation for Dermatology, Migrant Health Dermatology Working Group, London, UK
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Bozorgmehr K, McKee M, Azzopardi-Muscat N, Bartovic J, Campos-Matos I, Gerganova TI, Hannigan A, Janković J, Kállayová D, Kaplan J, Kayi I, Kondilis E, Lundberg L, Mata IDL, Medarević A, Suvada J, Wickramage K, Puthoopparambil SJ. Integration of migrant and refugee data in health information systems in Europe: advancing evidence, policy and practice. THE LANCET REGIONAL HEALTH. EUROPE 2023; 34:100744. [PMID: 37927430 PMCID: PMC10625017 DOI: 10.1016/j.lanepe.2023.100744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 11/07/2023]
Abstract
Coverage of migrant and refugee data is incomplete and of insufficient quality in European health information systems. This is not because we lack the knowledge or technology. Rather, it is due to various political factors at local, national and European levels, which hinder the implementation of existing knowledge and guidelines. This reflects the low political priority given to the topic, and also complex governance challenges associated with migration and displacement. We review recent evidence, guidelines, and policies to propose four approaches that will advance science, policy, and practice. First, we call for strategies that ensure that data is collected, analyzed and disseminated systematically. Second, we propose methods to safeguard privacy while combining data from multiple sources. Third, we set out how to enable survey methods that take account of the groups' diversity. Fourth, we emphasize the need to engage migrants and refugees in decisions about their own health data. Based on these approaches, we propose a change management approach that narrows the gap between knowledge and action to create healthcare policies and practices that are truly inclusive of migrants and refugees. We thereby offer an agenda that will better serve public health needs, including those of migrants and refugees and advance equity in European health systems. Funding No specific funding received.
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Affiliation(s)
- Kayvan Bozorgmehr
- Department of Population Medicine & Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
- Section Health Equity Studies & Migration, University Hospital Heidelberg, Heidelberg, Germany
- Lancet Migration European Hub
| | - Martin McKee
- European Observatory on Health Systems and Policies, London, UK
- London School of Medicine & Tropical Hygiene, London, UK
| | | | | | - Ines Campos-Matos
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK
| | | | - Ailish Hannigan
- WHO Collaborating Centre for Migrant’s Involvement in Health Research, School of Medicine, University of Limerick, Limerick, Ireland
| | | | - Daniela Kállayová
- Lancet Migration European Hub
- Department of Public Health, Screening and Prevention, Ministry of Health, Slovak Republic
- Trnava University, Trnava, Slovak Republic
| | - Josiah Kaplan
- UNICEF Global Office of Research and Foresight, Florence, Italy
| | - Ilker Kayi
- Department of Public Health, School of Medicine, Koç University, Istanbul, Türkiye
| | - Elias Kondilis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lene Lundberg
- Lancet Migration European Hub
- Norwegian Centre for E-health Research, Tromsø, Norway
| | | | - Aleksandar Medarević
- Institute of Public Health of Serbia 'Dr Milan Jovanovic Batut', Belgrade, Serbia
| | - Jozef Suvada
- St. Elizabeth University of Public Health and Social Work, Slovak Republic
- WHO Collaborating Centre for Infectious Diseases, Research Methods and Recommendations, and McMaster GRADE Centre, Department of Health Research Methods, Evidence and Impact, McMaster University, Canada
| | - Kolitha Wickramage
- UN Migration Agency Global Data Institute, Migration Health Division, International Organization for Migration, Berlin, Germany
| | - Soorej Jose Puthoopparambil
- WHO Collaborating Centre on Migration and Health Data and Evidence, Global Health and Migration Unit, Department of Women’s and Children’s Health, Uppsala University, Sweden
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İkiışık H, Surmeli A, Sever F, Maral I. Perceived Risk of COVID-19 and Anxiety in Syrian Refugees in Turkey. SOCIAL WORK IN PUBLIC HEALTH 2023; 38:259-267. [PMID: 36242533 DOI: 10.1080/19371918.2022.2134251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Pandemics are amongst the most destructive disasters to have afflicted humankind through history. These disasters entail a disproportionate effect on refugee populations, who are already in a state of high vulnerability. This study aims to assess the perception of risk of COVID-19 in the refugee populations in Turkey, in addition to evaluating anxiety levels during the pandemic. The participants of this study were refugees enrolled in a local nonprofit organization in Istanbul. They were asked to complete questionnaires which asked about COVID-19 and any self-protection measures. The questionnaire also incorporated the General Anxiety Disorder-7 screening test. In this young, male and mostly unemployed population, knowing someone who experienced COVID-19 was associated with a greater likelihood of compliance with hygiene and physical distancing measures. Anxiety levels were above 29%, and the highest scores were in the age group between 25 and 55 years. We argue that comprehensive public health measures against COVID-19 should include focused interventions for refugee populations that take the extra vulnerability (health, financial, and other) into account.
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Affiliation(s)
- Hatice İkiışık
- Department of Public Health, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Aral Surmeli
- Department of Executive Office, HERA Inc ., Boston, Massachusetts, USA
| | - Filiz Sever
- Department of Public Health, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Isil Maral
- Department of Public Health, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
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Torre C, Storer E. COVID-19 vaccines, mobility, and pandemic bureaucracies: Undocumented migrants' perspectives from Italy's Alpine border. J Migr Health 2023; 7:100189. [PMID: 37155498 PMCID: PMC10118066 DOI: 10.1016/j.jmh.2023.100189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 03/29/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023] Open
Abstract
While scholars have noted the deeply unequal effects of the pandemic containment, there has been limited attempt to map the socio-political lives of vaccination policies, particularly from the perspective of undocumented persons moving at state margins. This paper explores how undocumented migrants, who were predominantly male travellers attempting to cross Italy's Alpine borders, encountered Covid-19 vaccines and contemporary legislation. Based on ethnographic observations and qualitative interviews with migrants, doctors, and activists at safehouses both on the Italian and French sides of the Alpine border, we trace how mobility centred decisions to accept or reject vaccines were significantly shaped by exclusionary border regimes. We move beyond the exceptional focus of the Covid-19 pandemic to show how centring visions of health connected to viral risk diverted attention from migrants' wider struggles to move to obtain safety. Ultimately, we argue for a recognition of how health crises are not merely unequally experienced, but may result in the reconfiguration of violent governance practices at state borders.
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Morisod K, Grazioli VS, Schlüter V, Bochud M, Gonseth Nusslé S, D'Acremont V, Bühler N, Bodenmann P. Prevalence of SARS-CoV-2 infection and associated risk factors among asylum seekers living in asylum centres: A cross-sectional serologic study in Canton of Vaud, Switzerland. J Migr Health 2023; 7:100175. [PMID: 36938329 PMCID: PMC10005972 DOI: 10.1016/j.jmh.2023.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 02/05/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023] Open
Abstract
Background Understanding the factors influencing SARS-CoV-2 transmission in asylum seekers and refugees living in centres is crucial to determine targeted public health policies protecting these populations fairly and efficiently. In response, this study was designed to explore the pandemic's spread into asylum centres during the first wave of the pandemic in Switzerland. Specifically, it aimed to identify the risk factors associated with a positive anti-SARS-CoV-2 seroprevalence test after the first semi-confinement period (16 March to 27 April 2020) amongst asylum seekers and refugees living in centres. Methods This research is part of SérocoVID, a seroepidemiologic study of SARS-CoV-2 infection conducted in the canton of Vaud, Switzerland. Migrants living in two asylum centres, one known to have had an epidemic outbreak, were invited to participate in this study. Anti-SARS-CoV-2 IgG and IgA antibodies targeting the spike viral protein were measured in all participants using a Luminex immunoassay. Each participant also completed a questionnaire measuring socio-demographic characteristics, medical history (comorbidities, smoking status, BMI, flu-like symptoms), health literacy, public health recommendations (wearing a masque in a public area, social distancing and hands cleaning), behaviours and exposures (daily life activities, number of contacts weekly). The association of these independent variables with the serologic test result were estimated using a multivariable logistic regression model. Findings A total of 124 participants from the two asylum centres took part in the study (Centre 1, n = 82; Centre 2, n = 42). The mean participation rate was 36.7%. The seroprevalence in Centres 1 and 2 were 13% [95% CI 0.03, 0.14] and 50% [0.34, 0.65], respectively. Next, 40.63% of SARS-CoV-2 positive people never developed symptoms (asymptomatic cases), and no one had severe forms of the Covid-19 disease requiring hospitalisation. Participants report high compliance with public health measures, especially hygiene rules (96.3% of positive answers) and social distancing (88.7%). However, only 11.3% said they always wore a masque in public. After adjusting for individual characteristics, infection risk was lower amongst people with high health literacy (aOR 0.16, p = 0.007 [0.04, 0.60]) and smokers (aOR 0.20, p = 0.013 [0.06, 0.69]). Conclusion Despite the lack of severe complications of Covid-19 disease in this study, findings suggest that developing targeted public health measures, especially for the low health literacy population, would be necessary to limit the risk of outbreaks in asylum centres and improve this population's safety. Further investigations and qualitative approach are required to understand more finely how living conditions, risks and behaviours such as tobacco consumption, and the adoption of protective measures impact SARS-CoV-2 infection.
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Affiliation(s)
- Kevin Morisod
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Rue du Bugnon 44, Lausanne, Vaud 1011, Switzerland
- Chair of Medicine for Vulnerable Populations, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
- Corresponding author at: Chemin de Chantemerle 10, 1010 Lausanne, Vaud, Switzerland.
| | - Véronique S. Grazioli
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Rue du Bugnon 44, Lausanne, Vaud 1011, Switzerland
- Chair of Medicine for Vulnerable Populations, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
| | - Virginie Schlüter
- Department of Training, Research and Innovation, Center for Primary Care and Public Health (Unisanté), Route de Berne 113, Lausanne, Vaud 1010 Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
| | - Murielle Bochud
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
- Department of Epidemiology and Health systems, Center for Primary Care and Public Health (Unisanté), Route de la Corniche 10, Lausanne, Vaud 1010, Switzerland
| | - Semira Gonseth Nusslé
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
- Department of Epidemiology and Health systems, Center for Primary Care and Public Health (Unisanté), Route de la Corniche 10, Lausanne, Vaud 1010, Switzerland
| | - Valérie D'Acremont
- Department of Training, Research and Innovation, Center for Primary Care and Public Health (Unisanté), Route de Berne 113, Lausanne, Vaud 1010 Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
| | - Nolwenn Bühler
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Rue du Bugnon 44, Lausanne, Vaud 1011, Switzerland
| | - Patrick Bodenmann
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Rue du Bugnon 44, Lausanne, Vaud 1011, Switzerland
- Chair of Medicine for Vulnerable Populations, University of Lausanne, Rue du Bugnon 21, Lausanne, Vaud 1011, Switzerland
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Morisod K, Durand MA, Selby K, Le Pogam MA, Grazioli VS, Sanchis Zozaya J, Bodenmann P, von Plessen C. Asylum Seekers' Responses to Government COVID-19 Recommendations: A Cross-sectional Survey in a Swiss Canton. J Immigr Minor Health 2022; 25:570-579. [PMID: 36508030 PMCID: PMC9743178 DOI: 10.1007/s10903-022-01436-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 12/14/2022]
Abstract
Asylum seekers face multiple language, cultural and administrative barriers that could result in the inappropriate implementation of COVID-19 measures. This study aimed to explore their knowledge and attitudes to recommendations about COVID-19. We conducted a cross-sectional survey among asylum seekers living in the canton of Vaud, Switzerland. We used logistic regressions to analyze associations between knowledge about health recommendations, the experience of the pandemic and belief to rumors, and participant sociodemographic characteristics. In total, 242 people participated in the survey, with 63% of men (n = 150) and a median age of 30 years old (IQR 23-40). Low knowledge was associated with linguistic barriers (aOR 0.36, 95% CI 0.14-0.94, p = 0.028) and living in a community center (aOR 0.43, 95% CI 0.22-0.85, p = 0.014). Rejected asylum seekers were more likely to believe COVID-19 rumors (aOR 2.81, 95% CI 1.24-6.36, p = 0.013). This survey underlines the importance of tailoring health recommendations and interventions to reach asylum seekers, particularly those living in community centers or facing language barriers.
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Affiliation(s)
- Kevin Morisod
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Marie-Anne Durand
- grid.15781.3a0000 0001 0723 035XCERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France ,Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Kevin Selby
- Department Training, Research and Innovation, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Marie-Annick Le Pogam
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Véronique S. Grazioli
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Javier Sanchis Zozaya
- grid.8515.90000 0001 0423 4662Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Patrick Bodenmann
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Chair of Medicine for Vulnerable Populations, University of Lausanne, Lausanne, Switzerland
| | - Christian von Plessen
- Department of Ambulatory Care, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland ,Direction Générale de La Santé (DGS), Lausanne, Switzerland ,grid.10825.3e0000 0001 0728 0170Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Rajapaksha RMNU, Khatri RB, Abeysena C, Wijesinghe MSD, Endalamaw A, Thomas TK, Perera N, Rambukwella R, De Silva G, Fernando M, Alemu YA. Success and challenges of health systems resilience-enhancing strategies for managing Public Health Emergencies of International Concerns (PHEIC): A systematic review protocol. BMJ Open 2022; 12:e067829. [PMID: 36410836 PMCID: PMC9680175 DOI: 10.1136/bmjopen-2022-067829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Health systems resilience is the ability to prepare, manage and learn from a sudden and unpredictable extreme change that impacts health systems. Health systems globally have recently been affected by a number of catastrophic events, including natural disasters and infectious disease epidemics. Understanding health systems resilience has never been more essential until emerging global pandemics. Therefore, the application of resilience-enhancing strategies needs to be assessed to identify the management gaps and give valuable recommendations from the lessons learnt from the global pandemic. METHODS The systematic review will be reported using the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA-P) protocols guideline. Reporting data on World Health Organization (WHO) health system building blocks and systematic searches on resilience enhancing strategies for the management of Public Health Emergencies of International Concerns (PHEIC) after the establishment of International Health Regulations (IHR) in 2007 will be included. The search will be conducted in PubMed, Scopus, Web of Science and Google Scholar ETHICS AND DISSEMINATION: Ethics approval and safety considerations are not applicable. Pre-print of the protocol is available online, and the screening of the articles will be done using Rayyan software in a transparent manner. The findings will be presented at conferences and the final review's findings will be published in a peer-reviewed international journal and will be disseminated to global communities for the application of successful management strategies for the management of future pandemics. PROSPERO REGISTRATION NUMBER CRD42022352612; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022352612.
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Affiliation(s)
- R M Nayani Umesha Rajapaksha
- Ministry of Health, Colombo, Western Province, Sri Lanka
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Resham B Khatri
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Chrishantha Abeysena
- Department of Community Medicine, University of Kelaniya, Ragama, Western Province, Sri Lanka
| | | | - Aklilu Endalamaw
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Department of Pediatrics and Child Health Nursing, Bahir Dar University, Ethiopia Bahir Dar, University of Gondar, Gondar, Ethiopia
| | - Toms K Thomas
- Department of Public Health, SRM University Sikkim, Sikkim, India
| | - Nadeeka Perera
- Ministry of Health, Colombo, Western Province, Sri Lanka
- Community Medicine, Postgraduate Institute of Medicine University of Colombo, Colombo, Western Province, Sri Lanka
| | - Roshan Rambukwella
- Ministry of Health, Colombo, Western Province, Sri Lanka
- Community Medicine, Postgraduate Institute of Medicine University of Colombo, Colombo, Western Province, Sri Lanka
| | - Gayani De Silva
- Ministry of Health, Colombo, Western Province, Sri Lanka
- Community Medicine, Postgraduate Institute of Medicine University of Colombo, Colombo, Western Province, Sri Lanka
| | - Mekala Fernando
- Ministry of Health, Colombo, Western Province, Sri Lanka
- Community Medicine, Postgraduate Institute of Medicine University of Colombo, Colombo, Western Province, Sri Lanka
| | - Yibeltal Assefa Alemu
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Laursen BK, Motzer N, Anderson KJ. Pathway profiles: Learning from five main approaches to assessing interdisciplinarity. RESEARCH EVALUATION 2022. [DOI: 10.1093/reseval/rvac036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Monitoring and evaluating interdisciplinarity is crucial for informing decisions about interdisciplinary (ID) policies, funding, and work. Yet, the recent explosion of ID assessment approaches represents an overwhelming buffet of options that has produced little consensus, limited guidance, and minimal insights into interdisciplinarity and its value to society. This article extends findings from a companion study that systematically reviewed the ID assessment field from 2000 to 2019. Engaging with the same extensive dataset but in a new way, we employ typological analysis and condense 1,006 published assessment designs into just five main assessment approaches called Pathway Profiles. We then tailor assessment guidance to each Pathway Profile, including potential settings in which each could be most useful and ways each could be modified to reduce challenges and increase rigor. Our goal in defining and interacting with the core of the ID assessment field in this way is not only to clarify activity in this vast and disjointed space but also to simplify and facilitate processes of understanding, choosing from, and strategically developing this diverse landscape. Pathway Profiles can be used as heuristic gateways to the ID assessment field, particularly when it comes to finding relevant examples, adapting designs to situations, and ultimately uncovering the true outcomes of interdisciplinarity.
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Affiliation(s)
- Bethany K Laursen
- Laursen Evaluation & Design, LLC; The Graduate School, Michigan State University , 466 W. Circle Dr., East Lansing, MI 48824, USA
| | - Nicole Motzer
- National Socio-Environmental Synthesis Center, University of Maryland-College Park , 1 Park Place, Suite 300, Annapolis, MD 21401, USA
| | - Kelly J Anderson
- Department of Geographical Sciences, University of Maryland-College Park , 2180 Samuel J LeFrak Hall, 7251 Preinkert Drive, College Park, MD 20742, USA
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Bozorgmehr K, Zick A, Hecker T. Resilience of Health Systems: Understanding Uncertainty Uses, Intersecting Crises and Cross-level Interactions Comment on "Government Actions and Their Relation to Resilience in Healthcare During the COVID-19 Pandemic in New South Wales, Australia and Ontario, Canada". Int J Health Policy Manag 2022; 11:1956-1959. [PMID: 35658333 PMCID: PMC9808231 DOI: 10.34172/ijhpm.2022.7279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/23/2022] [Indexed: 01/12/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has created opportunities to study resilience in multiple, interrelated societal systems while considering the institutional, community and individual level. We aim to discuss critical, yet underrepresented, issues in resilience discourses which are fundamental to advance theories, concepts and measurement of health system resilience. These relate to a better understanding of (i) how government's handle and use uncertainties to facilitate or impede change, including the role of negotiation and conflicts, (ii) the intersections of health with multiple, co-occurring crises (systemic intersections), and (iii) cross-level interactions, ie, the interrelation between individual-level resilience, the collective resilience of groups and communities, and the resilience of a system as a whole (and vice versa). Analyses of these aspects can help to "contextualize" our understanding of resilience in complex adaptive systems. However, conceptual clarity is needed whether resilience is considered an underlying feature, outcome, or intermediate determinant of a (health) system's performance.
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Affiliation(s)
- Kayvan Bozorgmehr
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
- Institute for Interdisciplinary Research on Conflict & Violence (IKG), Bielefeld University, Bielefeld, Germany
- Section for Health Equity Studies & Migration, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas Zick
- Institute for Interdisciplinary Research on Conflict & Violence (IKG), Bielefeld University, Bielefeld, Germany
- Faculty of Educational Science, Bielefeld University, Bielefeld, Germany
- Research Institute Social Cohesion (FGZ/RISC), Bielefeld, Germany
| | - Tobias Hecker
- Institute for Interdisciplinary Research on Conflict & Violence (IKG), Bielefeld University, Bielefeld, Germany
- Working Unit Clinical Developmental Psychopathology, Faculty for Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
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Valente EP, Covi B, Mariani I, Morano S, Otalea M, Nanu I, Nanu MI, Elden H, Linden K, Zaigham M, Vik ES, Kongslien S, Nedberg I, Costa R, Rodrigues C, Dias H, Drandić D, Kurbanović M, Sacks E, Muzigaba M, Lincetto O, Lazzerini M. WHO Standards-based questionnaire to measure health workers' perspective on the quality of care around the time of childbirth in the WHO European region: development and mixed-methods validation in six countries. BMJ Open 2022; 12:e056753. [PMID: 35396296 PMCID: PMC8995570 DOI: 10.1136/bmjopen-2021-056753] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Develop and validate a WHO Standards-based online questionnaire to measure the quality of maternal and newborn care (QMNC) around the time of childbirth from the health workers' perspective. DESIGN Mixed-methods study. SETTING Six countries of the WHO European Region. PARTICIPANTS AND METHODS The questionnaire is based on lessons learnt in previous studies, and was developed in three sequential phases: (1) WHO Quality Measures were prioritised and content, construct and face validity were assessed through a Delphi involving a multidisciplinary board of experts from 11 countries of the WHO European Region; (2) translation/back translation of the English version was conducted following The Professional Society for Health Economics and Outcomes Research guidelines; (3) internal consistency, intrarater reliability and acceptability were assessed among 600 health workers in six countries. RESULTS The questionnaire included 40 items based on WHO Standards Quality Measures, equally divided into four domains: provision of care, experience of care, availability of human and physical resources, organisational changes due to COVID-19; and its organised in six sections. It was translated/back translated in 12 languages: Bosnian, Croatian, French, German, Italian, Norwegian, Portuguese, Romanian, Russian, Slovenian, Spanish and Swedish. The Cronbach's alpha values were ≥0.70 for each questionnaire section where questions were hypothesised to be interrelated, indicating good internal consistence. Cohen K or Gwet's AC1 values were ≥0.60, suggesting good intrarater reliability, except for one question. Acceptability was good with only 1.70% of health workers requesting minimal changes in question wording. CONCLUSIONS Findings suggest that the questionnaire has good content, construct, face validity, internal consistency, intrarater reliability and acceptability in six countries of the WHO European Region. Future studies may further explore the questionnaire's use in other countries, and how to translate evidence generated by this tool into policies to improve the QMNC. TRAIL REGISTRATION NUMBER NCT04847336.
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Affiliation(s)
- Emanuelle Pessa Valente
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Benedetta Covi
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Sandra Morano
- Medical School and Midwifery School, Genoa University, Genoa, Italy
| | - Marina Otalea
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- SAMAS Association, Bucharest, Romania
| | - Ioana Nanu
- National Institute for Mother and Child Health "Alessandrescu - Rusescu", Bucharest, Romania
| | - Micaela Iuliana Nanu
- National Institute for Mother and Child Health "Alessandrescu - Rusescu", Bucharest, Romania
| | - Helen Elden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mehreen Zaigham
- Department of Obstetrics and Gynecology - Institution of Clinical Sciences Lund, Lund University, Lund and Skåne University Hospital, Malmö, Sweden
| | - Eline Skirnisdottir Vik
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Sigrun Kongslien
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ingvild Nedberg
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Raquel Costa
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Human-Environment Interaction Lab, Universidade Lusófona, Porto, Portugal
| | - Carina Rodrigues
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Heloísa Dias
- Regional Health Administration of the Algarve, IP (ARS - Algarve), Albufeira, Portugal
| | | | | | - Emma Sacks
- Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Moise Muzigaba
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Ornella Lincetto
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
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Martínez HLH, Artmann E, Cruz SCDS, Farias DCS. Telemedicine in the fight against COVID-19: old and new challenges in health accessibility in Vitória/ES, Brazil. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-1104202213404i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to analyze telemedicine care in Vitória, Espírito Santo, Brazil, from April 2020 to March 2021. Method: based on Thied et al.’s dimensions of access, a case study was conducted using secondary data collected from the Bem Estar Network’s telemedicine reports. All 29 Basic Health Units of the municipality were included. Results: a total of 15,548 users were assisted in 21,481 consultations, 64% female (9,953) and 36% male (5,595). The most attended age group was 30-39 years old (19.5%). The number per 10,000 inhabitants for all causes ranged between 35.86/10,000 inhabitants from Oct-Dec/2020 and 65.75 from Apr-Jun/2020. Of these calls, 56% (11,946) targeted coronavirus (causes B342 and B972), ranging from 22.54 consultations per 10,000 inhabitants in Oct-Dec/2020 to 31.96 in Apr-Jun/2020. Conclusions: Results reflect the transformative impact COVID-19 had on telemedicine care as part of the first-line response to the pandemic in Vitória, Brazil. Inequalities in face-to-face access are reproduced in telemedicine, making it essential to maintain a strong relationship between the health system, health teams, and users when implementing telemedicine. Both forms of health care remain interdependent and complementary in the search to ensure equitable access to health.
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Martínez HLH, Artmann E, Cruz SCDS, Farias DCS. A telemedicina no combate à Covid-19: velhos e novos desafios no acesso à saúde no município de Vitória/ES, Brasil. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-1104202213404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: analisar o atendimento pela telemedicina em Vitória/ES de abril/2020 a mar/2021. Método: estudo de caso ancorado na categoria acesso de Thiede et al. e em dados secundários. Utilizaram-se relatórios das consultas de telemedicina da Rede Bem Estar. Incluíram-se todas as 29 Unidades Básicas de Saúde do município. Resultados: no período foram atendidos 15.548 usuários, 64% do sexo feminino (9.953) e 36% do masculino (5.595), em 21.481 consultas. O grupo etário mais atendido foi o de 30-39 anos (19,5%). O número por 10.000 hab. para todas as causas oscilou entre 35,86/10.000 hab. de out-dez/2020 e 65,75 de abr-jun/2020. Destes atendimentos, 56% (11.946) foram coronavírus (causas B342 e B972), sendo, 22,54 consultas por 10.000 hab. de out-dez/2020 e 31,96 de abr-jun/2020. Conclusões: Os resultados refletem o impacto transformador da Covid-19 nos cuidados à saúde por telemedicina como parte da resposta de primeira linha à pandemia no município de Vitória/ES. As desigualdades no acesso presencial se reproduzem na telemedicina, o que torna imprescindível manter um relacionamento forte entre o sistema de saúde, as equipes de saúde e os usuários na implantação da telemedicina. As duas formas permanecem interdependentes e complementares na busca de garantia do acesso equitativo em saúde.
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Jarroch R, Tajik B, Tuomainen TP, Kauhanen J. Economic Recession and the Long Term Risk of Psychiatric Disorders and Alcohol Related Diseases-A Cohort Study From Eastern Finland. Front Psychiatry 2022; 13:794888. [PMID: 35250662 PMCID: PMC8891480 DOI: 10.3389/fpsyt.2022.794888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/25/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Long-term development of psychiatric disorders and alcohol-related diseases after economic recessions is insufficiently studied. We investigated the overall impact of the economic recession between 1991 and 1994 in Finland on the long-term incidence of psychiatric and alcohol-related diseases. METHODS A population-based sample of 1,774 women and men aged 53-73 years were examined between 1998 and 2001 from the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD). Participants completed comprehensive questionnaires on the possible impact of the 1990s recession in Finland on their lives. They were followed-up until 2018. Cox proportional hazards regression was used to estimate hazard ratios (HR) of new incident psychiatric and alcohol-related disorders during the 20-years follow-up after linkage to the National Hospital Registry. Logistic regression was used to estimate odds ratios (OR) of psychiatric disorders at baseline. RESULTS At baseline, 93 participants had psychiatric disorders. During 20-years follow-up, 138 new psychiatric disorders and 45 alcohol-related diseases were developed. The covariate-adjusted risk of psychiatric disorders was over twice higher among men who experienced recession-induced hardships compared to those who did not (HR = 2.20, 95%CI = 1.04-4.70, p = 0.04). The risk of alcohol-related diseases was more than four times higher among men with hardships (HR = 4.44, 95%CI = 1.04-18.90, p = 0.04). No such associations were observed among women. No association was observed between recession-induced hardships and having psychiatric disorders at baseline in both genders (multivariate-adjusted p = 0.63 for women, multivariate-adjusted p = 0.36 for men). CONCLUSION Long-term risk of psychiatric disorders and alcohol-related diseases was increased after the 1990s economic recession in Finland, but only among middle-age and older men.
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Affiliation(s)
- Rand Jarroch
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Behnam Tajik
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Amoo OS, Adewara F, Tijani B, Onuigbo TI, Ikemefuna AS, Oraegbu JI, Rizvi T, Okwuraiwe A, Onwuamah C, Shaibu J, James A, Ohihoin G, Ige F, Kareithi D, David A, Karera S, Agboola H, Adeniyi A, Obi J, Achanya D, Odewale E, Oforomeh O, Liboro G, Nwogbe O, Ezechi O, Adegbola R, Audu R, Salako B. The use of DIY (Do it yourself) sampling and telemonitoring model for COVID-19 qPCR testing scale up. PLoS One 2021; 16:e0259398. [PMID: 34735503 PMCID: PMC8568151 DOI: 10.1371/journal.pone.0259398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022] Open
Abstract
The first case of COVID-19 in Nigeria was recorded on February 27, 2020, being an imported case by an Italian expatriate, to the country. Since then, there has been steady increase in the number of cases. However, the number of cases in Nigeria is low in comparison to cases reported by other countries with similar large populations, despite the poor health system prevailing in the country. This has been mainly attributed to the low testing capacity in Nigeria among other factors. Therefore, there is a need for innovative ways to increase the number of persons testing for COVID-19. The aim of the study was to pilot a nasopharyngeal swab self-sample collection model that would help increase COVID-19 testing while ensuring minimal person-to-person contact being experienced at the testing center. 216 participants took part in this study which was carried out at the Nigerian Institute of Medical Research between June and July 2020. Amongst the 216 participants, 174 tested negatives for both self-collected samples and samples collected by Professionals, 30 tested positive for both arms, with discrepancies occurring in 6 samples where the self-collected samples were positive while the ones collected by the professionals were negative. The same occurred in another set of 6 samples with the self-collected samples being negative and the professional-collected sample coming out positive, with a sensitivity of 83.3% and a specificity of 96.7%. The results of the interrater analysis are Kappa = 0.800 (95% CI, 0.690 to 0.910) which implies an outstanding agreement between the two COVID-19 sampling methods. Furthermore, since p< 0.001 Kappa (k) coefficient is statistically different from zero, our findings have shown that self-collected samples can be reliable in the diagnosis of COVID-19.
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Affiliation(s)
- Olufemi Samuel Amoo
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | | | | | | | | | - Joy Isioma Oraegbu
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Tazeen Rizvi
- Mobihealth International Limited, Abuja, Nigeria
| | - Azuka Okwuraiwe
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Chika Onwuamah
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Joseph Shaibu
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Ayorinde James
- Department of Biochemistry, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Greg Ohihoin
- Clinical Science Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Fehintola Ige
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | | | - Agatha David
- Clinical Science Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | | | - Hammed Agboola
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Anthony Adeniyi
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Josephine Obi
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Dominic Achanya
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Ebenezer Odewale
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Osaga Oforomeh
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Gideon Liboro
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Olayemi Nwogbe
- Department of Library and Information Technology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Oliver Ezechi
- Clinical Science Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Richard Adegbola
- Department of Biochemistry, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Rosemary Audu
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Babatunde Salako
- Department of Microbiology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
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de León EA, Shriwise A, Tomson GÖ, Morton S, Lemos DS, Menne B, Dooris M. Beyond building back better: imagining a future for human and planetary health. Lancet Planet Health 2021; 5:e827-e839. [PMID: 34774123 PMCID: PMC8600369 DOI: 10.1016/s2542-5196(21)00262-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/28/2021] [Accepted: 09/09/2021] [Indexed: 05/12/2023]
Abstract
COVID-19 is disrupting and transforming the world. We argue that transformations catalysed by this pandemic should be used to improve human and planetary health and wellbeing. This paradigm shift requires decision makers and policy makers to go beyond building back better, by nesting the economic domain of sustainable development within social and environmental domains. Drawing on the engage, assess, align, accelerate, and account (E4As) approach to implementing the 2030 Agenda for Sustainable Development, we explore the implications of this kind of radical transformative change, focusing particularly on the role of the health sector. We conclude that a recovery and transition from the COVID-19 pandemic that delivers the future humanity wants and needs requires more than a technical understanding of the transformation at hand. It also requires commitment and courage from leaders and policy makers to challenge dominant constructs and to work towards a truly thriving, equitable, and sustainable future to create a world where economic development is not an end goal itself, but a means to secure the health and wellbeing of people and the planet.
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Affiliation(s)
- Emilia Aragón de León
- Health Policy Development and Implementation, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Amanda Shriwise
- Political Economy of the Welfare State, Forschungszentrum Ungleichheit und Sozialpolitik, Research Centre on Inequality and Social Policy, Universität Bremen, Bremen, Germany; Department of Sociology, University of Kansas, Lawrence, KS, USA.
| | - GÖran Tomson
- President's Office, Karolinska Institutet, Stockholm, Sweden; Swedish Institute for Global Health Transformation, Royal Swedish Academy of Sciences, Stockholm, Sweden
| | - Stephen Morton
- Health and Sustainable Settings Unit, University of Central Lancashire, Preston, UK
| | - Diogo Simão Lemos
- Health Emergencies Programme, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Bettina Menne
- Office for Investment for Health and Development, World Health Organization Regional Office for Europe, Venice, Italy
| | - Mark Dooris
- Institute of Citizenship, Society, and Change, University of Central Lancashire, Preston, UK
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Training and assessment of medical specialists in clinical microbiology and infectious diseases in Europe. Clin Microbiol Infect 2021; 27:1581-1588. [PMID: 34260952 DOI: 10.1016/j.cmi.2021.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND There is wide variation in the availability and training of specialists in the diagnosis and management of infections across Europe. OBJECTIVES To describe and reflect on the current objectives, structure and content of European curricula and examinations for the training and assessment of medical specialists in Clinical (Medical) Microbiology (CM/MM) and Infectious Diseases (ID). SOURCES Narrative review of developments over the past two decades and related policy documents and scientific literature. CONTENT Responsibility for curricula and examinations lies with the European Union of Medical Specialists (UEMS). The ID Section of UEMS was inaugurated in 1997 and the MM Section separated from Laboratory Medicine in 2008. The sections collaborate closely with each other and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). Updated European Training Requirements (ETR) were approved for MM in 2017 and ID in 2018. These comprehensive curricula outline the framework for delivery of specialist training and quality control for trainers and training programmes, emphasizing the need for documented, regular formative reviews of progress of trainees. Competencies to be achieved include both specialty-related and generic knowledge, skills and professional behaviours. The indicative length of training is typically 5 years; a year of clinical training is mandated for CM/MM trainees and 6 months of microbiology laboratory training for ID trainees. Each Section is developing examinations using multiple choice questions to test the knowledge base defined in their ETR, to be delivered in 2022 following pilot examinations in 2021. IMPLICATIONS The revised ETRs and European examinations for medical specialists in CM/MM and ID provide benchmarks for national authorities to adapt or adopt locally. Through harmonization of postgraduate training and assessment, they support the promotion and recognition of high standards of clinical practice and hence improved care for patients throughout Europe, and improved mobility of trainees and specialists.
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Hintermeier M, Gencer H, Kajikhina K, Rohleder S, Hövener C, Tallarek M, Spallek J, Bozorgmehr K. SARS-CoV-2 among migrants and forcibly displaced populations: A rapid systematic review. J Migr Health 2021; 4:100056. [PMID: 34151312 PMCID: PMC8205550 DOI: 10.1016/j.jmh.2021.100056] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/09/2021] [Accepted: 06/13/2021] [Indexed: 12/23/2022] Open
Abstract
The economic and health consequences of the COVID-19 pandemic pose a particular threat to vulnerable groups, such as migrants, particularly forcibly displaced populations. The aim of this review is (i) to synthesize the evidence on risk of infection and transmission among migrants, refugees, asylum seekers and internally displaced populations, and (ii) the effect of lockdown measures on these populations. We searched MEDLINE and WOS, preprint servers, and pertinent websites between 1st December 2019 and 26th June 2020. The included studies showed a high heterogeneity in study design, population, outcome and quality. The incidence risk of SARS-CoV-2 varied from 0•12% to 2•08% in non-outbreak settings and from 5•64% to 21•15% in outbreak settings. Migrants showed a lower hospitalization rate compared to non-migrants. Negative impacts on mental health due to lockdown measures were found across respective studies. However, findings show a tenuous and heterogeneous data situation, showing the need for more robust and comparative study designs.
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Affiliation(s)
- Maren Hintermeier
- Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Hande Gencer
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Department Prevention and Evaluation, Unit Social Epidemiology, Achterstr. 30, 28359 Bremen, Germany
| | - Katja Kajikhina
- Robert Koch Institute, Unit 28 Social Determinants of Health, Department of Health monitoring and Epidemiology, General-Pape-Straße 62, 12101, Berlin, Germany
- Robert Koch Institute, Unit 38 Crisis management, outbreak investigations and training programmes, Department for Infectious Disease Epidemiolog, Seestr. 10, 13353 Berlin, Germany
| | - Sven Rohleder
- Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, D- 33501 Bielefeld, Germany
| | - Claudia Hövener
- Robert Koch Institute, Unit 28 Social Determinants of Health, Department of Health monitoring and Epidemiology, General-Pape-Straße 62, 12101, Berlin, Germany
| | - Marie Tallarek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Universitätsplatz 1, 01968 Senftenberg, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Universitätsplatz 1, 01968 Senftenberg, Germany
| | - Kayvan Bozorgmehr
- Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, D- 33501 Bielefeld, Germany
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Bohnet H, Rüegger S. Refugees and Covid-19: Beyond Health Risks to Insecurity. SCHWEIZERISCHE ZEITSCHRIFT FUR POLITIKWISSENSCHAFT = REVUE SUISSE DE SCIENCE POLITIQUE = SWISS POLITICAL SCIENCE REVIEW 2021; 27:353-368. [PMID: 35923364 PMCID: PMC8446961 DOI: 10.1111/spsr.12466] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/01/2021] [Accepted: 04/27/2021] [Indexed: 06/15/2023]
Abstract
The Covid-19 pandemic severely threatens refugees: Most refugees live in developing countries with poor health care systems, the lockdowns left many refugees without income, border closures prevented forced migrants from their right to seek asylum and anti-refugee sentiment as well as insecurity in refugee settlements increased. Building on past refugee research and reports on refugee-related challenges during the Covid-19 crisis, we explain how bad sanitation, inadequate accommodation, additional restrictions of movement and employment and language barriers increase grievances among refugees and tensions between refugees and host populations. Particularly in large and overcrowded settlements these issues can lead to violent conflict, as we demonstrate with a case study of the Moria refugee camp in Greece. Yet, the impact of Covid-19 on refugees generally lacks politicization, and many governments are reluctant or unable to provide adequate housing and sanitation to refugees. We present policy recommendations for improving refugee protection amidst Covid-19, including not only the prevention of further spread of the virus but also that of insecurity.
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Negev M, Dahdal Y, Khreis H, Hochman A, Shaheen M, Jaghbir MTA, Alpert P, Levine H, Davidovitch N. Regional lessons from the COVID-19 outbreak in the Middle East: From infectious diseases to climate change adaptation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 768:144434. [PMID: 33444865 PMCID: PMC7834362 DOI: 10.1016/j.scitotenv.2020.144434] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/06/2020] [Accepted: 12/09/2020] [Indexed: 05/04/2023]
Abstract
Global health threats including epidemics and climate change, know no political borders and require regional collaboration if they are to be dealt with effectively. This paper starts with a review of the COVID-19 outbreak in Israel, Palestine and Jordan, in the context of the regional health systems, demography and politics. We suggest that Israel and Palestine function as one epidemiological unit, due to extensive border crossing of inhabitants and tourists, resulting in cross-border infections and potential for outbreaks' transmission. Indeed, there is a correlation between the numbers of confirmed cases with a 2-3 weeks lag. In contrast, Jordan has the ability to seal its borders and better contain the spread of the virus. We then discuss comparative public health aspects in relation to the management of COVID-19 and long term adaptation to climate change. We suggest that lessons from the current crisis can inform regional adaptation to climate change. There is an urgent need for better health surveillance, data sharing across borders, and more resilient health systems that are prepared and equipped for emergencies. Another essential and currently missing prerequisite is close cooperation within and across countries amidst political conflict, in order to protect the public health of all inhabitants of the region.
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Affiliation(s)
- Maya Negev
- School of Public Health, University of Haifa, Israel.
| | | | - Haneen Khreis
- Texas A&M Transportation Institute, United States of America.
| | - Assaf Hochman
- Department of Tropospheric Research, Institute of Meteorology and Climate Research, Karlsruhe Institute of Technology, Germany.
| | | | | | | | - Hagai Levine
- School of Public Health, Hebrew University-Hadasdah, Israel.
| | - Nadav Davidovitch
- School of Public Health, Ben Gurion University of the Negev, Israel.
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Faria LRR. Conservation optimism and reckoning with the future. CONSERVATION BIOLOGY : THE JOURNAL OF THE SOCIETY FOR CONSERVATION BIOLOGY 2021; 35:745-747. [PMID: 32725805 DOI: 10.1111/cobi.13601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 06/11/2023]
Abstract
Article impact statement: The optimism permeating biological conservation should be recalibrated considering the future that present times portend.
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Affiliation(s)
- Luiz R R Faria
- Instituto-Latino Americano de Ciências da Vida e da Natureza, Universidade Federal da Integração Latino-Americana (UNILA), Av. Tarquínio Joslin dos Santos, 1000, Jd. Universitário, Foz do Iguaçu, PR, 85.870-901, Brazil
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22
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van Niekerk L, Manderson L, Balabanova D. The application of social innovation in healthcare: a scoping review. Infect Dis Poverty 2021; 10:26. [PMID: 33685487 PMCID: PMC7938294 DOI: 10.1186/s40249-021-00794-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/05/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Social innovation has been applied increasingly to achieve social goals, including improved healthcare delivery, despite a lack of conceptual clarity and consensus on its definition. Beyond its tangible artefacts to address societal and structural needs, social innovation can best be understood as innovation in social relations, in power dynamics and in governance transformations, and may include institutional and systems transformations. METHODS A scoping review was conducted of empirical studies published in the past 10 years, to identify how social innovation in healthcare has been applied, the enablers and barriers affecting its operation, and gaps in the current literature. A number of disciplinary databases were searched between April and June 2020, including Academic Source Complete, CIHAHL, Business Source Complete Psych INFO, PubMed and Global Health. A 10-year publication time frame was selected and articles limited to English text. Studies for final inclusion was based on a pre-defined criteria. RESULTS Of the 27 studies included in this review, the majority adopted a case research methodology. Half of these were from authors outside the health sector working in high-income countries (HIC). Social innovation was seen to provide creative solutions to address barriers associated with access and cost of care in both low- and middle-income countries and HIC settings in a variety of disease focus areas. Compared to studies in other disciplines, health researchers applied social innovation mainly from an instrumental and technocratic standpoint to foster greater patient and beneficiary participation in health programmes. No empirical evidence was presented on whether this process leads to empowerment, and social innovation was not presented as transformative. The studies provided practical insights on how implementing social innovation in health systems and practice can be enhanced. CONCLUSIONS Based on theoretical literature, social innovation has the potential to mobilise institutional and systems change, yet research in health has not yet fully explored this dimension. Thus far, social innovation has been applied to extend population and financial coverage, principles inherent in universal health coverage and central to SDG 3.8. However, limitations exist in conceptualising social innovation and applying its theoretical and multidisciplinary underpinnings in health research.
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Affiliation(s)
| | - Lenore Manderson
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,School of Social Sciences, Monash University, Clayton, Australia
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23
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Kim JU, Ingiliz P, Shimakawa Y, Lemoine M. Improving care of migrants is key for viral hepatitis elimination in Europe. Bull World Health Organ 2021; 99:280-286. [PMID: 33953445 PMCID: PMC8085634 DOI: 10.2471/blt.20.260919] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/03/2020] [Accepted: 10/07/2020] [Indexed: 02/08/2023] Open
Abstract
By 2040, deaths from chronic viral hepatitis worldwide are projected to exceed those from human immunodeficiency virus infection, tuberculosis and malaria combined. The burden of this disease is predominantly carried by low-resource countries in Africa and Asia. In resource-rich countries, the epidemiological spread of viral hepatitis is partially driven by migrant movements from areas of high endemicity. In the last decade, Member States of the European Union and the European Economic Area have experienced an unprecedented influx of migrants, which has resulted in the polarization of political views about migration. In addition, the coronavirus disease 2019 pandemic has worsened the economic and health conditions of migrants and contributed to hostility to ensuring their health rights. Moreover, the implementation of hostile laws in some host nations has increased the vulnerability of marginalized migrant subgroups, such as asylum seekers and undocumented individuals. These developments have complicated the historical challenge of identifying high-risk migrant groups for screening and treatment. However, if European countries can apply the simplified assessment tools and diagnostic tests for viral hepatitis that have been used for decentralized screening and monitoring in resource-poor countries, the uptake of care by migrants could be dramatically increased. Given the global calls for the elimination of viral hepatitis, European nations should recognize the importance of treating this vulnerable migrant population. Political and health strategies need to be adapted to meet this challenge and help eliminate viral hepatitis globally.
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Affiliation(s)
- Jin Un Kim
- Hepatology Section, Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, 10th Floor QEQM Wing, St Mary's Hospital Campus, Imperial College London, South Wharf Street, London W2 1NY, England
| | - Patrick Ingiliz
- Department of Gastroenterology and Hepatology, Charité University Medical Center, Berlin, Germany
| | - Yusuke Shimakawa
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - Maud Lemoine
- Hepatology Section, Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, 10th Floor QEQM Wing, St Mary's Hospital Campus, Imperial College London, South Wharf Street, London W2 1NY, England
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24
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Gottlieb N, Trummer U, Davidovitch N, Krasnik A, Juárez SP, Rostila M, Biddle L, Bozorgmehr K. Economic arguments in migrant health policymaking: proposing a research agenda. Global Health 2020; 16:113. [PMID: 33218359 PMCID: PMC7677743 DOI: 10.1186/s12992-020-00642-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/10/2020] [Indexed: 11/27/2022] Open
Abstract
Welfare states around the world restrict access to public healthcare for some migrant groups. Formal restrictions on migrants’ healthcare access are often justified with economic arguments; for example, as a means to prevent excess costs and safeguard scarce resources. However, existing studies on the economics of migrant health policies suggest that restrictive policies increase rather than decrease costs. This evidence has largely been ignored in migration debates. Amplifying the relationship between welfare state transformations and the production of inequalities, the Covid-19 pandemic may fuel exclusionary rhetoric and politics; or it may serve as an impetus to reconsider the costs that one group’s exclusion from health can entail for all members of society. The public health community has a responsibility to promote evidence-informed health policies that are ethically and economically sound, and to counter anti-migrant and racial discrimination (whether overt or masked with economic reasoning). Toward this end, we propose a research agenda which includes 1) the generation of a comprehensive body of evidence on economic aspects of migrant health policies, 2) the clarification of the role of economic arguments in migration debates, 3) (self-)critical reflection on the ethics and politics of the production of economic evidence, 4) the introduction of evidence into migrant health policymaking processes, and 5) the endorsement of inter- and transdisciplinary approaches. With the Covid-19 pandemic and surrounding events rendering the suggested research agenda more topical than ever, we invite individuals and groups to join forces toward a (self-)critical examination of economic arguments in migration and health, and in public health generally.
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Affiliation(s)
- Nora Gottlieb
- Department of Health Care Management, Berlin Technical University, Berlin, Germany. .,Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany.
| | | | - Nadav Davidovitch
- Department of Health Systems Management, School of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Allan Krasnik
- Department of Public Health, Center for Migration, Ethnicity and Health, University of Copenhagen, Copenhagen, Denmark
| | - Sol P Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institute, Stockholm, Sweden
| | - Mikael Rostila
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institute, Stockholm, Sweden
| | - Louise Biddle
- Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Kayvan Bozorgmehr
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany.,Section for Health Equity Studies and Migration, Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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25
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Reuter M, Dragano N, Wahrendorf M. Working while sick in context of regional unemployment: a Europe-wide cross-sectional study. J Epidemiol Community Health 2020; 75:jech-2020-214888. [PMID: 33188056 DOI: 10.1136/jech-2020-214888] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/16/2020] [Accepted: 10/28/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Research suggests that areas with high unemployment have lower rates of sickness absence, but the underlying mechanisms remain unclear. One assumption is that when unemployment is high people are more likely to work while being sick (discipline hypothesis). Against this background, we investigate the association between regional unemployment and sickness presenteeism. Second, we study interactions with factors of occupational disadvantage. METHODS We combined survey data of 20 974 employees collected 2015 in 232 regions from 35 European countries with data on regional unemployment rates obtained from Eurostat. Presenteeism was assessed by the fraction of days worked while ill among all days with illness (presenteeism propensity). To investigate if unemployment was related to presenteeism, we estimated multi-level models (individuals nested in regions) that were adjusted for socio-demographic and occupational covariates to account for compositional differences of the regions. RESULTS The mean presenteeism propensity was 34.8 (SD 40.4), indicating that workers chose presenteeism in 1 out of 3 days with sickness. We found that a change in unemployment by +10 percentage points was associated with a change in presenteeism by +5 percentage points (95% CI 1.2 to 8.6). This relationship was more pronounced among workers with low salary, low skill-level, and industrial and healthcare workers. CONCLUSION Our results support the assumption that high unemployment elevates presenteeism, and that people in disadvantaged occupations are particularly affected. Policies managing presenteeism should consider the labour market context, particularly during the aftermath of the COVID-19 pandemic.
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Affiliation(s)
- Marvin Reuter
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Dusseldorf, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Dusseldorf, Germany
| | - Morten Wahrendorf
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Dusseldorf, Germany
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26
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Actis AG, Pistone S. Europe, democracy and health after COVID-19: a strong union. Minerva Med 2020; 111:365. [DOI: 10.23736/s0026-4806.20.06665-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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27
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Haghani M, Bliemer MC, Goerlandt F, Li J. The scientific literature on Coronaviruses, COVID-19 and its associated safety-related research dimensions: A scientometric analysis and scoping review. SAFETY SCIENCE 2020; 129:104806. [PMID: 32382213 PMCID: PMC7203062 DOI: 10.1016/j.ssci.2020.104806] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/03/2020] [Indexed: 05/03/2023]
Abstract
The COVID-19 global pandemic has generated an abundance of research quickly following the outbreak. Within only a few months, more than a thousand studies on this topic have already appeared in the scientific literature. In this short review, we analyse the bibliometric aspects of these studies on a macro level, as well as those addressing Coronaviruses in general. Furthermore, through a scoping analysis of the literature on COVID-19, we identify the main safety-related dimensions that these studies have thus far addressed. Our findings show that across various research domains, and apart from the medical and clinical aspects such as the safety of vaccines and treatments, issues related to patient transport safety, occupational safety of healthcare professionals, biosafety of laboratories and facilities, social safety, food safety, and particularly mental/psychological health and domestic safety have thus far attracted most attention of the scientific community in relation to the COVID-19 pandemic. Our analysis also uncovers various potentially significant safety problems caused by this global health emergency which currently have attracted only limited scientific focus but may warrant more attention. These include matters such as cyber safety, economic safety, and supply-chain safety. These findings highlight why, from an academic research perspective, a holistic interdisciplinary approach and a collective scientific effort is required to help understand and mitigate the various safety impacts of this crisis whose implications reach far beyond the bio-medical risks. Such holistic safety-scientific understanding of the COVID-19 crisis can furthermore be instrumental to be better prepared for a future pandemic.
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Affiliation(s)
- Milad Haghani
- Institute of Transport and Logistics Studies, The University of Sydney Business School, The University of Sydney, NSW, Australia
- Corresponding author.
| | - Michiel C.J. Bliemer
- Institute of Transport and Logistics Studies, The University of Sydney Business School, The University of Sydney, NSW, Australia
| | - Floris Goerlandt
- Dalhousie University, Department of Industrial Engineering, Halifax, Nova Scotia B3H 4R2, Canada
| | - Jie Li
- Department of Safety Science and Engineering, School of Ocean Science and Engineering, Shanghai Maritime University, China
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28
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Pikoulis E, Puchner K, Riza E, Kakalou E, Pavlopoulos E, Tsiamis C, Tokakis V, Boustras G, Terzidis A, Karamagioli V. In the midst of the perfect storm: Swift public health actions needed in order to increase societal safety during the COVID-19 pandemic. SAFETY SCIENCE 2020; 129:104810. [PMID: 32398901 PMCID: PMC7214287 DOI: 10.1016/j.ssci.2020.104810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 05/10/2023]
Abstract
The phenomenal speed of COVID-19 has subjected the public health professionals worldwide to struggle to subdue the spread of the disease and its impact of the affected societies. The limited biomedical and epidemiological understanding of COVID-19 along with the lack of vaccines and therapeutics have led to the reception of draconian measures from the societal safety domain, limiting human interaction through social distancing. Grounded on the adopted approaches, interventions in sero-prevalence studies, mobilisation of the primary health care (PHC) sector, as well as target socially vulnerable groups should be taken into consideration by heath authorities.
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Affiliation(s)
- Emmanouil Pikoulis
- MSc Global Health – Disaster Medicine, School of Medicine, National & Kapodistrian University of Athens, Dilou 1, 11527 Goudi, Athens, Greece
| | - Karl Puchner
- MSc Global Health – Disaster Medicine, School of Medicine, National & Kapodistrian University of Athens, Dilou 1, 11527 Goudi, Athens, Greece
| | - Eleni Riza
- MSc Global Health – Disaster Medicine, School of Medicine, National & Kapodistrian University of Athens, Dilou 1, 11527 Goudi, Athens, Greece
| | - Eleni Kakalou
- MSc Global Health – Disaster Medicine, School of Medicine, National & Kapodistrian University of Athens, Dilou 1, 11527 Goudi, Athens, Greece
| | - Elias Pavlopoulos
- MSc Global Health – Disaster Medicine, School of Medicine, National & Kapodistrian University of Athens, Dilou 1, 11527 Goudi, Athens, Greece
| | - Constantinos Tsiamis
- MSc Global Health – Disaster Medicine, School of Medicine, National & Kapodistrian University of Athens, Dilou 1, 11527 Goudi, Athens, Greece
| | - Vassileios Tokakis
- MSc Global Health – Disaster Medicine, School of Medicine, National & Kapodistrian University of Athens, Dilou 1, 11527 Goudi, Athens, Greece
| | - Georgios Boustras
- CERIDES – Excellence in Innovation and Technology, European University Cyprus, 6 Diogenes Street, Egkomi, Nicosia 2404, Cyprus
| | - Agis Terzidis
- MSc Global Health – Disaster Medicine, School of Medicine, National & Kapodistrian University of Athens, Dilou 1, 11527 Goudi, Athens, Greece
| | - Vasiliki Karamagioli
- MSc Global Health – Disaster Medicine, School of Medicine, National & Kapodistrian University of Athens, Dilou 1, 11527 Goudi, Athens, Greece
- Corresponding author.
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29
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Rodin G, Zimmermann C, Rodin D, Al-Awamer A, Sullivan R, Chamberlain C. COVID-19, palliative care and public health. Eur J Cancer 2020; 136:95-98. [PMID: 32653775 PMCID: PMC7833837 DOI: 10.1016/j.ejca.2020.05.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 01/12/2023]
Abstract
The lack of integration between public health approaches, cancer care and palliative and end-of-life care in the majority of health systems globally became strikingly evident in the context of the coronavirus disease 2019 (COVID-19) pandemic. At the same time, the collapse of the boundaries between these domains imposed by the pandemic created unique opportunities for intersectoral planning and collaboration. While the challenge of integration is not unique to oncology, the organisation of cancer care and its linkages to palliative care and to global health may allow it to be a demonstration model for how the problem of integration can be addressed. Before the pandemic, the large majority of individuals with cancer in need of palliative care in low- and middle-income countries and the poor or marginalised in high-income countries were denied access. This inequity was highlighted by the COVID-19 pandemic, as individuals in impoverished or population-dense settings with weak health systems have been more likely to become infected and to have less access to medical care and to palliative and end-of-life care. Such inequities deserve attention by government, financial institutions and decision makers in health care. However, there has been no framework in most countries for integrated decision-making that takes into account the requirements of public health, clinical medicine and palliative and end-of-life care. Integrated planning across these domains at all levels would allow for more coordinated resource allocation and better preparedness for the inevitability of future systemic threats to population health. Integration across public health, clinical medicine and palliative care is needed. Oncology, palliative care and global health could be a demonstration model. The pandemic is a dramatic reminder of the need for such integration at all levels.
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Affiliation(s)
- Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
| | - Camilla Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto and Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Danielle Rodin
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
| | - Ahmed Al-Awamer
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Richard Sullivan
- Institute of Cancer Policy and Conflict and Health Research Group, School of Cancer Sciences, King's College London, London, United Kingdom.
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van Uden A, van Houtum H. Beyond Coronativism: The Need For Agape. TIJDSCHRIFT VOOR ECONOMISCHE EN SOCIALE GEOGRAFIE = JOURNAL OF ECONOMIC AND SOCIAL GEOGRAPHY = REVUE DE GEOGRAPHIE ECONOMIQUE ET HUMAINE = ZEITSCHRIFT FUR OKONOMISCHE UND SOZIALE GEOGRAPHIE = REVISTA DE GEOGRAFIA ECONOMICA Y SOCIAL 2020; 111:333-346. [PMID: 32834146 PMCID: PMC7361782 DOI: 10.1111/tesg.12438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 06/01/2023]
Abstract
In this contribution we focus on togetherness, as one of the key notions in the current COVID-19 crisis. Globally, it is seen as vital to stand and act together to combat the virus, and avoid a tragedy of the commons, in which actors are acting out of self-interest and counterproductively to the general interest. In this essay we analyse the current geographical dissonant developments that the required human togetherness across the globe is facing. We find that the main conflicting tendencies, that we summarise as utilitarian locking up, nationalistic locking in and exclusionary locking out, are all employing a notion of togetherness which is largely based on an in-group solidarity based on either age, gender, ethnicity, nationality or fitness. We argue that such narrow definition of togetherness falls short in dealing with the crisis in an effective as well as non-discriminatory manner, and potentially could even lengthen or worsen the corona crisis. We end with a plea for a different conceptualisation of solidarity in the combat of the crisis, a radical non-dividing form of togetherness: agape.
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Affiliation(s)
- Annelies van Uden
- Innovation StudiesCopernicus Institute of Sustainable DevelopmentUtrecht UniversityVening Meineszgebouw A, Princetonlaan 8a3584 CBUtrechtthe Netherlands
| | - Henk van Houtum
- Department of GeographyNijmegen Centre for Border ResearchRadboud UniversityP.O. Box 9108, 6500 HKNijmegenthe Netherlands
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31
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Current Response and Management Decisions of the European Union to the COVID-19 Outbreak: A Review. SUSTAINABILITY 2020. [DOI: 10.3390/su12093838] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
COVID-19 has proven to be a formidable challenge for many countries in the European Union to manage effectively. The European Union has implemented numerous strategies to face emerging issues. Member States have adopted measures such as the closure of borders and significant limitations on the mobility of people to mitigate the spread of the virus. An unprecedented crisis coordination effort between Member States has facilitated the ability to purchase equipment, personal protective equipment, and other medical supplies. Attention has also been focused on providing substantive money for research to find a vaccine and promote effective treatment therapies. Financial support has been made available to protect worker salaries and businesses to help facilitate a return to a functional economy. Lessons learned to date from COVID-19 in the European Union are many; the current crisis highlights the need to think about future pandemics from a population-based management approach and apply outside the box critical thinking. Due to the complexity, intensity, and frequency of complex disasters, global leaders in healthcare, government, and business will need to pivot from siloed approaches to decision-making to embrace multidisciplinary and transdisciplinary levels of cooperation. This cooperation requires courage and leadership to recognize that changes are necessary to avoid making the same mistakes we have planned countless times on avoiding. This study focuses on the European Union’s initial response to the COVID-19 pandemic, starting with how the European Union first learned and processed the global information arising out of China, followed by the incremental population-based medicine/management decisions made that currently are defining the European Union’s capacity and capability. The capacity to organize, deliver, and monitor care to a specific clinical population under a population-based management target includes strict social distancing strategies, contact testing and tracing, testing for the virus antigen and its antibodies, isolation, and treatment modalities such as new mitigating medications, and finally, a vaccine.
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