Health Policy Changes Research Articles

Health Policy Reforms and Their Effect on Healthcare Delivery: Utilizing Natural Language Processing (NLP) to Analyze Public Sentiment and Policy Feedback

For health policy reforms, they've a profound impact on the healthcare transport structures, shaping how services are given and obtained. For lawmakers to make knowledgeable decisions that cope with the concerns and wishes of the society, they need to be able to apprehend what the public senses and says about the ones changes. The effectiveness and acceptability of health policy reforms can be better understood by the use of Natural Language Processing (NLP), which has advanced strategies for analyzing huge quantities of public discourse. Decoding diverse and unstructured records resources along with open forums, social media posts as well as news tales is one out of several troubles this assignment tackles. Natural Language Processing-Based Integrated Sentiment Analysis (NLP-ISA) is a new approach to evaluating how healthcare delivery has been converted by using changes in health policy. To process big data sets consisting of public speeches, NLP-ISA combines sentiment evaluation with present day herbal language processing algorithms. This technique analyzes public temper to show worries approximately the change in guidelines, gratification, and potential challenges that want interest when it comes to it. This paper helps policymakers to improve carrier conveyance by demonstrating real-time outcomes that their regulations create. It could screen public response in the direction of new hints while ascertaining trends in opinion among contributors of the public. The efficiency will confirm if NLP-ISA is effective or now not through simulation analysis.This process includes comparing previous polls on health care deliveries with the results from previous polls concerning past improvements made on health policies. By simulating the effect of public opinion on policy outcomes, this simulation will show how well NLP-ISA can formulate evidence-based suggestions for policy changes.

Lung cancer mortality trends and disparities: A cross-sectional analysis 1999–2020

BackgroundLung cancer remains a leading cause of morbidity and mortality in the United States. Given the importance of epidemiological insight on lung cancer outcomes as the foundation for targeted interventions, we aimed to examine lung cancer death trends in the United States in the recent 22-year period, exploring demographic disparities and yearly mortality shifts. MethodsMortality information was obtained from the CDC Wide-ranging Online Data for Epidemiologic Research database from the years 1999–2020. Demographic information included age, sex, race or ethnicity, and area of residence. We performed log-linear regression models to assess temporal mortality shifts and calculated average annual percentage change (AAPC) and compared age-adjusted mortality rates (AAMR) across demographic subpopulations. ResultsA total of 3,380,830 lung cancer deaths were identified. The AAMR decreased from 55.4 in 1999-31.8 in 2020 (p<0.001). Males (AAMR 57.6) and non-Hispanic (NH) (AAMR 47.5) populations were disproportionately impacted compared to females (AAMR 36.0) and Hispanic (AAMR 19.1) populations, respectively. NH Black populations had the highest AAMR (48.5) despite an overall reduction in lung cancer deaths (AAPC −3.3 %) over the study period. Although non-metropolitan regions were affected by higher mortality rates, the annual decrease in mortality among metropolitan regions (AAPC −2.8 %, p<0.001) was greater compared to non-metropolitan regions (AAPC −1.7 %, p<0.001). Individuals living in the Western US (AAPC −3.4 %, p<0.001) experienced the greatest decline in lung cancer mortality compared to other US census regions. ConclusionsOur findings revealed lung cancer mortality inequalities in the US. By contextualizing these mortality shifts, we provide a larger framework of data-driven initiatives for societal and health policy changes for improving access to care, minimizing healthcare inequalities, and improving outcomes.

Impact of health policy changes on population health

Recent health policy changes have had a profound impact on population health, reflecting diverse approaches and outcomes across different regions. The affordable care act (ACA) in the United States expanded healthcare coverage, improving access to preventive services and chronic disease management. Despite these advancements, disparities in health outcomes persist, particularly among minority and low-income populations. In Europe, universal healthcare systems like those in Germany and the Netherlands have achieved near-universal coverage and high public satisfaction. However, socioeconomic inequalities continue to influence health outcomes, necessitating policies that address broader social determinants of health. Low- and middle-income countries (LMICs) have implemented universal health coverage (UHC) initiatives, such as Thailand's UHC scheme and Rwanda's community-based health insurance. These reforms have led to significant improvements in maternal and child health, reduced out-of-pocket expenditures, and increased healthcare utilization among the poor. However, disparities between urban and rural populations remain a challenge, underscoring the need for comprehensive strategies that strengthen healthcare systems and infrastructure. Future directions for health policy improvement include addressing health disparities, integrating technology, and promoting preventive care. Community-based interventions and cultural competency training for healthcare providers can reduce disparities and enhance patient satisfaction. The integration of telemedicine, electronic health records, and health information exchanges can improve care coordination and access to services, although equitable access to digital health tools is essential. Emphasizing preventive care through increased funding, incentivizing providers, and raising public awareness can significantly reduce the burden of chronic diseases. Engaging patients in their healthcare decisions and promoting shared decision-making fosters a collaborative and effective healthcare environment. Policymakers must adopt comprehensive and adaptable strategies to address persistent disparities, integrate technology, and promote preventive care, ultimately leading to more equitable and effective health outcomes for diverse populations.

Somebody to Lean on: Understanding Self-Stigma and Willingness to Disclose in the Context of Addiction.

Substance use self-stigma is a barrier to treatment and can negatively impact individuals' well-being and treatment engagement. Given the mixed findings in previous research and the limited specific investigation into the concept of self-stigma within the context of opioid misuse, examining factors associated with self-stigma in the context of opioid use disorder (OUD) is warranted. The current study examines the influence of individual-level factors (race, sex, urban/rural status, support group attendance) on self-stigma and willingness to disclose opioid use. Data for this study were from a larger study of OUD-related stigma among adults in Pennsylvania, U.S. The current study included participants who indicated a personal past or current history with OUD were included (n = 84). Exploratory factor analysis and multiple indicators, multiple causes (MIMIC) model were used to explore the associations between demographic factors (i.e., sex, age, race/ethnicity, urban/rural status), attendance at mutual support groups, and self-stigma factors. Results indicated that sex and attendance at mutual support groups significantly predicted levels of self-stigma. Women and individuals with no previous experience attending mutual support groups endorsed lower levels of self-stigma. Additionally, attendance at mutual support groups predicted willingness to self-disclose past and present opioid use. Individuals who reported no history of attending mutual support groups demonstrated less willingness to disclose past and present OUD use compared to participants who were support group attendees. The current research findings enhance the understanding of OUD-related self-stigma by examining its relationship with individual-level factors, disclosure, and attendance to mutual support groups. The results offer insights into the influence of sex and support group attendance on self-stigma and disclosure. These findings have significant clinical implications for developing future interventions and promoting health policy changes.

Evolving through multiple, co-existing pressures to change: a case study of self-organization in primary care during the COVID-19 pandemic in Canada

BackgroundPrimary care is often described as slow to change. But conceptualized through complexity theory, primary care is continually changing in unpredictable, non-linear ways through self-organization processes. Self-organization has proven hard to study directly. We aimed to develop a methodology to study self-organization and describe how a primary care clinic self-organizes over time.MethodologyWe completed a virtual case study of an urban primary care clinic from May-Nov 2021, applying methodological insights from actor-network theory to examine the complexity theory concept of self-organization. We chose to focus our attention on self-organization activities that alter organizational routines. Data included fieldnotes of observed team meetings, document collection, interviews with clinic members, and notes from brief weekly discussions to detect actions to change clinical and administrative routines. Adapting schema analysis, we described changes to different organizational routines chronologically, then explored intersecting changes. We sought feedback on results from the participating clinic.FindingsRe-establishing equilibrium remained challenging well into the COVID-19 pandemic. The primary care clinic continued to self-organize in response to changing health policies, unintended consequences of earlier adaptations, staff changes, and clinical care initiatives. Physical space, technologies, external and internal policies, guidelines, and clinic members all influenced self-organization. Changing one created ripple effects, sometimes generating new, unanticipated problems. Member checking confirmed we captured most of the changes to organizational routines during the case study period.ConclusionsThrough insights from actor-network theory, applied to studying actions taken that alter organizational routines, it is possible to operationalize the theoretical construct of self-organization. Our methodology illuminates the primary care clinic as a continually changing entity with co-existing and intersecting processes of self-organization in response to varied change pressures.

Socioeconomic Disparities in Healthcare Access and Implications for All-Cause Mortality among US Adults: A 2000-2019 Record Linkage Study.

The United States (US) has witnessed a notable increase in socioeconomic disparities in all-cause mortality since 2000. While this period is marked by significant macroeconomic and health policy changes, the specific drivers of these mortality trends remain poorly understood. In this study, we assessed healthcare access variables and their association with socioeconomic status (SES)-related differences (exposure) in US all-cause mortality (outcome), since 2000. Our research drew upon cross-sectional data from the National Health Interview Survey (NHIS, 2000-2018), linked to death records from the National Death Index (NDI, 2000-2019) (n=486,257). The findings reveal that the odds of a lack of health insurance and unaffordability of needed medical care were over two-fold higher among individuals with lower education, compared to those with high education, following differential time trends. Moreover, elevated mortality risk was associated with lower education (up to 77%), uninsurance (17%), unaffordability (43%), and delayed care (12%). Uninsurance and unaffordability accounted for 4-6% of the disparities in time to mortality between low- and high-education groups. These findings were corroborated by income-based sensitivity analyses, emphasizing that inadequate healthcare access partially contributed to socioeconomic disparities in mortality. Effective policies promoting equitable healthcare access are imperative to mitigate socioeconomic disparities in mortality.

Public health policy impact evaluation: A potential use case for longitudinal monitoring of viruses in wastewater at small geographic scales

Public health policy impact evaluation is challenging to study because randomized controlled experiments are infeasible to conduct, and policy changes often coincide with non-policy events. Quasi-experiments do not use randomization and can provide useful knowledge for causal inference. Here we demonstrate how longitudinal wastewater monitoring of viruses at a small geographic scale may be used in a quasi-experimental design to evaluate the impact of COVID-19 public health policies on the spread of COVID-19 among a university population. We first evaluated the correlation between incident, reported COVID-19 cases and wastewater SARS-CoV-2 RNA concentrations and observed changes to the correlation over time, likely due to changes in testing requirements and testing options. Using a difference-in-differences approach, we then evaluated the association between university COVID-19 public health policy changes and levels of SARS-CoV-2 RNA concentrations in wastewater. We did not observe changes in SARS-CoV-2 RNA concentrations associated with most policy changes. Policy changes associated with a significant change in campus wastewater SARS-CoV-2 RNA concentrations included changes to face covering recommendations, indoor gathering bans, and routine surveillance testing requirements and availability.

Addressing Maternal Perinatal Mortality: State Responsibility in Primary Health Care in Perú

Using data from the Comprehensive Health Insurance, this study examined Primary Health Care (PHC) and disparities in maternal-perinatal health in Peru. Its primary goal was to assess how PHC affected the decline in high and persistent maternal and perinatal mortality. The investigation also encompassed regional inequities and unequal access to health services. The study used a technique that integrated a qualitative approach, a review of scientific literature, and data analysis. It made clear how crucial it is to address inequality characteristics such as sociocultural accessibility, geographic, and economic in order to enhance care in the nation. The findings demonstrate the necessity of resolving these disparities in order to improve prenatal and maternal care. The present study offers a robust basis for subsequent inquiries and the development of evidence-based health policies. The Ministerio de la Mujer y Poblaciones Vulnerables (2021) recommended changes in health policy, which this study supports in order to enhance the health of vulnerable people and reduce inequities in access to maternal-perinatal care. The study also highlights the critical necessity of PHC in Peru. Its primary contributions are to deepen our understanding of disparities in obstetric treatment and to set the stage for future studies and national health policy.

Association of characteristics of cancer, patient, and county with telemedicine services use: Impact of the waiver of reimbursement restrictions on telemedicine.

11058 Background: Telemedicine services have great potential to improve access to care of cancer patients who are vulnerable in health status and may experience financial hardship due to the cost of their care. However, very little is known about how the Centers for Medicare and Medicaid Services’ waiver of reimbursement restrictions on telemedicine and characteristics of cancer affected their use of telemedicine services. We examined the changes in frequency of telemedicine use before and after the waiver and, after the waiver, the determinants of telemedicine use across medical provider types. Methods: We used the 5% Surveillance, Epidemiology and End Results registry file linked to Medicare data among patients who had a newly diagnosed cancer in 2019 and were enrolled in Medicare Parts A and B during 2019-2020, and Area Health Resources File. Our outcomes were binary variables of telemedicine services use in outpatient (OP), office-based clinics (OB), and emergency department (ED), respectively, and for detailed provider types in OB. Primary independent variables included the ten most frequently observed cancer sites (reference: all other sites), sequence of cancer, stage of diagnosis, and quarter of diagnosis in 2019. Analysis was by a multilevel mixed effects logistic regression model, adjusting characteristics of cancer, patient and county. Results: Among eligible patients (n = 14,226), telemedicine services use for all provider types increased from 4.3% in pre-waiver period to 40.3% (5.2% in OP, 39.3% in OB, and 0.2% in ED) in post-waiver period. Telemedicine services use varied by primary cancer site, but was higher for those with a cancer recurrence (odds ratio [OR] 1.36, 95% confidence interval [CI] 1.16-1.60) and advanced cancer stage (OR 1.24, 95% CI 1.03-1.48). For visits to oncologists, cancer characteristics such as recurrence (OR 1.67, 95% CI 1.34-2.08), advanced stage (OR 5.52, 95% CI 4.12-7.40) and diagnosis in the last quarter in 2019 (OR 1.39, 95% CI 1.20-1.61) were associated with greater use of telemedicine. Patients of older age and minority race/ethnicity and in non-Northeast regions were less likely to use telemedicine, while women, patients with dual eligibility for Medicaid, and those living in a county with high median household income and high availability of hospital beds were more likely to use telemedicine. Conclusions: Cancer patients used telemedicine services more frequently after the waiver and their cancer characteristics were most strongly associated with that use, implying their greater need for, and benefit from, telemedicine. Disparities in telemedicine use related to individual and county-level socio-demographics and medical supply suggest health policy changes to improve equitable access to telemedicine and efficient cancer care planning.

Contemporary Insights into Hepatitis C Virus: A Comprehensive Review.

Hepatitis C virus (HCV) remains a significant global health challenge. Approximately 50 million people were living with chronic hepatitis C based on the World Health Organization as of 2024, contributing extensively to global morbidity and mortality. The advent and approval of several direct-acting antiviral (DAA) regimens significantly improved HCV treatment, offering potentially high rates of cure for chronic hepatitis C. However, the promising aim of eventual HCV eradication remains challenging. Key challenges include the variability in DAA access across different regions, slightly variable response rates to DAAs across diverse patient populations and HCV genotypes/subtypes, and the emergence of resistance-associated substitutions (RASs), potentially conferring resistance to DAAs. Therefore, periodic reassessment of current HCV knowledge is needed. An up-to-date review on HCV is also necessitated based on the observed shifts in HCV epidemiological trends, continuous development and approval of therapeutic strategies, and changes in public health policies. Thus, the current comprehensive review aimed to integrate the latest knowledge on the epidemiology, pathophysiology, diagnostic approaches, treatment options and preventive strategies for HCV, with a particular focus on the current challenges associated with RASs and ongoing efforts in vaccine development. This review sought to provide healthcare professionals, researchers, and policymakers with the necessary insights to address the HCV burden more effectively. We aimed to highlight the progress made in managing and preventing HCV infection and to highlight the persistent barriers challenging the prevention of HCV infection. The overarching goal was to align with global health objectives towards reducing the burden of chronic hepatitis, aiming for its eventual elimination as a public health threat by 2030.

Carbapenem-Resistant NDM and OXA-48-like Producing K. pneumoniae: From Menacing Superbug to a Mundane Bacteria; A Retrospective Study in a Romanian Tertiary Hospital.

Carbapenem-resistant Klebsiella pneumoniae (Cr-Kpn) is becoming a growing public health problem through the failure of adequate treatment. This study's objectives are to describe the sources of Cr-Kpn in our hospital over 22 months, associating factors with the outcome of Cr-Kpn-positive patients, especially those with NDM+OXA-48-like (New Delhi Metallo-β-Lactamase and oxacillinase-48), and the effectiveness of the treatments used. A retrospective observational cohort study including all hospitalized patients with Cr-Kpn isolates. We reported data as percentages and identified independent predictors for mortality over hospital time through multivariate analysis. The main type of carbapenemases identified were NDM+OXA-48-like (49.4%). The statistical analysis identified that diabetes and co-infections with the Gram-negative, non-urinary sites of infection were factors of unfavorable evolution. The Cox regression model identified factors associated with a poor outcome: ICU admission (HR of 2.38), previous medical wards transition (HR of 4.69), and carbapenemase type NDM (HR of 5.98). We did not find the superiority of an antibiotic regimen, especially in the case of NDM+OXA-48-like. The increase in the incidence of Cr-Kpn infections, especially with NDM+OXA-48-like pathogens, requires a paradigm shift in both the treatment of infected patients and the control of the spread of these pathogens, which calls for a change in public health policy regarding the use of antibiotics and the pursuit of a One Health approach.

Barriers to equitable healthcare services for under-five children in Ethiopia: a qualitative exploratory study

BackgroundDisparities in child healthcare service utilization are unacceptably high in Ethiopia. Nevertheless, little is known about underlying barriers to accessing child health services, especially among low socioeconomic subgroups and in remote areas. This study aims to identify barriers to equity in the use of child healthcare services in Ethiopia.MethodsData were obtained from 20 key- informant interviews (KII) and 6 focus group discussions (FGD) with mothers and care givers. This study was conducted in Oromia Region, Arsi Zone, Zuway Dugda District from June 1–30, 2023. The study participants for this research were selected purposively. The information was collected based on the principle of saturation after sixteen consecutives interview were conducted. Both KII and FGD were audio-recorded and complementary notes were taken to record observations about the participants’ comments and their interactions. Each interview and FGD data were transcribed word-for-word in the local Afaan Oromo and Amaharic languages and then translated to English language. Finally, the data were analyzed thematically using NVivo 14 software and narrated in the linked pattern of child health service utilization.ResultsThis study identified six major themes which emerged as barriers to healthcare utilization equity for caregivers and their -under-five children. Barriers related to equity in low level of awareness regarding need, low socioeconomic status, geographical inaccessibility, barriers related to deficient healthcare system, community perception and cultural restrictions, and barriers of equity related to political instability and conflict. The most commonly recognized barriers of equity at the community level were political instability, conflict, and a tremendous distance to a health facility. Transportation challenges, poor functional services, closure of the health facility in working hours, and lack of proper planning to address the marginalized populations were identified barriers of equity at organizational or policy level.ConclusionThis study showed that inequity in child healthcare utilization is an important challenge confronting Ethiopia. To achieve equity, policy makers and planners need to change health policy and structure to be pro-poor. It is also necessary to improve the healthcare system to increase service utilization and access for impoverished women, individuals with lower levels of education, and residents of isolated rural areas. Furthermore, context specific information pertaining to cultural barriers and political ecology are required.

World Trauma Day: An Opportunity for Change

Abstract World Trauma Day started in 2011 in New Delhi due to the high number of road traffic casualties. Poor outcomes of traumatic injuries are often caused by inefficient pre-hospital emergency response and lack of resources. The day is held on the 17th of October to raise awareness of the need for trauma care. Education is also a powerful tool. Both trauma prevention and trauma management can be taught to school-age children, the public, and health professionals. Providing the public with basic trauma care knowledge, including how to effectively administer first aid in an emergency, can save lives. The next 17th of October is, therefore, a unique opportunity to celebrate achievements in Global Trauma Care, as well as push for improvement on areas we are still lacking. It is a necessary advocacy moment to bring attention to the gap in access to safe and timely trauma care, stakeholder awareness raising and health policy change.

A tale of two exemplars: the maternal and newborn mortality transitions of two state clusters in India

BackgroundIndia’s progress in reducing maternal and newborn mortality since the 1990s has been exemplary across diverse contexts. This paper examines progress in two state clusters: higher mortality states (HMS) with...

Pregnant and postpartum women’s experiences of the indirect impacts of the COVID-19 pandemic in high-income countries: a qualitative evidence synthesis

BackgroundPregnant and postpartum women’s experiences of the COVID-19 pandemic, as well as the emotional and psychosocial impact of COVID-19 on perinatal health, has been well-documented across high-income countries. Increased anxiety and fear, isolation, as well as a disrupted pregnancy and postnatal period are widely described in many studies. The aim of this study was to explore, describe and synthesise studies that addressed the experiences of pregnant and postpartum women in high-income countries during the first two years of the pandemic.MethodsA qualitative evidence synthesis of studies relating to women’s experiences in high-income countries during the pandemic were included. Two reviewers extracted the data using a thematic synthesis approach and NVivo 20 software. The GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) was used to assess confidence in review findings.ResultsSixty-eight studies were eligible and subjected to a sampling framework to ensure data richness. In total, 36 sampled studies contributed to the development of themes, sub-themes and review findings. There were six over-arching themes: (1) dealing with public health restrictions; (2) navigating changing health policies; (3) adapting to alternative ways of receiving social support; (4) dealing with impacts on their own mental health; (5) managing the new and changing information; and (6) being resilient and optimistic. Seventeen review findings were developed under these themes with high to moderate confidence according to the GRADE-CERQual assessment.ConclusionsThe findings from this synthesis offer different strategies for practice and policy makers to better support women, babies and their families in future emergency responses. These strategies include optimising care delivery, enhancing communication, and supporting social and mental wellbeing.

Experiences and Impacts of the COVID-19 Pandemic: A Thematic Analysis

The COVID-19 pandemic prompted global public health restrictions that impacted Canadians in multiple ways. The effects of the pandemic are well examined in specific populations and in researcher-defined areas (e.g., mental health, physical activity, social connections, and financial impacts). Few studies explore the complex perspectives of adults who experienced and were impacted by the pandemic. The purpose of this study was to understand Canadian adults’ perspectives of pandemic impacts over time. Methods: A sample of 347 Canadian adults were recruited during the first six months of the COVID-19 pandemic to respond to open-ended questions about the pandemic’s impacts, administered every two weeks between April 2020 and January 2021. The responses were amalgamated into epochs, defined by dates that paralleled infection rates and public health responses in Canada. Qualitative thematic analysis identified major themes for each epoch and changes in themes over time. Results: The participants predominately reported adverse impacts of the pandemic during each epoch assessed, particularly with respect to mental health, future-oriented worry, activity restrictions, and social, and employment disruptions. Key concerns were potentially driven by changes in infection rates and public health policy changes. Conclusions: The COVID-19 pandemic impacted individuals in predominantly negative and complex ways that varied over time with public health responses. Findings from the present study may direct future pandemic responses to mitigate adverse effects to best prevent infection while preserving wellbeing.

Endemic does not mean constant as SARS-CoV-2 continues to evolve.

COVID-19 has become endemic, with dynamics that reflect the waning of immunity and re-exposure, by contrast to the epidemic phase driven by exposure in immunologically naïve populations. Endemic does not, however, mean constant. Further evolution of SARS-CoV-2, as well as changes in behavior and public health policy, continue to play a major role in the endemic load of disease and mortality. In this article, we analyze evolutionary models to explore the impact that a newly arising variant can have on the short-term and longer-term endemic load, characterizing how these impacts depend on the transmission and immunological properties of the variants. We describe how evolutionary changes in the virus will increase the endemic load most for a persistently immune-escape variant, by an intermediate amount for a more transmissible variant, and least for a transiently immune-escape variant. Balancing the tendency for evolution to favor variants that increase the endemic load, we explore the impact of vaccination strategies and non-pharmaceutical interventions that can counter these increases in the impact of disease. We end with some open questions about the future of COVID-19 as an endemic disease.

The parallel lives of pandemics: COVID‑19 and obesity.

The present article discusses the interconnectedness of coronavirus disease 2019 (COVID-19) and obesity as global health crises. The similarities between the two conditions are highlighted; these include shared risk factors and comorbidities, and the impact of obesity on the immune system. The present article also mentions the challenges faced in combating both pandemics, including misinformation and prejudice against obesity. It discusses the development of therapeutic medications and vaccines for COVID-19 and the potential of injectable incretin analogues for weight loss. Socioeconomic issues are also addressed, with obesity being more prevalent in lower socioeconomic groups and the cost of obesity treatments being a barrier for those in need. The present article emphasizes the need for comprehensive and sustainable solutions, including public health interventions, education, policy changes and equitable distribution of resources, to address both COVID-19 and obesity.

Corneal blindness in the developing world: The role of prevention strategies.

Corneal blindness is an important contributor to the burden of global blindness and has a greater prevalence in low-income countries of the developing world where resources and infrastructure are limited. The causes of corneal blindness too are different from high-income countries and include infectious keratitis, ocular trauma, and xerophthalmia. Persons with these indications tend to have unfavourable outcomes after corneal transplantation, limiting their chances of benefitting from this sight-saving procedure. However, most causes of corneal blindness in the developing world are preventable. This highlights the importance of understanding the unique challenges in these regions and the need for targeted interventions. This article discusses various prevention strategies, including primordial, primary, and secondary prevention, aimed at reducing the burden of corneal blindness in low-income countries. These include capacity building, training, and awareness campaigns to reduce the risk factors of ocular trauma, infectious keratitis, and to improve access to first aid. It is also important to promote safe eye practices and tackle nutritional deficiencies through public health interventions and policy changes. Providing the required training to general ophthalmologists in the management of basic corneal surgeries and diseases and enhancing the accessibility of eye care services in rural areas will ensure early treatment and prevent sequelae. Current treatment modalities belong to the tertiary level of prevention and are largely limited to corneal transplantation. In developing nations, there is a scarcity of donor corneal tissue necessitating an urgent expansion of eye banking services. Alternative approaches to corneal transplantation such as 3D printed corneas, cultured stem cells, and biomaterials should also be explored to meet this demand. Thus, there is a need for collaborative efforts between healthcare professionals, policymakers, and communities to implement effective prevention strategies and reduce the prevalence of corneal blindness in the developing world.

Potential consequences of the Dobbs v. Jackson Women's Health Organization decision.

In June 2022, the U.S. Supreme Court released a landmark decision in which they held that the right to abortion is not protected by the U.S. Constitution, ending almost 50 years of federally legal abortion in the United States. Because prior research demonstrates linkages between reproductive health and substance use at multiple socioecological levels, in this special section, we present studies that take a broad scope to understanding how addictive behaviors and reproduction-related behaviors, options, and access to care interrelate across a variety of contexts. In this introduction, the guest editors detail the impetus for this special section, provide a brief overview of the present studies, discuss policy and intervention implications, and suggest future research directions. The five studies presented in this special section span a wide range of populations, methods, and substance use and reproduction-related issues, including reasons for past abortions among women with opioid use disorder, alcohol effects on men's condom use resistance, considerations regarding alcohol-involved rape on implementation of "rape exceptions" to abortion bans, the role of early exposure to substance use and sexual abuse on reproductive health outcomes, and the effects of exposure to abortion-related media coverage on alcohol use intentions following the Supreme Court decision. The studies in this special section highlight the ways in which substance use and reproductive health are inextricably intertwined. Recent and future changes in reproductive health legislation and policy underscore the critical need for continued empirical inquiry into these intersecting public health concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).