Health Crisis Research Articles

Cultivating emotional resilience in adolescent girls: Effects of a growth emotion mindset lesson.

To address the widespread mental health crisis facing adolescent girls, this study examined whether a growth emotion mindset lesson can enhance emotional competence. During 2018-2022, adolescent girls (Mage = 15.68 years; 66.3% White) were randomized to a growth mindset (E-MIND; N = 81) or brain education (control; N = 82) lesson, completed the Trier Social Stressor Test, and reported on various aspects of emotional competence. Compared with the control group, the E-MIND group reported more adaptive emotion mindsets, higher emotion regulation self-efficacy, and more proactive invivo and daily efforts to regulate emotions (effect sizes = small-to-medium to medium), with several differences remaining 4-month later. Findings provide novel insight into one promising approach for cultivating emotional resilience among adolescent girls.

‘My research agenda may never recover’: pandemic work-life demands and obstacles to career advancement for faculty mothers

ABSTRACT Historically, university systems have maintained gender inequities that facilitate promotion and advancement for Caucasian men, while creating barriers to career advancement for women and marginalised groups. Significant obstacles have existed for faculty mothers who have attempted to fulfill responsibilities as both mother and worker, particularly amid the COVID-19 global pandemic. The purpose of this study is to explore how, during the health crisis, faculty mothers perceived their experiences to impact their research productivity. Based on demographic and open-ended questionnaire data from 134 study participants in the United States, the findings suggest that as supportive duties demanded participants’ prompt attention, research was pushed to the side, resulting in perceived threats to faculty mothers’ careers. Given the value many institutions place on publications in the hiring, tenure, and promotion process, decreased or stalled publications could result in career repercussions. Specifically, participants viewed losses in research productivity as hindering job mobility for adjuncts and instructors; creating barriers to tenure and promotion for tenure-track faculty; and stalling career advancement for tenured faculty.

Increasing medication assisted treatment in rural primary care practice: a qualitative comparative analysis from IT MATTTRs Colorado

PurposeOpioid dependence and use disorders (OUDs) are serious public health crises resulting in a rising number of opioid-related deaths. Medication assisted treatment (MAT), in this case treatment with buprenorphine, is an evidence-based solution to combatting OUD; however, MAT has been largely unavailable in rural areas. This study investigated what it took to increase MAT in rural Colorado primary care practices.MethodsMixed methods study using qualitative and quantitative data collected from interviews, observations, surveys, and practice-reported data. Participants were staff members from 35 rural primary care practices in Colorado, United States. We qualitatively analyzed the data, then transformed the data, then analyzed it using qualitative comparative analysis (QCA).ResultsHaving a MAT waivered prescribing clinician on staff and a MAT system in place were necessary conditions to providing MAT (consistency = 1.0; coverage = 0.53 & 0.39 respectively). Practice size (number of providers) was associated with differences in conditions that provided sufficient aspects for MAT provision. Small (1–2 medical providers), non-private practices benefited from the presence of behavioral health and a clinician with MAT experience. Medium sized practices (3–5 providers) whether private or not benefited from behavioral health, often in combination with a clinician with MAT experience. In large practices (6 or more providers), behavioral health was not a factor while having a clinician with MAT experience mattered half of the time.ConclusionImplementation of MAT in rural primary care is a complex task that may benefit from the resources of behavioral health and a clinician with prior MAT experience.

COMPARATIVE LEGAL ANALYSIS OF TAX MEASURES TAKEN IN CRISIS CONDITIONS

The world's economic and legal systems are facing a huge challenge to overcome the negative consequences imposed by recent social distortions. In 2020, what started as a health crisis quickly turned into an economic-social problem where an express response was required to ensure the functioning of social actors. This economic-social crisis was followed in a short period by new security crises with additional consequences on national systems. The response to the newly created conditions requires a multidisciplinary approach that will include measures of a health, economic, social, and security nature, adopted on the principles of legislation and expediency within the national legal systems. These measures have their own direct or indirect tax component. The purpose of this paper is to perform a legal analysis of the tax measures taken in the national systems. The scope of the research covers the member states and candidate countries for membership in the European Union. The focus is on the more recent crisis period, with particular emphasis on the COVID-19 period. The analysis primarily focuses on the legal element of the tax measures, the procedure of their implementation, and their legal nature. Also analyzed are the challenges that they have on the taxpayers and the administrative authority for their performance. The method of comparison in the paper is used to compare the similarities and differences between the tax measures in the different national systems and to detect the legal challenges imposed by the established crisis conditions. At the end, conclusions are given about the current situation and recommendations on how the establishment of tax systems should be in the future in crisis conditions.

Examining the spread of disinformation on Facebook during the first wave of the Covid-19 pandemic: A case study in Switzerland

Abstract Disinformation poses a significant threat to democratic societies, particularly in the context of the Covid-19 health crisis. This study delves into the prevalence and nature of disinformation in social media by analyzing Facebook accounts of political actors and alternative media within the unique Swiss landscape during the first wave of the pandemic. Using standardized quantitative content analysis, we categorize posts as either accurate, reconfigured, or fabricated. Our findings reveal a disconcerting pattern: Disinformation was shared more frequently than accurate information. Notably, right-wing politicians and parties, alongside alternative media sources, emerged as the most prolific disseminators of disinformation. Digging deeper, we discovered that the predominant form of disinformation shared on social media was reconfigured disinformation, signifying manipulated or contextually distorted information. This prevalence of reconfigured disinformation on social media platforms raises pressing concerns about the public’s ability to discern fact from fiction. Moreover, our study shines a spotlight on the inadvertent or perhaps deliberate contributions of right-wing politicians and parties and alternative media sources to the propagation of disinformation. By examining this phenomenon within the Swiss context during the initial wave of the pandemic, we provide valuable insights into the dynamics of disinformation and its implications for society during crisis situations.

Marketing mental health services: a mixed-methods analysis of racially and ethnically diverse college students’ engagement with and perspectives on U.S. university mental health clinics’ websites

BackgroundThe United States (U.S.) faces a significant mental health crisis, with around 52.9 million adults experiencing mental health disorders, with young adults (18–25 years old), such as college students, having the highest prevalence and lowest service utilization rates. While efforts to expand mental health services through “push” strategies are in place (e.g., training therapists in evidence-based therapies), limited initial engagement suggests a need for “pull strategies” and targeted marketing that make services attractive to college students and increase demand. This mixed-methods study identifies U.S. university mental health clinic websites and website characteristics that are attractive and engaging to college students interested in seeking mental health services (i.e., students were considering or actively looking for mental health support).MethodsEleven U.S. university websites were chosen (10 randomly and one from the university where students were attending) from a pool of 44 Psychological Clinical Science Accreditation System training clinics websites. Fifty-seven college students (Mage = 20.95, SD = 2.97; 81% female; 68% racial/ethnic minority) were videorecorded engaging with two U.S. university mental health clinic websites, completed self-report engagement measures, and gave detailed feedback about websites through semi-structured interviews.ResultsLikert scale scores revealed moderate engagement with all websites (e.g., they were interesting and helpful). Qualitative results indicated that websites that provided important and easily understood information about key features of services (e.g., types, evidence-base, and cost), therapist backgrounds, psychoeducation, used lay language, and had an appealing website layout (e.g., color, font, images, organization, and interactive components) generated greater consumer interest and trust in their mental health services.ConclusionsThis study emphasizes the importance of using marketing strategies to enhance college students’ engagement through mental health service websites. Salient features, psychoeducation, and effective promotional strategies (e.g., how information is presented) were identified as crucial for website engagement and subsequent mental health service uptake. Using marketing strategies, such as tailoring language to consumer literacy levels, describing the evidence-base of services, and improving website design may address college students’ needs and enhance initial mental health service engagement.

Implication of Parental Engagement to the Students in Home-School Learning

Parental involvement in home-school learning also helps to strengthen the relationship, fosters greater autonomy and responsibility in children, and flexible learning experiences. This study used a descriptive-phenomenological study that divulged the context of home-school learning during the health crisis brought by COVID-19 among elementary pupils. Ten (10) Grade 4 pupils, currently enrolled in S.Y. 2021-2022 and who had been studying both before and during the pandemic, participated in the interview. Colaizzi's data analysis approach was later used to analyze the interview data. Findings indicated that elementary pupils have a variety of experiences in home-school learning and are also experiencing challenges in home-school learning. The study's findings also revealed the role of their parents during home-school learning by giving them a lot of time teaching the reading and constant follow-ups with their children. The different challenges and experiences in home-school learning were evident in the pupil's responses. Hence, the result of the study also revealed that the pupils had difficulty in reading and writing during home-school learning. Students can benefit from parental support and guidance, which can improve their motivation, attitudes, and communication skills.

Evolving Role of Coronary Collaterals in STEMI Outcomes: A Comparative Analysis of Pandemic and Post-Pandemic Phases.

Acute ST-elevation myocardial infarction (STEMI) is a critical condition where coronary collaterals can mitigate myocardial damage. The Coronavirus Disease 2019 (COVID-19) pandemic introduced unique challenges in STEMI management, potentially affecting outcomes. This study evaluates the efficacy of coronary collaterals during the pandemic compared to the post-pandemic period. A review of 1465 STEMI patients treated at a high-volume tertiary care center from April 2020 to December 2022 was conducted. Collaterals were assessed using the Rentrop classification. In-hospital mortality and 1-year major adverse cardiac events (MACE) were analyzed based on collateral status and timeframes. During the pandemic, there was a higher incidence of robust collaterals (28.2% vs 23.2%, P = .04), but they were less protective, with similar in-hospital mortality (14.4% vs 8.1%, P = .07) and 1-year MACE rates (21.9% vs 30.4%, P = .09) across groups. Post-pandemic, robust collaterals showed significant protective effects with reduced in-hospital mortality (3.6% vs 7.4%, P = .04) and 1-year MACE rates (17.1% vs 24.9%, P = .03). These findings highlight a dynamic role of collaterals in STEMI management, with the pandemic impairing their functionality. This underscores the need for adaptive STEMI care strategies, especially during global health crises.

Policy and practice review consensus statements and clinical guidelines on managing pediatric trauma and orthopedics during the COVID-19 pandemic: a systematic review on the global response for future pandemics and public health crises

IntroductionThe COVID-19 pandemic has been recognized as an unprecedented global health crisis. Over 7 million mortalities have been documented with many paediatric fatalities. Trauma and orthopaedic care, much like other specialities, were marginalized due to resource allocation during the pandemic which affected paediatric care. This is the first systematic review to centralise and compile the recommended published guidelines from professional bodies in principally English speaking countries on managing paediatric trauma and orthopaedic care. These guidelines will be required to be implemented sooner and more effectively in case of future pandemics with similar impact.MethodsA search was conducted on PubMed/MedLine, Cochrane Library and Embase using terms including p(a)ediatric or child* and/or COVID* or coronavirus or SARS-CoV-2 and/or trauma and/or orthop(a)edic* with a simplified MeSH heading [mh] in order to make the search as comprehensive as possible. General terminology was utilized to make the search as exhaustive as possible for this systematic review. Another search was conducted on resources available in the public domain from professional bodies publishing on consensus statements and clinical practice guidelines in countries where English is the principal language managing pediatric trauma and orthopedics. The review adhered to PRISMA guidance.ResultsThe search revealed a total of 62 results from both databases and professional bodies. Duplicates were removed. This was then reviewed to identify a total of 21 results which fit the inclusion criteria and included within the main analysis. The guidelines from professional bodies were outlined and categorized into aspects of clinical care.DiscussionThe impact of COVID-19 pandemic has compelled for changes in clinical practice and pediatric management. The systematic review highlights the relevant guidelines on service provision for pediatric patients including indications for urgent referrals, surgical prioritization, reasons for follow-up and trauma guidelines. The rationale for care during the unpredictable evolution of the COVID-19 pandemic may have the potential to be translated and replicated in future pandemics of similar significance.

100 Autologous Fat Transfer Procedure Complications in the Emergency Department: A Public Health Crisis

100 Autologous Fat Transfer Procedure Complications in the Emergency Department: A Public Health Crisis

Rural community pharmacists' willingness to receive, administer, and recommend COVID-19 vaccines after the First U.S. vaccine rollout

IntroductionVaccines remain the cornerstone for prevention of COVID-19. Particularly in rural areas, community pharmacists are among the most accessible healthcare professionals. Their advocacy for immunization can help overcome patients' vaccine hesitancy and close the disparity gap between rural and urban regions. This study explored factors influencing the willingness to recommend and administer COVID-19 vaccines among rural community pharmacists after the first U.S. vaccine rollout. MethodsA convenience sample of rural community pharmacists completed a selfadministered, validated paper/online survey (n = 86, 23.4 % response rate). Measures included COVID-19 vaccination status, perceived benefits of offering COVID-19 immunization services at the pharmacy, and willingness to recommend and administer COVID-19 vaccines. Descriptive, bivariate, and multivariate statistics were used to analyze potential nonresponse bias, survey responses, and associations between variables as appropriate. Alpha was set at 0.05. ResultsThe proportion of pharmacists who were vaccinated against COVID-19 was 79.1 %. Over 75 % of participants were in favor of recommending COVID-19 immunizations to eligible family members and patients and almost 85 % agreed that they would administer COVID-19 vaccines to their patients. Most pharmacists perceived COVID-19 immunization services to be beneficial, such as attracting more patients into the pharmacy (81.2 %), increasing pharmacy revenue (75.3 %), and enhancing relationships with local clinics/public health agencies (74.1 %). COVID-19 vaccination status and the perceived benefit of offering immunization services at the pharmacy were significantly associated with pharmacists' willingness to recommend and administer COVID-19 vaccines. ConclusionThe relatively high rates of COVID-19 vaccination uptake and the strong willingness of rural community pharmacists to recommend and administer COVID-19 vaccines, after the first national vaccine rollout, were encouraging. The findings underscore the importance of engaging rural community pharmacists in efforts to prepare for and respond to future pandemics and public health crises.

Evaluation of a massive open online course for just-in-time training of healthcare workers

IntroductionCOVID-19 created a global need for healthcare worker (HCW) training. Initially, mass trainings focused on public health workers and physicians working in intensive care units. However, in resource-constrained settings, nurses and general practitioners provide most patient care, typically lacking the training and equipment to manage critically ill patients. We developed a massive open online course (MOOC) for HCWs in resource-constrained settings aimed at training bedside providers caring for COVID-19 patients. We describe the development, implementation and analysis of this MOOC.MethodsFrom May through June 2020, the course was developed by a multi-disciplinary team and launched on two online platforms in July. The 4-hour course comprises 6 video-based modules. Student knowledge was assessed using pre- and post-module quizzes and final exam, while demographics and user experience were evaluated by pre- and post-course surveys and learning platform data.ResultsFrom July 17th to September 24th, 30,859 students enrolled, 18,818 started, and 7,101 completed the course. Most participants worked in healthcare (78%) and resided in lower middle- (38%) or upper middle- (20%) income countries. Learners from upper middle-income and lower middle-income countries had higher completion rates. Knowledge gains were observed from pre-module to post-module quizzes and a final exam. Afterward, participants reported increased self-efficacy regarding course objectives, a 0.63 mean increase on a 4-point scale (95% CI [0.60,0.66]). Most participants (93%) would recommend the course to others.ConclusionThis article demonstrates the potential of MOOCs to rapidly provide access to emerging medical knowledge during a public health crisis, particularly for HCWs in high- and middle-income countries.

Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul: a multifaceted time series approach.

This study investigated the impact of the COVID-19 pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from South Korea's National Health Insurance. We analyzed records of total, complicated, and uncomplicated appendicitis cases, as well as the ratio of complicated to uncomplicated appendicitis, using natural spline and piecewise regression models to identify trends and breakpoints. Bayesian structural time-series (BSTS) models were used to evaluate the causal impact of social distancing on appendicitis incidences. The spline regression analysis indicated decreasing trends in both total and uncomplicated appendicitis cases. Conversely, the incidence of complicated appendicitis and the ratio of complicated to uncomplicated cases increased. Breakpoints for a decline in uncomplicated appendicitis and a rise in the ratio occurred at 31 weeks in 2020 (95% confidence interval [CI], 23.2 to 38.8) and at 33.9 weeks (95% CI, 28.3 to 39.6), respectively. The BSTS model demonstrated a 7.8% reduction in total appendicitis cases (95% credible interval [CrI], -12.0% to -3.3%). It also showed a 17% decrease in uncomplicated cases (95% CrI, -22% to -12%) and increases of 13% (95% CrI, 4.9% to 22.0%) in complicated cases and 39% (95% CrI, 27.0% to 53.0%) in the ratio of complicated to uncomplicated appendicitis. The COVID-19 pandemic resulted in a decrease in both total and uncomplicated appendicitis cases, while the number of complicated cases increased. Reduced medical visits likely accounted for these changes. Strategies are needed to manage changes in disease pathophysiology resulting from altered healthcare utilization during health crises.

Social Media and the Crisis of Adolescent Mental Health.

Waking up to a public health emergency.

A systematic review on social media utilization by health communicators in India: Insights from COVID-19 pandemic

Social media has become a vital tool for facilitating health communications, particularly during emerging health crises such as the COVID-19 pandemic. This systematic literature review aims to synthesize evidence regarding the benefits and barriers associated with the utilization of social media by health communicators in India for disseminating health-related information. A comprehensive search of databases like CINAHL, Google Scholar, PubMed, and WHO Global Index Medicus databases yielded a total of 13 relevant studies. The narrative analysis revealed six key benefits attributed to the usage of social media by health communicators, including the widespread adoption of social media platforms for health communications, health communicators leveraging social media as an information source, fostering the development of protective behaviors, aiding prompt and transparent health communication, promoting participatory communication and empowerment, and employing social media as a tool for monitoring public sentiments and mental well-being. Conversely, challenges such as the proliferation of misinformation and communication inequalities were identified as significant barriers in social media health communications. While social media platforms hold immense potential in advancing crisis communication agendas, health communicators are advocated to adopt a multifaceted approach by prioritizing digital inclusivity, combating misinformation, and fostering synergetic collaborations between governmental bodies and community entities.

Incorporating Complexity and System Dynamics into Economic Modelling for Mental Health Policy and Planning.

Care as usual has failed to stem the tide of mental health challenges in children and young people. Transformed models of care and prevention are required, including targeting the social determinants of mental health. Robust economic evidence is crucial to guide investment towards prioritised interventions that are effective and cost-effective to optimise health outcomes and ensure value for money. Mental healthcare and prevention exhibit the characteristics of complex dynamic systems, yet dynamic simulation modelling has to date only rarely been used to conduct economic evaluation in this area. This article proposes an integrated decision-making and planning framework for mental health that includes system dynamics modelling, cost-effectiveness analysis, and participatory model-building methods, in a circular process that is constantly reviewed and updated in a 'living model' ecosystem. We describe a case study of this approach for mental health system policy and planning that synergises the unique attributes of a system dynamics approach within the context of economic evaluation. This kind of approach can help decision makers make the most of precious, limited resources in healthcare. The application of modelling to organise and enable better responses to the youth mental health crisis offers positive benefits for individuals and their families, as well as for taxpayers.

Cooperative Intelligence Platform for Primary Health Care (Picaps): techno-scientific solutions in digital health to confront COVID-19 and other crises

The arrival of COVID-19 in Brazil had a marked impact on the health network as well as on the professionals involved, due to the significant number of cases and constantly updated information. In this context, the Cooperative Intelligence Platform for Primary Health Care - Picaps - is set up as a technological platform that assists by systematizing the communication and negotiation processes among actors, with a focus on science and technology. This article sets out to describe the processes of Picaps, which consist of a collaborative system conceived of as a public solution capable of generating innovations in the areas of Science, Technology and Health, in order to tackle COVID-19 in territories with populations in socially vulnerable situations in the Federal District (DF). It integrates data collection and processing, as well as the dissemination of information for its use, both at the governmental and societal levels. Picaps can be seen as a powerful government instrument to help societies across the country, especially those in vulnerable situations, capable of assisting in the use of cooperative intelligence in primary care and health surveillance actions to build innovative solutions such as rapid responses to face health crises in modern times.

Research on Mental Health Assessment and Intervention Methods for College Students based on Big Data Analysis

This study introduces the novel Fuzzy-Enhanced Predictive Neural System for Student Mental Health (FEPS-MH) approach to mental health assessment and intervention for college students. FEPS-MH synergistically combines a Backpropagation (BP) Neural Network with a Deep Fuzzy-Based Neural Network (DFBNN), leveraging the strengths of both systems to handle the complexities of mental health data in the context of big data analytics. The BP Neural Network, known for its effective learning and generalization capabilities, is integrated with the DFBNN to process imprecise, uncertain, or subjective data, typical in mental health assessments. The core objective of FEPS-MH is to provide a more accurate, robust, and sensitive analysis of mental health states, incorporating the nuanced variations and uncertainties inherent in psychological data. This system is designed to analyze a vast array of data sources, including but not limited to, behavioral patterns, self-reported questionnaires, and social media interactions, to identify potential mental health issues among college students. FEPS-MH’s capabilities extend beyond mere assessment; it is also equipped to recommend personalized intervention strategies. Utilizing big data analysis, the system not only predicts potential mental health crises but also suggests tailored intervention approaches based on the unique psychological profile of each student. This study demonstrates the feasibility and effectiveness of FEPS-MH through a series of tests and validations using real-world data. The results indicate a significant improvement in both the accuracy of mental health assessments and the efficacy of suggested interventions. FEPS-MH stands as a promising tool for educational institutions, offering a data-driven, sensitive, and comprehensive approach to student mental health care. Its implementation could revolutionize the field of mental health support in college environments, making it a vital asset for proactive psychological wellness in educational settings.

International monetary fund conditionality and structural reforms: Evidence from developing countries

AbstractThe global economy, dominated by the consequences of a disastrous health crisis and international tensions, needs policy support to regain its growth dynamic. To regain an inclusive and sustainable growth dynamic, structural policies of governments are needed to allow a reallocation of resources and to stimulate productivity. International cooperation seems to be necessary and the IMF's contribution could play an important role in promoting reforms. Indeed, in IMF‐supported programmes, the conditions for developing countries' transition to liberalization and open markets are often common. We address the question of whether periods of International Monetary Fund (IMF) conditionality contribute to the promotion of structural reforms in developing countries. Through the entropy balancing method and alternative identification strategies, we show that IMF conditionality programmes promote structural reforms in developing countries. We show that the effect of IMF conditionality can vary depending on the type of conditionality, the type of reform, the time frame and the initial level of structural reforms and can depend on some structural factors including the business cycle, the quality of fiscal and monetary policy, the level of development and the quality of institutions. Furthermore, we show that IMF conditionality can have spillover effects on trading partners and that IMF conditionality programmes that are met tend to have a greater impact on structural reforms. Finally, the effects of adopting reforms under IMF conditionality depend on domestic partisan politics.

Addressing Systemic Racism in Mental Health Care

Systemic racism is a public health crisis that needs to be urgently and effectively addressed. Historical racism, contemporary biases, and prejudicial attitudes have persistently affected and damaged the mental health of people of color (POC) throughout the world. Although the 2021 apology from American Psychological Association (APA) acknowledged the profession’s contribution to racism, much more work needs to be done to rectify and address past and current harm. A comprehensive, actionable, and concrete plan is needed to catalyze change. Adopting a socioecological approach can help tackle the multiple levels in which discrimination and unequal treatment take place. This necessitates more than just addressing the social determinants of illness, but also transforming the cultural competence of providers, organizations, and the mental health delivery system. Key to improving outcomes for POC domestically and abroad is increasing the affordability and access to care, diversifying and improving the cultural competence of the mental health workforce, and developing culturally adapted and effective care tailored to meet the culture-specific needs of diverse communities. Progress can only happen through proactive action and utilization of an anti-racist stance that commits significant financial and scientific resources to promote institutional, structural, systemic, and policy changes.