scholarly journals Managing Borders During Public Health Emergencies of International Concern: A Proposed Typology of Cross-border Health Measures

2021 ◽  
Author(s):  
Kelley Lee ◽  
Karen A Grépin ◽  
Catherine Worsnop ◽  
Summer Marion ◽  
Julianne Piper ◽  
...  
Keyword(s):  
Public Health ◽  
Research Policy ◽  
Grey Literature ◽  
World Health ◽  
Border Health ◽  
Policy And Practice ◽  
Public Health Emergencies ◽  
Cross Border ◽  
Health Measures ◽  
Starting Point

Abstract BackgroundThe near universal adoption of cross-border health measures during the COVID-19 pandemic worldwide has prompted significant debate about their effectiveness and compliance with international law. The number of measures used, and the range of measures applied, have far exceeded previous public health emergencies of international concern. However, efforts to advance research, policy and practice to support their effective use has been hindered by a lack of clear and consistent definition. ResultsBased on a review of existing datasets for cross-border health measures, such as the Oxford Coronavirus Government Response Tracker and World Health Organization Public Health and Social Measures, along with analysis of secondary and grey literature, we propose six categories to define measures more clearly and consistently – type of movement (travel and trade), policy goal, level of jurisdiction, use by public versus private sector, stage of journey, and degree of restrictiveness. These categories are then be brought together into a proposed typology that can support research with generalizable findings and comparative analyses across jurisdictions. The typology facilitates evidence-informed decision-making which takes account of policy complexity including trade-offs and externalities. Finally, the typology can support efforts to strengthen coordinated global responses to outbreaks and inform future efforts to revise the WHO International Health Regulations (2005). ConclusionsThe widespread use of cross-border health measures during the COVID-19 pandemic has prompted significant reflection on available evidence, previous practice and existing legal frameworks. The typology put forth in this paper aims to provide a starting point for strengthening research, policy and practice.

scholarly journals Managing borders during public health emergencies of international concern: a proposed typology of cross-border health measures

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Kelley Lee ◽  
Karen A. Grépin ◽  
Catherine Worsnop ◽  
Summer Marion ◽  
Julianne Piper ◽  
...  
Keyword(s):  
Public Health ◽  
Research Policy ◽  
Grey Literature ◽  
World Health ◽  
Border Health ◽  
Policy And Practice ◽  
Public Health Emergencies ◽  
Cross Border ◽  
Health Measures ◽  
Starting Point

Abstract Background The near universal adoption of cross-border health measures during the COVID-19 pandemic worldwide has prompted significant debate about their effectiveness and compliance with international law. The number of measures used, and the range of measures applied, have far exceeded previous public health emergencies of international concern. However, efforts to advance research, policy and practice to support their effective use has been hindered by a lack of clear and consistent definition. Results Based on a review of existing datasets for cross-border health measures, such as the Oxford Coronavirus Government Response Tracker and World Health Organization Public Health and Social Measures, along with analysis of secondary and grey literature, we propose six categories to define measures more clearly and consistently – policy goal, type of movement (travel and trade), adopted by public or private sector, level of jurisdiction applied, stage of journey, and degree of restrictiveness. These categories are then brought together into a proposed typology that can support research with generalizable findings and comparative analyses across jurisdictions. Addressing the current gaps in evidence about travel measures, including how different jurisdictions apply such measures with varying effects, in turn, enhances the potential for evidence-informed decision-making based on fuller understanding of policy trade-offs and externalities. Finally, through the adoption of standardized terminology and creation of an agreed evidentiary base recognized across jurisdictions, the typology can support efforts to strengthen coordinated global responses to outbreaks and inform future efforts to revise the WHO International Health Regulations (2005). Conclusions The widespread use of cross-border health measures during the COVID-19 pandemic has prompted significant reflection on available evidence, previous practice and existing legal frameworks. The typology put forth in this paper aims to provide a starting point for strengthening research, policy and practice.

scholarly journals The impact of COVID-19 on the care of people living with noncommunicable diseases in low- and middle-income countries: an online survey of physicians and pharmacists in nine countries

2021 ◽  
Vol 22 ◽  
Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Online Survey ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Measures ◽  
The Impact ◽  
Low And Middle Income

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.

scholarly journals “No Entry into New South Wales”: COVID-19 and the Historic and Contemporary Trajectories of the Effects of Border Closures on an Australian Cross-Border Community

Land ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 610
Author(s):  
Dirk H. R. Spennemann
Keyword(s):  
Public Health ◽  
Economic Impact ◽  
New South ◽  
Community Integration ◽  
New South Wales ◽  
The State ◽  
Cross Border ◽  
Health Measures ◽  
Border Community ◽  
South Wales

Given its intensity, rapid spread, geographic reach and multiple waves of infections, the COVID-19 pandemic of 2020/21 became a major global disruptor with a truly cross-sectoral impact, surpassing even the 1918/19 influenza epidemic. Public health measures designed to contain the spread of the disease saw the cessation of international travel as well as the establishment of border closures between and within countries. The social and economic impact was considerable. This paper examines the effects of the public health measures of “ring-fencing” and of prolonged closures of the state border between New South Wales and Victoria (Australia), placing the events of 2020/21 into the context of the historic and contemporary trajectories of the border between the two states. It shows that while border closures as public-health measures had occurred in the past, their social and economic impact had been comparatively negligible due to low cross-border community integration. Concerted efforts since the mid-1970s have led to effective and close integration of employment and services, with over a quarter of the resident population of the two border towns commuting daily across the state lines. As a result, border closures and state-based lockdown directives caused significant social disruption and considerable economic cost to families and the community as a whole. One of the lessons of the 2020/21 pandemic will be to either re-evaluate the wisdom of a close social and economic integration of border communities, which would be a backwards step, or to future-proof these communities by developing strategies, effectively public health management plans, to avoid a repeat when the next pandemic strikes.

scholarly journals Dementia Care under COVID-19 and Infectious Disease Pandemic Restrictions

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 941-942
Author(s):  
Kelly Bradbury ◽  
Elaine Moody ◽  
Katie Aubrecht ◽  
Meaghan Sim ◽  
Melissa Rothfus
Keyword(s):  
Public Health ◽  
Health Equity ◽  
Assessment Tool ◽  
Grey Literature ◽  
Limited Information ◽  
Public Health Emergencies ◽  
People With Dementia ◽  
English Articles ◽  
Emergency Measures ◽  
Dementia Services

Abstract Emergency measures including social distancing and program restrictions during COVID-19 has reduced supports for people living with dementia and family/friend caregivers in the community. Consequently, these reductions in dementia services and resources have added to existing challenges and (in)equities for this stigmatized population. The objectives of this study were to identify how community-based resources and services for people with dementia and their caregivers are impacted by public health emergency measures enacted during COVID-19 and other infectious pandemics and secondly, use an intersectional health equity perspective to explore how supports for people and families living with dementia are affected by social determinants of health. A scoping review using JBI methodology was conducted. Academic databases searched included Embase, Medline, CINAHL and PAIS. Grey literature was searched using the CADTH tool. English articles published after 2000 in high-income countries were included. Data was extracted by two reviewers using an adaptation of the Health Equity Impact Assessment tool to explore factors related to health equity. Findings included articles discussing the COVID-19 pandemic (N=15). Most alterations to dementia services included switching to telehealth platforms with some advantages/disadvantages of this method discussed. Limited information on how different populations experienced service changes was identified and more research is needed to address issues of (in)equities for people living with dementia and their caregivers during public health emergencies. Information on how health emergency responses affects dementia services and their users will provide important information on resources for current and future efforts to analyze and assess their impacts.

scholarly journals Taking action on violence through research, policy, and practice

2021 ◽  
Author(s):  
Ilene Hyman ◽  
Mandana Vahabi ◽  
Annette Bailey ◽  
Sejal Patel ◽  
Sepali Guruge ◽  
...  
Keyword(s):  
Public Health ◽  
Social Norms ◽  
Violence Prevention ◽  
Community Violence ◽  
Thematic Analysis ◽  
Research Policy ◽  
Structural Violence ◽  
Gender Based Violence ◽  
Policy And Practice ◽  
Gender Based

Background Violence is a critical public health problem associated with compromised health and social suffering that are preventable. The Centre for Global Health and Health Equity organized a forum in 2014 to identify: (1) priority issues related to violence affecting different population groups in Canada, and (2) strategies to take action on priority issues to reduce violence-related health inequities in Canada. In this paper, we present findings from the roundtable discussions held at the Forum, offer insights on the socio-political implications of these findings, and provide recommendations for action to reduce violence through research, policy and practice. Methods Over 60 academic researchers, health and social service agency staff, community advocates and graduate students attended the daylong Forum, which included presentations on structural violence, community violence, gender-based violence, and violence against marginalized groups. Detailed notes taken at the roundtables were analyzed by the first author using a thematic analysis technique. Findings The thematic analysis identified four thematic areas: 1) structural violence perpetuates interpersonal violence - the historical, social, political and economic marginalization that contributes to personal and community violence. 2) social norms of gender-based violence—the role of dominant social norms in perpetuating the practice of violence, especially towards women, children and older adults; 3) violence prevention and mitigation programs—the need for policy and programming to address violence at the individual/interpersonal, community, and societal levels; and 4) research gaps—the need for comprehensive research evidence made up of systematic reviews, community-based intervention and evaluation of implementation research to identify effective programming to address violence. Conclusions The proceedings from the Global Health and Health Equity Forum underscored the importance of recognizing violence as a public health issue that requires immediate and meaningful communal and structural investment to break its historic cycles. Based on our thematic analysis and literature review, four recommendations are offered: (1) Support and adopt policies to prevent or reduce structural violence; (2) Adopt multi-pronged strategies to transform dominant social norms associated with violence; (3) Establish standards and ensure adequate funding for violence prevention programs and services; and (4) Fund higher level ecological research on violence prevention and mitigation.

scholarly journals The Stellenbosch Consensus on Legal National Responses to Public Health Risks

2020 ◽  
pp. 1-68
Author(s):  
Roojin Habibi ◽  
Steven J. Hoffman ◽  
Gian Luca Burci ◽  
Thana Cristina de Campos ◽  
Danwood Chirwa ◽  
...  
Keyword(s):  
Public Health ◽  
Global Health ◽  
International Health ◽  
World Health ◽  
Vienna Convention ◽  
Health Security ◽  
Public Health Emergencies ◽  
The Face ◽  
Health Organization ◽  
Health Regulations

Abstract The International Health Regulations (ihr), of which the World Health Organization is custodian, govern how countries collectively promote global health security, including prevention, detection, and response to global health emergencies such as the ongoing covid-19 pandemic. Countries are permitted to exercise their sovereignty in taking additional health measures to respond to such emergencies if these measures adhere to Article 43 of this legally binding instrument. Overbroad measures taken during recent public health emergencies of international concern, however, reveal that the provision remains inadequately understood. A shared understanding of the measures legally permitted by Article 43 is a necessary step in ensuring the fulfillment of obligations, and fostering global solidarity and resilience in the face of future pandemics. In this consensus statement, public international law scholars specializing in global health consider the legal meaning of Article 43 using the interpretive framework of the Vienna Convention on the Law of Treaties.

scholarly journals Bridging the gap between research, policy, and practice: Lessons learned from academic–public partnerships in the CTSA network

2020 ◽  
Vol 4 (3) ◽  
pp. 201-208 ◽  
Author(s):  
Amytis Towfighi ◽  
Allison Zumberge Orechwa ◽  
Tomás J. Aragón ◽  
Marc Atkins ◽  
Arleen F. Brown ◽  
...  
Keyword(s):  
Public Health ◽  
Population Health ◽  
Research Policy ◽  
Care Delivery ◽  
Lessons Learned ◽  
Dissemination And Implementation ◽  
Policy And Practice ◽  
Sustainable Infrastructure ◽  
Dissemination And Implementation Science ◽  
Competing Priorities

AbstractA primary barrier to translation of clinical research discoveries into care delivery and population health is the lack of sustainable infrastructure bringing researchers, policymakers, practitioners, and communities together to reduce silos in knowledge and action. As National Institutes of Healthʼs (NIH) mechanism to advance translational research, Clinical and Translational Science Award (CTSA) awardees are uniquely positioned to bridge this gap. Delivering on this promise requires sustained collaboration and alignment between research institutions and public health and healthcare programs and services. We describe the collaboration of seven CTSA hubs with city, county, and state healthcare and public health organizations striving to realize this vision together. Partnership representatives convened monthly to identify key components, common and unique themes, and barriers in academic–public collaborations. All partnerships aligned the activities of the CTSA programs with the needs of the city/county/state partners, by sharing resources, responding to real-time policy questions and training needs, promoting best practices, and advancing community-engaged research, and dissemination and implementation science to narrow the knowledge-to-practice gap. Barriers included competing priorities, differing timelines, bureaucratic hurdles, and unstable funding. Academic–public health/health system partnerships represent a unique and underutilized model with potential to enhance community and population health.

scholarly journals Making evidence and policy in public health emergencies: lessons from COVID-19 for adaptive evidence-making and intervention

2020 ◽  
Vol 16 (3) ◽  
pp. 477-490 ◽  
Author(s):  
Kari Lancaster ◽  
Tim Rhodes ◽  
Marsha Rosengarten
Keyword(s):  
Public Health ◽  
Rapid Assessment ◽  
Social Practices ◽  
Knowledge Generation ◽  
Evidence Based ◽  
Multiple Forms ◽  
Policy And Practice ◽  
Public Health Emergencies ◽  
Key Points ◽  
Speed Up

Background:In public health emergencies, evidence, intervention, decisions and translation proceed simultaneously, in greatly compressed timeframes, with knowledge and advice constantly in flux. Idealised approaches to evidence-based policy and practice are ill equipped to deal with the uncertainties arising in evolving situations of need. Key points for discussion:There is much to learn from rapid assessment and outbreak science approaches. These emphasise methodological pluralism, adaptive knowledge generation, intervention pragmatism, and an understanding of health and intervention as situated in their practices of implementation. The unprecedented challenges of novel viral outbreaks like COVID-19 do not simply require us to speed up existing evidence-based approaches, but necessitate new ways of thinking about how a more emergent and adaptive evidence-making might be done. The COVID-19 pandemic requires us to appraise critically what constitutes ‘evidence-enough’ for iterative rapid decisions in-the-now. There are important lessons for how evidence and intervention co-emerge in social practices, and for how evidence-making and intervening proceeds through dialogue incorporating multiple forms of evidence and expertise. Conclusions and implications:Rather than treating adaptive evidence-making and decision making as a break from the routine, we argue that this should be a defining feature of an ‘evidence-making intervention’ approach to health.

scholarly journals PRESIDENTIAL SYMPOSIUM: EDUCATION NETWORKS: STRENGTHENING GERONTOLOGY AND GERIATRICS THROUGH CONNECTIVITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S421-S422
Author(s):  
Judith L Howe ◽  
Kathryn Hyer
Keyword(s):  
Graduate Education ◽  
International Organizations ◽  
Research Policy ◽  
Scientific Meeting ◽  
World Health ◽  
Policy And Practice ◽  
The Third ◽  
The World ◽  
Competency Based ◽  
Health Organization

Abstract The AGHE Presidential Symposium, related to the theme of the annual scientific meeting, underscores the importance of networks, collaborations and partnerships in advancing education in gerontology and geriatrics. AGHE has been at the forefront of many innovative programs since it was founded in 1974, contributing to the growth of the field and the recognition of education as one pillar of the field of gerontology and geriatrics, along with research, policy and practice. This symposium highlights three ongoing initiatives that promote connections and collaborations. The first paper discusses the Age-Friendly University (AFU) network which is made of institutions around the globe who have committed themselves to becoming more age-friendly in their programs and policies. AGHE endorses the AFU principles and invites its members and affiliates to call upon their institutions become part of this pioneering initiative. The AFU initiative is one of several international activities that AGHE, global leaders in education on aging, has engaged in. The second paper describes international networking activities such as collaborations with international organizations including the World Health Organization and connecting international and US students. In the third paper, initiatives to connect disciplines and professions through competency-based education and curricula are discussed. For instance, the Gerontology Competencies for Undergraduate and Graduate Education and the Program of Merit promote competency-based gerontology education across disciplines and professions.

The Use of Palliative Sedation to Treat Existential Suffering: A Scoping Review on Practices, Ethical Considerations, and Guidelines

2019 ◽  
Vol 35 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Allysa L. Ciancio ◽  
Raza M. Mirza ◽  
Amy A. Ciancio ◽  
Christopher A. Klinger
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Research Policy ◽  
Grey Literature ◽  
Palliative Sedation ◽  
Ethical Considerations ◽  
Policy And Practice ◽  
Refractory Symptoms ◽  
Existential Suffering ◽  
The Impact

Context: Though palliative sedation has been recognized as an acceptable practice in Canada for many years now, there is a lack of clinical research and guidelines pertaining to its use as a treatment of existential refractory symptoms in the terminally ill. Objectives: This scoping review aimed to survey the literature surrounding palliative sedation and existential suffering and to inform research, policy, and practice. Methods: To address the main research question: Is palliative sedation an acceptable intervention to treat existential refractory symptoms in adults aged 65 and older? a scoping review following Arksey and O’Malley’s framework was performed, spanning electronic databases of the peer reviewed and grey literature. Articles were screened for inclusion, and a thematic content analysis allowed for a summary of key findings. Results: Out of 427 search results, 71 full text articles were obtained, 20 of which were included. Out of these articles, four themes were identified as key findings. These included: (1) Ethical considerations; (2) The role of the health care provider; looking specifically at the impact on nurses; (3) The need for multidisciplinary care teams; and (4) Existential suffering’s connection to religiosity and spirituality. Conclusion: Palliative sedation to treat existential refractory symptoms was labelled a controversial practice. A shortage of evidence-based resources limits the current literature’s ability to inform policy and clinical practice. There is a need for both qualitative and quantitative multi-center research so health care professionals and regional-level institutions have firm roots to establish proper policy and practice.

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