scholarly journals Nothing about us without us: Canadian vaccine decision making must involve disabled people

2021 ◽  
Author(s):  
Holly Witteman ◽  
Gabrielle Peters ◽  
Cassandra Vujovich-Dunn ◽  
Amine Ouertani ◽  
Sharmistha Mishra
Keyword(s):  
Decision Making ◽  
Scientific Evidence ◽  
Severe Disease ◽  
National Policy ◽  
Risk Groups ◽  
Policy Recommendations ◽  
Disabled People ◽  
Pandemic Planning ◽  
Vaccination Campaigns ◽  
Vaccine Decision Making

Across Canada, national and provincial Covid-19 vaccine prioritization guidance and strategies have failed to appropriately include people with disabilities. Since the early goal of vaccination was to reduce severity, those at higher risk of severe disease if infected were meant to be prioritized early in vaccination campaigns, directly reducing their chance of death due to Covid-19. Older adults and some other higher-risk groups were therefore accorded high priority. However, younger disabled people were not prioritized for vaccines at levels commensurate with their risk of severe Covid-19 outcomes. Consequently, Canadian national policy recommendations have been incongruent with peer countries’ vaccine prioritization, scientific evidence, and priorities expressed by Canadians regarding how we should allocate Covid-19 vaccines. To avoid repeating these mistakes, current and future pandemic planning must include disabled people as full members of decision-making committees, in keeping with the longstanding demand of disabled people: “Nothing about us without us.” (1)

scholarly journals Nursing Home and Vaccination Consent: The Italian Perspective

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 429
Author(s):  
Nunzia Cannovo ◽  
Roberto Scendoni ◽  
Marzia Maria Fede ◽  
Federico Siotto ◽  
Piergiorgio Fedeli ◽  
...  
Keyword(s):  
Decision Making ◽  
Nursing Home ◽  
Informed Consent ◽  
General Principle ◽  
Scientific Evidence ◽  
Herd Immunity ◽  
Healthcare Services ◽  
Decision Making Processes ◽  
Vaccination Campaigns ◽  
To Receive

Since the beginning of the Covid-19 pandemic, many countries have begun vaccination campaigns, with different methods and timelines, with the goal of vaccinating over 75% of the population and thus achieving herd immunity. Initially it was necessary to identity the categories of citizens who should be the first to receive the vaccines, on the basis of scientific evidence. On the basis of this information, elderly residents in nursing homes and the staff who care for them should be the highest priority subjects for vaccination. In this context, obtaining informed consent to Covid-19 vaccination presents a considerable challenge, as the advanced age and frequent comorbidities of a significant number of the residents may mean that they are incapable of expressing consent themselves. The legislation of various Western nations substantially agrees on the general principle that those capable of judgement must be asked for their consent for healthcare services, and that even those with psychological weaknesses that limit their full ability to decide must be involved in these decision-making processes. The article can help systematize the processes to be implemented to protect the health of individuals as members of a close and fragile community.

scholarly journals High risk groups for severe COVID-19 in a whole of population cohort in Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bette Liu ◽  
Paula Spokes ◽  
Wenqiang He ◽  
John Kaldor
Keyword(s):  
Socioeconomic Status ◽  
New South ◽  
Severe Disease ◽  
Risk Groups ◽  
Prevention Strategies ◽  
Complete Case ◽  
Relative Risks ◽  
South Wales ◽  
Hazard Ratios

Abstract Background Increasing age is the strongest known risk factor for severe COVID-19 disease but information on other factors is more limited. Methods All cases of COVID-19 diagnosed from January–October 2020 in New South Wales Australia were followed for COVID-19-related hospitalisations, intensive care unit (ICU) admissions and deaths through record linkage. Adjusted hazard ratios (aHR) for severe COVID-19 disease, measured by hospitalisation or death, or very severe COVID-19, measured by ICU admission or death according to age, sex, socioeconomic status and co-morbidities were estimated. Results Of 4054 confirmed cases, 468 (11.5%) were classified as having severe COVID-19 and 190 (4.7%) as having very severe disease. After adjusting for sex, socioeconomic status and comorbidities, increasing age led to the greatest risk of very severe disease. Compared to those 30–39 years, the aHR for ICU or death from COVID-19 was 4.45 in those 70–79 years; 8.43 in those 80–89 years; 16.19 in those 90+ years. After age, relative risks for very severe disease associated with other factors were more moderate: males vs females aHR 1.40 (95%CI 1.04–1.88); immunosuppressive conditions vs none aHR 2.20 (1.35–3.57); diabetes vs none aHR 1.88 (1.33–2.67); chronic lung disease vs none aHR 1.68 (1.18–2.38); obesity vs not obese aHR 1.52 (1.05–2.21). More comorbidities was associated with significantly greater risk; comparing those with 3+ comorbidities to those with none, aHR 5.34 (3.15–9.04). Conclusions In a setting with high COVID-19 case ascertainment and almost complete case follow-up, we found the risk of very severe disease varies by age, sex and presence of comorbidities. This variation should be considered in targeting prevention strategies.

scholarly journals Public health decisions in the COVID-19 pandemic require more than ‘follow the science’

2021 ◽  
pp. medethics-2020-107134
Author(s):  
Thana Cristina de Campos-Rudinsky ◽  
Eduardo Undurraga
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Health Policy ◽  
Empirical Evidence ◽  
Empirical Data ◽  
Public Health Policy ◽  
Scientific Evidence ◽  
Ethical Reasoning ◽  
Reliable Data ◽  
Good Decision

Although empirical evidence may provide a much desired sense of certainty amidst a pandemic characterised by uncertainty, the vast gamut of available COVID-19 data, including misinformation, has instead increased confusion and distrust in authorities’ decisions. One key lesson we have been gradually learning from the COVID-19 pandemic is that the availability of empirical data and scientific evidence alone do not automatically lead to good decisions. Good decision-making in public health policy, this paper argues, does depend on the availability of reliable data and rigorous analyses, but depends above all on sound ethical reasoning that ascribes value and normative judgement to empirical facts.

scholarly journals Promoting Interpersonal Relationships through Elbow Tag, a Traditional Sporting Game. A Multidimensional Approach

2021 ◽  
Vol 13 (14) ◽  
pp. 7887
Author(s):  
Verónica Muñoz-Arroyave ◽  
Miguel Pic ◽  
Rafael Luchoro-Parrilla ◽  
Jorge Serna ◽  
Cristòfol Salas-Santandreu ◽  
...  
Keyword(s):  
Decision Making ◽  
Social Interactions ◽  
Interpersonal Relationships ◽  
Predictive Power ◽  
Ad Hoc ◽  
Scientific Evidence ◽  
Point Of View ◽  
Registration System ◽  
Motor Behaviors ◽  
Quasi Experimental

The aim of this research was to study from a multidimensional point of view (decisional, relational and energetic) the interpersonal relationships established by girls and boys in the traditional sport game of Elbow Tag. Scientific evidence has shown that Traditional Sport Games (TSG) trigger different effects on male and female genders in relation to emotional experiences, decision-making, conflicts and motor relationships. Despite the fact that these dimensions are intertwined, there are hardly any studies that interpret motor behaviors holistically, i.e., taking a multidimensional (360°) view of these dimensions. For this study, a quasi-experimental design was used and a type III design was applied, inspired by the observational methodology N/P/M. A total of 147 university students participated (M = 19.6, SD = 2.3): 47 girls (31.97%) and 100 boys (68.02%). A mixed ‘ad hoc’ registration system was designed with acceptable margins of data quality. Cross-tabulations, classification trees and T-patterns analysis were applied. The results indicated that social interactions between girls and boys in a mixed group were unequal. This difference was mainly due to decision-making (sub-role variable), which has much greater predictive power than the energetic variables (MV and steps).

scholarly journals Resource allocation in the Covid-19 health crisis: are Covid-19 preventive measures consistent with the Rule of Rescue?

2021 ◽  
Author(s):  
Julian W. März ◽  
Søren Holm ◽  
Michael Schlander
Keyword(s):  
Resource Allocation ◽  
Large Scale ◽  
Preventive Measures ◽  
Risk Groups ◽  
Healthcare Resources ◽  
Health Crisis ◽  
Rule Of Rescue ◽  
Post War ◽  
Vaccination Campaigns ◽  
N95 Respirators

AbstractThe Covid-19 pandemic has led to a health crisis of a scale unprecedented in post-war Europe. In response, a large amount of healthcare resources have been redirected to Covid-19 preventive measures, for instance population-wide vaccination campaigns, large-scale SARS-CoV-2 testing, and the large-scale distribution of protective equipment (e.g., N95 respirators) to high-risk groups and hospitals and nursing homes. Despite the importance of these measures in epidemiological and economic terms, health economists and medical ethicists have been relatively silent about the ethical rationales underlying the large-scale allocation of healthcare resources to these measures. The present paper seeks to encourage this debate by demonstrating how the resource allocation to Covid-19 preventive measures can be understood through the paradigm of the Rule of Rescue, without claiming that the Rule of Rescue is the sole rationale of resource allocation in the Covid-19 pandemic.

scholarly journals The problems of increasing transparency on uncertainty

2017 ◽  
Vol 27 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Magda Osman ◽  
Amanda J. Heath ◽  
Ragnar Löfstedt
Keyword(s):  
Decision Making ◽  
Disease Prevention ◽  
Prevention And Control ◽  
Scientific Evidence ◽  
European Medicines Agency ◽  
Scientific Process ◽  
The Public ◽  
And Control ◽  
Current Guidelines ◽  
Practical Implications

Public regulators (such as European Food Safety Authority, European Medicines Agency, and European Centre for Disease Prevention and Control) are placing increasing demands on scientists to make uncertainties about their evidence transparent to the public. The stated goal is utilitarian, to inform and empower the public and ensure the accountability of policy and decision-making around the use of scientific evidence. However, it is questionable what constitutes uncertainty around the evidence on any given topic, and, while the goal is laudable, we argue the drive to increase transparency on uncertainty of the scientific process specifically does more harm than good, and may not serve the interests of those intended. While highlighting some of the practical implications of making uncertainties transparent using current guidelines, the aim is to discuss what could be done to make it worthwhile for both public and scientists.

A Value Focused Thinking Approach to Decommissioning Decision Making

2021 ◽  
Author(s):  
Aaron Tung
Keyword(s):  
Decision Making ◽  
Scientific Evidence ◽  
Analysis Tool ◽  
Stakeholder Values ◽  
A Value ◽  
Value Focused Thinking ◽  
Science Theory ◽  
Past Experiences ◽  
Stakeholder Acceptance

Abstract Values are what stakeholders regard to be important to decisions (Kruglanski & Higgins 2007). How stakeholder prioritize, rank, balance, and trade-off values can have significant influence on their reasoning and evaluation of decommissioning outcomes and decisions. Stakeholder values can vary depending on various factors including religious beliefs, personal interests, and past experiences (Lechner et al., 2017). Value-focused thinking is a decision science theory developed by Keeney (1992) which builds upon the concept of varying stakeholder values. Keeney (1992) argues that the best decision is one that best reflects the actual values of stakeholders. which suggests that the acceptability of decommissioning decisions (full removal, partial removal, leave in-situ, rigs-to-reefs, etc.) by stakeholders will vary depending on the values of stakeholder in that particular context. This paper explores the idea of value-focused thinking and derive implications for decommissioning decision-making. Overall, the research finding suggests that rather than basing a decommissioning decision solely on scientific evidence, there is also a need for the decommissioning decisions to be able to reflect the actual values of stakeholders in that particular context. The criteria and weightage of the adopted multi-criteria decision analysis tool, for example, should accurately represent the actual values of stakeholders, so as to enable the tool to produce outcomes and decisions that has a higher probability of stakeholder acceptance.

Timing of Vaccine Decision-Making Among First-Time Parents

2021 ◽  
Author(s):  
J. Nathan Yarnall ◽  
Carl Seashore ◽  
Carrie A. Phillipi ◽  
Joseph E. Hatch ◽  
Beth King ◽  
...  
Keyword(s):  
Decision Making ◽  
Vaccine Decision Making ◽  
First Time

scholarly journals The PICO strategy for the research question construction and evidence search

2007 ◽  
Vol 15 (3) ◽  
pp. 508-511 ◽  
Author(s):  
Cristina Mamédio da Costa Santos ◽  
Cibele Andrucioli de Mattos Pimenta ◽  
Moacyr Roberto Cuce Nobre
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Research Question ◽  
Clinical Decision ◽  
Evidence Based ◽  
Review Of The Literature

Evidence based practice is the use of the best scientific evidence to support the clinical decision making. The identification of the best evidence requires the construction of an appropriate research question and review of the literature. This article describes the use of the PICO strategy for the construction of the research question and bibliographical search.

scholarly journals Addiction journals and the management of conflicts of interest

2016 ◽  
Vol 5 (1) ◽  
pp. 9-10 ◽  
Author(s):  
Kerstin Stenius
Keyword(s):  
Decision Making ◽  
Drug Research ◽  
Conflicts Of Interest ◽  
Scientific Evidence ◽  
Research Articles ◽  
Policy Makers ◽  
Research Findings ◽  
New Research ◽  
Political Decisions

Stenius, K. (2016). Addiction journals and the management of conflicts of interest. The International Journal Of Alcohol And Drug Research, 5(1), 9-10. doi:http://dx.doi.org/10.7895/ijadr.v5i1.233Scientific journals are crucial for a critical and open exchange of new research findings and as guardians of the quality of science. Today, as policy makers increasingly justify decision-making with references to scientific evidence, and research articles form the basis for evidence for specific measures, journals also have an indirect responsibility for how political decisions will be shaped.

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