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During the first year of the global COVID-19 pandemic, Ghana’s creative arts communities captured its complex facets through various art forms. In Chapter 8, I focus on how these spontaneous artistic responses afforded the opportunity to examine in real time how grassroots arts and bottom-up social responses to health crises influenced health communication. Artists channelled ‘creative practices of the imagination’ regarding COVID-19, highlighting a mutually constitutive relationship between lay responses to the pandemic and what artists produced. The COVID arts they produced functioned in three arts and health domains: health education and knowledge production, disease prevention, and (indirectly) contributing to COVID-19 policy development. These intersecting functions converged on the science, culture and politics of COVID-19. I outline the subtle and radical ways artists translated the science, culture and politics of the COVID-19 pandemic to Ghanaian communities at home and abroad. I reflect on the insights these new art forms present for health communication during the COVID-19 pandemic and beyond.
How did populist governments handle the COVID-19 pandemic? Did they act as erratic, irrational and unsound – in short: ‘populist’ – as observers expected them to do? Through which social policies did they respond to the hardships caused by the pandemic? And, what does populist governance explain about these governments’ social policies? This article explores these questions through a comparative analysis of a diverse set of six populist governments. We first conceptualize, operationalize and measure populist governance by constructing a novel Populist Governance Index. Second, we describe and measure governments’ welfare policies through a novel Social Policy Response Index. Third, we relate social policy responses to variations in populist governance across countries. Our mixed-method study suggests that populism explains the politics rather than the policies of populist governments. We conclude that this is the case because populism fundamentally defines a mode of governance rather than policy content
To date, no research has explored the impact of the COVID-19 pandemic on psychotropic prescription patterns among young people in Japan, where lockdown measures were relatively less stringent.
Aims
This study aimed to investigate changes in the prescription patterns of psychotropic medications for Japanese young people before and after the COVID-19 pandemic, using the DeSC Database.
Method
We conducted an interrupted time-series analysis, with data from February 2016 to November 2022, to assess the pandemic’s effects on psychotropic prescriptions for children, adolescents and young adults. The analysis included subgroups based on age (6–11, 12–17 and 18–22 years) and gender. The number of patients prescribed psychiatric drugs before and after the pandemic was analysed.
Results
Among 93 385 individuals, psychotropic prescriptions – except anxiolytics – increased overall, although not uniformly across age and gender groups. Significant upward trends were observed in the prescription rates of antidepressants (from 2.53 (95% CI 2.21–2.84) to 6.47 (95% CI 5.89–7.05) patients per month), anxiolytics (from −1.83 (95% CI −2.52 to −1.13) to 7.37 (95% CI 6.06–8.67) per month) and hypnotics/sedatives (from −1.48 (95% CI 0.73–2.24) to 6.62 (95% CI 5.21–8.03) per month).
Conclusions
A persistent increase in psychotropic medication prescriptions was observed after the COVID-19 pandemic. Given the influence of age and gender, clinicians and society must prioritise the mental health needs of the female and adolescent populations. These findings may be generalisable to other countries that implemented less stringent lockdown measures.
The COVID-19 pandemic has placed unprecedented strain on global health systems, significantly affecting both the physical and emotional well-being of populations. Nursing students represent a particularly vulnerable group due to the pandemic’s impact on their mental health and academic progression. This study aims to assess the level of resilience among Spanish university nursing students during the pandemic.
Method
A longitudinal study was conducted with 361 nursing students from March to October 2020. Self-report questionnaires measured emotional intelligence, resilience, anxiety, depression, optimism, and self-efficacy during the first and second COVID-19 waves. Analyses included descriptive statistics, Spearman’s correlations, and hierarchical multiple regression.
Results
Resilience slightly decreased from March to October 2020, while anxiety increased and depression remained stable. Resilience was positively correlated with optimism, self-efficacy, and emotional intelligence, particularly emotion regulation. Higher resilience was predicted by not living alone, greater optimism, and stronger emotion regulation skills.
Conclusions
Spanish nursing students showed variable resilience during COVID-19, positively associated with optimism, self-efficacy, emotional intelligence, and mental health factors like anxiety and depression. Findings highlight the psychological impact of the pandemic and support resilience-focused interventions in nursing education.
Ethnic inequalities in compulsory psychiatric hospital detentions are well-documented in the UK and internationally. It is unknown how UK coronavirus disease 2019 (COVID-19) lockdown measures, which led to restrictions in public movement, gatherings, in-person health service delivery and changes to police powers, further impacted inequalities.
Aims
In this study, we assessed whether national lockdown measures impacted ethnic inequalities in voluntary and compulsory psychiatric hospital admissions during the COVID-19 pandemic.
Method
Daily counts of admissions and detentions to psychiatric hospitals were extracted from a large population-level sample of secondary mental health service users in South East London. Changes during two COVID-19 lockdown periods, over 2020–2021, were compared with pre-pandemic periods (2016–2019) with the use of a regression discontinuity in time design to assess ethnic inequalities in voluntary and compulsory mental health admissions.
Results
Compared to the pre-pandemic reference (2016–2019), after adjusting for seasonal and weekly trends, overall admissions to mental health units dropped during the first COVID-19 lockdown (incidence rate ratio (IRR) 0.87 (95% CI: 0.75–1.00)), but compulsory detentions rose (IRR 1.25 (1.05–1.54)). This was mostly due to higher compulsory detentions in the Black Caribbean group (IRR 1.54 (1.08–2.19)). During the second COVID-19 lockdown, whereas total daily admissions remained similar to the pre-pandemic reference (IRR 1.03 (0.92–1.15)), total new daily detentions was elevated (IRR 1.28 (1.11–1.49)), specifically in Black Caribbean (IRR 1.53 (1.14–2.06)) and Black African (IRR 1.57 (1.06–2.34)) groups.
Conclusions
COVID-19 lockdown measures exacerbated pre-existing ethnic inequalities in compulsory psychiatric detention, particularly for those from Black Caribbean and Black African backgrounds. There is a need to address ethnic inequalities in compulsory psychiatric detentions and attend to exacerbations of pre-existing inequalities during health emergencies like the COVID-19 pandemic. This cannot be achieved without addressing systemic racism within criminal justice and healthcare systems and tackling inequalities in wider social and economic determinants of mental health.
This chapter discusses possible interpretations for the failure of COVID-19 tracking apps during the pandemic in the Western world in the context of digitalisation. It revisits the impact of digitalisation in public law and examines specific norms governing the right to health. The chapter explores key barriers, including privacy concerns, technological limitations, and public distrust, that contributed to the inefficacy of these digital tools. By analysing these challenges, the study identifies lessons for future digital health policies, emphasising the need for transparent governance, legal safeguards, and public engagement. It argues that human rights law must evolve to better balance privacy with public health objectives, ensuring digital technologies enhance rather than undermine fundamental rights.
The right to education is a human right recognised by a number of international legal instruments and the civilised world. Agreement about the language used as the medium of instruction, however, is not so easily achieved – should it be available only in the official language or should it also be provided in minority languages? Is there a right or even a duty to learn the official language? There have been recent developments in international law clarifying this issue, and problems were also identified during the COVID-19 pandemic. There is abundant research that the COVID-19 pandemic had more negative effects on ethnic and national minorities than on the majority population, including in the field of education. Facilitation of access to education was ensured mostly in the official language, while students studying in minority languages were left behind.
This chapter examines the evolution of China’s innovation system over the past thirty-five years, detailing how government policies, R&D investment, and strategic international engagement have spurred a remarkable surge in patent activity and technological advancement. It outlines the transition from a weak, planned economy to one where domestic enterprises dominate innovation, emphasizing the shift from quantity-focused utility model patents to an increasing quality of invention patents. The analysis highlights the role of FDI and regional dynamics in boosting local innovation while comparing domestic and foreign patenting trends. Key external challenges are discussed, including the impacts of the Belt and Road Initiative, the Sino-US trade war and technology decoupling, and the disruptions caused by the COVID-19 pandemic. Looking forward, the chapter proposes future directions in sectors such as electric vehicle batteries, semiconductors, and digital startups, stressing that achieving sustained independent innovation will require enhanced basic research, collaborative international efforts, and a move beyond reliance on government policy alone.
Quick and accurate forecasts of incidence and mortality trends for the near future are particularly useful for the immediate allocation of available public health resources, as well as for understanding the long-term course of the pandemic. The surveillance data used for predictions, however, may come with some reporting delays. Consequently, auxiliary data sources that are available immediately can provide valuable additional information for recent time periods for which surveillance data have not yet become fully available. In this work, a set of Google search queries by individual users related to COVID-19 incidence and mortality is collected and analyzed. The information from these queries aims to improve quick forecasts. Initially, the identified search query keywords were ranked according to their predictive abilities with reported incidence and mortality. After that, the ARIMA, Prophet, and XGBoost models were fitted to generate forecasts using only the available reported incidence and mortality (baseline model) or together with combinations of searched keywords identified based on their predictive abilities (predictors model). In summary, the inclusion of top-ranked keywords as predictors significantly enhanced prediction accuracy for the majority of scenarios in the range from 50% to 90% across all considered models and is recommended for future use. The inclusion of low-ranked keywords did not provide such an improvement. In general, the ranking of predictors and the corresponding forecast improvements were more pronounced for incidence, while the results were less pronounced for mortality.
This chapter discusses the broader role and impact of analytics science in improving various aspects of society. It introduces what the book is about, and what the reader should expect to learn from reading this book. It also discusses the analytics revolution in the private and public sector, and introduces a key element of the book — insight-driven problem solving — by highlighting its vital role in addressing various societal problems.
Global public health is now seen as a security issue by many nations across the globe. Aside from naturally occurring outbreaks of infectious disease, deliberate attacks involving biological agents have emerged as a major security concern and a source of public anxiety in recent decades. Though many public health and security experts now recognize that effective prevention and response to these threats depend on building resilient public health systems around the world and international cooperation in maintaining them, it is unclear that the kind of sustained political will and economic resources exist to address such a massive undertaking that would need to take a holistic approach to human security and incorporate measures addressing: poverty; food insecurity; environmental degradation; lack of access to basic health-care services; adequate education; housing; sanitation and clean water; as well as more conventional aspects of security.
The right to life is the preeminent human right - without it, all other rights are nugatory. Yet, the scope of the protection afforded by the right is contested, particularly the extent to which States are obligated to protect life. This chapter examines the protection which the common law and the ECHR affords to the right to life, noting that under the common law, the courts have tended towards a recognition of the value or sanctity of life, as distinct from a right to life. In contrast, Article 2 ECHR very clearly enshrines a right to life and imposes obligations on States to ensure its protection. There is a considerable corpus of case law concerning the scope of the right in Article 2 including a number of cases from UK courts which centre on the jurisdictional reach of the right and its enforceability under the Human Rights Act 1998. This chapter considers the protective potential of the right to life in specific contexts including in response to climate change and domestic abuse. A separate chapter examines specific issues surrounding STATE regulation of the beginning and end of life.
This chapter examines the likelihood of voluntary compliance in public health contexts, with emphasis on lessons learned during COVID-19 regarding trust in mask wearing, social distancing, and vaccine uptake.
Community health centers (CHCs) and those most burdened by disease are important partners in setting research agendas to address the needs of people who are medically underserved.
Objectives:
Identify and prioritize health equity-focused research priorities using a collaborative approach to community engagement of key informants.
Methods:
We used five stepwise phases from January 2021 to February 2023 to formulate and prioritize a set of health equity-focused research topics among CHC staff (leaders, clinicians), their key advisors (patients and community members), and researchers from academic medical centers in California. Phases included: (1) community advisory board formation, (2) key informant identification, (3) individual/small group interview guide development and administration, (4) initial health equity-focused topic categorization, and (5) in-person meeting with community advisors for final topic prioritization using nominal group technique.
Results:
Twenty individual or small group interviews were completed with 44 diverse participants, along with engagement from our community advisory board, which resulted in an initial list of 11 health equity-focused research topics. Ninety advisors including diverse community members, CHC staff/leaders, and researchers prioritized six overarching research topics. Final prioritized health-equity focused research topics include addressing mental health challenges, improving public’s trust in healthcare and science, healthcare delivery models to increase access and utilization, build and sustain an anti-racist healthcare system, strategies and interventions to address health misinformation, and continuing and sustaining polices based on lessons learned from COVID-19.
Conclusions:
Results offer future direction for community-engaged research agendas to advance health equity among medically underserved and vulnerable patient populations.
The chapter demonstrates how religious freedom and robust pluralism can be catalysts for social healing – benefiting individuals and communities, building social capital, and encouraging solidarity. The chapter concludes with four case studies of bridging religious divides to achieve positive change, address injustice, reach compromise, and overcome adversity.
During times of crisis, such as the COVID-19 pandemic, policymakers and the public reveal a strong preference for fairness in pricing even when that would reduce efficiency. For example, they support the application of price gouging laws that prevent prices for necessities from skyrocketing but probably also dampen incentives for firms to produce more and alleviate the shortage. More generally, a growing body of research reveals that consumers have a strong preference for fairness over wealth maximization. This suggests that in making price policy, governments should abandon neoclassical economics and its wealth maximization criterion in favor of an approach that treats fairness in pricing as a first principle and paramount value. The chapter considers the implications of this "neo-Kantian" approach to price policy for antitrust law and policy in particular.
Who do we blame when bad things happen? Has division in American society made us less sympathetic to victims of tragedies? In previous trying times (e.g., 9/11 and Columbine), Americans rallied together to support victims and seek government solutions. In a highly polarized era, however, we have witnessed further division rather than unity. In this paper, I leverage original, pre-registered survey experiments to examine how much Americans blame and sympathize with someone who has tragically died from COVID-19. The studies find consistent evidence that partisans blame victims who hold an anti-vaccine perspective, regardless of partisanship. Less consistent evidence suggests that Democrats also blame victims who were Republican, but less than they do victims who held anti-vaccination views. Further, partisans are less sympathetic when the victim was anti-vaccine, but Democrats and Republicans are also less sympathetic when the person who died was an outpartisan. These results indicate that animosity towards outpartisans persists even through tragedy, but demonstrates limits to affective partisan polarization paired with evidence of rational blame and sympathy responses.
Alors que la constitutionnalité de la Loi sur la laïcité de l’État était contestée devant la Cour supérieure du Québec, détournant les regards pour les orienter vers la question du port de symboles religieux dans la fonction publique, se jouait un autre enjeu de laïcité sur un terrain inattendu. Les politiques gouvernementales de gestion de la pandémie de COVID-19 allaient en effet mettre à l’épreuve deux principes aux fondements de la laïcité québécoise – la séparation des Églises et de l’État ; la liberté de conscience et de religion –, sans que ces atteintes ne soient diagnostiquées comme telles. Cet article se penche sur cet impensé des débats récents sur la laïcité québécoise à partir d’un rappel de ses fondements historico-juridiques, puis d’une analyse des effets du dispositif juridique mis en place pour lutter contre la COVID-19 sur l’autonomisation de l’État à l’égard du religieux et la liberté de conscience et de religion.
The COVID-19 pandemic exacerbated psychological distress, but limited information is available on the shifts in mental health symptoms and their associated factors across different stages. This study was conducted to more reliably estimate shifts in mental health impacts and to identify factors associated with symptoms at different pandemic stages.
Methods
We performed a national repeated cross-sectional study at stable (2021), recurrence (2022), and end-of-emergency (2023) stages based on representative general national population with extensive geographic coverage. Anxiety, depression, post-traumatic stress disorder (PTSD) and insomnia symptoms were evaluated by GAD-7, PHQ-9, IES-R and ISI scales, respectively, and their associated factors were identified via multivariable linear regression.
Results
Generally, 42,000 individuals were recruited, and 36,218, 36,097 and 36,306 eligible participants were included at each stage. The prevalence of anxiety, depression and insomnia symptoms increased from 13.7–16.4% at stable to 17.3–22.2% at recurrence and decreased to 14.5–18.6% at end of emergency, while PTSD symptom continuously increased from 5.1% to 7.6% and 9.2%, respectively (all significant, P < 0.001). Common factors associated with mental health symptoms across all stages included centralized quarantine, frontline work and residence in initially widely infected areas. Centralized quarantine was linked to anxiety, depression, PTSD and insomnia during the stable, recurrence and end-of-emergency stages. Frontline workers exhibited higher risks of anxiety, depression and insomnia throughout these stages. Individuals in initially widely infected areas were more likely to experience depression and PTSD, particularly during the stable and recurrence stages. Stage-specific risk factors were also identified. Lack of outdoor activity was associated with anxiety, depression and insomnia during the stable and recurrence stages. Residents in high-risk areas during the recurrence stage correlated with increased anxiety and insomnia. Suspected infection was tied to anxiety and insomnia in the recurrence and end-of-emergency stages, while the death of family or friends was linked to PTSD during recurrence and to depression, PTSD and insomnia at the end-of-emergency stage.
Conclusions
Mental health symptoms increased when pandemic recurred, and could remain after end-of-emergency, requiring prolonged interventions. Several key factors associated with mental symptoms and their variations were identified at different pandemic stages, suggesting different at-risk populations.
To evaluate the hospital-level impact of the COVID-19 pandemic on U.S. academic medical centers (AMCs) and assess regional variation in care delivery to inform public health emergency preparedness strategies.
Methods
We retrospectively analyzed adult inpatient discharges from 106 AMCs using Vizient® Clinical Data Base from October 2019 to December 2023. The study period was divided into pre-COVID (Oct 2019-Mar 2020), early-COVID (Apr 2020-Dec 2020), late-COVD (Jan 2021-May 2023), and post-COVID (Jun-Dec 2023). Outcomes included hospital encounters, length of stay (LOS), ICU admissions, ICU LOS, mortality, and case mix index (CMI). Mixed models assessed temporal and regional variation.
Results
Among 13.5 million discharges, monthly encounters declined during early COVID and rebounded post-COVID (P < 0.0001). Observed LOS increased from 6.2 to 6.7 days during the pandemic and remained elevated post-COVID (P < 0.0001). ICU LOS rose during early and late COVID (P < 0.0001), while ICU admission rates declined slightly over time (P = 0.0112). Mortality peaked at 3.4% during early COVID and returned to 2.8% post-COVID (P < 0.0001).
Conclusions
The COVID-19 pandemic significantly disrupted inpatient operations at U.S. AMCs, with increased LOS, ICU burden, and case complexity. By segmenting the pandemic into phases, we identified patterns in hospital performance that reflect evolving public health challenges.