Month: September 2024

Abstract

Background

The COVID-19 pandemic and response severely impacted people living with non-communicable diseases (PLWNCDs) globally. It exacerbated pre-existing health inequalities, severely disrupted access to care, and worsened clinical outcomes for PLWNCDs, who were at higher risk of morbidity and mortality from the virus. The pandemic’s effects were likely magnified in humanitarian settings, where there were pre-existing gaps in continuity of care for non-communicable diseases (NCDs). We sought to explore factors affecting implementation of NCD care in crisis settings during the COVID-19 pandemic and the adaptations made to support implementation.

Methods

Guided by the Consolidated Framework for Implementation Research, we undertook an online survey of 98 humanitarian actors from multiple regions and organization types (March-July 2021), followed by in-depth interviews with 13 purposively selected survey respondents (October-December 2021). Survey data were analysed using descriptive statistics, while interview data were analysed thematically, using both deductive and inductive approaches.

Results

Initially, humanitarian actors faced challenges influenced by external actors’ priorities, such as de-prioritisation of NCD care by governments, travel restrictions and supply chain interruptions. With each infection wave and lockdown, humanitarian actors were better able to adapt and maintain NCD services. The availability of COVID-19 vaccines was a positive turning point, especially for the risk management of people with NCDs and protection of health workers. Key findings include that, despite pre-existing challenges, humanitarian actors largely continued NCD services during the crisis. Enabling factors that supported continuity of NCD services included the ability to quickly pivot to remote means of communication with PLWNCDs, flexibility in medicine dispensing, and successful advocacy to prioritize NCD management within health systems. Key lessons learned included the importance of partnerships and cooperation with other health actors, and the mobilisation or repurposing of community health workers/volunteer networks.

Conclusions

The COVID-19 experience should prompt national and global health stakeholders to strengthen inclusion of NCDs in emergency preparedness, response, and resilience planning. Key lessons were learned around remote care provision, including adapting to NCD severity, integrating community health workers, providing context-adapted patient information, combating misinformation, and strengthening cross-sectoral partnerships.

Abstract

Due to their coastal location, mangrove ecosystems are especially susceptible to various human-caused disturbances. These disturbances can result in a loss of original mangrove cover, a decline in biodiversity, and a degradation of their ecological functions. This study examines a restored mangrove area within the Barão de Mauá Natural Municipal Park (PNMBM) in Guanabara Bay, Brazil, two decades after the initiation of a restoration project. We used a multidisciplinary approach, combining remote sensing analyses, assessment of the vegetation structure, and genetic diversity analysis to evaluate this restored mangrove forest. Remote sensing data demonstrated high Normalized Difference Vegetation Index values following the restoration project’s completion, indicating the revegetation’s success. Exploring the structure of the new forest, we found Laguncularia racemosa to be the most abundant species, with a higher density and dominance for adults and seedlings. Conversely, Avicennia schaueriana was the least abundant in all areas, indicating a need for species enrichment. Planting age affected the forest structure, suggesting the capacity of this mangrove to achieve a natural maturity state. There was a genetic erosion in L. racemosa individuals, both adults and seedlings and low diversity was observed in A. schaueriana individuals. The PNMBM mangrove forest has shown remarkable resilience in maintaining its vegetation cover after restoration despite previous deforestation cycles. Moreover, as a young mangrove forest, it will continue to go through successional stages naturally. The loss of genetic diversity could be a concern for long-term survival, highlighting the need for genetic management. Integrating remote sensing, phytosociology, and genetic diversity analyses provided a comprehensive and detailed view of the park’s restoration outcome. These results should be used as guidelines for future interventions outlined in this work and can help ensure the resilience and sustainability of any restored mangrove.

Abstract

British higher education is ranked among the best in the world, but some of its core values are under strain. Knowledge and critical thinking can be undermined by biased mind-sets, especially when engaging with the social media. Research demonstrates that false news goes viral much more quickly than true news. Political correctness and the woke movement can militate against freedom, especially in gender-related matters. Surveys show that many staff and students have a lower sense of wellbeing than the rest of the population. Conscious of these problems, the Government has responded with an Act to place extensive new obligations on certain types of online service providers, requiring them to protect their users by managing risks relating to illegal and harmful content. A separate Act has also been passed to protect freedom of speech in universities. The issue of staff and student unhappiness is much less amenable to legislation because it is so multi-faceted. However, it is a very important issue for a healthy, democratic society that fosters cooperation, trust and community. It needs to be addressed.

Abstract

Background

Research dissemination is essential to accelerate the translating of evidence into practice. Little is known about dissemination among Chinese public health researchers. This study aimed to explore the understanding and practices of disseminating research findings and to identify barriers and facilitators that influence dissemination activities to non-research audiences.

Methods

This study deployed an exploratory qualitative design with purposive and snowball sampling. One focus group with 5 participants and 12 in-depth interviews were conducted with participants working in diverse fields from universities (n = 10), the National Chinese Center for Disease Control and Prevention (n = 4), the Chinese National Cancer Center (n = 1), the Chinese National Center for Cardiovascular Disease (n = 1), and China office of a global research institute (n = 1) from May to December 2021 to reach saturation. Data were initially analyzed using inductive thematic analysis. The designing for dissemination (D4D) logic model was then used to organize themes and subthemes. Two coders independently coded all transcripts and discussed disparities to reach a consensus.

Results

Out of 17 participants, 12 misunderstood the concept of dissemination; 14 had disseminated to non-research audiences: 10 to the public, 10 to practitioners, and 9 to policymakers. We identified multiple barriers to dissemination to non-research audiences across four phases of the D4D logic model, including low priority of dissemination, limited application of D4D strategies, insufficient support from the research organizations, practice settings, and health systems, and overemphasis on academic publications.

Conclusions

There was a lack of understanding and experience of dissemination, indicating a lack of emphasis on active dissemination in China. We provide implications for raising awareness, building capacity, facilitating multidisciplinary collaboration, providing incentives and infrastructure, changing climate and culture, establishing communication and executive networks, and accelerating systematic shifts in impact focus.