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The COVID-19 pandemic and lockdowns had a significant impact on mental well-being and (mental) healthcare systems globally.
Aims
To describe trends and dynamics of out-patient prescribing of psychotropic medications during the COVID-19 pandemic in The Netherlands.
Method
Dispensed psychotropic medication prescriptions during the COVID-19 pandemic from March 2020 to March 2022 were retrieved from national registry data. Numbers of total and incident dispensed prescriptions and defined daily doses (DDDs) were identified for six medication groups. Overall pandemic-related changes in prescribing trends were analysed using interrupted time-series analyses. Lockdown-related prescribing dynamics were described using monthly risk ratios.
Results
No overall pandemic-related changes in prescribing were detected, except for alcohol addiction medication, for which a pre-pandemic decline in total dispensed prescriptions and DDDs levelled off during the pandemic: +10 prescriptions per week (95% CI 7–11, P ≤ 0.001) and +111 DDDs per week (95% CI 56–165, P = 0.001). Monthly prescribing dynamics showed transient increases in all medication groups during the second and third lockdown periods. There were decreases in dispensed incident antidepressant and opioid addiction medication prescriptions during the first lockdown (average risk ratios: 0.87 and 0.88 respectively), and DDDs of dispensed incident and total attention-deficit hyperactivity disorder medication prescriptions and incident benzodiazepine prescriptions were elevated from the end of the second lockdown (average risk ratios: 1.40, 1.12 and 1.17, respectively).
Conclusions
These findings raise concerns regarding possible over- and under-prescribing during the pandemic. Further understanding of specific factors driving these changes is necessary to help prepare for future mental health(care) challenges.
Internationally, the home is legally protected as a bastion of private life, where one may retreat to and recollect oneself after a day’s work and enjoy family life. With the outbreak of the Covid-19 pandemic, working from home – facilitated by new collaborative information and communications technology (ICT) platforms and tools – became mandatory in several countries. For many, the workplace was brought into the home. This article examines how working from home on a mandatory basis during the pandemic affected employees’ perceptions and practices of privacy, and its implications for the legal understanding of privacy. With Norway as a case, it investigates the measures taken by employees and employers to safeguard privacy during this period. The data collection and method combine an interpretation of legal sources with qualitative interviews. The analysis shows experiences and practices that suggest a blurring of roles and physical spaces, and the adoption of boundary-setting measures to safeguard privacy.
This conversation addresses the impact of artificial intelligence and sustainability aspects on corporate governance. The speakers explore how technological innovation and sustainability concerns will change the way companies and financial institutions are managed, controlled and regulated. By way of background, the discussion considers the past and recent history of crises, including financial crises and the more recent COVID-19 pandemic. Particular attention is given to the field of auditing, investigating the changing role of internal and external audits. This includes a discussion of the role of regulatory authorities and how their practices will be affected by technological change. Further attention is given to artificial intelligence in the context of businesses and company law. As regards digital transformation, five issues are reflected, namely data, decentralisation, diversification, democratisation and disruption.
How do different regime types execute a security response during a pandemic? We interrogate the politics of monopolistic securitization which we argue to have significantly directed and influenced the COVID-19 policy strategies adopted in the ‘democratic’ United Kingdom (UK) and ‘authoritarian’ Thailand. Despite their stark political differences, we contend that the British and Thai states’ parallel resort to monopolistic securitization as an overarching pandemic approach effectively made them ‘functionally similar’ by producing security responses that differed only in magnitude and scale but not in kind. Integrating securitization and democratic standards violations frameworks, we find out that the British and Thai authorities’ monopolistic securitization of COVID-19 initially constrained the intersubjective process required to socially construct the pandemic as a primary existential threat endangering both countries. This significantly diminished their public audiences’ individual/agential and collective/institutional capacity to deliberate the immediate emergency measures they unilaterally deployed, particularly during the pandemic’s early stages. Consequently, whether it was in the UK with a supposedly robust democracy or in Thailand with at best a hybrid regime if not outright authoritarian, the security responses that emerged constituted varying types and degrees of violations within the illiberal-authoritarian spectrum. Nevertheless, as the pandemic progressed, the fundamental deliberative-iterative mechanism underpinning securitization enabled the British and Thai public audiences to gradually reclaim their role and space, allowing them to challenge the appropriateness and legitimacy of the existing emergency measures, thereby weakening the states’ monopolistic control over the process.
Young people with childhood adversity (CA) were at increased risk to experience mental health problems during the COVID-19 pandemic. Pre-pandemic research identified high-quality friendship support as a protective factor that can buffer against the emergence of mental health problems in young people with CA. This longitudinal study investigated friendship buffering effects on mental health symptoms before and at three timepoints during the pandemic in 102 young people (aged 16–26) with low to moderate CA. Multilevel analyses revealed a continuous increase in depression symptoms following the outbreak. Friendship quality was perceived as elevated during lockdowns and returned to pre-pandemic baseline levels during reopening. A stress-sensitizing effect of CA on social functioning was evident, as social thinning occurred following the outbreak. Bivariate latent change score modeling revealed that before and during the pandemic, young people with greater friendship quality self-reported lower depression symptoms and vice versa. Furthermore, sequential mediation analysis showed that high-quality friendships before the pandemic buffered depression symptoms during the pandemic through reducing perceived stress. These findings highlight the importance of fostering stable and supportive friendships in young people with CA and suggest that through reducing stress perceptions high-quality friendships can mitigate mental health problems during times of multidimensional stress.
This article analyses the constitutional framework regulating states of emergency in Poland and addresses key issues related to their interpretation and implementation. The first part discusses the conditions for declaring martial law, a state of an extraordinary situation, and a state of natural disaster, as well as the specific rules for the operation of public authorities in such emergencies. The next part analyses the practice, revealing the consistent reluctance of Polish authorities to invoke states of emergency, even in circumstances that seem to justify such measures. Consequently, a state of emergency under the 1997 Constitution was declared in Poland only once – in 2021, in response to a migration crisis on the border with Belarus. No constitutional emergency was declared during the COVID-19 pandemic, despite the introduction of far-reaching restrictions on individual rights and freedoms. The article argues that state authorities can abuse emergency regulations, either through their unjustified application or by deliberately circumventing them.
The COVID-19 pandemic has presented multifaceted challenges globally, impacting adolescent health. Among these, food security and nutrition are intertwined closely with mental health outcomes. In Indonesia, with its diverse socio-economic landscape, these interconnections may have been exacerbated by the pandemic. This study investigated the relationship between food security, nutrition and adolescent mental health in Indonesia during COVID-19. Longitudinal data were collected from 511 adolescent boys and girls in 2021–2022 in Gunungkidul district, Yogyakarta. Food security was measured using the Household Food Insecurity Access Scale (HFIAS), and the validated Kessler-10 Psychological Distress Scale (K10) was used to measure adolescent depression. Multivariate linear regression and linear mixed-effects regression were employed to explore associations between these variables, while adjusting for sex, age, pubertal status and household income. Overall, food insecurity score was positively associated with depressive symptoms (β: 0·72, 95 % CI 0·52, 0·92), while BMI z-score was inversely associated (β: −0·31, 95 % CI 0·68, −0·03). We found an increase in strength of association between food insecurity and depressive symptoms over time (moderately food-insecure: β: 1·36 (95 % CI −0·10, 2·83) to 4·63 (95 % CI 2·17, 7·09); severely food-insecure: β: 1·89 (95 % CI 0·36, 3·41) to 3·30 (95 % CI 1·50, 5·10). Enhancing food access, improving nutritional status and providing mental health support are crucial components of adolescent health.
Determining whether the incidence of suicidal behavior during the COVID-19 pandemic changed for those with severe mental disorders is essential to ensure the provision of suicide preventive initiatives in the case of future health crises.
Methods
Using population-based registers, quarterly cohorts from the first quarter of 2018 (2018Q1) to 2021Q4 were formed including all Swedish-residents >10 years old. Interrupted time series and generalized estimating equations analyses were used to evaluate changes in Incidence Rates (IR) of specialised healthcare use for suicide attempt and death by suicide per 10 000 person-years for individuals with or without specific severe mental disorders (SMDs) during, compared to before the pandemic.
Results
The IR (95% Confidence interval, CI) of suicide in individuals with SMDs decreased from 16.0 (15.0–17.1) in 2018Q1 to 11.6 (10.8–12.5) in 2020Q1 (i.e. the quarter before the start of the pandemic), after which it dropped further to 6.7 (6.3–7.2) in 2021Q2. In contrast, IRs of suicide attempt in SMDs showed more stable trends, as did the trends regarding suicide and suicide attempt for individuals without SMD. These discrepancies were most evident for individuals with substance use disorder and ASD/ADHD. Changes in IRs of suicide v. suicide attempt for one quarter during the pandemic for substance misuse were 11.2% v. 3.6% respectively. These changes for ASD/ADHD were 10.7% v. 3.6%.
Conclusions
The study shows pronounced decreases in suicide rates in individuals with SMDs during the pandemic. Further studies aiming to understand mechanisms behind these trends are warranted to consult future suicide prevention strategies.
During the global COVID-19 pandemic, many countries have expanded the level and coverage of current social insurance and social assistance programs as well as implemented new programs. Based on three separate datasets, V-Dem V-Party dataset; fourteen structured expert interviews; and a dataset of 114 social security measures, we study the link between the welfare regime, pandemic-related social policy measures, and incumbents’ ideological stand. Does the pandemic-related social policy measures mirror the political attitudes of the incumbents? What role did the welfare regime play? We scrutinise eight OECD countries (Denmark, Finland, Germany, Netherlands, Norway, Sweden, UK, and the US) representing three different welfare regimes: corporatist-conservative countries, liberal countries, and socio-democratic countries. The key findings of this article show that the pandemic-related social policy measures did not mirror the political attitudes of the incumbents.
Trade secrets raise three primary issues. First, if an entity is forced to share trade secrets to expedite development and to expand the supply of needed products, must or should the government compensate the rights holder? Although this chapter addresses this question, it is largely unnecessary to answer it. This is because compensation is not required under international law, and because reasonable compensation should normally be provided for compelled trade secret sharing. Second, does international law prohibit governments from compelling the sharing of trade secrets, including by compulsory licensing? The short answer is no. Third, what authorities currently exist or could be adopted for governments to compel the sharing of trade secrets? The chapter provides general overview of a range of existing authorities, as well as a framework for addressing the latter two questions and for understanding the complexity of the first question.
This chapter identifies three distinct reasons why China took a middle-of-the-road position in the debate on the COVID-19 TRIPS waiver at the WTO. It also recounts the country’s more assertive position in the run-up to the adoption of the Ministerial Decision on the waiver. Drawing eight lessons from the international debate on the waiver and the subsequent Ministerial Decision, the chapter offers insights into the future role China can or will play in future international policy debates at the intersection of intellectual property and public health, including during the next pandemic.
As has been the case outsideAfrica, African countries have experienced multiple consequences from the COVID-19 pandemic that extend beyond its immediate impact on human health. In Africa, much like elsewhere in the world, the pandemic has had a significant economic impact, leading to profound global economic distress. African countries have also experienced consequences that are unlike those of much of the rest of the world. For example, the pandemic has contributed to a sovereign debt crisis that led to sovereign defaults by Zambia in late 2020, Mali in early 2022, and Ghana in late 2022, and might lead to additional defaults. Travel bans and COVID-19 vaccine exclusion are key policies that have also had a particular impact in Africa. These and other COVID-19 policies in African contexts reflect patterns of exclusion that are at least in part a consequence of continuing colonial hangover.
The chapter begins with the genesis of relevant regulatory protections and their general parameters before discussing their prevalence among countries. It then turns to discussion of proposed and actual modification of TRIPS requirements for COVID and how that intersects with these regulatory barriers. The chapter concludes with recommendations.
For many years, some lawmakers, scholars, and activists have argued that firms located in each developing country (or each regional set of developing countries) should produce more of the drugs that the residents there need. They contend that local production would benefit the residents of those countries in two ways. The chapter first discusses some recent developments that have altered the relative strength of these competing considerations, sharply increasing the likelihood that fostering local production in developing countries would be socially beneficial.It then proposes five legal reforms and economic initiatives that could help build local pharmaceutical production capacity and thereby save lives.
At the outset of the COVID-19 pandemic, numerous observers recognized the potential for patents and other intellectual property (IP) rights to hinder the development and dissemination of medical equipment and products responsive to the virus. Concerns over the impact of IP rights on pandemic response led to a range of national and international governmental interventions. Yet these concerns also spurred voluntary, private action by IP rights holders. This chapter discusses and assesses these private initiatives, with a focus on the Open Covid Pledge (OCP), an initiative that the author helped to organize. The OCP eventually led to the voluntary commitment of an estimated 500,000 patents to the COVID-19 response, was endorsed by Universities Allied for Essential Medicines (UAEM) and adopted by the WHO’s Covid Technology Access Pool (C-TAP) as a recommended mechanism for making technology available in the COVID-19 response.
The COVID-19 pandemic unquestionably disrupted established norms and procedures. Climate networks in Sweden and the associated actors had to adapt to and navigate this dramatic and unpredictable situation. The chapter provides initial insights into how the pandemic affected a business network, a government-led multi-stakeholder platform and a social movement. Arguing that COVID-19 can constitute both an opportunity and a risk for non-state climate action, we investigate whether or not the pandemic created a window of opportunity for non-state actors to achieve their voluntary pledges or push the state to adopt more ambitious action, and whether or not the state has been able to mobilize non-state actors, or if it has made it harder for them for them to mobilize. Our findings indicate that thus far, the pandemic has not led to deeper changes, either in the climate debate in Sweden or in the climate work of individual actors. The members of climate networks have changed their working procedures and modified their communication strategies when it comes to climate action. However, the pandemic affected the ability of social movements to carry out their main activity, at least in the short term, that is, to go out on the streets and demonstrate.
The COVID pandemic has had deleterious effects on the mental health of the global population. Parents of children with CHD were particularly vulnerable to negative mental health outcomes such as depression, anxiety, and perceived stress. A better understanding of the CHD parent experiences, needs, and concerns while navigating the healthcare system during a pandemic is needed.
Methods:
Online survey responses from 71 parents of young children with CHD representing families across the United States of America and Canada were analysed. Qualitative data were collected one year into the COVID pandemic. Thematic analysis was used to examine responses to the open-ended question “What would you like healthcare professionals (doctors, nurses) to know about your experience of being a parent with a child with CHD during the COVID-19 pandemic?.”
Results:
Two major themes with subthemes and an umbrella theme emerged from the parents’ responses (1) Pandemic Parenting: The Emotional Toll of Hospital Visitation Restrictions, Dealing with Social Distancing, Feeling Isolated, Decision Making in Uncertainty, and Playing it Safe versus Returning to Normal and (2) Unmet Expectations of Care: Needing Information, Wanting Empathy, Requesting Respect, Questioning Care Quality, and the umbrella theme of: Our Lives were Turned Upside Down.
Conclusion:
CHD parents describe a negative impact of healthcare-related challenges during the COVID pandemic. These findings may offer insight to how healthcare professionals can better support the mental health and care burden of CHD parents during future pandemics.
The concurrent challenges of the COVID-19 pandemic and a significant earthquake in Izmir on October 30, 2020, presented a unique scenario for disaster management and response. This study focuses on the impact of the earthquake, which resulted in 117 fatalities, including 1 due to drowning, and injured 1034 individuals, alongside widespread structural damage including to the Izmir Democracy University Buca Seyfi Demirsoy Training and Research Hospital. The objective is to assess the activation and implementation of the hospital disaster plan amidst the ongoing pandemic. Through a retrospective evaluation of all actions undertaken as per the Hospital Disaster Emergency Plan within the Disaster Management cycle, this study examines the decision-making process for the hospital evacuation on October 30, 2020, the evacuation of COVID-19 patients, and the strategies employed to increase hospital capacity. Of 216 patients hospitalized at the time of the earthquake, 65 were transferred to other facilities under COVID-19 protocols. The prolonged nature of pandemics and the likelihood of secondary disasters underscore the importance of comprehensive risk assessments and dynamic disaster planning, considering simultaneous multiple hazards. This study suggests the inclusion of multi hazard scenarios and diverse evacuation methods by using types of ambulances, such as ground, helicopter, and boat.
This retrospective study provides insights on linguistic development in exceptional circumstances assessing 378 children (between 2;6 and 3;6) who lived their first years during the COVID-19 pandemic and comparing it with normative data collected before this period (CDI-III-PT; Cadime et al., 2021). It investigates the extent to which linguistic development was modulated by a complex set of factors, including sex, maternal education, book reading, language-promoting practices, COVID-19 infection, parental stress and sleeping problems, considering three periods (during lockdowns, out of lockdowns and at present). The results show a substantial negative effect of the pandemic on both lexical and syntactic development. Considering individual variation, structural equation modelling unveiled a complex scenario in which age, sex, book reading, language-promoting practices, sleeping problems and COVID-19 infection showed a direct effect on linguistic development. Maternal education and parental stress had an indirect effect on children’s language, mediated by book reading and sleeping problems, respectively.
I investigate why some countries were more successful in containing the death toll than others during the COVID-19 pandemic. I focus on the role of socialism and on the existence of long-term regime-driven legacies that may have had an impact on the containment of COVID-related deaths. I claim that countries that went through successful socialist revolutions have specific features that equip them with better resources to cope with public challenges such as pandemics. Furthermore, these features remain even after the demise of the socialist regime. I find a positive effect of socialist revolutions over COVID-19 containment at the country level. I investigate three possible causal mechanisms for this relationship: authoritarianism, state capacity, and mass mobilization. Through mediation analysis, I find the socialist legacy seems to be channeled through higher levels of mobilization and also more authoritarian institutions.