BACKGROUND: Telehealth is a healthcare delivery platform that allows for clinicians to deliver care via the phone or computer. The public health restrictions associated with the Covid-19 pandemic have shown how telehealth could be used as a platform to deliver care. With state-wide stay at home orders and the associated suspension of elective medical procedures telehealth rose as an option to deliver care to patients. Prior authors described that telehealth usage increased at the start of the pandemic and then decreased once the reopening processes in several states commenced in the May to June period. Although these studies have provided valuable information regarding telehealth, many of these did not look beyond the June time frame. In addition, the implications from the range of telehealth policies remain largely unexplored. OBJECTIVE: We sought to assess policies and other drivers of telehealth use. In order to achieve this, we described the change in telehealth usage over the year of 2020, identified potential drivers of increased telehealth usage at the patient and policy level, and explored the heterogeneity of state policies. METHODS: We performed a retrospective cohort study of 417,963 de-identified individuals with healthcare visits between December 2019 to December 2020. This data was extracted from HealthJump, which contains Electronic Health Record data sourced from participating members of its network. Visits were labeled telehealth by using CPT billing codes. We explored national and state-level trends in telehealth use, as well as patient-level drivers such as demographics, medical diagnoses, and Covid-19 status. RESULTS: Telehealth usage increased at the onset of the pandemic across the nation, different age groups, and various health diagnoses. The relaxation of state policies led to a decrease in telehealth usage across the nation and individual states but was higher than pre-pandemic conditions. Telehealth was used more by those with conditions deemed “at-high-risk” for Covid-19 as well as medical specialties that were more feasible for the virtual platform. Patients who were Covid-19 positive used telehealth more in the latter part of the year. Patients who were 65 and older did use telehealth, even though it was at a lower volume than the other age group (under 65). CONCLUSION: The Covid-19 pandemic has shown how telehealth can be an effective alternative to in-person visits for medical needs that are elective or non-life-threatening. Although telehealth may not be used in the same capacity as it was during Covid-19, the results show that people are willing to use it and that looking into the future Telehealth can be implemented into the healthcare system.

The study investigates the impact of Covid-19 on employment in Sweden, it focuses on how men and women have been affected during the pandemic. Despite Sweden being one of the top countries in terms of gender equality, we want to see if the effects of the crisis differ for each of them, and to help us with our research we will go through different industries in the Swedish labor market to examine the impact on men and female workers in those industries during the pandemic.The results show that Female workers in Sweden have been more negatively impacted during COVID-19 than men, also we find out that the employment situation of men and women may also have different effects within the same industry

Objectives: To evaluate associations between public health measure adherence and changes in alcohol consumption and binge drinking during the COVID-19 pandemic and identify potential modifiers of these associations. Methods: A longitudinal study was conducted using the Canadian Longitudinal Study on Aging Baseline, Follow-Up 1, and COVID-19 Questionnaires (N=23,615). Multinomial logistic regression was used to examine associations between public health measure adherence (including self-quarantine, public gathering attendance, leaving home, mask-wearing, and handwashing) and 1) self-reported alcohol consumption changes during the first year of the pandemic 2) prospectively measured alcohol consumption changes from 2015-2018 to early pandemic (2020), and 3) prospectively measured changes in binge drinking events from 2015-2018 to early pandemic. Models were adjusted for sex, age, education, marital status, region, income, immigration status, and racial background. Results: During the first year of the pandemic, 13% (N=2,733) of participants self-reported increased alcohol use, while 13% (N=2,921) reported decreased use. Prospective measures suggested 19% (N=4,421) increased and 35% (N=7,971) decreased use, while 13% (N=1,427) increased and 18% (N=1,953) decreased binge drinking events. Compared to low public health measure adherence, high adherence was not associated with self-reported changes in alcohol use, with prospectively measured increased alcohol use, or with prospectively measured changes in binge drinking. However, high adherence was associated with higher odds of prospectively measured decreased alcohol use (aOR=1.17; 95% CI=1.05, 1.29). Conclusion: Higher public health measure adherence during the COVID-19 pandemic was not associated with increased alcohol use, suggesting that adherence did not negatively impact alcohol consumption. Findings may inform public health interventions throughout future pandemics. / Thesis / Master of Public Health (MPH)

Bakgrund: Covid-19 är det senaste coronavirus som upptäckts, de tidigare varianterna är SARS och MERS alla tre virus leder till svår luftvägsinfektion. Covid-19 var det största utbrottet av coronavirusfamiljen och ledde till en pandemi. I en vårdrelation ska patienten kunna känna en gemenskap med sjuksköterskan och medverka i sin egen vård. Patienter uttryckte bland annat oro över brist på kunskap om sjukdomen covid-19 samt att sjuksköterskors visat distans gentemot dem. Syfte: Syftet var att skapa en översikt över sjuksköterskors erfarenheter av att vårda patienter som har insjuknat i Covid-19. Metod: En allmän litteraturöversikt med totalt 14 kvalitativa och kvantitativa artiklar som analyserats. Resultat: Resultatet presenteras under tre kategorier: ''Brist på kunskap'' ''Den egna rädslans inverkan'' ''Skyddsutrustningens inverkan''. Det framkom att olika faktorer påverkade sjuksköterskors arbete för att ge den vård som bör ges till patienter som vårdades på sjukhusen. Detta innefattade faktorer som fysisk press, andfåddhet, rädsla för sjukdomen, rädsla för att smitta andra, oro för felagerande, brist på vetenskaplig information om viruset. Slutsats: Klara riktlinjer och vidare forskning krävs för att ha beredskap inför framtida hälsorisker för att erbjuda en god och säker vård. Ledningen bör i framtiden erbjuda utbildningar samt information för att förbereda sjuksköterskor inför framtida utmaningar.

Inledning: Världen förändrades när covid-19 pandemin bröt ut. På bara några dagar förändrades sjukvården drastiskt med nya arbetssätt och rutiner som sjukvårdspersonal behövde anpassa sig till. Diagnostisering med hjälp av röntgenundersökningar spelade en stor roll i vården av patienter med covid-19. Det innebar att röntgensjuksköterskor fick ställa om sitt arbetssätt och fick mer akuta patienter som behövde genomgå röntgenundersökningar. Syfte: Syftet med studien var att beskriva röntgensjuksköterskors upplevelser av att arbeta under covid-19 pandemin. Metod: Författarna har gjort en litteraturstudie med kvalitativ innehållsanalys. Nio artiklar analyserades med manifest ansats. Resultat: Litteraturstudien visade att röntgensjuksköterskor kände rädsla och oro över viruset. De upplevde frustration och maktlöshet gällande otydliga instruktioner om skyddsutrustning och arbetsrutiner, samt att de inte kunde utföra en personcentrerad vård. Ökad arbetsbelastning medförde att röntgensjuksköterskor beordrades längre arbetspass. Till följd av detta upplevde flera röntgensjuksköterskor stress och ångest. Röntgensjuksköterskor upplevde att de inte ansågs vara en del av frontlinjen, trots att de dagligen hade ett patientnära arbete med covidsjuka patienter. Slutsats: Röntgensjuksköterskorna har haft en viktig del i diagnostiseringen av covidsjuka patienter. Olika faktorer har gemensamt påverkat röntgensjuksköterskors upplevelser av sin arbetssituation under pandemin. För att värna om röntgensjuksköterskans arbetsförhållanden inför framtida pandemier bör en bättre beredskap implementeras.

<p>As in many other aspects of society, the COVID-19 pandemic imposed a stress test on the entire healthcare system. Hospitals faced complex challenges, including making adaptations to each unit's specific characteristics and needs. Inpatient psychiatric units differ substantially from other hospital units, creating unique problems and considerations to safely manage patients, families, and healthcare staff during a pandemic. As research is done to improve our infrastructure for future pandemics, facilities with psychiatric units have unique design considerations. This thesis aims to examine the effects of the COVID-19 pandemic on the workflow of a psychiatric unit and its possible implications on future design requirements. Specifically, looking at transitions, i.e., what areas remained unchanged, what changes were made but have not persisted, and those that persisted, and what needs to be improved to better function in the next pandemic. The methodology used in this study included an examination of current design requirements and specifications and the workflow in a facility of this type. To maintain the facility's and staff's privacy, the specific unit is identified as Unit-A. A construction firm provided access to drawings, and engineers were interviewed to elucidate specific design/performance requirements. The methodology also included interviews of nurses and administrative staff actively engaged within Unit-A throughout the pandemic. A workflow was established based on the information collected before and during the pandemic. An analysis of the interviews and the workflow revealed: (i) the highest demands were placed on the direct-care staff, and (ii) policies implemented by the hospital without special consideration for the psychiatric unit caused unintended strain on the workflow. These significant findings suggest that each hospital should have a unique pandemic plan to accommodate their respective units. Obtaining more input from those directly impacted will improve the resiliency of the workflow. These findings also suggest that design specifications need to more effectively incorporate the needs of the professional staff, such as including a larger number of spaces for the healthcare staff in the hospital compared to current standards </p>

Introduktion/Bakgrund: Covid-19 upptäcktes i Kina, klassificerades som pandemi våren 2021. Ett halvår senare hade närmare sex miljoner människor avlidit. Hälso-och sjukvården har varit belastad. Medicinska och icke-medicinska åtgärder behövde implementeras och prioriteras för att förhindra smitta och minimera spridningen. Sjuksköterskan var mest involverad vid vårdandet av patienter. Arbetsuppgifter och arbetsmiljön har påverkats under pandemin. Syfte: Syftet var att belysa sjuksköterskans upplevelser av att vårda patienter under covid-19 pandemin. Metod: Litteraturstudien utformades efter Polit &amp; Beck (2021) nio steg för systematiskt utförande. Cinahl och PubMed var relevanta databaser utefter litteraturstudiens syfte, de är inriktade på forskning inom omvårdnad och medicin. Kvalitetsgranskning utfördes utefter Polit &amp; Beck (2021) granskningsmall där 10 kvalitativa artiklar kvarstod. Databearbetningen utfördes utifrån induktiv förhållningssätt och analyserades tematiskt. Resultat: Fem teman utformades, dessa var: ”att bli känslomässigt berörd”, ”att ställas inför nya utmaningar”, ”att förhålla sig till och bära skyddsutrustning i kliniskt arbete”, ”att uppleva ökad arbetsbelastning ” och ”att uppleva stigmatisering”. Slutsats: Majoriteten av sjuksköterskor hade identiska upplevelser i kliniskt arbete under covid-19 pandemin. Emotionella känslor som oro, rädsla och ångest kunde identifieras. Effekterna av skyddsutrustningen som fanns att tillgå orsakade fysiska besvär, förändrad arbetsmiljö och försämrad vårdkvalitet.

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This thesis examines the impact of the COVID-19 pandemic on individual gambling behavior by testing whether ticket sales and revenues in the multi-state parimutuel PowerBall and MegaMillions lotteries decreased or increased between the pre-COVID and COVID periods in Florida, Texas, and Colorado. Two competing hypotheses are investigated. First, gambling activity may have decreased during COVID either due to increased risk-aversion induced by the pandemic, negative changes in household income from the loss of employment, or a combination of the two. Second, gambling activity may have increased during COVID either due to increased willingness to take risks, substitution of income previously spent on other recreational activities to consumption of gambling products, or a combination of the two. To test these hypotheses, I use linear regression methods to model sales of tickets and revenues over the period from May 2016 to March 2022. My findings reveal that ticket sales decreased across all three states and PowerBall revenues declined significantly in Florida during the COVID period. Additionally, the mean marginal effects of the lagged amount of the jackpot and the unemployment rate differ significantly between the periods.