AJPM focus最新文献

{"title":"Differences in Report of Post-COVID Conditions Among Adults Tested for SARS-CoV-2 by Race and Ethnicity: 2022 Porter Novelli SummerStyles Survey, U.S.","authors":"Leora R. Feldstein PhD, MSc ,&nbsp;Deja Edwards MPH ,&nbsp;Jennifer R. Cope MD, MPH ,&nbsp;Melissa Briggs Hagen MD, MPH ,&nbsp;Sharon Saydah PhD, MHS","doi":"10.1016/j.focus.2023.100181","DOIUrl":"10.1016/j.focus.2023.100181","url":null,"abstract":"<div><h3>Introduction</h3><p>Since March 2020, Hispanic and Black/African American persons have made up a disproportionate number of COVID-19 cases, hospitalizations, and deaths. However, little is known about whether the prevalence of postacute sequelae or post-COVID conditions differs by race/ethnicity.</p></div><div><h3>Methods</h3><p>This study used cross-sectional survey data collected by Porter Novelli Public Services to determine the prevalence of ≥1 ongoing symptom lasting ≥4 weeks by SARS-CoV-2 test status and racial/ethnic groups among 2,890 adults in the U.S.</p></div><div><h3>Results</h3><p>Overall, 57% (95% CI=54%, 60%) of respondents with positive SARS-CoV-2 tests reported ≥1 ongoing symptom, compared with 22% (95% CI=20%, 24%) of respondents who tested negative. Among those with positive SARS-CoV-2 tests, Hispanic respondents had higher AORs of experiencing ≥1 ongoing symptom (AOR=1.79, 95% CI=1.27, 2.53) than non-Hispanic White respondents. In addition, Hispanic respondents had significantly higher ORs of experiencing 2 or more ongoing symptoms (AOR=2.03, 95% CI=1.45, 2.86), respiratory/cardiac symptoms (AOR=1.47, 95% CI=1.03, 2.07), neurologic symptoms (AOR=1.77, 95% CI=1.26, 2.48), and other symptoms (AOR=1.53, 95% CI=1.09, 2.14) than non-Hispanic White respondents. Non-Hispanic other respondents who reported at least 1 positive SARS-CoV-2 test had significantly higher ORs of experiencing gastrointestinal symptoms (AOR=4.06, 95% CI=1.78, 8.89) than non-Hispanic White respondents.</p></div><div><h3>Conclusions</h3><p>These results highlight potential disparities in ongoing symptoms, even after accounting for demographic differences, and reinforce the need for culturally appropriate and targeted strategies to increase access to health care and reduce SARS-CoV-2 infections.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065423001189/pdfft?md5=6090e6757d88150a28380349955c888c&pid=1-s2.0-S2773065423001189-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139191378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insufficient Impact: Limited Implementation of Federal Regulatory Changes to Methadone and Buprenorphine Access in Arizona During COVID-19","authors":"Beth E. Meyerson PhD ,&nbsp;Keith G. Bentele PhD ,&nbsp;Benjamin R. Brady DrPh ,&nbsp;Nick Stavros MBA ,&nbsp;Danielle M. Russell PhD ,&nbsp;Arlene N. Mahoney BSW ,&nbsp;Irene Garnett MLIS ,&nbsp;Shomari Jackson ,&nbsp;Roberto C. Garcia BA ,&nbsp;Haley B. Coles MPH ,&nbsp;Brenda Granillo DrPh ,&nbsp;Gregory A. Carter PhD","doi":"10.1016/j.focus.2023.100177","DOIUrl":"10.1016/j.focus.2023.100177","url":null,"abstract":"<div><h3>Introduction</h3><p>This study examined the impact of federal regulatory changes on methadone and buprenorphine treatment during COVID-19 in Arizona.</p></div><div><h3>Methods</h3><p>A cohort study of methadone and buprenorphine providers from September 14, 2021 to April 15, 2022 measured the proportion of 6 treatment accommodations implemented at 3 time periods: before COVID-19, during Arizona's COVID-19 shutdown, and at the time of the survey completion. Accommodations included (1) telehealth, (2) telehealth buprenorphine induction, (3) increased multiday dosing, (4) license reciprocity, (5) home medications delivery, and (6) off-site dispensing. A multilevel model assessed the association of treatment setting, rurality, and treatment with accommodation implementation time.</p></div><div><h3>Results</h3><p>Over half (62.2%) of the 74-provider sample practiced in healthcare settings not primarily focused on addiction treatment, 19% practiced in methadone clinics, and 19% practiced in treatment clinics not offering methadone. Almost half (43%) were unaware of the regulatory changes allowing treatment accommodation. Telehealth was most frequently reported, increasing from 30% before COVID-19 to 80% at the time of the survey. Multiday dosing was the only accommodation substantially retracted after COVID-19 shutdown: from 41% to 23% at the time of the survey. Providers with higher patient limits were 2.5–3.2 times as likely to implement telehealth services, 4.4 times as likely to implement buprenorphine induction through telehealth, and 15.2–20.9 times as likely to implement license reciprocity as providers with lower patient limits. Providers of methadone implemented 12% more accommodations and maintained a higher average proportion of implemented accommodations during the COVID-19 shutdown period but were more likely to reduce the proportion of implemented accommodations (a 17-percentage point gap by the time of the survey).</p></div><div><h3>Conclusions</h3><p>Federal regulatory changes are not sufficient to produce a substantive or sustained impact on provider accommodations, especially in methadone medical treatment settings. Practice change interventions specific to treatment settings should be implemented and studied for their impact.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065423001141/pdfft?md5=195d1c5472cff33fd51d0825fefa446d&pid=1-s2.0-S2773065423001141-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139191212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative Lifetime Violence and Bacterial Vaginosis Infection in Sexually Transmitted Infections: Findings From a Retrospective Cohort Study Among Black Women at Risk for HIV","authors":"Yordanos Tesfai BS ,&nbsp;Marguerite B. Lucea PhD, MSN, MPH ,&nbsp;Erica Chan BS ,&nbsp;Theresa Asuquo MD ,&nbsp;Helen Zhu BS ,&nbsp;Tommi L. Gaines DrPH, MS ,&nbsp;Jacquelyn C. Campbell PhD, MSN, RN ,&nbsp;Jamila K. Stockman PhD, MPH ,&nbsp;Kiyomi Tsuyuki PhD, MPH","doi":"10.1016/j.focus.2023.100180","DOIUrl":"10.1016/j.focus.2023.100180","url":null,"abstract":"<div><h3>Introduction</h3><p>Bacterial vaginosis is the most common vaginal condition among women of reproductive age and has been associated with sexually transmitted infections. This study examines the association between cumulative lifetime violence exposure, bacterial vaginosis, and sexually transmitted infections among Black women at risk for HIV.</p></div><div><h3>Methods</h3><p>HIV-negative Black women in a retrospective cohort study (N=230) completed survey questions on cumulative violence (exposure to sexual or physical abuse before age 18 years and exposure to intimate partner violence or sexual violence [partner or other] after age 18 years and past year), bacterial vaginosis (lifetime and past year), and sexually transmitted infection diagnosis (lifetime and past year). Logistic regression models estimated the associations between cumulative violence, bacterial vaginosis, and sexually transmitted infections. Bacterial vaginosis was examined as a moderator in the association between cumulative violence and sexually transmitted infections.</p></div><div><h3>Results</h3><p>Many women reported cumulative violence exposure (40%), lifetime bacterial vaginosis diagnosis (53%), and lifetime sexually transmitted infection diagnosis (73%). Cumulative violence experience was significantly associated with increased adjusted odds of lifetime bacterial vaginosis diagnosis (AOR=1.98; 95% CI=1.10, 3.54). Lifetime bacterial vaginosis diagnosis (AOR=2.76; 95% CI=1.45, 5.22) and past-year bacterial vaginosis diagnosis (AOR=2.16; 95% CI=1.14, 4.10) were significantly associated with increased odds of lifetime sexually transmitted infection diagnosis. Lifetime bacterial vaginosis diagnosis (AOR=2.10; 95% CI=1.19, 3.70) and past-year bacterial vaginosis diagnosis (AOR=3.00; 95% CI=1.70, 5.31) were significantly associated with past-year sexually transmitted infection diagnosis. Lifetime bacterial vaginosis infection significantly increased the odds of lifetime sexually transmitted infection diagnosis with increasing cumulative violence exposure.</p></div><div><h3>Conclusions</h3><p>Our findings support educating and screening Black women who experience cumulative violence for bacterial vaginosis to reduce the risk of untreated bacterial vaginosis and sexually transmitted infections.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065423001177/pdfft?md5=764493cf254518a26495151c9649b7c5&pid=1-s2.0-S2773065423001177-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139192439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Vaccine Hesitancy in the Perinatal Period: A Survey Among Residents of Hawaii","authors":"Mary S. Tschann PhD, MPH ,&nbsp;Taylor N. Ronquillo MPH ,&nbsp;Lauren M. Sternberg BS ,&nbsp;Zarina J. Wong BA ,&nbsp;Reni Soon MD, MPH ,&nbsp;Bliss E.K. Kaneshiro MD, MPH","doi":"10.1016/j.focus.2023.100179","DOIUrl":"10.1016/j.focus.2023.100179","url":null,"abstract":"<div><h3>Introduction</h3><p>This study describes the vaccination status among people in Hawaii who are attempting pregnancy, currently pregnant, recently delivered (&lt;6 months), and/or breastfeeding and documents common concerns and information sources associated with vaccine decision making.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional online survey between April and September 2022 throughout Hawaii. The anonymous surveys were disseminated through flyers and online links posted by physician offices and community partners throughout Hawaii.</p></div><div><h3>Results</h3><p>Final analyses included 165 responses. Almost half of the respondents (<em>n</em>=75, 45%) were unvaccinated, 38% (<em>n</em>=62) were fully vaccinated, and 17% (<em>n</em>=28) were partially vaccinated. The most influential sources for vaccine decision making for vaccinated respondents were their healthcare providers (<em>n</em>=28, 45%) and official healthcare organizations (<em>n</em>=22, 36%), whereas unvaccinated respondents reported friends/family (<em>n</em>=28, 37%) and their healthcare providers (<em>n</em>=26, 35%) as their most influential sources. Top COVID-19 vaccine concerns for unvaccinated individuals were reactions to vaccine (<em>n</em>=78, 76%) and concerns for safety of the vaccine (<em>n</em>=75, 73%).</p></div><div><h3>Conclusions</h3><p>Efforts should be made to increase and expand vaccine education about the benefits and safety of vaccines during pregnancy beyond the pregnant person to create more supportive social norms for COVID-19 vaccination in the perinatal period. Consistent and unequivocal support across medical specialties, including obstetrics, pediatrics, and family medicine, is also crucial for encouraging the uptake of the vaccine during pregnancy or when breastfeeding.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065423001165/pdfft?md5=54875a9c96bed93e71c2e4d1b82e50ab&pid=1-s2.0-S2773065423001165-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139192280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Not Throw Away Your Shot: Pilot Study in Improving Medical School Curricula Through Focused Vaccine Education","authors":"Jorna Sojati MS ,&nbsp;Anjana Murali BS, BPhil ,&nbsp;Glenn Rapsinski MD, PhD ,&nbsp;John V. Williams MD","doi":"10.1016/j.focus.2023.100178","DOIUrl":"https://doi.org/10.1016/j.focus.2023.100178","url":null,"abstract":"<div><h3>Introduction</h3><p>With widely prevalent vaccine hesitancy and medical mistrust, future healthcare providers require knowledge of vaccines and comfort in discussing vaccines with patients. However, many U.S. medical schools do not offer formal or elective curricula focused on vaccine education.</p></div><div><h3>Methods</h3><p>We sought to identify the need for such a curriculum and student gaps in knowledge through a pilot study surveying first- and second-year medical students at a large Pennsylvania medical school to assess knowledge about vaccine initiatives/policies, comfort in discussing vaccines, attitudes toward curricular changes, and effects of COVID-19 on willingness for vaccine education.</p></div><div><h3>Results</h3><p>Many participants (&gt;40%) reported insufficient knowledge of vaccine policy, vaccine development and testing, and community vaccine initiatives. The majority (&gt;50%) indicated discomfort in discussing vaccines in a clinical setting. Importantly, 79% of participants reported insufficient coverage of vaccine topics in the current curriculum. A total of 54% decisively wanted formal/mandatory education versus 72% who decisively wanted elective education. Desiring formal education was associated with less comfort in discussing vaccines overall and with vaccine-hesitant people in clinical settings. Reassuringly, 74% of participants noted that the COVID-19 pandemic made them want to learn more about vaccines. Guided by these findings, we conducted a pilot elective teaching about vaccines through case studies, interactive discussions, and role-playing scenarios. Pre- and postcourse surveys showed improvement in student knowledge in all vaccine-related topics assessed.</p></div><div><h3>Conclusions</h3><p>These data can inform the development of formal and elective curricula that effectively prepare medical students for patients’ vaccine questions.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065423001153/pdfft?md5=b36464ce3cf407ac11c479d6f8a9e495&pid=1-s2.0-S2773065423001153-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Differences in the Association Between Screen Time and Depression","authors":"Lauren E. Kleidermacher MSc ,&nbsp;Mark Olfson MD, MPH","doi":"10.1016/j.focus.2023.100176","DOIUrl":"10.1016/j.focus.2023.100176","url":null,"abstract":"<div><h3>Introduction</h3><p>Previous research has shown that screen time is associated with depression, especially in children. Some evidence further suggests that the association may be stronger in women than in men, although findings are inconclusive. This cross-sectional study examines the association between screen time and depression in representative U.S. adults, stratified by gender.</p></div><div><h3>Methods</h3><p>This study used data from the 2015–2016 National Health and Nutrition Examination Survey; analysis was conducted in 2023. Screen time was partitioned into 3 categories—0–2 hours, 3–4 hours, and &gt;4 hours—and included TV and computer time. Depression was defined as a Patient Health Questionnaire score ≥10. TV time and computer time were also analyzed as separate exposures. A multivariable logistic regression model examined the association between screen time and depression.</p></div><div><h3>Results</h3><p>Results showed that there was a significant interaction between gender and screen time. An association between the highest screen time exposure group and depression was observed for women (&gt;4 hours per day: OR=3.09; 95% CI=1.68, 5.70). The type of screen time affected the relationship, with TV showing a stronger association than computer time. There were no significant associations in men across all exposure groups.</p></div><div><h3>Conclusions</h3><p>Further research is needed to determine whether higher levels of screen time, especially TV, may be a depression risk marker for women but not men.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277306542300113X/pdfft?md5=ccec016c847611385b0c11397206e8c4&pid=1-s2.0-S277306542300113X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139018006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Chronic and Heavy Opioid Use Among Elderly Community Dwellers in the U.S.","authors":"Morgan I. Bromley MPH, PhD,&nbsp;Easter P. Gain MSPS,&nbsp;Mark'Quest Ajoku MPH,&nbsp;Meredith A. Ray PhD,&nbsp;Fawaz Mzayek MD, PhD,&nbsp;Satish K. Kedia PhD,&nbsp;Xinhua Yu MD, PhD","doi":"10.1016/j.focus.2023.100175","DOIUrl":"10.1016/j.focus.2023.100175","url":null,"abstract":"<div><h3>Introduction</h3><p>Opioid overprescribing may fuel the opioid epidemic and increase the risk of complications of opioid misuse. This study examined trends and determinants of chronic and heavy opioid use among elderly community dwellers in the U.S.</p></div><div><h3>Methods</h3><p>Medicare Current Beneficiary Surveys data from 2006 to 2019 were used. Common opioid medications were identified in the prescription medication files (<em>n</em>=47,264). <em>Patients with Chronic users</em> were defined as those receiving 6 or more opioid prescriptions within a year or on medication for 3 or more months, and heavy users were those having an average daily dose of 90 or more morphine milligram equivalents or 3,780 morphine milligram equivalents or more per continuous treatment episode.</p></div><div><h3>Results</h3><p>One in 6 elderly community dwellers ever used opioids during the study period. Chronic users were more likely to be women than men (68.9% vs 31.1%, <em>p</em>&lt;0.001). Of all survey participants, 4.3% were chronic users, and 2.8% were heavy users. Among ever users, 27.7% were chronic users, and 18.1% were heavy users. The rate of opioid use rose from 12.1% in 2006, peaked at 22.8% in 2013, and decreased to 11.7% in 2019. Chronic use was 5.1%, 10.7%, and 7.6%, respectively. Heavy use was 5.5%, 10.7%, and 7.6%, respectively. However, for chronic and heavy users, there was no significant difference in the median opioid dosage and opioid duration between males and females.</p></div><div><h3>Conclusions</h3><p>Among elderly Medicare beneficiaries, opioid prescriptions have been decreasing since 2013. However, a substantial number of elderly people were chronic and heavy users, calling for better opioid management among them.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065423001128/pdfft?md5=c38e968ebae43df2341e2a3ce5a09c5e&pid=1-s2.0-S2773065423001128-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139024550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Foci of the Public Health Preventive Medicine Specialty","authors":"Yuri T. Jadotte MD, PhD, MPH ,&nbsp;Dorothy S. Lane MD, MPH","doi":"10.1016/j.focus.2023.100174","DOIUrl":"10.1016/j.focus.2023.100174","url":null,"abstract":"","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065423001116/pdfft?md5=d84552bb5775c3a1d530252ce710fa2d&pid=1-s2.0-S2773065423001116-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral Distress and Moral Injury in Military Healthcare Clinicians: A Scoping Review","authors":"Melissa A. Wilson PhD ,&nbsp;Amy Shay PhD ,&nbsp;J. Irene Harris PhD ,&nbsp;Nicole Faller ,&nbsp;Timothy J. Usset MDiv, MPH ,&nbsp;Angela Simmons PhD","doi":"10.1016/j.focus.2023.100173","DOIUrl":"10.1016/j.focus.2023.100173","url":null,"abstract":"<div><h3>Introduction</h3><p>Healthcare clinicians are often at risk of psychological distress due to the nature of their occupation. Military healthcare providers are at risk for additional psychological suffering related to unique moral and ethical situations encountered in military service. This scoping review identifies key characteristics of moral distress and moral injury and how these concepts relate to the military healthcare clinician who is both a care provider and service member.</p></div><div><h3>Methods</h3><p>A scoping review of moral distress and moral injury literature as relates to the military healthcare clinician was conducted on the basis of the Joanna Briggs Institute scoping review framework. Databases searched included CINAHL, Cochrane Central Register of Controlled Trials, MEDLINE (Ovid), Embase (Ovid), PsycInfo, 2 U.S. Defense Department sources, conference papers index, and dissertation abstracts. Reference lists of all identified reports and articles were searched for additional studies.</p></div><div><h3>Results</h3><p>A total of 573 articles, published between the years 2009 and 2021, were retrieved to include a portion of the COVID-19 pandemic period. One hundred articles met the inclusion criteria for the final full-text review and analysis.</p></div><div><h3>Discussion</h3><p>This scoping review identified moral distress and moral injury literature to examine similarities, differences, and overlaps in the defining characteristics of the concepts and the associated implications for patients, healthcare clinicians, and organizations. This review included the unfolding influence of the COVID-19 pandemic on moral experiences in health care and the blurring of those lines between civilian and military healthcare clinicians. Future directions of moral injury and moral distress research, practice, and care are discussed.</p></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065423001104/pdfft?md5=eda7c6eb786ab18e3f7af4e6d881a093&pid=1-s2.0-S2773065423001104-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139018694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment, Policy Development, and Assurance: Evolving the Core Functions of Public Health to Address Health Threats","authors":"Ijeoma A. Perry MS, MPH","doi":"10.1016/j.focus.2023.100172","DOIUrl":"10.1016/j.focus.2023.100172","url":null,"abstract":"","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065423001098/pdfft?md5=9617fada809a19a79512a61dea777218&pid=1-s2.0-S2773065423001098-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138615026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}