• COVID-19
• English close
• Vrije Universiteit Amsterdam (VU Amsterdam) - Institutional Repository close
• VIUSpace close
• COVID-19 close

Background: A worldwide vaccination program is the chosen strategy against the COVID-19 pandemic. Vaccine hesitancy however, forms a threat because vaccine uptake is voluntary in most countries. Care-professionals of people with intellectual disabilities are exposed to greater risks than other healthcare workers due to the vulnerable group they attend to and the assisted-living facilities in which they often work. Little is still known of the reasons for vaccine hesitancy in this specific group in contrast to those of other healthcare workers.Objective: To provide insight in the intentions and attitudes on COVID-vaccination of healthcare workers, including those who care for people with intellectual disabilities, by means of a scoping review.Methods: The databases that were searched for papers are CINAHL, APA PsycArticles, APA PsycInfo, Web of Science, Semantic Scolar, Prospero, Outbreak Science, Cochrane and Scopus. The search was broadened to healthcare workers in general because only two papers were found on those caring for people with intellectual disabilities. A total of 26 papers were identified concerning the vaccine intentions of 43,199 healthcare workers worldwide. Data were gathered both quantitively and qualitatively. The papers were analysed for all themes regarding vaccine willingness and vaccine hesitancy.Results: The themes that came to light included: percentages of vaccine willingness, predictors of willingness differentiated by 11 sub-themes (mainly profession, age, gender and past vaccine behaviour), attitudes of willingness and hesitancy differentiated by 19 sub-themes (perceived COVID treat and protecting others for willingness, concerns on vaccine safety and efficacy for hesitancy), sources of vaccination information, contextual factors and changes in COVID-19 vaccine acceptance over time and finally, future strategies for interventions.Conclusions: There was overlap in the percentages of vaccination, predictors of vaccine willingness and the attitudes of vaccine willingness and hesitancy between healthcare workers and those caring for people with intellectual disabilities. Vaccine safety and efficacy are the most prominent concerns with regard to vaccine hesitancy. Therefore, future strategies for interventions should address vaccine safety and efficacy. Furthermore, interventions are recommended to be interactive in order to facilitate exchange. Discussion groups that are able to address specific concerns and personal experiences, show to be effective in addressing vaccine hesitancy. Accurate information can also be made more accessible to target groups by promoting video’s on social media platforms. Hence, further research is necessary to specify more precisely the attitudes of healthcare workers caring for people with intellectual disabilities and in more countries worldwide.

This report on COVID-19 Crisis Governance is Deliverable 1.2 ‘Lessons learned and best practices’ of the project HERoS - Health Emergency Response in Interconnected Systems. It builds on HERoS’ Deliverable 1.1 ‘Recommendations for governance and policies in the COVID-2019 response’. This Deliverable contains three parts. Part A drives on extensive qualitative research in three European countries (the Netherlands, Finland, and Ireland). Part B presents best governance practices and challenges in cross-border medical supply chain. It takes lessons learned from the EU joint procurement and the COVAX initiative for the purchase and distribution of COVID-19 vaccines. Part C reflects on the social network Municipio Solidale in Rome the charity work in the years of the COVID-19 pandemic. Part D provides the best practices from deployment of UK-MED and PCPM’s Emergency Medical Teams (EMTs). Part A presents collected evidence and share best practices and lessons learned related to the governance of the COVID-19 crisis within nursing homes and secondary schools in Europe. Using a whole-of-society approach which we presented in Deliverable 1.1, we looked at three analytical layers: (1) the state and the institutional landscape, (2) established and emerging response organizations and networks, (3) societal resilience and participation. We conducted in-depth interviews, observations, and focus group discussions, and in the Netherlands, we additionally made use of a participatory action research approach wherein we used visual ethnography, photovoice, video diary and arts-based engagement research. Regarding nursing homes, three main themes emerged from our data. First, we found high levels of trauma among nursing home workers and supporting organisations. Therefore, on-site group therapy is the envisioned response needed. Second, we found a major workforce outflow of the sector. This could be mitigated by a structural wage development that is in line with the value of performing essential work duties and would additionally heighten the attractiveness of the nursing profession. Third, due to lack of governmental and public appreciation we have found diminished levels of professional pride, which could be addressed with aligning nursing home working conditions with national hospital standards. In conclusion, we warn about the possible uprising of a European social care crisis which could be mediated by rapid policy-level action in line with our findings.For secondary schools, we also derived three main themes from our data. First, we argue that there is a need in European countries for leadership that facilitates action towards the well-being of our young populations. Experts stressed the importance of strengthening adolescents’ lobbies and advocacy groups in decision making processes. Second, there is an urgent need for funding into tackling COVID-19 associated increases in inequalities among adolescents. Extra time and attention should be allocated to adolescents who have fallen behind with their studies during the past two years. Lastly, we discovered many adolescent accounts of depressive and anxiety symptoms and we emphasise the urgency of closing Europe’s biggest treatment gap within mental health services for youth by reducing waiting times. There is no doubt that the COVID-19 pandemic has caused long-lasting, and in some cases even life-long difficulties to young people.In conclusion, nursing homes and secondary schools are dealing with different vulnerable groups, risks, and priorities and hence, this fuelled variations in crisis response. General measures (e.g. school closures/visitor ban) should be decided upon by central authorities supported by proper coordination mechanisms, while more specific guidelines that depend on the individual attributes of the field needs to be decentralized and bottom-up. Deepening citizens’ participation into the crisis response gives them ownership and control to influence public decision-making that affects their lives.Part B presents the desk review on the European Union’s joint procurement for personal protective equipment, ventilators, laboratory equipment, therapeutic remdesivir and ICU medicines and vaccines, and the COVAX Facility for equitable access to COVID-19 vaccines. Since the COVID-19 pandemic has changed how we govern global medical supply chains unprecedented joint procurement and collaboration initiatives have been set up during the pandemic. In this part we refelct on such cross-border governance mechanisms of joint procurement initiatives in medical supply chains. It examines challenges and best practises by collaborative initiatives from both the EU and the COVAX’ COVID-19 vaccine procurement and distribution. Both comprise innovative cross-border collaborative mechanisms for vaccine procurement and distribution, yet differ across membership, geographic scale, policies, and organizational governance arrangements. They were both values-driven initiatives, inspired by calls for solidarity, but also stemming from necessity.The EU’s procurement for innovation mechanism required the adoption of novel practices in contract development and management, plus new governing institutions (first RescEU, now also HERA). This Part 2 shows how the EU faced unique challenges with one of their co-funded vaccine developers that resulted in disputes over delivery volumes and schedules. However, the joint purchasing of COVID-19 vaccines using Advance Purchase Agreements with vaccine manufacturers through funds under the European Commission´s Emergency Support instrument has been an innovative cross-border governance initiative that could inspire similar collaboration in other domains (e.g., energy). It comprised a centralised or ‘centre-out’ governance arrangement co-ordinated by the European Commission with formal rules within a fragmented bureaucracy, pursuing legal and political alignment among member states of a tightly connected union. It is characterised by broad regional scope, being far more ambitious than earlier EU procurement strategies. Part C is a presentation of the case Municipio Solidale, a local solidarity project in Rome that started at the beginning of the pandemic in March 2020 and lasted until the end of July 2020. The case is about the distribution of food in a municipality in Rome by spontaneous volunteers and social networks. The case presents the challenges the social network had to overcome. The fact that most of the planned activities are still ongoing in 2020 and are permanently included in the territorial offers, shows not only how urgent these measures were in the most difficult period of the pandemic crisis, but above all how necessary they were in general. The response of the territorial community itself, the degree of mobilization and passion that characterized all the activities of the project, as well as the welcome of citizens tell us that Municipio Solidale has managed to respond to a complex request already present in the VIII Municipality, which are further amplified by the COVID-19 pandemic: a demand for primary goods and relational goods among the most vulnerable. The case shows that local initiatives will last and grew into stable charity mechanisms and have the potential to become part of whole of society governance mechanisms. Part D describes PCPM part in EMTs that were one of few emergency response mechanisms that were of relevance in the COVID-19 pandemic. The teams of highly specialized medical staff, with considerable international experience and working under the auspices of the WHO, could have and in many instances were, a very meaningful support to the developing countries facing the worst brunt of the pandemics, coupled with shortages of skills, experienced personnel and equipment. This part summarizes main operational difficulties faced by UK-Med and Polish PCPM’s Emergency Medical Teams, stemming from 25 and 7 COVID-19 deployments respectively. In particular it discusses the changing role of EMTs, as well as challenges faced in meeting high expectations of the respective ministries of health.

In response to the shift to remote learning in Jordan since March 2020, this report analyses the findings of a research project on the impact of Covid-19 on education one year after the first cases of Covid-19 were recorded in the country. The research project was driven by four specific objectives: 1) understanding the impact of the lockdown and remote learning on refugee and host community students, caregivers, teachers, school administration and the wider education sector in Jordan; 2) producing data on protection concerns and vulnerabilities brought about or heightened during the lockdown period; 3) informing the education sector on resources and skills needed to mitigate the negative impacts and ongoing challenges; and 4) developing actionable recommendations for the short, medium and long term.

In april van dit jaar deden wij onderzoek naar de maatschappelijke gevolgen van COVID-19 voor Nederlanders en meer specifiek Rotterdammers en Hagenaars. Die bleken aanzienlijk. Velen waren bang voor baan- of inkomensverlies en zagen COVID-19 als een bedreiging voor zichzelf, hun vrienden en familie, hun stad en voor heel Nederland. Twee maanden later, in de eerste helft van juli 2020, deden we opnieuw onderzoek naar de gevolgen van het coronavirus voor Nederlanders, waarbij we behalve over Rotterdam en Den Haag nu ook verslag doen over hoe Amsterdammers de gevolgen van het virus ervaren. De context waarin de tweede meting plaatsvond was heel anders dan die van deeerste meting. Begin juli nam het aantal besmettingen en ziekenhuisopnames snel af en de overheid versoepelde de maatregelen die eerder getroffen waren om de verspreiding van het virus tegen te gaan. De vraag is hoe Nederlanders de gevolgen van COVID-19 in deze veranderde context ervaren.Dit onderzoek laat zien dat de coronacrisis ook in juli 2020 grote maatschappelijke impact had. Meer dan een derde van alle respondenten is bang voor verlies aaninkomen of lijdt dat al. Ruim een kwart van de werknemers onder de respondenten is bang voor baanverlies.Een kwart van de bevolking vreest zelf COVID-19 op te lopen en bijna de helft vreest dat voor zijn of haar familie. Een vergelijking van uitkomsten met de vorige meting laat ook bemoedigende resultaten zien, bijvoorbeeld op het terrein van zorg. Opmerkelijke uitkomst bij eerste meting was dat veel mensen zorg meden. Dit aandeel is twee maanden later aanzienlijk gedaald. Na de afronding van de dataverzameling rond half juli is het aantal besmettingen in de vier weken daarna weer opgelopen. De lossere gedragsvormen zijn daar mede debet aan. In deze studie signaleren we ook dat het risicomijdend gedrag begin juli lager lag dan in april.Tegelijkertijd nuanceren we de beeldvorming dat een groot deel van de Nederlanders de gedragsregels in de wind slaat. We laten ook zien dat vertrouwen in overheden en gezondheidsinstanties wat is afgenomen, maar nog steeds van een hoog niveau is. Uit ons onderzoek blijkt dat er nog steeds een grote vertrouwensbasis voor overheden en gezondheidsinstituties is, maar een afkalvende vertrouwensbasis kan het draagvlak voor noodzakelijke coronamatregelen in gevaar brengen. Na half juli is het vertrouwen in overheden en instellingen als RIVM en GGD meer onder druk komen te staan dooreen groeiende kritiek op de inhoudelijke adviezen van het RIVM, de communicatie door de overheid, en op het vermogen van GGD’s om snel coronatesten uit te voeren en adequaat ‘contact tracing’ te doen. In volgende metingen gaan we hier nader op in.

“Tree hole” refers to a social media formed after the death of a social media user, in which other users continue to leave messages due to emotional resonance. This paper focuses on exploring the fluctuation of emotions with time in a “tree hole” of social media such as Microblog, and provides ideas and support for suicide warning, rescue, and user portraits of patients with depression in the “tree hole”. In this paper, the dataset of 2,356,066 messages captured from the “tree hole” Microblog with the “tree hole” agent (i.e., an AI program) and pre-processed. Subsequently, the effective dataset was labeled by a text sentiment analysis model based on BERT and BiLSTM, and accordingly the sentiment was scored. Then the scored data was visualized and analyzed in the time dimension. Finally, it was found that the sentiment of the “tree hole” messages reached a trough at 4:00 am and a peak around 8:00 am. In addition, the overall trend of “tree hole” sentiment has fluctuated downwards from Monday to Sunday. We have concluded that the sentiment of patients with depression fluctuates regularly at some special time points, and special events such as the outbreak of COVID-19 and so on, have a great impact on the emotions of patients with depression. Therefore, it is necessary to strengthen warning and intervention for those who has expressed thoughts of suicide at special points to prevent the spread and fermentation of suicidal emotions in the “tree hole” in time. In addition, the rescue volunteers for patients with depression as Tree Hole Rescue Team should make corresponding adjustments to the rescue strategy when special events occur. This research is of great significance for the emergency response of “tree hole” depressed users in major events such as COVID-19 epidemic.

Het raakvlak tussen de conditie van het gebit en algemene gezondheid is buitengewoon interessant en relevant. De meeste voorgaande onderzoeken op dit gebied zijn op zoek naar een causaal verband tussen dentale pathologie en systemische ziekten, voornamelijk gebaseerd op afgeleide parameters. Dit proefschrift biedt nieuwe inzichten in deze interactie, uitgewerkt in twee essentiële algemene gezondheidsproblemen: hart- en vaatziekten (als de belangrijkste oorzaak van wereldwijde sterfte) en COVID-19 (als recent voorbeeld van een wereldwijde pandemie). Hiermee wordt een globaler en meer wijdverbreid statement gemaakt over dit boeiende en vooral belangrijke onderwerp.Aandoeningen van het gebit en verschillende systemische ziekten zijn gebaseerd op overlappende complexe pathofysiologische mechanismen, met genetische en epigenetische factoren die interageren met levensstijl en omgevingsfactoren. De resulterende "gevoeligheid" van de gastheer lijkt het fundament van het verband tussen de conditie van het gebit en algemene gezondheid. Bewijs voor mogelijke causale verbanden ontbreekt nog steeds, en de noodzaak voor causale verklaringen verdwijnt steeds meer naar de achtergrond. De conditie van het gebit is nog steeds van ondergeschikt belang. Dat is exact de reden waarom een groter bewustzijn over “het gebit als weerspiegeling van de algemene gezondheid”, moet worden toegevoegd aan de wereldwijde gezondheidsagenda.Door de dentale conditie te vereenvoudigen tot "tandverlies", als het ultieme gevolg van dentale pathologie en slechte mondgezondheid, lijkt dit een snelle en gemakkelijk toegankelijke marker voor de algemene gezondheid. Uiteindelijk moet inspectie van het gebit door alle zorgverleners worden geaccepteerd als een standaard, globaal diagnostisch hulpmiddel.