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This paper considers the ways that publicly funded developmental services for adults with developmental disabilities in southern Ontario are limited in how they support clients. This paper is informed by field research conducted in the summer of 2019, which was composed of semi-structured interviews, focus groups, and a policy review. Informed by parent advocates who are the main caregivers of their adult children labelled with intellectual and developmental disabilities, this paper claims that the administrative processes of the Ontario ministry that manages and funds adult disability services relate to broader exclusionary patterns among adults with developmental disabilities. I explore this claim by reviewing how common ableist assumptions of people with developmental disabilities are ingrained in the policies and administrative processes of these services. I contribute to ongoing discussions among Critical Disability Scholars of the ways that disability as a social category can be articulated outside of ableist assumptions. Informed by parent caregiver perspectives, this article outlines how the limitations of provincially funded disability services in Ontario, Canada cause significant challenge in the lives of those labelled with intellectual and developmental disabilities. One possible explanation for these limitations is that there is a disconnect between how the provincial government classifies who should receive immediate services and how many services, versus the actual need of those labelled with intellectual and developmental disabilities. The criteria for high supports, such as monthly funding, placement into a living facility, and the provincial assessment for determining a person's 'adaptive functioning' are rooted in problematic assumptions made of people labelled with intellectual and developmental disabilities. [ABSTRACT FROM AUTHOR]

There has been a major growth in global health networks in recent decades to address health issues including tobacco use, alcohol abuse, and maternal mortality. Most conditions that incur high costs have provoked networks of advocates working to mitigate the impact, increase investment in research, and establish campaigns. Global health networks often work simultaneously across policy, knowledge creation, and advocacy. Until recently there has been limited activity in global health networks and advocacy addressing hearing loss and deafness which has contributed to its relatively low visibility with policymakers compared to other health conditions. This discussion paper reports on a global consultation that explored the views of advocacy groups and individuals on advocacy for the management of hearing loss, and cochlear implantation (CI). It focussed on stakeholders' views of current advocacy endeavours, opportunities and barriers, and the possible development of a global advocacy network to improve access to cochlear implantation and the supporting services. The subsequent development of a global health network, the Cochlear Implant International Community of Action (CIICA) is discussed and the conditions necessary for the successful development of health networks are explored. This paper will be of interest to those wishing to understand the factors influencing the development of health networks and advocacy. [ABSTRACT FROM AUTHOR]

In emerging economies like India, the focus of public health policies is shifting toward the treating non-communicable diseases to preventing communicable diseases. The public welfare demands appropriate targeted healthcare subsidies for non-communicable diseases. In this paper, we investigate whether out-of-pocket expenditure toward mitigating non-communicable diseases for the poorer section of the population is catastrophic by nature. In a representative futuristic scenario for an emerging economy, we have collected the cancer patients' expenditure data from the patients and hospital management in a not-for-profit cancer hospital located in the state of Kerala. We have analyzed the variation of expenditure categorized as government subsidy toward treatment, private expenditure toward medical goods and services, and private expenditure toward non-medical goods and services against different socio-economic variables. The analysis of catastrophic health expenditure data reveals that relatively lower income lower-income households face more risk of catastrophic health expenditure and are in greater need of government subsidy. [ABSTRACT FROM AUTHOR]

There have been 188 rural hospital closures in the United States since 2010 with approximately 20% of these in Appalachia. Telehealth has become a way that nurses can reach rural patients who might not otherwise receive health care. The purpose of this paper is to (1) outline the federal policies enacted during COVID-19 for broadband expansion; and (2) suggest how advanced practice nursing care might be affected by broadband expansion and telehealth in the region. A search of PubMed was conducted in January 2023, using the search words, "policy", "telehealth", "broadband", and "Appalachia". New laws appropriated funds to expand broadband infrastructure that made it possible for telehealth to be used by nurses to deliver health care to rural patients. This discussion paper found that broadband legislation was instrumental in expanding telecommunications and telehealth by NPs. There is a great need for broadband to continue to expand and for trained nurses to provide care via telehealth. [ABSTRACT FROM AUTHOR]

This paper problematizes the precision medicine approach embraced by the All of Us Research Program (US) and by Genomics England (UK) in terms of benefits distribution, by arguing that current "diversity and inclusion" efforts do not prevent exclusiveness, unless the framing and scope of the projects are revisited in public health terms. Grounded on document analysis and fieldwork interviews, this paper analyzes efforts to address potential patterns of exclusion upstream (from participating in precision medicine research) and downstream (from benefitting from precision medicine outputs). It argues that efforts for inclusion upstream are not corresponded downstream, and this unbalance jeopardizes the equitable capacities of the projects. It concludes that enhanced focus on socio-environmental determinants of health and aligned public health interventions as precision medicine outputs would be to the benefit of all and especially of those who are most at risk of (upstream as well as downstream) exclusion. [ABSTRACT FROM AUTHOR]

Alcohol use disorders (AUD) are associated with several mental health, family, and social consequences. This paper analyzes the few studies on BIs in primary care in Chile and Latin America through a culturally critical view. Future research should address the need of culturally appropriate BI for AUD, so that decisions on policies and programs are made based on evidence-based, culturally appropriated practices. The Chilean context presents a unique opportunity to implement BI, since primary care counts on resources and protocols already installed. Clinical social workers should play a key role in this challenge. [ABSTRACT FROM AUTHOR]

Policy studies have addressed many issues on the topic of policy change, generally following the ideas about policy composition set out by Hall and others. These typically view 'significant' policy change as related to alterations in the macro elements of policies, namely policy paradigms and governance preferences. These studies have also examined the roles of meso-level policy objectives and policy instrument preferences in these dynamics but see these as subsequent or subordinate to more macro-level changes. In contrast, the role of changes in policy specifications and tool calibrations at the micro-level of policies remain under-investigated and under-theorized despite growing recognition of their sometimes transformative role in policy dynamics. This paper re-examines foundational work on policy change in order to develop a clearer understanding of the content and significance of both calibrations and policy specifications. The significance of these insights is illustrated through a case study of recent healthcare policy reform efforts in South Korea after 1988 which highlights the role that micro-level policy changes played in shaping broader and deeper policy changes over the period. [ABSTRACT FROM AUTHOR]

Trauma-informed care (TIC) is not a new concept. Despite TIC being at the forefront of international acute public mental health services policy, and researched since 2006, implementation has been hampered. This paper reports findings from a scoping study examining clinical and lived experience workers experience of TIC in Acute Adult Public Mental Health Services. In this scoping study five databases and grey literature were scanned in 2021 and updated in 2023, to address the question: What is known about TIC concerning the clinical and mental health lived experience workforce in the acute adult public mental health service? Forty-six papers met the inclusion criteria. Analysis revealed commitment in conceptualisation of TIC in mental health policy, requirements for incorporating TIC in acute adult mental health care, and barriers to implementation, including dissonance towards role expectations. The literature calls for investment in implementing TIC, which includes an increased workforce consisting of mental health lived experience workers, clinical staff with TIC knowledge and skills, and specialist TIC experts. Further research is needed to understand more fully the opportunities and barriers to implementing TIC in acute public mental health settings. [ABSTRACT FROM AUTHOR]

This paper sets out the Collaborative Service Design Playbook, to guide planning, design, and implementation of co-created health services. Successful health service development and implementation is best guided by theoretically informed approaches; however, organisations often lack design and implementation know-how and have difficulty applying it. This study seeks to improve health service design and potential for scale-up by proposing a tool to guide an end-to-end process, drawing together service design, co-design, and implementation science; and exploring the tool's feasibility to establish a sustainable service solution developed with participants and experts that is scalable and sustainable. The Collaborative Service Design Playbook phases include, (1) Define the opportunity and initiatives, (2) Design the concept and prototype, (3) Deliver to scale and evaluate; and (4) Optimise to transform and sustain. This paper has implications for health marketing through providing an end-to-end approach with phased guidance for health service development, implementation, and scale up. [ABSTRACT FROM AUTHOR]

AbstractThere has been growing recognition of the need to address the sexual and reproductive health (SRH) needs of men and boys, including a need for more explicit guidance in domestic health policy and plans. This paper reports on a policy analysis, covering five East and Southern African countries, and discusses the extent and ways in which male clinical and non-clinical needs, and their roles in SRH are currently being reflected. It draws attention to the policy discourse, trends, and gaps in including men in the region as clients, partners and change agents to inform a way forward. [ABSTRACT FROM AUTHOR]

Examining the representation of COVID-19-related scientific uncertainty in Moroccan media, this paper investigated how legacy and social media’s framing of scientific uncertainty contributed to shaping public opinion regarding public decision-making orientations. For this aim, Al Ouala TV and 2 M TV were selected among traditional media channels for their wide viewership and governmental stance. Additionally, various social media platforms were selected based on their active role in COVID-19 discourse. Using a purposive sampling method, a qualitative analysis was conducted on media coverage of COVID-19, focusing on the framing of uncertainties surrounding virus transmission, face mask usage, and vaccination between March 1, 2020 and July 30, 2022. Drawing on framing theory-based content analysis, the study found that the media framing did not allow for resolving the complexities involved in communicating scientific uncertainty and corresponding public decisions. The active use of social media has actually fostered affective polarization in the related context of fear, worry, and distrust, increasing resistance to public decision-making orientations and negatively impacting perceptions and motivations to respond to COVID-19 measures. Implications for public health communication and policy are discussed. [ABSTRACT FROM AUTHOR]

In this paper, we critically analyse the response to the COVID-19 pandemic, highlighting not only the breadth of knowledge geographers have already contributed to this assessment, but also the surprisingly limited critique within geography, social sciences and the broadly defined 'Academic Left' of the authoritarian dimension of the public health policies of 2020 onwards. We conclude with a number of research questions for the aftermath of the pandemic, with the hope that they will help spur the growth of a new wave of anti-authoritarian Leftist geographical thinking that reaffirms the centrality of human rights and civil liberties to making the world a better place. [ABSTRACT FROM AUTHOR]

A growing number of researchers are trying to provide explanations for continuity and change in drug policy in different contexts. Such research predominantly falls in the pluralist realm of public policy where various actors compete to have their policy proposals accepted. Using a critical framework called Policy Constellations (PC), developed by Stevens and Zampini, this paper attempts to explain reactions of the British Government to Novel Psychoactive Substances (NPS) between 2008 – 2016. Qualitative data comes from in-depth interviews with stakeholders (N = 15), including NGO workers, a former Home Secretary, drugs ministers, governmental advisors, a former senior police officer, former Deputy Drug Coordinator, and a former Advisory Council for the Misuse of Drugs (ACMD) member. Two 'constellations' competed in British NPS policy setting. The PC framework illustrates power imbalances between these competing stakeholders. Abstinence orientated actors (the conservative constellation) enjoyed strategic advantages and media power which allowed them to create a favourable policy setting. These advantages were not enjoyed by the liberal constellation who struggled to access the policy setting and influence policy developments. The prohibitive nature of the policy used to counter NPS can be explained with the domination of actors whose values align with the conservative constellation. [ABSTRACT FROM AUTHOR]

This article explores the intersection of public health protection policy and sports. It reviews the strategic responses to restarting sports after the disruption of COVID-19. The author explores interdisciplinary work between public health, health protection policy and the sports sector. In addition, the author examines strategies to restart sport during COVID-19. This research highlights balancing the health protection policy and the integrity of sports, the ability to implement certain strategies strongly influenced the acceptance of the resumption of the sport in a phased approach during COVID-19 period. Further, objective medical information is key to informing the process. This research will offer guidance to policy makers in the sport sector as they need to resolve challenges with solutions that are in alignment with evolving public health policies. The changing landscape of sports has had a far-reaching social impact on how it's going to be administered and viewed in the future. This paper adds value to the discourse on interdisciplinary work between health protection policies and sport; with a specific focus of reviewing the strategic responses to restarting sport in a global pandemic like COVID-19. [ABSTRACT FROM AUTHOR]

In this paper, we apply the reproductive justice framework to discuss how gendered racism disadvantages pregnant and parenting young Black women aging out of foster care. Specifically, we highlight the reversal of Roe v Wade as reflective of the United States' long legacy of efforts to control Black women's reproduction. We then discuss the structural factors contributing to the reproductive injustices of young Black women aging out of care, including a lack of access to sexual and reproductive health education, barriers to educational attainment, and foster care-based relational and placement deficits. We conclude with research, practice, and policy enhancements. [ABSTRACT FROM AUTHOR]

Literature on occupational risks among organic farmers is scarce. This study explored safety practices and non-fatal injuries among organic producers, and the role of sociodemographic, work, and farm characteristics on safety and injury. Cross sectional survey of certified organic crop producers in the Southwest (SW) region of the United States (US). The Organic Integrity Database was used for recruitment. Data were collected through an electronic and paper survey. Analyses were conducted on 115 cases; response rate was estimated at 25%. A high majority of respondents owned their operation and were younger than 65 years, male, educated beyond high-school, and non-Hispanic whites. Less than half had more than 10 years of experience in organic farming; one-third worked off the farm year-round. Safety practices were very basic despite the widespread use of equipment and machinery, and limited to wearing normal clothing and apparel such hats and glasses. About half of respondents (52.6%) reported non-fatal injuries in the past year; and one-third (32.7%) time lost due to injuries. The overall cumulative incidence rate was estimated at 5.3 injuries per 10 workers within the last year. The injury rate decreased with hours worked. Significant differences were found on gender and education level and safety practices, with female respondents and the more educated being more proactive in practicing safety. Those working less than 40 h/week, in farms smaller than 50 acres, using light machinery or compact utility tractors, and tractors without roll-over protection reported significantly higher injury frequency compared to their counterparts. This study contributes unique data on an essential workforce not captured by current occupational injury and illness surveillance systems. It identifies important personal and contextual factors that may contribute to safety and injury in this population. The findings indicate the need to promote safety and prevent injuries that result in work time lost. This study may also inform future occupational safety and health research and practice, including surveillance, injury prevention programs that target certain workers and production practices, and policies that support and protect the organic farmer. [ABSTRACT FROM AUTHOR]

Environmental health remains a niche topic in bioethics, despite being a prominent social determinant of health. In this paper we argue that if bioethicists are to take the project of health justice as a serious one, then we have to address environmental injustices and the threats they pose to our bioethics principles, health equity, and clinical care. To do this, we lay out three arguments supporting prioritizing environmental health in bioethics based on bioethics principles including a commitment to vulnerable populations and justice. We also highlight and advocate for environmental law efforts that align with these priorities, focusing specifically on the need for a right to a healthy environment. Our intention is to draw attention to the legal and ethical concepts that underlie the importance of a healthy environment, and urge bioethicists to prioritize both legal and ethical advocacy against environmental injustices in their practice. [ABSTRACT FROM AUTHOR]

Talking about death and dying is promoted in UK health policy and practice, from a perception that to do so encourages people to plan for their end of life and so increase their likelihood of experiencing a good death. This encouragement occurs alongside a belief that members of the public are reluctant to talk about death, although surveys suggest this is not the case. This paper describes findings from a research study in which people participated in deliberative discussion groups during which they talked about a range of topics related to death, including talking about death, the good death, choice and planning and compassionate communities. Here we report what they had to say in relation to talking about death and dying. We identified three themes: 1. The difference between talking about death as an abstract concept and confronting the certainty of death, 2. how death and dying presents issues for planning and responsibility, and 3. approaches to normalising death within society. For our participants, planning was considered most appropriate in relation to wills and funerals, while dying was considered too unpredictable to be easy to plan for; they had complex ideas about the value of talking about death and dying. [ABSTRACT FROM AUTHOR]

The Pugwash Conferences have been a highly visible attempt to create profoundly important discussions on matters related to global safety and security at the highest levels, starting in 1957 at the height of the Cold War. This paper assesses, for the first time, the formal comments offered at this first Pugwash Conference by the Nobel Prize-winning radiation geneticist, Hermann J. Muller, on the effects of ionizing radiation on the human genome. This analysis shows that the presentation by Muller was highly biased and contained scientific errors and misrepresentations of the scientific record that resulted in seriously misleading the attendees. The presentation of Muller at Pugwash served to promote, on a very visible global scale, continued misrepresentations of the state of the science and had a significant impact on policies and practices internationally and both scientific and personal belief systems concerning the effects of low dose radiation on human health. These misrepresentations would come to affect the adoption and use of nuclear technologies and the science of radiological and chemical carcinogen health risk assessment, ultimately having a profound effect on global environmental health. [ABSTRACT FROM AUTHOR]

Suicide remains a leading cause of death worldwide, with an estimated 700,000 suicide deaths per year. The World Health Organization identifies reducing alcohol use as one component of comprehensive approaches to suicide prevention. This paper conducted a rapid review of the evidence on alcohol-related suicide prevention interventions. PubMed, Embase and Web of Science were searched for articles related to alcohol, suicide, prevention, and policies, published between 1990 and 2020. 5293 articles were identified; after deduplication, 2567 studies were screened at the title and abstract level. 402 articles underwent full-text review. 69 articles were ultimately included and underwent data extraction. Interventions were categorized as policy interventions, community-based interventions, and clinical interventions. While there is evidence that policy interventions targeting alcohol may be associated with lower suicide rates, more evidence using stronger study designs is needed. The evidence for community interventions was mixed and supported the need for further research on these types of interventions. Pharmaceutical and therapy-based clinical interventions also showed some promise, with more research needed. Overall, despite evidence of alcohol's role in suicide attempts and deaths, few interventions have been developed with the purpose of addressing alcohol-related suicide. More research is needed to identify effective interventions to prevent alcohol-related suicide. [ABSTRACT FROM AUTHOR]

Family members are essential contributors to the quality of life (QoL) of persons living in residential long-term care (RLTC). This paper analyzes how the system enables or inhibits family involvement with residents in RLTC. Our analysis of 21 policies that regulate long-term care in four Canadian Provinces reveal differences in their portrayal of residents' families. Family roles are characterized procedurally (task-oriented) or relationally (interactive). Operational standards linked to licensing of RLTC homes employ more formal terminology, while RLTC program guidelines, use facilitative language to engage families and build relationships. Examples of orientation procedures, care protocols, living at risk, and end-of-life care reveal inter-provincial variations. We argue that there are opportunities to further engage families within the current regulatory framework and improve their continued contributions in the post-pandemic era. [ABSTRACT FROM AUTHOR]

The present study aimed to explore lived experiences of Czech adolescents with a focus on mental health and well-being during the COVID-19 pandemic. To meet the study objective, the qualitative analysis employed focus group interviews with 12 selected adolescent participants. The participants described a wide array of behavioral changes, feelings, experiences, and opinions related to their mental health and well-being across a wide range of contexts. The thematic analyses revealed 23 specific factors characteristic to the context of the response to the pandemic emerged within the context of school and study, followed by the context of families, peer and social interactions, as well as the situation of coronavirus and pandemic in society. The specifically emerged themes were described as potential factors leading to aggravating or mitigating mental health problems in reference to already published findings. The results can potentially draw implications for public health policy in the event of the reemergence of potential societal threats. [ABSTRACT FROM AUTHOR]

Janani Suraksha Yojana (JSY) is a public health programme in India involving multiple stakeholders across sectors with the common goal of reducing mother and infant mortality by boosting institutional deliveries. Under JSY, pregnant women receive financial assistance in the form of cash transfers into their bank accounts. Using data from the latest National Family Health Survey providing a sample of 15,968 poor women, we show that Financial inclusivity is associated with greater uptake of JSY. Our research highlights the inter-relatedness of health and financial sector policies, signifying the need to address citizen-centric development beyond the silos of schemes. [ABSTRACT FROM AUTHOR]

The societal role which sports clubs can play in promoting health has been underexploited, and sports clubs have called for support from policymakers. Based on the Health Promoting Sports Clubs National Audit Tool, the present study has as objective to investigate how national public policies support health promotion in sports clubs, by questioning indicators of quality (references to other document, policy framing and evaluation), the content (target groups, health topics, type of policy instruments) and the mechanisms used by Irish decision-makers for coordination, evaluation, dissemination and implementation of these policies. The tool was completed in two steps comprising a systematic search of policy plans, programmes or regulations and 12 interviews with key informants. A content analysis of 17 policy documents, identified 49 policy actions targeting HP in sport clubs, coming from different sectors, but only policies from the health sector considered a settings-based approach, supporting a unique sports federation programme. Policies focus on a single health behaviour, where the most targeted were physical activity participation, gender inequity and the disability gap in access to sport clubs. The policy structure lacks coordination, monitoring, media campaigns and events, and therefore not adopting the HPSC concept, but only a health education approach. Future studies should support the acknowledgement of HP as an umbrella concept, in order to support the understanding and development of organisation and system change since policies are drivers for sport federations, local sport actors and sports clubs. [ABSTRACT FROM AUTHOR]

Improving nutritional intake contributes to maintaining the health and quality of life of the older population and reducing individual and societal healthcare costs. We collaborated with two community service hubs and a public health center in Taipei's Daan District to develop a personalized community-based health and nutrition program using service design. The design was validated through a model encompassing perceived usefulness, service experience, perceived value, and behavioral intention, analyzed using PLS-SEM modeling on 76 individuals. The results showed bidirectional influences among these factors. This study provides practical recommendations for formulating public health policies and health promotion programs for older adults. [ABSTRACT FROM AUTHOR]

Medicaid funding for home- and community-based services (HCBS) has increased substantially in recent decades. Prior research has investigated the effects of this expansion on outcomes for individuals as well as costs to Medicaid, often using state policy as a proxy for access to HCBS or implicitly assuming that more generous policies affect outcomes through access, an assumption that may not hold. In this study, using survey data linked to Medicaid claims, we assess the extent to which common measures of state Medicaid HCBS generosity correspond to increased individual use of HCBS among older adults with potential needs. We find several measures to have strong predictive power, but only with relatively large changes in policy generosity. Our findings imply that increased funding of HCBS is not sufficient to ensure access to services and that researchers should be careful when using state policy generosity as a proxy for access. [ABSTRACT FROM AUTHOR]

Professional sports clubs (PSCs) are potentially effective settings for health promotion; however, their role within policy is unclear. Potential reasons include lack of awareness about existing provision of health and wellbeing (H&W) programmes and adequacy of monitoring and evaluation (M&E) practices. This review aimed to: (i) map the provision of H&W programmes delivered by PSCs in the United Kingdom (UK), and (ii) explore current M&E practices of PSCs and consider the policy implications of this. Websites from eight professional sport leagues were hand-searched for programmes and impact reports. Suitable programmes were quantified, whilst impact reports were analysed via inductive documentary content analysis. Results identified 176 H&W programmes and 36 impact reports, as well as 43 H&W impact statements, but only 14 of these were aligned to specific H&W outcomes. The H&W aims of programmes were typically vague, measurement tools were rarely used, and evaluations were usually anecdotal case studies and based on engagement figures, which may not only limit the potential uptake of these programmes but also the relevance of PSCs to public policy. Further research is thus needed to build a stronger evidence base for the use of PSCs as vehicles of public health promotion and policy, and to better address the challenges faced when seeking to monitor and evaluate PSC programmes effectively. [ABSTRACT FROM AUTHOR]

The Scottish Government's policy of minimum unit price (MUP) for alcohol has received significant scholarly attention. Much of the focus of this literature has been on the efforts by sections of the alcohol industry to oppose the policy, including attempts to 'frame' key terms of the debate and an understanding of its legitimacy and effects within the wider field of interpretative policy analysis. The present article builds on these studies by re-conceptualizing the MUP debate through the lens of post-structuralist discourse theory and the logics of critical explanation that emerge from this. It argues that the success and failure of MUP (as a projected social logic) can be understood through the shifting coalitions of actors that emerged (political logics) and the affective hold that industry narratives were able to exert (fantasmatic logics) in this context. While focused on UK alcohol policy, the article speaks to a wider research agenda on the 'commercial determinants of health' and, through the application of the critical logics approach, offers new analytical insights beyond those provided by existing models of industry influence. Similarly, it contributes to the field of post-structural policy analysis through its novel focus on the role of commercial entities as health policy actors. [ABSTRACT FROM AUTHOR]

The emergence of molecular HIV surveillance (MHS) and cluster detection and response (CDR) programs as key features of the United States (US) HIV strategy since 2018 has caused major controversies. HIV surveillance programs that re-use individuals' routinely collected clinical HIV data do not require consent on the basis that the public benefit of these programs outweighs individuals' rights to opt out. However, criticisms of MHS/CDR have questioned whether expanded uses of HIV genetic sequence data for prevention reach beyond traditional public health ethics frameworks. This study aimed to explore views on consent within MHS/CDR among critical stakeholders. In 2021 we interviewed 26 US HIV stakeholders who identified as being critical or concerned about the rollout of MHS/CDR. Stakeholders included participants belonging to networks of people living with HIV, other advocates, academics, and public health professionals. This analysis focused on identifying the range of positions among critical and concerned stakeholders on consent affordances, opt-outs, how to best inform people living with HIV about how data about them are used in public health programs, and related ethical issues. Participants were broadly supportive of introducing some forms of consent into MHS/CDR. However, they differed on the specifics of implementing consent. While some participants did not support introducing consent affordances, all supported the idea that people living with HIV should be informed about how HIV surveillance and prevention is conducted and how individuals' data are used. MHS/CDR has caused sustained controversy. Among critical stakeholders, consent is generally desirable but contested, although the right for people living with HIV to be informed was centrally supported. In an era of big data-driven public health interventions and routine uses of HIV genetic sequence data in surveillance and prevention, CDC and other agencies should revisit public health ethics frameworks and consider the possibility of consent processes. [ABSTRACT FROM AUTHOR]

Throughout the COVID-19 pandemic, politicization of public health policy has loomed over the governmental response in the United States. The scope of politicization is underscored by instances of political pressures faced by public employees across state and local government. Observation of such instances prompts questions regarding the implications of highly politicized crisis on public personnel systems. Using systematic qualitative content analysis of data from syndicated news articles, this study identifies publicized instances of adverse personnel actions experienced by public employees during the first six months of the COVID-19 pandemic. Following the identification of publicized instances, this study also explores legislative trends focusing on public personnel systems during highly politicized emergency conditions. Results outline the positional roles subject to adverse actions, along with traits of legislative activity changing public personnel systems in the states identified. Implications of the study and considerations for future research are then discussed. [ABSTRACT FROM AUTHOR]