Global antimicrobial resistance (AMR) is currently governed by a decentralized regime complex composed of multiple institutions with overlapping and sometimes conflicting principles, norms, rules, and procedures. Such a decentralized regime complex provides certain advantages and disadvantages when compared to a centralized regime. A pandemic instrument can optimize the regime complex for AMR by leveraging the strengths of both centralization and decentralization. Existing climate treaties under the UNFCCC offer lessons for achieving this hybrid approach.

To address the complex challenge of global antimicrobial resistance (AMR), a pandemic treaty should include mechanisms that 1) equitably address the access gap for antimicrobials, diagnostic technologies, and alternative therapies; 2) equitably conserve antimicrobials to sustain effectiveness and access across time and space; 3) equitably finance the investment, discovery, development, and distribution of new technologies; and 4) equitably finance and establish greater upstream and midstream infection prevention measures globally. Biodiversity, climate, and nuclear governance offer lessons for addressing these challenges.

The inclusion of antimicrobial resistance (AMR) and increased research and development (R&D) capabilities in the most recent outline of the World Health Organization’s (WHO’s) international pandemic instrument signals an opportunity to reshape pharmaceutical R&D system in favour of antimicrobial product development. This article explains why the current innovation ecosystem has disadvantaged the creation of antimicrobial products for human use. It also highlights how the COVID-19 pandemic experience can inform and stimulate international cooperation to implement innovative R&D incentives (...) to bring new, life-saving antimicrobial products to the market. (shrink)

Governments can practically and efficiently address zoonoses and AMR –– within the text of the new pandemic instrument. We map the overlaps between the efforts needed to address both pandemic threats, including (a) equitable access to medical countermeasures, (b) globally integrated One Health surveillance and monitoring systems, (c) increased technical and laboratory capacity in low- and middle-income countries, and (d) a regulatory framework governing the stewardship of antimicrobials. By outlining potential dual-purpose provisions that could be included in (...) a pandemic instrument, we argue that addressing AMR in the pandemic instrument is practicable, the most effective use of limited time and resources, and provides the best opportunity for future global pandemic readiness. (shrink)

Despite recognition of the health threat posed at the human-animal-environment interface long ago, One Health has yet to be meaningfully integrated into global pandemic prevention, preparedness, and response. With the negotiation of the forthcoming pandemic instrument under the auspices of the World Health Organization (WHO) — which is inherently restricted by its own constitutional mandate of human health — One Health risks being sidelined once again. Genuine integration of a One Health approach into this treaty will require (...) the institutionalization of formal One Health coordination mechanisms. (shrink)

In the wake of COVID-19, the World Health Organization established an Intergovernmental Negotiating Body to negotiate a new instrument for pandemic prevention, preparedness, and response. This special issue of the Journal of Law, Medicine & Ethics brings together multidisciplinary scholarship to address the question of whether antimicrobial resistance should be included in this new instrument. Drawing from disciplines including law, anthropology, history, public health, public policy, economics, and veterinary medicine, this special issue explores the inclusion of AMR (...) within the Pandemic Instrument from three perspectives: first, through the lens of global AMR governance, second, from the perspective of technical governance challenges and opportunities affecting the global ability to address AMR and future pandemics, and third, from the perspective of pandemic instrument mechanisms for strengthening global AMR governance. Each paper makes a concrete recommendation with respect to the importance of including AMR within the scope of the pandemic instrument. (shrink)

Ensuring that life-saving antimicrobials remain available as effective treatment options in the face of rapidly rising levels of antimicrobial resistance will require a massive and coordinated global effort. Setting a collective direction for progress is the first step towards aligning global efforts on AMR. This process would be greatly accelerated by adopting a unifying global target — a well-defined global target that unites all countries and sectors. The proposed pandemic instrument — with its focus on prevention, preparedness and (...) response — represents an ideal opportunity to develop and adopt a unifying global target that catalyzes global action on AMR. We propose three key characteristics of a unifying global target for AMR that — if embedded within the pandemic preparedness instrument — could rally public support, funding, and political commitment commensurate with the scale of the AMR challenge. (shrink)

The complex history of pandemics has created a diversified array of anti-epidemic responses, which have allowed structures of authority to express their power in multiple ways. In this paper, by considering theories applicable to cases ranging from Europe to Asia, from the 11th to the 18th century, we conduct a comparative analysis capable of identifying common traits and radical differences, aiming to show how such deployment of power was not always commensurate with the medical theories of the age, and with (...) the gravity of the epidemiological situation. Specifically, we analyse how Western European States, in their process of formation, employed the concept of ‘public health’ to create the grounds for an unprecedented exercise of power over the private sphere. Furthermore, we compare this attitude with the discrimination of the minority known as burakumin in Japan, which was destined to undertake any ‘dirty’ or ‘impure’ occupation, to preserve the immunity of the community. In other words, we examine how structures of power have exploited states of exception to implement control measures beyond the needs of the situation through an increasingly hypertrophic apparatus of security; and ways in which political authorities have not aligned with medical or philosophical authorities of their times, for opportunistic reasons that benefited their own social, religious, or racial group. (shrink)

As Member States of the World Health Organization (WHO) meet in an International Negotiating Body (INB) to negotiate a legally binding agreement on pandemic prevention, preparedness, and response for submission to the 77th World Health Assembly in May 2024, this column reflects on creative but pragmatic and complementary means that could be employed in the short timeframe allotted for this important global health law negotiation.

This chapter provides a high-level overview of key ethical issues raised by the use of surveillance technologies, such as digital contact tracing, disease surveillance, and vaccine passports, to combat the COVID-19 pandemic. To some extent, these issues are entirely familiar. I argue that they raise old questions in new form and with new urgency, at the intersection of information ethics, research ethics, and public health. Whenever we deal with data-driven technologies, we have to ask how they fare in relation (...) to important values like privacy, fairness, transparency, and accountability—values emphasized by information ethics scholars. Likewise, when such technologies put individuals at risk in order to drive scientific research and knowledge construction, we have to ask how they implicate values such as autonomy, beneficence and non-maleficence, and justice—values central to research ethics. And as researchers focusing on health information have long argued, when the data collected by these technologies pertain to individuals and public health, these ethical issues take on a special cast. -/- It is also true, however, that the pandemic has placed these questions in a new and revealing light. I highlight three insights from information ethics and research ethics that can help us navigate this difficult terrain. First, the value of privacy is instrumental, not absolute—there is nothing wrong with asking how to balance privacy against other important values. Second, privacy has both individual and social importance. Weighing privacy, on one hand, and public health, on the other, is not, therefore, a contest between individual and collective interests. Rather, it is an attempt to balance disparate public goods. Third, we ought to put these kinds of ethical decisions in the hands of third parties, rather than leaving them up to those who directly stand to benefit from them. In the case of pandemic surveillance technologies, this should mean more public, democratic oversight. (shrink)

The pandemic motivated nutrition and healthy living to maintain a healthy lifestyle. The objective is to analyze and describe the perspectives of post-pandemic lifestyles of university students, using the quantitative cross-sectional method with non-probabilistic sampling and survey that measures the nutritional level and level of physical activities, 1033 university students participated. The results showed that the measurement instrument in the Peruvian context is acceptable and that the level of lifestyle is moderate. In conclusion, nutritional policies and physical (...) activities should be considered in universities so that university students practice a healthy lifestyle and take care of their health. (shrink)

In the near future, experts predict, an influenza pandemic will likely spread throughout the world. Many countries have been creating a contingency plan in order to mitigate the severe health and social consequences of such an event. Examination of the pandemic plans of Canada, the United Kingdom and the United States, from an ethical perspective, raises several concerns. One: scarcity of human and material resources is assumed to be severe. Plans focus on prioritization but do not identify resources (...) that would be optimally required to reduce deaths and other serious consequences. Hence, these plans do not facilitate a truly informed choice at the political level where decisions have to be made on how much to invest now in order to reduce scarcity when a pandemic occurs. Two: mass vaccination is considered to be the most important instrument for reducing the impact of infection, yet pandemic plans do not provide concrete estimates of the benefits and burdens of vaccination to assure everyone that the balance is highly favorable. Three: pandemic plans make extraordinary demands on health care workers, yet professional organizations and unions may not have been involved in the plans' formulation and they have not been assured that authorities will aim to protect and support health care workers in a way that corresponds to the demands made on them. Four: all sectors of society and all individuals will be affected by a pandemic and everyone's collaboration will be required. Yet, it appears that the various populations have been inadequately informed by occasional media reports. Hence, it is essential that plans are developed and communication programs implemented that will not only inform but also create an atmosphere of mutual trust and solidarity; qualities that at the time of a pandemic will be much needed. (shrink)

Antimicrobial resistance (AMR) is one of the defining global health threats of our time, but no international legal instrument currently offers the framework and mechanisms needed to address it. Fortunately, the actions needed to address AMR have considerable overlap with the actions needed to confront other pandemic threats.

The most urgent challenge of this year – the COVID-19 pandemic and measures of response to it – has sharpened and accelerated the process which was initially driven by bureaucratization and formalization: increasing depersonalization of academic life and the erosion of the university as a unique form of coexistence. The Assuming the concept of the university as a value category, this article aims to review and assess the changes in the self-perception of the academic community that have matured and (...) acquired institutional forms in an attempt to adapt to rapidly shifting societal expectations and needs. Modern trends in university development are best expressed in terms such as “bureaucratization”, “formalization”, “depersonalization”, “instrumentalization of knowledge”, and “community fragmentation”. The pandemic of effective management that has affected Western universities and has gradually reached Vilnius University, no less than the pandemic of COVID-19 and administrative response to it, weakens the academic community based on autonomous and collegial decisions, which should be considered among the most important grounds of uniqueness of university as an institution. (shrink)

Securing equitable antibiotic access as an essential component for health system resilience and pandemic preparedness requires a systems perspective. This article discusses key components that need to be coordinated and paired with adequate financing and resources to ensure antibiotic effectiveness as a global public good, which should be central while discussing a new global agreement.

Since 2020, the COVID-19 pandemic had an impact on education worldwide. There is increased discussion of possible negative effects on students’ learning outcomes and the need for targeted support. We examined fourth graders’ reading achievement based on a school panel study, representative on the student level, with N = 111 elementary schools in Germany. The students were tested with the Progress in International Reading Literacy Study instruments in 2016 and 2021. The analysis focused on total average differences in reading (...) achievement between 2016 and 2021, average differences controlling for student composition, and changes in achievement gaps between student subgroups. The methodological approach met international standards for the analysis of large-scale assessments. The results showed a substantial decline in mean reading achievement. The decline corresponds to one-third of a year of learning, even after controlling for changes in student composition. We found no statistically significant changes of achievement gaps between student subgroups, despite numerical tendencies toward a widening of achievement gaps between students with and without immigration background. It is likely that this sharp achievement decline was related to the COVID-19 pandemic. The findings are discussed in terms of further research needs, practical implications for educating current student cohorts, and educational policy decisions regarding actions in crises such as the COVID-19 pandemic. (shrink)

The COVID-19 pandemic has challenged the world for a year, where a study in China showed that the disease increased psychological distress among adolescents and college students, such as anxiety about the academic setback, economic effects, and impact on their daily life. However, a further study examining the impact of the disease on the mental health of students is required. Social support is the most vital psychosocial protective resource, where effective coping can reduce stress levels and prevent individuals from (...) experiencing more severe psychological distress. Therefore, this study investigated the coping strategy, social support, and psychological distress among university students in Jakarta who are also the epicenter of COVID-19 in Indonesia. The psychological distress and coping strategy variable were measured through the Hopkins Symptoms Checklist-25 and the COPE Brief instrument, respectively. Meanwhile, the Multidimensional Perceived Social Support-12 instrument was used to measure the social support variable. The study was disseminated via an online form and the number of research subjects included 250 students who matched the research criteria, including DKI Jakarta domicile and active students registered in the area that were confirmed to be COVID-19 positive. According to the results, coping strategies and increased social support were significantly correlated with decreased psychological distress and may serve as the basis for interventions. (shrink)

This study aimed to analyse the contribution of infaq funds to the social and economic resilience of the community during the COVID-19 pandemic in West Papua, Indonesia. This study uses a mixed-method approach, combining qualitative and quantitative studies. Qualitative data were collected through focus group discussions with administrators, Dai [Islamic preacher] and mosque congregations to obtain information about the form and mechanism for disbursing infaq funds. Furthermore, the state of distribution of infaq funds is confirmed to the recipient community (...) with an online survey as quantitative data. The data obtained were tabulated and analysed with descriptive and inferential statistics using multiple linear regression assisted by SPSS software 25 version. The research findings show that: firstly, the form of the social-economic contribution of infaq funds is carried out by: (1) financial assistance, (2) social assistance, and (3) health assistance. Secondly, infaq, an instrument of Islamic economics, can contribute to tackling the social and economic impacts of the community amid the COVID-19 outbreak. Thirdly, of the three forms of assistance provided, the health assistance aspect contributed 38.320%, the financial assistance aspect amounted to 37.173% and 24.339% to social assistance. This study shows that the community most needed health and financial assistance from infaq funds during the COVID-19 pandemic.Contribution: This study complements the existing literature and provides a new scientific treasure. That the infaq fund, as a philanthropy, turned out to be able to contribute to realising the social-economic resilience of the community during a disease outbreak. The form of health, financial and social assistance from infaq funds is a priority in accelerating the community’s economic recovery. It can be a countermeasure to socio-economic impacts during disasters and disease outbreaks. (shrink)

The Brazilian Federal Senate created a Parliamentary Inquiry Commission (CPI) to investigate the Bolsonaro government's irregularities in the management of the COVID-19 pandemic. One of the cases that drew attention was the research conducted by Prevent Senior, a private health insurance company, on the early treatment of COVID-19. The article analyzes the scientific validity of the research and the ethical problems related to its implementation. It is based on analysis of Prevent Senior's report of the clinical study, the Brazilian (...) and USA clinical trial registries, the Senate's CPI report, and on the information reported by the media. This case of scientific fraud and political-ideological bias exemplifies how Prevent Senior, using a questionable protocol to enhance its reputation and gain government support, was instrumental in building the “early treatment” narrative for COVID-19, and shows how it served as a basis for a government public policy that promoted the use of ineffective drugs. (shrink)

Social policy is based, since its inception, on a certain “philosophy” regarding the desirable social model, encompassing religious, political and social values, as well as appropriate objectives and tools for protecting vulnerable target groups. This philosophy differs both geographically and historically. Thus, European social policies have a specific axiological foundation comparing to social models developed on other continents. Even if relatively stable, this foundation is continuously redefined and, therefore, the European social model is an evolving concept. Our paper analyses how (...) social vulnerability and vulnerable groups are redefined within the European social policies, during Covid-19 pandemic. If in recent decades the European social policies have tried to implement more selective and means-tested social protection, the approach to social protection during the pandemic is different, there are indications of increasing the universalisation of social benefits for covering new vulnerabilities. In our analysis, the pandemic accentuated some pre-existing trends to redefine the predilect target groups and their social protection: larger decommodification, protection for atypical employment, social security schemes covering new risks, and instruments for a new work-life balance. At the same time, European social protection policies tend towards synergy with actions in the fields of digitalisation and ecology. Are these changes temporary or will they last even after the pandemic? Of course, it is difficult to make predictions, but we believe that some of them anticipate possible structural reforms of more humane, less biopolitical European social protection policies. Our analysis is based on data from social statistics, official documents and public speeches. (shrink)

Recent debate over World Health Organization reform has included unprecedented attention to international lawmaking as a future priority function of the Organization. However, the debate is largely focused on the codification of new binding legal instruments. Drawing upon lessons from the success of the Global AIDS Reporting Mechanism, established pursuant to the United Nations' Declaration of Commitment on HIV/AIDS, we argue that effective global health governance requires consideration of a broad range of instruments, both binding and nonbinding. A detailed examination (...) of the Global AIDS Reporting Mechanism reveals that the choice of the nonbinding format makes an important contribution to its effectiveness. For instance, the flexibility and adaptability of the nonbinding format have allowed the global community to: (1) undertake commitments in a timely manner; (2) adapt and experiment in the face of a dynamic pandemic; and (3) grant civil society an unparalleled role in monitoring and reporting on state implementation of global commitments. UNAIDS' institutional support has also played a vital role in ensuring the continuing effectiveness of the Global AIDS Reporting Mechanism. Overall, the experience of the Global AIDS Reporting Mechanism evidences that, at times, nimbler nonbinding instruments can offer benefits over slower, more rigid binding legal approaches to governance, but depend critically, like all instruments, on the perceived legitimacy thereof. (shrink)

Abstract2020 saw the rapid onset of a global pandemic caused by the SARS‐CoV‐2 virus. For healthcare systems worldwide, the pandemic called upon quick organization ensuring treatment and containment measures for the new virus disease. Nurses were seen as constituting a vital instrumental professional component in this study. Due to the pandemic's unpredictable and potentially dangerous nature, nurses have faced unprecedented risks and challenges. Based on interviews and free text comment from a survey, this study explores how ethical (...) challenges related to “being a nurse” during the COVID‐19 pandemic was experienced and understood by Danish hospital‐based nurses. Departing from anthropologist Jarett Zigon's notion of moral breakdown, the study demonstrates how the rapid onset of the pandemic constitutes a moral breakdown raising ethical demands for nurses. Analytically we identify three different ethical demands experienced by the nurses. These ethical demands are Nursing and societal ethical demands, Nursing and personal ethical demands, and Nursing and conflicting ethical demands. These demands represent not only very different understandings of ethical demands but also different understandings of ethical acts that are seen as necessary to respond to these demands. (shrink)

Distinct sources of stress have emerged during the COVID-19 pandemic. Particularly, fear is expected to generate significant psychological burden on individuals and influence on either unsafe behavior that may hinder recovery efforts or virus-mitigating behaviors. However, little is known about the properties of measures to capture them in research and clinical settings. To resolve this gap, we evaluated the psychometric properties of a novel measure of fear of illness and viruses and tested its predictive value for future development of (...) distress. We extracted a random sample of 450 Chilean adult participants from a large cross-sectional survey panel and invited to participate in this intensive longitudinal study for 35 days. Of these, 163 ended up enrolling in the study after the demanding nature of the measurement schedule was clearly explained to them. For this final sample, we calculated different Confirmatory Factor Analyses (CFA) to evaluate the preliminary proposed structure for the instrument. Complementarily, we conducted a content analysis of the items to qualitatively extract its latent structure, which was also subject to empirical test via CFA. Results indicated that the original structure did not fit the data well; however, the new proposed structure based on the content analysis did. Overall, the modified instrument showed good reliability through all subscales both by its internal consistency with Cronbach’s alphas ranging from 0.814 to 0.913, and with test–retest correlations ranging from 0.715 to 0.804. Regarding its convergent validity, individuals who scored higher in fears tended to also score higher in depressive and posttraumatic stress symptoms at baseline. Furthermore, higher fears at baseline predicted a higher score in posttraumatic stress symptomatology 7 days later. These results provide evidence for the validity, reliability, and predictive performance of the scale. As the scale is free and multidimensional potentially not circumscribed to COVID-19, it might work as a step toward understanding the psychological impact of current and future pandemics, or further life-threatening health situations of similar characteristics. Limitations, practical implications, and future directions for research are discussed. (shrink)

With the outbreak of COVID-19 pandemic in 2020, teaching online became a norm for universities in Canada. Besides the challenges of teaching topics that may be impossible to be taught online, a major issue that the mandatory physical distancing brought is the relationality between teachers and students. In order to investigate how educators were making sense of such changes, semi-structured interviews were conducted with 12 education professors across Canada. In light of Derrida’s and Ruitenberg’s ethic of hospitality, this paper (...) explores how the abrupt shift to online education unveiled the nature and challenges of hospitable education, especially in the online context. The implications of online instruction to professors’ relationality, however, are also instrumental in illuminating the complexities and ambiguities of a teacher’s responsibility even in what could be considered the “normal circumstances” of face-to-face instruction. (shrink)

In the past decade, numerous ethical frameworks have been developed to support public health decision‐making in challenging areas. Before the COVID‐19 pandemic began, members of the authorship team were involved in research programmes, in which the development of ethical frameworks was planned, to guide (a) the use of new technologies for emerging infectious disease surveillance; and (b) the allocation of scarce supplies of pandemic influenza vaccine. However, as the pandemic evolved, significant practical challenges emerged that led to (...) our questioning the value of these frameworks. We now believe that a normative instrument, such as a framework, cannot adequately or reliably provide the ethical guidance that needs to be incorporated into public health decision‐making during natural disasters or infectious disease emergencies. Recently it has been suggested that there are potentially more dynamic, flexible, and effective ways to navigate decisions involving complex considerations entailed in policies and practices during a public health emergency. In this paper, we first outline the key functions of a public health ethics framework, before describing why we believe it would not be fit for purpose during a crisis. We end by considering whether proposed alternative methods to promote ethical public health decision‐making goals have the potential to meet these objectives. (shrink)

The Coronavirus disease 2019 pandemic is affecting many areas of life and has led to major changes in undergraduate medical education. Even before the COVID-19 pandemic, high mental burden of medical students has frequently been reported in the literature. Additional pandemic-specific stressors could exacerbate this situation. This study aimed to assess mental health outcomes among medical students during the first semester after the COVID-19 outbreak and perception of the students on how the learning environment has changed. In (...) May 2020, we conducted a cross-sectional survey among undergraduate medical students at a large medical school in Germany. The survey included validated mental health instruments and self-developed items to examine the perception of the study situation during the COVID-19 pandemic. Open-ended questions were analyzed by conventional content analyses. The response rate was 59.2%. Overall, 61.9% of the students reported distress levels above the cutoff. Year 1 students reported significantly higher levels of distress, anxiety and depression than students during their second to fourth year of studies. 48.3% of the students indicated a decrease in their study motivation since the beginning of the COVID-19 pandemic with significant differences between study years. The binary logistic regression model showed that male gender, being in study year 2, higher distress scores and higher symptoms of depression were significantly associated with a higher likelihood for experiencing serious worries. In the open-ended questions on current concerns related to the impact of the COVID-19 pandemic on their studies, students most frequently reported concerns about missing relevant practical learning experience, difficulties with self-regulated learning and self motivation as well as study-related worries. Year 4 students reported significantly more worries about the lack of practical training than students from study years 1 to 3. Analysis of gender differences showed that female students reported more frequently diverse worries. In contrast, female students shared more frequently helpful strategies in all the categories compared to male students. Our findings suggest that medical students experience significant levels of distress and mental burden during the COVID-19 pandemic and highlight the need for ongoing psychological and educational support for medical students during the COVID-19 pandemic and after. (shrink)

This study examines the practice of corporate social responsibility (CSR) during COVID-19. Little is known about how organizations practice CSR during acute exogenous crises. Overlooking how CSR practices change during a crisis matters because organizations are compelled into trade-offs that carry implications for their CSR initiatives. Analysis of interview data with CSR managers, from 21 Dubai-based business organizations during COVID-19, uncovers changes in the content and process of CSR during the pandemic. The results show that the practice of CSR (...) underwent a fundamental change in focus as organizations shifted to an employee-centric model of CSR and away from an environmental one. Measures placed on organizations and society to combat the pandemic also led to a recalibration of stakeholder and issue salience, with notable effects on CSR that challenge the capability of the power–legitimacy–urgency framework to anticipate these shifts. We consider the impacts associated with the shift in the content of CSR initiatives and process of their implementation and discuss the implications of the findings for CSR theory, research, policy, and practice. (shrink)

The presented study raises the issue of contribution payers in the field of social insurance, in particular based on the Covid-19 pandemic. Searching for ways of supporting was determined by the deterioration of the financial condition of entrepreneurs as payers of contributions. In 2020, there were no instruments or mechanisms to support entrepreneurs in a lockdown situation, which implied the need to build such tools and the legal environment for SMEs practically from the beginning. The Social Insurance Institution (ZUS) (...) was entrusted with the role of a stabilizer, consisting in servicing entrepreneurs as part of subsequent editions of the Anti-Crisis Shield. During the announcement of the COVID-19 pandemic, ZUS used the following forms of support for contribution payers: exemption from the obligation to pay contributions, postponement of the payment of contributions and payment of contributions in installments. The research question concerned the enforcement of the law and respect for the basic rights of entrepreneurs in the scope of the support used. In order to solve the research task legal interpretation were used in the work. The author’s considerations lead to the conclusion that forms of support used in connection with the Covid-19 pandemic turned out to be effective and may be used in the future in emergency situations. An important science contribution of the article results from the combination of the selected legal and economic aspects. (shrink)

This article examines the legitimization process of the public health preventive measures implemented in many Western countries following the SARS-CoV-2 outbreak. Through concepts such as governmentality, disciplinarization and security mechanisms proposed by Foucault, we trace some of the basic principles and implications of the relationship between biopower and medicine, as well as the media dissemination of an official narrative on scientific truth. These reflections are complemented by the contributions of Francois Lyotard and Jean Baudrillard. Lyotard reflects on the relationship between (...) science and a “performative game”, whose own staging is the core of its criteria of truth. Baudrillard shows the relevance of a “hyperreality” in which the signs presented by the media take precedence over the experience of the subjects. We argue that a mediatized version of science, defined through a strong disciplinarization of knowledge and the censorship of dissident voices, played a key role in the establishment of consensus and the legitimization of policies that granted extraordinary power to governments and transnational elites. Although the work of Foucault in this demonstration is essential, the contributions of Lyotard and Baudrillard provide additional elements to understand a fundamental problem: the public acceptance of “truth” as an instrument of governmentality on a global scale. (shrink)

Telepsychotherapy is an increasingly common way of conducting psychotherapy. Previous research has shown that patients usually have positive experiences of online therapy, however, with large individual differences. The aim of this study was to explore patients’ experiences of transition from in-person psychotherapy sessions to telepsychotherapy during the COVID-19 pandemic, as well as variation in the experiences with regard to the patients’ personality orientation. Seven psychotherapy patients in Sweden were interviewed and the transcripts were analyzed using thematic analysis. Additionally, the (...) participants were asked to rate their dissatisfaction/satisfaction with the transition, how hindering/helpful the transition was, and how unsafe/safe they felt after the transition in comparison to before. Personality orientation on relatedness or self-definition was assessed applying a self-assessment instrument. The participants experienced telepsychotherapy as qualitatively different from in-person psychotherapy. They reported several essential losses: the rituals surrounding therapy sessions were lost, including the transitional time and space between their every-day life and the therapy sessions, less therapeutic work was done, the therapists could lose their therapeutic stance, the sense of rapport was impaired, and the patients felt less open and emotionally available. On the other hand, some patients could feel freer online. As six of the participants had an anaclitic personality orientation, the present study could especially contribute to the understanding of how patients with strong affiliative needs and fear of abandonment experience the transition to meeting their therapists via communication technology. The participants’ self-ratings showed that they were only marginally dissatisfied with the transition and experienced the transition as slightly hindering, whereas they felt rather safe after the transition, indicating low concordance between qualitative and quantitative evaluations. New studies are needed to explore the introjective patients’ experiences of the transition. An essential topic is also to collect evidence and to test how the impaired sense of rapport when using communication technology can be remedied by adequate, patient-tailored interventions, a topic that has to be included in psychotherapy education and training. (shrink)

The World Health Organization (WHO) is currently in advanced stages of developing a ‘WHO convention, agreement, or other international instrument on pandemic prevention, preparedness and response’ (also known as WHO CA+, referred to below as: Pandemic Agreement).1 Rightly, the instrument places equity at the centre. Yet, it currently also omits reference to an impactful tool to promote equity that has been adopted in an unprecedented manner during COVID-19—a set of measures known as disadvantage indices. Embedding disadvantage (...) indices would provide concrete constructive guidance; align the Pandemic Agreement with the use of indices by other United Nations (UN) agencies; help realise the Agreement’s goal of addressing social and other determinants of health within countries, and furthermore offer feasible ways improving equity in allocation across countries. WHO member states began work on a Pandemic Agreement in December 2021. The current timeline envisages a final version to be considered by the May 2024 World Health Assembly.1 The publicly available version of the Pandemic Agreement at the time of writing comprises 36 articles under three separate chapters (Bureau’s Text, A/INB/7/3, 30 Oct 2023).1 Chapter 1 provides general scene setting describes objectives, and highlights key terms. While the concept of equity is still somewhat implicit and would benefit from further articulation,2 overall, there seems to be a latent understanding that inequity obtains when there are unfair differences in health outcomes and opportunities within and across countries. Correspondingly, ‘[e]quity is at the centre of pandemic prevention, preparedness, response, both at the national level within States and at the international level between States. It requires, inter alia, specific measures to protect persons in vulnerable situations’.1 Chapter 3 addresses procedural issues, such as the establishment and rules of interactions of different types of advisory committees. Chapter 2 is titled ‘The world together equitably: …. (shrink)

COVID-19 catalyzed a renewed focus on the interconnected nature of human health. Together with the climate crisis, it highlighted not only intra-human connections but the entanglement of human health with the health of non-human animals, plants, and ecological systems more broadly. In this article, we challenge the persistent notion that humans are ontologically distinct from the rest of nature and the ethics that flow from this understanding. Imposing this privileged view of humans has devastating consequences for beings other than humans (...) and for humans and impedes effective responses to crises. We situate the COVID-19 pandemic within the “polycrisis,” and argue that one component of addressing multidimensional crises must involve fully embracing a relational ontology and ethics. We discuss two approaches to relationality, one articulated by ecofeminists and the second inhering in an Indigenous Māori worldview. Two dominant approaches, One Health and Planetary Health, purport to take account of relational ontologies in their approaches to health, but, we argue, persist in casting the more-than-human world in an instrumental role to secure human health. We suggest that Multispecies Justice, which draws on ecofeminist and Indigenous approaches, affords a fully relational approach to health and well-being. We explore the implications of relationality, and suggest fresh ways of understanding humans’ connections with the more-than-human world. (shrink)

Considering the high impact strain that the severe acute respiratory syndrome coronavirus 2 pandemic has put on medical personnel worldwide, identifying means to alleviate stress on healthcare professionals and to boost their subjective and psychological wellbeing is more relevant than ever. This study investigates the extent to which the relationships between the status of working in healthcare and the subjective and psychological wellbeing are serially mediated by work recovery experiences and the need for recovery. Data were collected from 217 (...) Romanian employees using a cross-sectional design with self-report instruments, during the first stage of the nationwide lockdown. The results of the serial mediation analyses revealed that working in the medical field is indirectly related to subjective and psychological wellbeing through the following: mastery experiences and mastery experiences as an antecedent of the need for recovery. As such, our findings indicate that working in the medical field is, in fact, linked to healthcare professionals’ subjective and psychological wellbeing, and they provide some input on how recovery experiences and the need for recovery intervene in these relationships. Based on these findings, theoretical, methodological, and practical implications were suggested, and future research directions were proposed to maximize healthcare professionals’ wellbeing. (shrink)

Business ethics researchers and practitioners are interested in understanding the temporal mechanisms of various managerial activities, processes, and policies. In this direction, I borrow notions of time from Virginia Woolf’s _Mrs. Dalloway_ to examine how social time intersperses with the paid and (unpaid) care work of female employees during the pandemic. I explore how discussions of social time in connection to care work appear in newspaper discourses of “shecession”, i.e. the large-scale job/income losses experienced by women during the COVID-19 (...) pandemic. Since shecession is a byproduct of the pandemic times, exploring the role of time in it is crucial. In fact, my findings show that the macro social time of the pandemic affects working women with care responsibilities who are situated at the intersection of multiple vulnerable social categories by simultaneously being a penalizer and a lost opportunity. Similarly, I also find that the micro social times of working women embed, stratify, and synchronize differently during the pandemic when compared to normal times. Working women with care responsibilities are thus adversely affected by both micro and macro social time changes. My findings, therefore, could be instrumental in developing and implementing inclusive policies and processes in business organizations and labor markets. In so doing, my study also indicates how a consideration of social time enriches the application of care ethics in work contexts. Ultimately, this article is also about developing caring organizations, societies, and families which care for the caregivers (working women), since receiving care is a precondition of giving care. (shrink)

IntroductionIn the coronavirus disease 2019 pandemic, Romanian universities switched to emergency relocation and online education, with students experiencing a sense of isolation, which affected their well-being, pace and normal learning style, relationships with other colleagues, and Professors. Beyond the technological obstacles that have arisen in learning, the aim of this study is to highlight the psychological variables that are associated and that explain the self-perceived well-being of students, in university, in the pandemic. The psychological variables studied were the (...) following: the level of openness and personal autonomy, as personality traits of students but also the mechanisms for regulating their academic motivation.MethodWe used a questionnaire-based survey, wherein all four research instruments had been validated and adapted to the investigated population. The subjects were BA and MA students at the University of Oradea, Romania, the majority being females with the age range of 27 years old. Pearson Correlation and Multiple Linear Regression were used to test the two hypotheses.ResultsResearch data obtained in the correlation analysis, point out association relationships with moderate and high effects size, between positive attitude toward self, others and student life and: openness to learning, openness to aesthetics, behavioral autonomy, cognitive autonomy, intrinsic motivation, and identification motivation. Furthermore, in regression analysis, it was revealed that regarding the variance of results concerning students’ self-perceived well-being in university, it contributes both of students’ personality traits and their intrinsic motivation and identification motivation.ConclusionThe fundamental conclusion of the research is that, although the personality traits of students explain in a higher percentage the variability of results in students’ self-perceived well-being, motivation regulation mechanisms play an important role, especially in the conditions of online activities. The results have direct implications for the work carried out in universities. The educational policies developed by specialists and government will have to emphasize the ways of forming resilient student communities in periods of sudden transition and adaptation to change which take place in education and society. (shrink)

Household confinement due to the rapid spread of the pandemic caused by COVID-19 has brought very significant changes, such as the forced stay-at-home of children due to the closure of schools. This has meant drastic changes in the organization of daily life and restrictions on their activities, including exercise, which could affect the quality of life of the children due to its importance. In order to study the relationship between physical activity and psychological well-being of minors, a study has (...) been carried out with Mixed Methods Research, combining survey methodology with transversal design with qualitative methodology using discourse analysis. A total of 234 parents of minors in Spain and several Spanish-speaking countries in America participated. The instrument was a questionnaire in Google Forms, which included the Kidscreen-27 quality of life scale. The results show significant differences in both the type of physical activity and its frequency due to age, and differences in parents’ perception of whether their children’s physical activity levels were sufficient or not, both on the health, mood and school subscales, and in the categorization of open responses referring to concerns due to the pandemic, analyzed with the ALCESTE technique. The relationship between physical activity of children and adolescents and quality of life is clearly concluded. (shrink)

Anti-theory is a multi-faceted critique of moral theory which, it appears, is undergoing something of reassessment. In a recent paper Hämäläinen discusses the relevance of an anti-theoretical perspective for the activity of applied ethics. This paper explores her view of anti-theory. In particular I examine its relevance for understanding the formal guidance on pandemic flu planning issues by the Department of Health in the UK and some subsequent discussions around triage and reverse triage decisions which may be considered by (...) both Primary and Secondary Care Trusts. in setting their own policies and which may face clinicians in the eventuality of a pandemic. Following Hämäläinen in contrasting reflective equilibrium with her anti-theory inspired suggestion of an instrumental approach to moral theory in practice I demonstrate how this understanding complements the diversity of our intuitive moral judgements. Consequentially I suggest that this anti-theoretical instrumental approach is in greater accord with the conditions under which such policy planning and decision making is, or will be, made. Furthermore, on the grounds of keeping open the ethical dimensions of medical practice in conditions of uncertainty, i.e. during a pandemic, I suggest that the anti-theoretical instrumental perspective is, ethically, the preferable approach to producing such policies and guidelines. (shrink)

BackgroundThe relatively young and inexperienced healthcare professionals in Mongolia faced with an unprecedent service demand in response to the COVID-19 pandemic. Due to the small size of the healthcare workforce the Mongolian Health Ministry had no choice but to mandate continuous and long workhours from the healthcare workforce. Many of the healthcare professionals exhibited signs and symptoms of mental health disorders. This study aimed to discern the prevalence various mental health concerns, i.e., depression, anxiety and stress, insomnia, and to (...) discern the factors that increased susceptibility to mental health disorders among frontline healthcare professionals providing healthcare services for COVID-19 patients in Mongolia.MethodsA Cross-sectional research design was implemented. We collected data from 965 healthcare professional, randomly selected from 18 government hospitals, in four regions of Mongolia. Data were collected using the Depression Anxiety Stress-21, the General Self-Efficacy Scale, and the Insomnia Severity Index instruments. We constructed the scale of Pandemic Response Symptoms which captured stress, depression, and anxiety. Data were analyzed using descriptive statistics, Kruskal–Wallis statistical test and multinominal logistic regression analysis.ResultsPrevalence of depression, anxiety, and stress was documented among Mongolian healthcare professionals. Perception of self-efficacy reduced susceptibility to PaReSy either at mild/moderate or severe/extremely severe level. Within each stratum of insomnia, the risk of experiencing PaReSy increased almost linearly both in the category of mild/moderate PaReSy and in the category of severe/extremely severe PaReSy.ConclusionImproving self-efficacy and sleeping quality can assist healthcare workers to manage depression, anxiety, and stress. Findings provide important evidence to implement measures and strategies to assist healthcare professionals in low- and middle-income countries to constructively address their mental health concerns and needs. (shrink)

The novel COVID-19 infection has spread all over the world and is still generating a lot of issues at different levels. There is a lack of control in disease early diagnosis and rapid evolution, which impacts both the medical and the economic system. Young gastroenterologists should adapt to overcome current difficulties and continue their life and general training. This is a multi-center national study, which aims to assess the general perspective of young gastroenterologists from six university centers in Romania regarding (...) their current training and the psychological effect the pandemic has on their life and job. An online survey with 58 items was distributed using Google Forms, and quality of life and anxiety were assessed. The validated instruments 15D and endler multidimensional anxiety scales were used. All analyses were performed using SPSS 25. Of the 174 gastroenterologists approached, 96 responded. A majority of the respondents were residents in gastroenterology, and 40.6% were male. The pandemic influenced the number of examined patients as well as young gastroenterologists’ endoscopy training. Health-related quality of life was negatively associated with the level of anxiety generated by the cognitive component of anxiety as a state, the new and ambiguity of the state, and how threatened the respondent felt. The level of anxiety was moderate, and no difference was found between the physicians working in a designated hospital or not. General caution should be considered for young gastroenterologists’ training, and continuous observation should be done to ensure better mental health on the current evolution. These findings would need to be verified in larger-sample studies and in different types of specialties. (shrink)

Codes of medical ethics (codes) are part of a longstanding tradition in which physicians publicly state their core values and commitments to patients, peers, and the public. However, codes are not static. Using the historical evolution of the Canadian Medical Association's Code of Ethics as an illustrative case, we argue that codes are living, socio-historically situated documents that comprise a mix of prescriptive and aspirational content. Reflecting their socio-historical situation, we can expect the upheaval of the COVID-19 pandemic to (...) prompt calls to revise codes. Indeed, Alex John London has argued in favour of specific modifications to the World Medical Association's International Code of Medical Ethics (which has since been revised) in light of moral and scientific failures that occurred during the COVID-19 pandemic. Responding to London, we address the more general question: should codes be modified to reflect lessons drawn from the COVID-19 pandemic or future such upheavals? We caution that codes face limitations as instruments of policy change because they are inherently interpretive and ‘multivocal’, that is, they usually underdetermine or provide more than one answer to the question, ‘What should I do now?’ Nonetheless, as both prescriptive and aspirational documents, codes also serve as tools for reflection and deliberation—collective practices that are necessary to engaging with and addressing the moral and scientific uncertainties inherent to medicine. (shrink)

The accelerated rates of scientific and technological progress and the intellectualization of the main factors of production play a leading role in ensuring the economic recovery of national economies, in particular in the conditions of the existence of today's post-pandemic consequences. The technological development of the leading countries of economic development poses difficult tasks for other participants in the world economic space to avoid a significant lag, especially in today's post-pandemic society. For the countries of Eastern Europe, this (...) task is complicated not only by political and social tensions, but also by the lack of effective government regulation instruments that could provide support for the high-tech sector as a locomotive for the modernization of the national economy. Moreover, enterprises of the high-tech sector of the economy, being deprived of state support, must independently ensure their functioning by creating a system of economic security. Ensuring safety in a post-pandemic society of such enterprises is characterized by significant differences, which are most related to the need to create safe conditions for the activities of workers - the most valuable resource. The development of enterprises in the high-tech sector of the economy is impossible without taking into account the safety aspects, it requires the intensification of scientific research in this area. The purpose of the article is to form information support for managing the economic security of enterprises in the high-tech sector of the economy in the context of post-pandemic modernization. (shrink)

Since the onset of the COVID-19 pandemic, many parents have felt anxious, overwhelmed, and stressed out due to the changes in education and family and working routines. This work aimed to describe three dimensions of perceived parenting in the COVID-19 pandemic context, describe possible changes perceived by mothers in their children’s behavior during the social isolation phase, analyze if behavioral changes vary according to the dimension of perceived parenting, and analyze whether the characteristics of perceived parenting dimensions vary (...) with mother’s age, number of children and number of work hours. The purposive sample consisted of 646 mothers of school-aged children in Argentina. Questionnaires on sociodemographic and work-related data, and on children’s behavior were administered, as well as an instrument that assessed the three parenting dimensions. The sociodemographic and work-related variables of the study were described using descriptive statistics: measures of central tendency, frequencies, and percentages. The changes perceived in children’s behavior according to the reports given by the mothers regarding positive parenting, parenting stress, and school support were compared using the Mann Whitney’s U test, respecting the qualitative nature of the evaluated indicators. A factorial MANOVA was conducted to analyze the effect of mother’s age, ä number of children, and the number of work hours on parenting perceived by mothers. Parenting dimensions influenced the perceived children’s behavior. Mothers with higher positive parenting perceived more changes in their children’s behavior. In addition, those mothers who were more stressed out perceived more problems in almost all the measured behaviors than less stressed mothers. The mothers who reported to have provided more school support to their children perceived that they adapted better to online classes. Finally, mothers’ age and the number of children I parenting, particularly on parenting stress and school support, whereas work hours did not. A number of children affected stress and school support, and age only affected parenting stress. The only significant interaction regarding parenting was observed between the number of children and the number of work hours, which specifically affected parenting stress. Although social isolation due to COVID-19 affected children’s behavior, according to mothers, this might be partially linked to the number of children, mothers’ age, and the mothers’ parenting style. These initial findings may allow the identification of some protective factors and some risk factors of parenting in the Argentine context of a pandemic, and the design of preventive psychoeducational interventions to optimize the psychological wellbeing of families. (shrink)

During the initial phases of the COVID-19 pandemic, stress and anxiety were pervasive among the masses due to high morbidity and mortality. Besides the fear of coronavirus was also particularly driven by social media. Many people started to look for faith and spiritual connections to gain comfort. The role of spiritual ties and religious beliefs in relation to coping with pandemic stress gained the attention of researchers in some parts of the world. This cross-sectional survey aimed at assessing (...) the intensity of stress and anxiety symptoms experienced by people and how much they were alleviated by employing spiritual connections. The study sample comprises 795 respondents with 52% males and 48% females living in Saudi Arabia. The brief online study questionnaire collected data about background variables, anxiety and stress scale from DASS-21, and items from the WHOQOL instrument assessed the use of spiritual beliefs to cope. Multiple regression models were tested to determine the role of spiritual connections after adjusting demographic variables. Results illustrated that after adjusting for gender and age, participants' anxiety symptoms decreased by units with each unit increase in the use of spiritual connections, and participants’ stress symptoms reduce by units with each unit increase in coping with spirituality. Additionally, females’ risk to experience anxiety and stress symptoms was more than males and, respectively. An increase in age decreases the likelihood of experiencing anxiety symptoms and stress symptoms by and units respectively. Findings support the protective role of spiritual connections despite small beta coefficients. The social and cultural context in Saudi Arabia favors deep-rooted connections with spirituality and faith. Our findings support that the reliance on spiritual connections helped older people to deal with exaggerated fear during the initial phase of the COVID-19 pandemic and reduces the risk of experiencing anxiety and stress symptoms. Females and younger participants were relatively vulnerable to developing these symptoms. We discussed these findings considering some recent studies that reported similar relationships and made recommendations for future research. (shrink)

The article offers a theoretical analysis of the incorrect overlapping of the terms competence and value, value and belief, the confusion in using the terms value and value orientation and, as a result, the definitions of the concepts value and value orientation are proposed. The study aims to determine the dynamic and specifics of value manifestation in contemporary adolescents and young people in pre-pandemic and pandemic situations. The main part of the article is dedicated to the presentation of (...) obtained experimental data research received by four instruments used to get the most complex data regarding values and value orientations held by subjects. The focus of this article is on specificity of values held/maintained by contemporary adolescents and young people, relationship between terminal and instrumental values, significance of value differences in adolescents and young people, the changes that occurred in the value orientations during the pandemic period. (shrink)

Introduction: There is currently no binding, internationally accepted and successful approach to ensure global equitable access to healthcare during a pandemic. The aim of this ethical analysis is to bring into the discussion a legally regulated vaccine allocation as a possible strategy for equitable global access to vaccines. We focus our analysis on COVAX (COVID-19 Vaccines Global Access) and an existing EU regulation that, after adjustment, could promote global vaccine allocation. -/- Methods: The main documents discussing the two strategies (...) are examined with a qualitative content analysis. The ethical values reasonableness, openness and transparency, inclusiveness, responsiveness and accountability serve as categories for our ethical analysis. -/- Results: We observed that the decision-making processes in a legal solution to expand access to vaccines would be more transparent than in COVAX initiative, would be more inclusive, especially of nation states, and the values responsiveness and accountability could be easily incorporated in the development of a new regulation. -/- Discussion: A legal strategy that offers incentives to the pharmaceutical industry in return for global distribution of vaccines according to the Fair Priority Model is an innovative way to achieve global and equitable access to vaccines. However, in the long term, achieving the Sustainable Development Goals will require from all nations to work in solidarity to find durable solutions for global vaccine research and development. Interim solutions, such as our proposed legal strategy for equitable access to vaccines, and efforts to find long-term solutions must be advanced in parallel. (shrink)

The COVID-19 disease has caused thousands of deaths worldwide and required the rapid and drastic adoption of various protective measures as main resources in the fight to reduce the spread of the disease. In the present study we aimed to identify socio cognitive factors that may influence adherence to protective measures toward COVID-19 in a Spanish sample. This longitudinal study analyzes the predictive value of perceived severity and vulnerability of infection, self-efficacy, direct exposure to the virus, and instrumental focused coping (...) style for adhering to infection protection behaviors during the first months of the COVID-19 pandemic. It also tests sex and age differences in these factors and changes over time. A two-wave longitudinal study was conducted in March and April 2020 starting the day after a strict national lockdown was decreed in Spain. A path analysis was used to test direct and indirect effects between vulnerability and the adherence to protective behaviors. Results suggest that individuals' perceived severity and vulnerability to COVID-19 and instrumental coping strategies are related to the use of more protective behaviors. This coping strategy mediates the effect of perceived vulnerability on engaging in protective behaviors, and this effect depends on direct exposure to COVID-19 and perceived self-efficacy moderators. Results suggest that recognizing one's own abilities to engage in instrumental actions may facilitate adherence to protective measures in people who had not been directly exposed to COVID-19. Therefore, adopting instrumental coping strategies to manage an individual's perceived vulnerability to infection may positively impact the adherence to protective behaviors, especially during the onset of an unexpected threat and when there is no prior direct experience with the situation. (shrink)

While COVID-19 has generated a massive burden of illness worldwide, healthcare workers (HCWs) have been disproportionately exposed to SARS-CoV-2 coronavirus infection. During the so-called ‘first wave’, infection rates among this population group have ranged between 10% and 20%, raising as high as one in every four COVID-19 patients in Spain at the peak of the crisis. Now that many countries are already dealing with new waves of COVID-19 cases, a potential competition between HCW and non-HCW patients for scarce resources can (...) still be a likely clinical scenario. In this paper, we address the question of whether HCW who become ill with COVID-19 should be prioritised in diagnostic, treatment or resource allocation protocols. We will evaluate some of the proposed arguments both in favour and against the prioritisation of HCW and also consider which clinical circumstances might warrant prioritising HCW and why could it be ethically appropriate to do so. We conclude that prioritising HCW’s access to protective equipment, diagnostic tests or even prophylactic or therapeutic drug regimes and vaccines might be ethically defensible. However, prioritising HCWs to receive intensive care unit (ICU) beds or ventilators is a much more nuanced decision, in which arguments such as instrumental value or reciprocity might not be enough, and economic and systemic values will need to be considered. (shrink)

The transition and adaptation of students to higher education involve a wide range of challenges that justify some institutional practices promoting skills that enable students to increase their autonomy and to face the difficulties experienced. The requirements for this adaptation were particularly aggravated by the containment and sanitary conditions associated with coronavirus disease 2019. With the aim of promoting academic success and preventing dropout in the first year, a support program was implemented for students enrolled in two courses in the (...) area of education at a public university in northern Portugal during the first semester of 2020/2021. Three sessions of 50/60 min were implemented, namely, the first session focused on the verbalization of the demands, challenges, and difficulties of the transition, and the second and third sessions focused on the difficulties of academic adaptation and academic performance. Data from a dropout risk screening instrument and from the activities performed during sessions were analyzed. The main results point to student satisfaction with the content and the activities of the sessions and their usefulness. Students report not only high satisfaction levels with HE attendance, but also some emotional exhaustion due to academic activities. The continuity of the program is recommended with some improvements in its planning to ensure a more definitive version of the program in the next two years. (shrink)

COVID-19 caused nearly every college and university in the United States to rapidly shift to remote learning during the spring 2020 semester. While this impacted all students to different degrees, students with disabilities faced new challenges related to their mental health, the accessibility of their instruction, the receipt of accommodations, and their interactions with faculty and student support personnel. Literature is emerging that describes the experiences of SWD during the spring 2020 semester and the swift change to remote learning. However, (...) little is currently known about what followed for these students. The present study builds from a prior investigation of SWD during the spring 2020 semester and examines student experiences and perceptions during the 2020–2021 academic year. Eighty-eight SWD from colleges across the United States completed an instrument that contained a mix of demographic, yes/no, Likert scale and open-ended items. Responses revealed most items related to accessing services and instruction showed no improvement from the spring 2020 semester, and that items related to mental health, motivation to learn, and connections with peers were perceived as worse than in spring 2020. Open-ended responses revealed similar themes, with some students describing no improvements, and others noting that accessibility service offices and faculty provided enhanced methods of communication and support. Implications for practice and future research are presented. (shrink)