On-line (DAD) in kindergarten: Parents' experiences

The last months of the third year of kindergarten are considered a period full of expectations in view of the transition to primary school. The advent of the SARS-CoV-2 pandemic changed this final moment of the preschool cycle, and children and their families had to face the lock-down and on-line learning experience. With a series of interviews made in the months of June-July 2020 with the parents of children who had just finished the last year of kindergarten, we tried to understand what the emotional experiences of this population in a delicate moment of transition between school orders were, in a historical period in which, due to emergency needs, on-line learning methods were introduced that had never before been used extensively for this age group. 16 semi-structured interviews were carried out, with the methodology of the explicitation interview (Vermersch, 2005), to the parents of 18 children (9 females, a triplet of dizygotic twins) who attended the last year of kindergarten. 14 mothers and 2 fathers, 14 Italian families, and 2 of foreign origin responded. The interviews were carried out remotely and videotaped, fully transcribed, and then encoded with content analysis. We analyzed the experiences of children concerning the DAD: their participation, their difficulties, and the positive aspects encountered;moreover, we analyzed the parents' experience: parents were confronted with a very new task of teachers, but they encountered practical, and technological difficulties as well. The in-depth analysis allowed using the explicitation interview makes the collected data particularly interesting in the line of studies on the SARS-CoV-2 pandemic, precisely because it explores the qualitative aspect of experience in a field that is certainly new to any researcher. Some of the indications that emerged may be useful not only concerning the lived experience and in general the reflection on the role of online learning, but also concerning the meaning of teaching with children in kindergarten.

“We Have Been Part of the Response”: The Effects of COVID-19 on Community and Allotment Gardens in the Global North

Throughout history, urban agriculture practitioners have adapted to various challenges by continuing to provide food and social benefits. Urban gardens and farms have also responded to sudden political, economic, ecological, and social crises: wartime food shortages;urban disinvestment and property abandonment;earthquakes and floods;climate-change induced weather events;and global economic disruptions. This paper examines the effects on, and responses by, urban farms and gardens to the COVID-19 pandemic. The paper is based on data collected in the summer of 2020 at the onset of the pandemic when cities were struggling with appropriate responses to curb its spread. It builds on an international research project (FEW-meter) that developed a methodology to measure material and social benefits of urban agriculture (UA) in five countries (France, Germany, Poland, UK and USA) over two growing seasons, from a Food-Energy-Water nexus perspective. We surveyed project partners to ascertain the effects of COVID-19 on those gardens and farms and we interviewed policy stakeholders in each country to investigate the wider impacts of the pandemic on UA. We report the results with respect to five key areas: (1) garden accessibility and service provision during the pandemic;(2) adjustments to operational arrangements;(3) effects on production;(4) support for urban farms and gardens through the pandemic;and (5) thoughts about the future of urban agriculture in the recovery period and beyond. The paper shows that the pandemic resulted in multiple challenges to gardens and farms including the loss of ability to provide support services, lost income, and reductions in output because of reduced labor supply. But COVID-19 also created several opportunities: new markets to sell food locally;more time available to gardeners to work in their allotments;and increased community cohesion as neighboring gardeners looked out for one another. By illustrating the range of challenges faced by the pandemic, and strategies to address challenges used by different farms and gardens, the paper illustrates how gardens in this pandemic have adapted to become more resilient and suggests lessons for pandemic recovery and longer-term planning to enable UA to respond to future public health and other crises. © Copyright © 2021 Schoen, Blythe, Caputo, Fox-Kämper, Specht, Fargue-Lelièvre, Cohen, Poniży and Fedeńczak.

Impact of lockdown restrictions due to covid-19 pandemic on hiv care in italy

Background: It has been observed that lockdown restrictions during COVID-19 pandemic may have had a negative impact on HIV epidemic goals with disruption in care. We aim to analyse the trends in non-viral suppression for PLWH during and after the lockdown for COVID-19 pandemic in Italy compared to 2019. Methods: We included all participants in the ICONA cohort for whom there was ≥1 viral load (VL) in the window Nov 2019-Jan 2020 and with most recent VL≤50 copies/mL (exposed to lockdown), and over Nov 2018-Jan 2019 (not exposed). New enrolments in the study period were excluded. At population level and separately by year, we calculated proportion with VL≤50 copies/mL at each month over March-September and we performed an intermittent time series (ARIMA) model centred in March. In addition, we defined an individual outcome using the first VL over May-September (>50 vs. ≤50 copies/mL), comparing proportion with VL>50 copies/mL between exposed and not exposed by means of logistic regression models. PLWH with missing VL in the outcome window were excluded from the analysis. We also performed an alternative analysis in which censoring bias was minimised using inverse probability of weighting. Sensitivity analyses were performed after restricting to clinical sites with electronic linkage with laboratory data and to the subset of PLWH under follow-up in both years. Results: A total of 3,684 PLWH were included (2019=2,948;2020=736). PLWH exposed to lockdown were significantly older, less frequently MSM, non-Italian, had a higher CD4+ count and more frequently resident in north of Italy. The mean proportion of VL<50 copies/mL was 97% at March 2020 (ref.), 99% before March 2020, 82% at April 2020 (ARIMA estimates -21% 95% CI:-28%;-14%;P=0.01) and 97% after April 2020. In the 2019, the same proportions were 100%, 98%, 95%, and 97% with evidence for a lower drop in April (-6%, 95% CI:-8%;-3%, p=0.02). The results of the logistic regression model are reported in Table 1. When restricting to sites with electronic VL linkage and to those followed-up in both years the IPW OR of 2020 vs. 2019 were 1.23 (0.69-2.18) and 1.03 (0.48-2.19), respectively. Conclusion: We found little evidence for a difference in the proportion of PLWH with a VL>50 copies/mL, following stable suppression, in the period post lockdown due to COVID-19 as compared to the previous year. Although selection bias was minimized, reasons for a missing VL should be further investigated.

Severe systemic thrombosis in a young COVID-19 patient with a rare homozygous prothrombin G20210A mutation

COVID-19 patients may experience a hypercoagulable condition, leading to thrombotic events. We describe a patient with COVID-19, carrying a rare homozygous mutation of the prothrombin gene, who developed a severe systemic vein thrombosis. In COVID-19 patients with hypercoagulability disorders the most common inherited and acquired risk factors should be investigated.

Two nasal swabs may not be enough to exclude SARS-CoV-2 infection in symptomatic patients.

Abstracts: The spread of COVID-19 (COronaVIrus Disease 2019), due to SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus 2) has taken on dramatic pandemic proportions, affecting over 100 countries in a matter of weeks. Italy has had 237,828 confirmed cases according to the Istituto Superiore di Sanità as of May 13, and 34,448 deaths (1).

Peculiar clinical presentation of COVID-19 and predictors of mortality in the elderly: A multicentre retrospective cohort study.

BACKGROUND: The spectrum of COVID-19 clinical manifestations is not yet known. In the elderly, mortality and extrapulmonary involvement appears more frequent than expected. METHODS: A multicentre-retrospective-case-series study of COVID-19 patients, aged ≥65 years, hospitalised between March 1 and June 15, 2020. Patients were classified at admission into 3 groups based on their Clinical Frailty Scale (CFS) score: 1-3 (group A), 4-6 (group B) and 7-9 (group C). RESULTS: Of the 206 patients in the study, 60 (29%) were assigned to group A, 60 (29%) to B and 86 (42%) to C. Significantly more frequent in group C than in B or A were: mental confusion (respectively 65%, 33%, 7%; P < 0.001), kidney failure (39%, 22%, 20%; P = 0.019), dehydration syndrome (55%, 27%, 13%; P < 0.001), electrolyte imbalance (54%, 32%, 25%; P = 0.001), and diabetic decompensation (22%, 12%, 7%; P = 0.026). Crude mortality was 27%. By multivariate logistic regression model independent predictors of death were male sex (adjusted odds ratio (aOR) = 2.87,95%CI = 1.15-7.18), CFS 7-9 (aOR = 9.97,95%CI = 1.82-52.99), dehydration at admission (aOR = 4.27,95%CI = 1.72-10.57) and non-invasive/invasive ventilation (aOR = 4.88,95%CI = 1.94-12.26). CONCLUSIONS: Elderly patients with a high CFS showed frequent extrapulmonary signs at admission, even in the absence of lung involvement. These findings, along with a high CFS, predicted a significant risk of mortality.

Tocilizumab and corticosteroids for covid-19 treatment in elderly patients

Background. The mortality rate for coronavirus disease-19 (COVID-19) increases with age. Some anti-inflammatory drugs such as tocilizumab or steroids have been proposed for the treatment of severe disease;however, few data are available in the elderly. Methods. A retrospective case-series of patients hospitalized between March 1st and June 15th, 2020 with confirmed COVID-19 by RT-PCR testing on throat/nasopharyngeal swabs and age ≥ 65 years was analysed. Patients were retrospectively divided into three groups according to the chosen treatment [standard of care (SOC), tocilizumab or corticosteroids] and patient characteristics and occurrence of adverse events were compared among groups. Results. Overall, 206 patients were included, 148 treated with standard of care, 42 with steroids and 16 with tocilizumab. Patients treated with steroids or Tocilizumab presented more frequently with fever (p =.003), dyspnea (p <.001), bilateral opacities/infiltrates at chest X-ray (p =.026) or CT-scan (p =.020), and more frequently required non-invasive/invasive ventilation (p <.001). Crude mortality was 27%, without differences among groups (p =.074). No specific adverse events were observed during/after the administration of steroids or tocilizumab;however, a trend towards an increased risk of secondary infections was described compared to SOC (p =.097). At multivariate logistic regression, only tocilizumab administration was an independent predictor of secondary infections (aOR = 6.72, 95% CI = 1.43-31.39, p =.015). Conclusions. Tocilizumab and corticosteroid could have a possible role for severe form of pneumonia in course of COVID-19 also in elderly patients, even if great attention to the monitoring of infectious complications should be paid in this special population.

Seroprevalence of SARS-COV-2 antibodies in Southern Italy's hospital staff

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the first pandemic caused by a coronavirus. Respiratory/aerial droplets transmission and the high number of "hidden" asymptomatic cases play a critical role in the rapid spread of the virus across countries. The seroprevalence of SARS-CoV-2 antibodies in the general population is currently unknown. It has been estimated that undocumented infections were the source for #80% of the documented cases before traveling restriction policies took place. Serological evaluation is essential for investigating the extent of SARS-CoV-2. Even more, assessing the prevalence of anti-SARSCoV-2 in hospital staff offers a unique opportunity to study the correlation between seroconversion and immunization because of their occupational exposure and at higher risk of contagious. Methods: The study enrolled a total of 3242 employees of our hospital, "Policlinico Riuniti" of Foggia. The employees' group was stratified in 3 subgroups according to their relative exposure to SARS-CoV-2 (high, intermediate, and low-risk groups). We used a chemiluminescent immunoassay (CLIA, Shenzhen YHLO Biotech) to study the seroprevalence of SARS-COV-2 specific antibodies (IgG and IgM against nucleocapsid and spike proteins). The cut-off was set to 8 AU/mL for both IgG and IgM (specificity of 98,8% and 100%, respectively). A control group of 83 samples sera collected before the Italian COVID-19 outbreak (2018-19) was also tested. Healthcare workers with IgG or IgM concentration above 6.0 and below 8.0 AU/mL were considered borderline. Nevertheless, all of them were tested for the SARS-CoV-2 viral RNA presence (Allplex™ 2019 n-CoV Assay, Seegene). Results: Sixty-two individuals (1.9%, 1.4-2.3%, 95% CI) tested positive for at least one antibody anti-SARS-CoV-2. Five individuals (8.0% of the positive) had IgG and IgM positive test results, while 32 and 25 had only IgG and only IgM positive results. Instead, viral RNA was detected in only nine individuals (13.8% of Ig positive) by RTPCR. The cumulative proportion of individuals who tested positive (IgG and/or IgM) varied between 1-2.4%. The seroprevalence was lower in the high-risk group 1.4% (6/428,0.5-2.6%, 95% CI) vs. intermediate-risk group 2.0 % (55/2736, 1.5-2.5%, 95% CI). Only one participant (1.3%, 0-3.8%, 95% CI) of the low-risk group tested positive for SARS-CoV-2 IgM antibodies. Conclusions: The low level of seropositivity (1.9%) shows that the COVID-19 containment measures adopted were adequate and effective. Moreover, the combination of both serological and molecular tests can improve the likelihood of identifying asymptomatic subjects.

Diabetes and severity of COVID-19: What is the link?

In Diabetes Mellitus the loss of capacity to regulate immunity, the reduction of pulmonary functions and the pro-thrombotic state determine the severity of COVID-19.

Baricitinib: a chance to treat COVID-19?

Currently, there are no approved therapies for the treatment of COVID-19. With most of the world on lockdown and the looming threat of millions of deaths, there is immense pressure to find a therapy for this disease. This article is protected by copyright. All rights reserved.