Learning Modality and Quality of Life Among US School-Age Children During the Coronavirus Pandemic.

BACKGROUND: Shifts from in-person learning to virtual and hybrid learning modes in response to the coronavirus pandemic potentially impacted children's physical, emotional, social, and academic development. This study examined the association between virtual, in-person, and hybrid learning modality with parent-reported quality of life among US students (kindergarten-12th) in early 2021. METHODS: Parents reported current learning modality and physical, emotional, social, and school quality of life for children (aged 5-11, n = 1381) and adolescents (aged 12-17, n = 640). Multivariable logistic regression models assessed the odds of impaired quality of life by learning modality. RESULTS: Among children, hybrid and virtual learners had greater odds of impaired quality of life (adjusted odds ratio [aOR] 1.79, 95% confidence interval [CI] 1.22, 2.64 and aOR 1.57, 95% CI 1.17, 2.12, respectively) relative to in-person learners. Among adolescents, virtual learners had greater odds impaired physical (aOR 2.06, 95% CI 1.26, 3.38) and school function (aOR 2.23, 95% CI 1.38, 3.61) relative to in-person learners. CONCLUSIONS: Learning modality was associated with student well-being, and appropriate alternative learning modalities may differ for younger and older students in terms of educational quality and quality of life.

Novel estimates reveal subnational heterogeneities in disease-relevant contact patterns in the United States.

Population contact patterns fundamentally determine the spread of directly transmitted airborne pathogens such as SARS-CoV-2 and influenza. Reliable quantitative estimates of contact patterns are therefore critical to modeling and reducing the spread of directly transmitted infectious diseases and to assessing the effectiveness of interventions intended to limit risky contacts. While many countries have used surveys and contact diaries to collect national-level contact data, local-level estimates of age-specific contact patterns remain rare. Yet, these local-level data are critical since disease dynamics and public health policy typically vary by geography. To overcome this challenge, we introduce a flexible model that can estimate age-specific contact patterns at the subnational level by combining national-level interpersonal contact data with other locality-specific data sources using multilevel regression with poststratification (MRP). We estimate daily contact matrices for all 50 US states and Washington DC from April 2020 to May 2021 using national contact data from the US. Our results reveal important state-level heterogeneities in levels and trends of contacts across the US over the course of the COVID-19 pandemic, with implications for the spread of respiratory diseases.

Application of remote videoconferencing to home monitor and support patients with major congenital heart disease during the COVID-19 pandemic

Background and Aim: The COVID-19 pandemic presented unique challenges to global healthcare provision. Face-to-face outpatient care was dramatically reduced as a consequence. This study imple-mented a remote videoconferencing call (VC) service delivered by a mobile app to continue close monitoring of our most vulnerable patients in their home environment. The patient cohort was fol-lowed up at a regional paediatric cardiology centre. Method(s): Patient recruitment began in September 2020, concluding in December 2021. Most participants were identified in the new-born/infant period and consisted of a mixture of cyanotic and acya-notic congenital heart disease. All study participants required regular, frequent outpatient monitoring in usual circumstances. Parents/guardians of identified patients received written and verbal explan-ation of study aims and objectives prior to giving written consent. The videoconferencing interface was delivered by PEXIP Infinity Connect Mobile app and conducted by experienced medical and/or nursing staff. This app was already a well established method of communication within the Regional Paediatric Cardiology Team. Primary outcome measures included admissions to hospital and avoidance of hospital attendances. Clinical proformas including growth parameters and clinical observations was recorded at each vir-tual appointment. Patient and parent related research data was col-lected at the first, fourth and eighth appointment. A select number of patients were given home saturation monitors and weight scales. Result(s): A total of 32 patients were enrolled. 164 VCs were deliv-ered (patient mean = 5.8). The average age at recruitment was 10.8 weeks. 18 patients had surgical intervention during the study period. There were 11 admissions to hospital directly resulting from the VC;the commonest indication was abnormal oxygen sat-urations (45%). 33 hospital attendances were avoided;the com-monest concern reported by parents was difficulty related to infant feeding (36%). Conclusion(s): Qualitative and quantitative measurement tools showed reduction in parental anxiety. The study was well received by par-ticipating families. There was prompt identification of unwell chil-dren on VCs as well as providing advice to prevent unnecessary hospital attendance. Videoconferencing technology proved very user friendly and proved to be a very valuable adjunct to the pro-vision of good patient care during challenging circumstances.

Combating the Current Pandemic and Preparing for the Next: Lessons Learned From the COVID-19 Pandemic From the Perspective of Deployed Special Operations Forces.

The coronavirus 2019 (COVID-19) pandemic continues to be a threat to global health, including the health of deployed armed forces. Servicemembers had to adjust to the "new normal" while maintaining the interests of the nation's security as well as that of our host nation partners. This commentary examines how Special Operations Forces operating within four different regions worldwide leveraged the challenges presented by the onset of this pandemic in maintaining stability, sustaining a ready force, and operating forward deployed. Deployed forces face constant difficulties with logistical support, varied medical resources access and a medical system predominantly focused on trauma care. At the onset of the COVID-19 pandemic there was little guidance specific to these circumstances which required an improvised adaptation of the recommendations set by national and Department of Defense medical authorities. Plans were constantly revised to match the ever changing medical and operational environment. Strategies such as the "Bubble Philosophy" and tiered force protection measures helped our units to maintain a rigorous training cycle. New methods of communication and training with our host nation partners such as the use of Unmanned Aerial Systems (UAS) platforms to survey host nation training became standard. Through these measures all of our forces were able to maintain operational capacity, protect the force, and maintain rapport with the host nations. We hope these experiences will provide a rough framework for future forces faced with a similar struggle. We also want to stress that challenges vary depending on the area of operations and the pathogen responsible for the pandemic. Any feedback and collaboration that may come from this work is appreciated and encouraged.