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Previous studies have demonstrated that low-intensity intervention is effective in improving mental health in young people. Whilst interventions have majorly been offered online during COVID-19 pandemic, it is not known whether low-intensity interventions delivered online can also help reduce the level of distress experienced by young people. The study aimed to determine whether a low-intensity online intervention (LiON) can reduce levels of distress in young people greater than those in similar initial distress levels but received no intervention. Young people aged 15 to 24 were recruited for the 4-weekly LiON intervention consisting of three modules namely sleep and relaxation, stress-coping and problem-solving. The reductions in distress level after intervention were compared to those that occurred over a period of 3 months among community young people with similar baseline K6 distress levels. Seventy-four young people (mean age 20.24 [SD 2.26] years, 71.6% female) received the LiON intervention from December 2021 to July 2022. We observed a greater improvement in their distress levels after receiving the intervention than those with no intervention in the community (beta -4.13, 95%CI -5.12, -3.07, p < .001, Cohen's f2 0.027). The findings offered evidence that the LiON intervention significantly reduced young people's distress level in addition to the improvement that may occur naturally. The use of LiON is adaptable to a wider variety of frontline community organizations. Future evaluation of its cost-effectiveness is warranted.
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Limited data exist on COVID-19 vaccination efficacy in patients with acute myeloid leukemia and myelodysplasia with excess blasts (AML/MDS-EB2). We report results from a prospective study, PACE (Patients with AML and COVID-19 Epidemiology). 93 patients provided samples post-vaccine 2 or 3 (PV2, PV3). Antibodies against SARS-COV-2 spike antigen were detectable in all samples. Neutralization of the omicron variant was poorer than ancestral variants but improved PV3. In contrast, adequate T-cell reactivity to SARS-COV-2 spike protein was seen in only 16/47 (34%) patients PV2 and 23/52 (44%) PV3. Using regression models, disease response (not in CR/Cri), and increasing age predicted poor T cell response.
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Background: During the initial rollout of COVID-19 vaccination in Singapore, the Ministry of Health (MOH) issued recommendations that patients with a history of any previous vaccine allergy be referred to an allergist for further review on suitability to proceed with mRNA-based COVID-19 vaccines. We review the evaluation of these patients with suspected vaccine allergies prior to receiving mRNA-based COVID-19 vaccines. Method(s): Between 8 April and 22 September 2021, 304 patients were evaluated prior to receiving the COVID-19 vaccinations. Of these, 63 (20.7%) patients with suspected immediate hypersensitivity reactions to non-COVID polysorbate-containing vaccines proceeded to have skin prick test (SPT) and Intradermal test (IDT) to polyethylene glycol (PEG)-3350, polysorbate 80 and polysorbate 20 containing products. Another 62 (20.4%) who reported delayed hypersensitivity reactions to polysorbate-containing vaccines proceeded to have direct inoculation (DI) of the Pfizer BNT162b2 vaccine under the supervision of an allergist. The remaining 242 (76.6%) finally assessed not allergic polysorbate-or tolerated previous non-polysorbate- containing vaccines were recommended to proceed with COVID-19 vaccinations at the community vaccination sites. 99 patients in the SPT/IDT and DI group completed a questionnaire-based survey to report any post vaccination reactions. (Figure 1) Results: Of 63 patients who underwent SPT/IDT, 2 (3.2%) with equivocal IDT tolerated both doses of the BNT162b2 vaccine without major allergic reactions. 61 (6.8%) patients with negative SPT/IDT and 62 (100%) in the DI group completed both doses of BNT162b2 vaccination without major reactions. Among those who completed the questionnaire survey, 13 (13%) reported reactions including non-specific rashes and mild urticaria/angioedema post first dose vaccine. All subsequently completed the second dose of the BNT162b2 vaccine following allergist review;with 8 (61.5%) reporting similar mild skin reactions. Conclusion(s): Majority of those with suspected reactions to polysorbate containing vaccines are able to tolerate the BNT162n2 vaccine which contains PEG-2000. Skin tests prior to mRNA COVID-19 vaccination is unnecessary. Those who report mild potentially allergic reactions after the first dose are able to tolerate the second dose of the BNT162b2 vaccine.
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Introduction: The COVID-19 pandemic has been hugely affecting access to the health care system and quality of services for all patients including for those who had a stroke during the pandemic. It is important to explore the experiences and issues that patients and providers faced during the pandemic to identify deficits in the system. Further, we need to identify possible strategies to tailor stroke care for the benefit of those who faced challenges during the pandemic and for future patients in case of a severe wave. The aim of this study is to explore experiences of people with stroke, therapists' experiences, patients' needs and rehabilitation priorities after their stroke during the pandemic. Method(s): Semi-structured interviews were conducted using two separate topic guides for therapists who treated patients with stroke and the people who had a stroke during the pandemic. Qualitative data were analysed using a reflexive thematic analysis approach. Each interview was coded and categories were developed by two independent researchers and cross checked by a third researcher. Findings from therapists' interviews were triangulated with findings from survivors' interviews. Result(s): 22 participants (12 therapists and 10 patients) from stroke acute, subacute, and chronic settings were interviewed. The quantity and quality of care for people post-stroke has been affected by the impact of the pandemic to various extents including earlier discharge patients from acute care facilities and lack/limited care post discharge from hospital. There has been a variability in the organisational and individual responses to the changes in the care practice. Patients needed more support to address their physical and mental health issues. Remote rehabilitation and self-management strategies were facilitated by care teams as a new approaches to deliver care for stroke population. However, therapists seemed unsatisfied with the quality of care delivered and suggested that the system should be better prepared to deal with similar situations in the future. Conclusion(s): The findings of this study demonstrate the impact of the pandemic on stroke care and provide suggestions for optimal delivery of care in similar situations. Future research is warranted to examine the efficacy of new strategies such as reducing the time for acute care and remote delivery of rehabilitation for people with mild to moderate impairments post stroke.
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Background: Cancer patients are at high risk of severe COVID infection and recommended at least three doses of SARS-CoV2 mRNA vaccines. Various anti-neoplastic treatments may affect long-term vaccine immunogenicity. Methods: Patients with solid or haematological cancer were recruited from two Singapore hospitals between July 2021 and March 2022. GenScript cPASS surrogate virus neutralisation assays measured antibody responses, which were correlated with clinical outcomes obtained from medical records and national mandatory-reporting databases. Results: In total, 273 patients were recruited (40 with haematological malignancies and the rest solid tumours). Two-hundred and four patients (74.7%) were receiving active cancer therapy: 98 (35.9%) receiving systemic chemotherapy and the rest targeted or immunotherapy. All patients were seronegative at baseline. After receiving one, two and three doses of SARS-CoV-2-mRNA vaccination, seroconversion rate was 35.2%, 79.4% and 92.4% respectively. After three doses, patients on active treatment for haematological malignancies had lower antibodies (57.3%±46.2) as compared to patients on immunotherapy (94.1%±9.56, p<0.05) and chemotherapy (92.8%±18.1, p<0.05). SARS-CoV-2 infection was reported in 77 (28.2%) patients of which 18 were severe. Conclusion: This study demonstrates high immunogenicity of three doses of vaccines and protection against severe infection in cancer patients.
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The fresh e-commerce industry has seen a sudden and substantial rise since the outbreak of COVID-19. The rapid development of this industry calls for a comprehensive and systematic review of its research status, hotspots and future trends, which will have significant implications for researchers in related fields. This paper first conducts a current situation analysis of the core literature on fresh e-commerce retrieved from four databases – CNKI, CSSCI, Wanfang and VIP – to categorize the research status of fresh e-commerce in three dimensions: the year of publication, article sources, and distribution of subjects. CiteSpace is then used to perform a bibliometric analysis of the data and to create visualized knowledge maps. The results show that the research on fresh e-commerce can be divided into three stages: rapid development (2012-2015), exploration and transformation (2016-2019), maturity and upgrade (2020-present). At each stage, the research evolves toward diversity and maturity with policy developments and changes in the external environment. Cold chain logistics, business models, freshness-keeping of products and e-commerce are ongoing research hotspots in fresh produce e-commerce, while later studies focus more on the transformation and upgrade of products, logistics, distribution and platforms to better serve consumers' consumption habits and environmental requirements. This study provides valuable insights for researchers and enterprises who are engaged in the industry and for those who are interested in the development of fresh e-commerce in China. © 2022 International Consortium for Electronic Business. All rights reserved.
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While gerotranscendence theories postulate that older adults tend to orient themselves toward solitude, activity theories highlight the importance of continuing social and meaningful engagement for well-being across lifespan. The distinction between loneliness and social isolation is particularly observable in older adults of advanced age who are often facing accelerated decline in physical and functional health, therefore restricting their opportunities to interact with others. This has been particularly disturbing during the previous two years under COVID. This study utilized data from the 2nd Hong Kong Centenarian Study which interviewed 120 family caregivers of older adults aged 95 or above in 2021–2022 when the city experienced almost an entire year of the outbreak. Using family or friend proxy information as well as caregiver ratings of whether older adults expressed feelings of social isolation and loneliness, we found that 10.7% of older adults reported high levels of loneliness and isolation;26.7% feeling low in both;11.5% were isolated but not lonely, and 38.2% were lonely but not isolated. Loneliness ratings were more strongly associated with psychological well-being (Patient Health Questionnaire-4), autonomy, happiness, perceived usefulness, worries, and death anxiety than did isolation, with the latter negatively correlated with optimism. Participants rated in the low isolation/loneliness group were least (death) anxious than the other three groups. Our findings underscore the divergence of isolation and loneliness for adults of advanced age and call for psychological support for oldest-old adults who continue to face social isolation, especially when society gradually recovers from COVID.
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Unlike pandemics in the past, the outbreak of coronavirus disease 2019 (COVID-19), which rapidly spread worldwide, was met with a different approach to control and measures implemented across affected countries. The lack of understanding of the fundamental nature of the outbreak continues to make COVID-19 challenging to manage for both healthcare practitioners and the scientific community. Challenges to vaccine development and evaluation, current therapeutic options, convalescent plasma therapy, herd immunity, and the emergence of reinfection and new variants remain the major obstacles to combating COVID-19. This review discusses these challenges in the management of COVID-19 at length and highlights the mechanisms needed to provide better understanding of this pandemic.
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Introduction: In-class engagement enhances learning and can be measured using observational tools. As the COVID-19 pandemic shifted teaching online, we modified a tool to measure the engagement of instructors and students, comparing in-person with online teaching and different class types. Methods: Video recordings of in-person and online teachings of six identical topics each were evaluated using our ‘In-class Engagement Measure’ (IEM). There were three topics each of case-based learning (CBL) and lecture-based instruction (LLC). Student IEM scores were: (1) no response, (2) answers when directly questioned, (3) answers spontaneously, (4) questions spontaneously, (5) initiates group discussions. Instructor IEM scores were: (1) addressing passive listeners, (2) asking ≥1 students, (3) initiates discussions, (4) monitors small group discussion, (5) monitoring whole class discussions. Results: Twelve video recorded sessions were analysed. For instructors, there were no significant differences in percentage time of no engagement or IEM scores when comparing in-person with online teaching. For students, there was a significantly higher percentage time of no engagement for the online teaching of two topics. For class type, there was overall less percentage time of no engagement and higher IEM scores for CBL than LLC. Conclusion: Our modified IEM tool demonstrated that instructors’ engagement remained similar, but students’ engagement reduced with online teaching. Additionally, more in-class engagement was observed in CBL. “Presenteeism”, where learners were online but disengaged was common. More effort is needed to engage students during online teaching. © 2022 TAPS. All rights reserved.
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BACKGROUND: The coronavirus disease 2019 (COVID-19) has caused many lifestyle changes, especially in the diet. Policies such as physical distancing and quarantine orders aimed to mitigate to spread of COVID-19 have affected the economy and, therefore, the dietary habits of the people. AIM: The purpose of this study was to analyze the associations between income levels and dietary habits during the COVID-19 pandemic. METHODS: This cross-sectional study included 697 Indonesian adults from various regions in Indonesia. The study was conducted from June to August 2020. Data were obtained through a self-administered online questionnaire including dietary habits, lifestyles, and quality of life data adapted from MyNutriLifeCOVID-19 online survey. To analyze the associations between income levels and dietary habits during the COVID-19 pandemic, a Chi-square test was used. Data were analyzed using SPSS version 20. RESULTS: Respondents had mean age of 27.56 ± 8.58 years and the majority were women (83.6%). The percentage of people with large-scale social restrictions was 47.5%. Respondents reported that their dietary habits were healthier during the pandemic (46.2%), with the majority categorized as high-and very high-income status (59.1%). From self-reported of the people in Indonesia, there was association between high-income level and selfperceived healthier dietary habits. Higher-income level was also associated with higher frequency of online food/ drink delivery, consuming western diet foods, consuming dietary supplements, and probiotic consumption (p < 0.05). CONCLUSIONS: During the COVID-19 pandemic, the dietary habits of people with a very high monthly income had eating healthier than before the pandemic. However, it is also related to higher energy, cholesterol, and saturated fat intakes due to consuming high western diet foods. Social inequalities in dietary intake should be considered through promoting a healthy balanced diet with affordable price and healthy food processing in the community.
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Chemistry laboratory experiments are invaluable tostudents'acquisition of necessary synthetic, analytical, andinstrumental skills during their undergraduate studies. However,the COVID-19 pandemic rendered face-to-face (f2f), in-personteaching laboratory experiences impossible from late 2019-2020and forced educators to rapidly develop new solutions to deliverchemistry laboratory education remotely. Unfortunately, achievinglearning and teaching objectives to the same caliber of in-personexperiments is very difficult through distance learning. Toovercome these hurdles, educators have generated many virtual and remote learning options for not only foundational chemistrycourses but also laboratory experiments. Although the pandemic challenged high-level chemistry education, it has also created anopportunity for both students and educators to be more cognizant of virtual learning opportunities and their potential benefits withinchemistry curriculum. Irrespective of COVID-19, virtual learning techniques, especially virtual lab experiments, can complement f2flaboratories and offer a cost-efficient, safe, and environmentally sustainable alternative to their in-person counterparts.Implementation of virtual and distance learning techniques???including kitchen chemistry and at-home laboratories, prerecordedvideos, live-stream video conferencing, digital lab environment, virtual and augmented reality, and others???can provide a wide-ranging venue to teach chemistry laboratories effectively and encourage diversity and inclusivity in thefield. Despite their relevanceto real-world applications and potential to expand upon fundamental chemical principles, polymer lab experiments areunderrepresented in the virtual platform. Polymer chemistry education can help prepare students for industrial and academicpositions. The impacts of polymers in our daily life can also promote students'interests in science and scientific research. Hence, thetranslation of polymer lab experiments into virtual settings improves the accessibility of polymer chemistry education. Herein, weassess polymer experiments in the emergence of virtual learning environments and provide suggestions for further incorporation ofeffective polymer teaching and learning techniques into virtual settings
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BACKGROUND: SARS-CoV-2 can cause outbreaks in community- and hospital-based settings. The aim of this study was to provide a detailed epidemiologic account of a hospital-wide SARS-CoV-2 outbreak and provide a description of case evaluations, transmission networks and the interventions implemented to stem the outbreak. METHODS: We conducted a retrospective descriptive study of a hospital-wide SARS-CoV-2 outbreak at the Misericordia Community Hospital (Edmonton) from June 21 to Aug. 14, 2020. We reviewed hospital chart, public health and occupational health records to determine demographics, case type (community- or hospital-acquired), need for critical care and outcome for each case linked to the outbreak (patients, hospital staff, and community and patient visitors). We developed detailed transmission networks using epidemiologic data to determine what variables may have contributed to transmission. RESULTS: Fifty-eight cases of SARS-CoV-2 infection were linked to this hospital outbreak (31 patients, 25 staff members and 2 visitors; 66% female, age range 19-97 years). One patient required critical care, and 11 deaths were recorded (all among inpatients). Most cases were hospital-acquired (91%), and 28% were asymptomatic at the time of diagnosis. The outbreak was composed of 2 clusters driven by protective equipment breaches, premature removal of precautions, transmission in small staff quarters and infection of a staff member after exposure to a wandering patient with dementia and asymptomatic, undetected SARS-CoV-2 infection. INTERPRETATION: A detailed epidemiologic review of this hospital-wide outbreak shows that a SARS-CoV-2 outbreak can involve complex transmission chains and clusters. Multipronged bundled approaches, aggressive contact tracing, and patient and staff prevalence screening are important to help bring such outbreaks under control, along with ongoing vigilance in detecting delayed cases.
Subject(s)
COVID-19/epidemiology , COVID-19/virology , Disease Outbreaks , SARS-CoV-2 , Tertiary Care Centers , COVID-19/transmission , Canada/epidemiology , Contact Tracing , Cross Infection , Female , Health Personnel , Hospitals, Community , Humans , Male , Prevalence , Public Health Surveillance , Retrospective StudiesABSTRACT
The impact of Coronavirus disease 2019 (COVID-19) on outcomes in patients with cancer remains unclear. Acute Myeloid Leukemia (AML)/high-risk myelodysplasia (MDS) are common hematological malignancies resulting in profound immunosuppression, which is exacerbated by intensive and less-intensive chemotherapy. Importantly, venetoclax based regimens have been increasingly used during the pandemic as a strategy to reduce patient hospitalization however, there is little information concerning the impact of such regimens on COVID-19 infection rates. We therefore opened a prospective clinical study (PACE), at the start of the current pandemic in April 2020 to characterize the risk of COVID-19 infection in patients with AML/MDS-EB2 receiving intensive or non-intensive treatment, including patients treated with venetoclax-based regimens. The primary aim was to determine the incidence of COVID-19 in patients with AML /MDS-EB2 including both, prior to study entry and during treatment until 4 weeks after the last cycle of treatment. Secondary aims were to: characterize the presentation of COVID-19;define the severity and type of both non-COVID-19 and COVID-19 infections;and undertake an exploratory analysis to quantify the incidence of COVID-19 infection in patients receiving (less-intensive) venetoclax based regimens. All analysis conducted to date has been descriptive. 211/230 recruited patients had full treatment histories available, of whom 116 patients received intensive chemotherapy and 95 low intensity regimens. 48 patients received a venetoclax-based regimen. The median age of the non-intensive treatment arm was 72 years;(range 19.1-86.5) and of the intensive arm was 59 years (range 16.1-76.1). There were more cases of secondary AML and relapsed disease in the non-intensive arm as compared to the intensive arm. 25/226 evaluable patients tested positive for COVID-19 as defined by positive SARS-CoV2 PCR test, 10 with a prior diagnosis at study entry and 15 tested positive during the study. The incidence of COVID-19 infection for patients with AML/MDS-EB2 was 11.1% (90%CI: 7.8%-15.1%) (Table). A lower proportion of patients (n=6/91 6.6%) undergoing non-intensive treatment suffered COVID-19 as compared to those undergoing more intensive chemotherapy regimens (n=19/116, 16.4%). Specifically, only 3/48 (6.3%) patients undergoing a venetoclax regimen were infected with SARS-CoV2. The most common presenting symptoms of COVID-19 in this study, regardless of the intensity of chemotherapy, was fever and cough with 6/25 patients asymptomatic. The risk of death at 30 days following study entry in patients who had prior COVID-19 infection or who contracted COVID-19 during this period was 13.6%, compared to 3.9% in the overall cohort without COVID-19 infection. There was a lower incidence of non-COVID-19 related infections in patients receiving venetoclax-based regimens, n=43 infections in 24 (50.0%) of patients;with 313 infections in 94 (81%) of intensively treated patients. The overall occurrence of non-COVID-19 infection in the non-intensive arm was 87 infections in 50 (54.9%) patients. Our multi-center study provides real-world estimates for the incidence and presentation of COVID-19 infection in a cohort of patients with AML/MDS-EB2, and indicates a higher risk of death at 30 days in patients with prior COVID-19 infection prior to, or during treatment. Venetoclax based, and other non-intensive, regimens, increasingly implemented during the pandemic, to minimize patient exposure and reduce usage of hospital beds, appeared to be associated with a low incidence of COVID-19. Further follow-up will be required to understand the long-term impact of this strategy. Analysis of immune responses to COVID-19 infection and vaccination is on-going. Acknowledgments: This study was funded by Cure Leukaemia under the Trials Acceleration Program (TAP), and grants from BMS and Blood Cancer UK. [Formula presented] Disclosures: Loke: Novartis: Other: Travel;Janssen: Honoraria;Amgen: Honoraria;Pfizer: Honoraria;Daichi Sankyo: Other: Travel. K apper: Pfizer: Consultancy, Speakers Bureau;Astellas: Ended employment in the past 24 months, Speakers Bureau;Jazz: Consultancy, Speakers Bureau;Novartis: Consultancy, Research Funding, Speakers Bureau. Khan: Abbvie: Honoraria;Astellas: Honoraria;Takeda: Honoraria;Jazz: Honoraria;Gilead: Honoraria;Novartis: Honoraria. Dillon: Amgen: Other: Research support (paid to institution);Astellas: Consultancy, Other: Educational Events, Speakers Bureau;Menarini: Membership on an entity's Board of Directors or advisory committees;Novartis: Membership on an entity's Board of Directors or advisory committees, Other: Session chair (paid to institution), Speakers Bureau;Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: educational events;Jazz: Other: Education events;Abbvie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Research Support, Educational Events;Shattuck Labs: Membership on an entity's Board of Directors or advisory committees. Culligan: AbbVie Ltd: Honoraria, Speakers Bureau;Celgene Ltd: Honoraria, Speakers Bureau;Gilead: Honoraria, Speakers Bureau;Jazz Pharma: Honoraria, Speakers Bureau;Takeda UK Ltd: Honoraria, Speakers Bureau. McMullin: Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees, Other: clinical trial support, Research Funding;Celgene: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;AbbVie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;AOP Orphan: Research Funding, Speakers Bureau. Murthy: Abbvie: Other: support to attend educational conferences. Craddock: Novartis Pharmaceuticals: Other: Advisory Board;Celgene/BMS: Membership on an entity's Board of Directors or advisory committees, Research Funding.
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Incidents of racism against Asians have been rising since the COVID-19 pandemic turned global in early 2020. Employing Foucault's concept of panopticism and Kathryn Lofton's insights on the function of religion to demarcate group boundaries, this article argues that American religion constructs Asian American stereotypes to limit the discursive space within which Asian Americans may negotiate their identities. These discursive limitations have, in turn, buttressed white supremacy. This article examines how some Asians and Asian Americans respond to anti-Asian sentiments during the pandemic by performing a close reading of an op-ed by prominent Asian American politician Andrew Yang in The Washington Post. This reading reveals that Yang's colorblind solution upholds whiteness as the American gnosis and limits the discursive space in which Asian Americans may negotiate their identities. This article also discusses how the myth of America as a white Christian country withstands challenges from minority groups contesting its dominance.