Are Parents Willing to Vaccinate Their 6 to 11 Year Old Children Against COVID-19? A Community Based Study in Murshidabad, India

Context/Background: The future of Corona virus disease is still uncertain due to viral mutations. Immunization against COVID-19 has not yet been introduced for children aged 6-11 years. Parents are instrumental for the success of any immunization programme, being the chief decision makers for their wards. The study aims to assess the perceptions of parents regarding COVID 19 vaccination among children aged 6-11 years in an urban slum of Murshidabad and identify the factors influencing such perceptions among them. Methodology: A cross sectional study was conducted among 106 parents in a slum area of Murshidabad, West Bengal. Participants were interviewed using a validated WHO Vaccine Hesitancy Scale (VHS). Bivariate and multivariable analysis were done using Chi square test and binary logistic regression respectively. Results: Majority of the study subjects instead of parents were unlikely to vaccinate their children against COVID-19. The major concern centered around the safety (73.5%) of the vaccine. Higher level of education (p=0.003), previous history of COVID-19 infection in the family (p=0.004) and having a children aged between 6-8 years (p=0.006), influenced such perceptions, with the latter being the single most important predictor (AOR 4.126, P=0.007). Conclusions: The likelihood of parents to vaccinate their child was found to be low. This underscores the importance of an effective communication strategy when such programme will be rolled out. © 2023 National Journal of Community Medicine.

Exploring Trauma Literacy Quotient Among Indian Journalists and a Way Forward in Post-Pandemic Era: A Case Study of India

The American Psychological Association defines trauma as "an emotional response to a terrible event. . ..” Trauma can be experienced as a response to either physical or emotionally disturbing circumstances. The Journalism and the Pandemic Project from the International Center for Journalists (ICFJ) and the Tow Center for Digital Journalism at Columbia University, in their global survey of journalists, have studied the impact of the pandemic on journalists across the globe. The COVID-19 pandemic has caused varying degrees of disruptions in the personal and professional lives of journalists. Traumatic experiences like covering traumatic events up close, COVID-induced health issues, job loss, pay cuts, and insecurity at the workplace have consumed journalists like never before. Overwhelming emotions like shock, helplessness, loneliness, depression, and anxiety are some of the reactions observed by mental health experts. Indian journalists, too, like their counterparts across the globe, have had to take on the challenges posed by this unprecedented crisis. This article intends to study the impact of the pandemic on Indian journalists both from physical and emotional perspectives. The objectives of the study include—(a) to analyze the journalists' response to traumatic experiences during the pandemic, (b) to study the nature of trauma experienced by journalists during the pandemic, (c) to analyze how traumatic experiences affected the journalists, and (d) to explore and analyze how journalists managed to cope with the traumatic experiences. The study adopts social cognitive theory (SCT) as the framework. SCT comprises four goal realization processes: self-observation, self-evaluation, self-reaction, and self-efficacy. The four components are interrelated, and all influence motivation and goal attainment. Social cognition includes diverse processes linking the perception of social information with a behavioral response, including perception, attention, decision-making, memory, and emotion. The post-traumatic reactions include re-experiencing the traumatic event in flashbacks, recurrent nightmares, and intrusive memories, hypervigilant arousal, impaired concentration, depression, sleep disturbances, self-devaluation, avoidance of reminders of traumatic experiences, emotional detachment from others, and disengagement from aspects of life that provide meaning and self-fulfillment, which impair intrapersonal, interpersonal, and occupational functioning. The scope of the study covers the journalists' responses to traumatic experiences specific to the pandemic. The study adopts a mixed research method with a thematic analysis of the qualitative data from interviews of journalists followed by a factor analysis of the quantitative data from the survey of the journalists. [ FROM AUTHOR] Copyright of Journalism & Mass Communication Educator is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Comparative retrieval approaches for concentrated Suspended Particulate Matter (CSPM) detection in the Ganges using Sentinel-2 and Cloud Computing

In this paper, there are four distinct models utilized for the retrieval of CSPM from the Sentinel 2A/2B satellite imageries by using cloud computing techniques. In this study, a comparative analysis of different CSPM models was carried out at three different sites (Haridwar, Varanasi, and Hooghly). The study reveals that there are significant changes in CSPM in the Ganges in three different periods such as pre, during, and post-COVID. Noteworthy, fewer anthropogenic activities have generated important transformations in aquatic environments during the COVID. © 2023 IEEE.

Theory-Guided Bayesian Analysis for Modeling Impact of COVID-19 on Gross Domestic Product

GDP or Gross Domestic Product is a key indicator of economic status, which provides an omni-comprehensive measure of the wealth of a country or a state. With the sudden proliferation of novel coronavirus disease (COVID-19), there has been increasing interest in forecasting GDP, since this may be severely impacted by the various pandemic control measures imposed in recent days. An accurate forecast of GDP can extensively help in putting forth right administrative measures while ensuring minimum disruption in economy. Though the recent researches focus on various machine learning-based data-driven models for this purpose, these primarily analyze the change in observed GDP data without explicitly modeling the pandemic impact. We address this issue by proposing a novel approach that incorporates epidemiological insights into Bayesian network-based predictive analytics to account for the influence of COVID-19 development on the GDP. Rigorous experimentation on state-level and country-level datasets of India demonstrates that a judicious combination of theoretical and data-driven models can substantially improve GDP forecast performance. Our model produces an average prediction error of 0.002% and outperforms several state-of-the-art techniques with a large margin. © 2022 IEEE.

Lab-on-PCB-Based Electrical Immunosensing Platform for Point-of-Care Detection of SARS-CoV-2

The present work shows a multiplexed lab-on-printed circuit board (PCB) platform for label-free immunosensing of SARS-CoV-2 nucleocapsid and spike antigens based on electrical impedance measurements. The sensor consists of an interdigitated electrode of soft gold integrated on a PCB with microwells for sample loading. A mercaptoundecanoic acid-protein-G-based site-specific biofunctionalization strategy is employed to efficiently immobilize dual antibodies on the device surface toward the sensitive and rapid antigen test of SARS-CoV-2. Electrical impedance measurements carried out in a point-of-care setting using the PalmSens Sensit Smart system that could detect nucleocapsid and spike proteins with a detection limit of 40 and 20 pg each. Experiments with nasopharyngeal swab samples from N = 5 healthy and N = 14 SARS-CoV-2 positive subjects showed significantly different electrical responses for subjects with high viral load (Ct < 25) compared with healthy subjects and control.

MeDiFakeD: Medical Deepfake Detection using Convolutional Reservoir Networks

Generation of photo-realistic fake content using Artificial Intelligence (AI)-based Generative Adversarial Networks has not only engulfed media, facial recognition or social networks, but is now rapidly surging ahead in the realm of medical imaging and is further facilitated by worldwide Covid-19 outbreak. Medical Deepfake pertains to application of AI-triggered deepfake technology on to medical modalities like Computed Tomography (CT) scan, X-Ray, Ultrasound etc. Owing to its high degree of privacy and sensitivity, any threats originating from exposed vulnerabilities, or, attacks on patients medical imagery takes an extremely threatening stance, either devastating the patients remaining lifespan, or resulting in grave financial frauds while satiating corrupt business motives. These tampering attacks, involve either insertion or removal of certain disease conditions, tumors in/from the modality under analysis. This paper implements and demonstrates a practical, lightweight technique which aims to accelerate deepfake detection for biomedical imagery by detecting malignant tumors injected in modalities of healthy patients. The developed technique makes use of convolutional reservoir networks (CoRN), which enable ensemble feature extraction and results in improved classification metrics. We further corroborate its effectiveness while working with a miniscule (< 100) set of images and illustrate the extent of generalization attained with different forms of the same medical imagery. © 2022 IEEE.

A Workshop on Disability Inclusive Remote Co-Design

The COVID-19 pandemic forced researchers to find new ways to continue research, as universities and laboratories experienced closure due to nationwide lockdowns in many countries worldwide, including conducting experiments, workshops, and ethnographic work online. While this had a significant impact on the majority of research work across SIGCHI, research relating to disability and ageing was most impacted due to the additional challenges of recruiting participants, finding accessible online platforms, and ensuring seamless participation while juggling platform accessibility issues, facilitation, and supporting participants' needs. These challenges were more extreme for disabled researchers. In this workshop, we aim to bring together researchers, designers, and practitioners to explore effective strategies and brainstorm actionable guidelines for supporting disability inclusive online research methods and platforms. © 2022 ACM.

The effect of Pirfenidone on pulmonary function parameters in post recovery COVID-19 patients with pulmonary fibrosis compared to placebo in a Government Medical College, West Bengal

Introduction and Aim: The recent COVID 19 pandemic has created an unprecedented challenge to the entire global healthcare system by affecting many people worldwide. Post COVID complications are multi-systemic, but pulmonary post COVID complications are most common. Involvement of the lung parenchyma ultimately leads to pulmonary fibrosis in many of the patients. Pirfenidone is a widely used antifibrotic medication in the field of idiopathic pulmonary fibrosis (IPF) management. Our study has assessed the effect of Pirfenidone on spirometry parameters in post recovery COVID 19 patients with diagnosed pulmonary fibrosis as compared to those that received placebo. Material(s) and Method(s): After obtaining approval from Institutional Ethics Committee, 70 adult patients of COVID-19 with established pulmonary fibrosis in the post recovery phase were chosen and allocated into two groups by randomization in 1:1 ratio. All other factors remaining same, one group was administered the recommended dose of Pirfenidone and the other group received a placebo. Spirometry parameters such as FEV1, FEV1 /FVC ratio, FVC, PEFR of both the groups were recorded on Day 0 and Day 90 and compared using standard statistical tests. Result(s): It was found that on Day 0, PFT parameters of the two groups was comparable (P value>0.05). PFT parameters of the group receiving Pirfenidone showed significant improvement on day 90 (P value<0.05). In addition, on day 90, the PFT parameters of the group receiving Pirfenidone showed significantly better values than the group receiving placebo, P value <0.05. Conclusion(s): As there is a significant improvement in the PFT parameters of post recovery COVID-19 patients suffering from pulmonary fibrosis, we conclude that Pirfenidone is helpful to improve the pulmonary function parameters in post recovery COVID-19 patients with established lung fibrosis as compared to placebo. Copyright © 2022, Indian Association of Biomedical Scientists. All rights reserved.

Supporting Ultra-poor Children with Cerebral Palsy and Their Families with Integrated Microfinance/ livelihood and Community-based Rehabilitation Program -A Cluster Randomized Controlled Trial

Background and Objective(s): Poverty is a key contributor to delayed diagnosis and limited access to early intervention and rehabilitation for children with cerebral palsy (CP) in rural Bangladesh. Earlier studies suggested that efforts to improve outcomes for children with disabilities in low-and middle-income countries should include combined measures to improve service provision and family economic/ social capital. This trial aimed to test the efficacy of an integrated microfinance/livelihood and community-based rehabilitation (CBR) (IMCBR) program in improving health-related quality of life (HRQoL) and motor function of children with CP from ultra-poor families and social capital gain to those families from such intervention in rural Bangladesh. Study Design: Cluster randomised controlled trial. Study Participants & Setting: Children with CP aged <=5 years from ultra-poor families in rural Bangladesh. Materials/Methods: Children with CP were randomly allocated in three arms;Arm-A: livelihood support and CBR (IMCBR), Arm-B: CBR only, and Arm-C: care-as- usual. Livestock (e.g. goat, lamb, chicken, etc.) or sewing machines were provided as livelihood support. As part of CBR, group-based goal directed training sessions and parent training sessions were organised weekly and home visits were made fortnightly. The CBR was stopped 2.5 months post-enrollment due to the COVID-19 pandemic and was replaced with phone follow-up. The primary outcome was HRQoL of children while Gross Motor Function Classification System (GMFCS) level of children and social capital of their families were the secondary outcomes. Intention-to- treat analysis was performed. Result(s): Twenty-four clusters including 251 children-primary caregivers' dyads were assigned to three arms;Arm-A= 80, Arm-B= 82, and Arm-C= 89. Between baseline and endline, the percentage change in mean HRQoL was highest in Arm-A (30.0%) with significant mean differences between Arm-A and Arm-B (p=0.015). The GMFCS level significantly changed both in Arm-A (p=0.007) and Arm-C (p=0.011). Also, the improvement in mean total social capital score was significantly higher in Arm-A compared to Arm-B (p<0.001) and Arm-C (p<0.001). Conclusions/Significance: The findings suggest that IMCBR could improve HRQoL and motor functions of children with CP and the social capital of their ultra-poor families. Long-term follow-up of the trial participants and/ or future exploration of such interventions is essential.

Design and Development of a Robust CPAP Device for Respiratory Support

The COVID-19 pandemic has been a challenging time that the mankind had experienced since the Spanish flue where there is no available treatment except supportive care. The patients with COVID-19 suffered from mild to severe breathing difficulties and respiratory support was the main reason of hospitalization. Ventilator is generally used for the respiratory support which mixes air under pressure with required oxygen concentrations. Invasive mechanical ventilator (IMV) is a complex computer-driven machine delivering positive pressure to the lungs via an endotracheal or tracheostomy tube to support full ventilation. IMV is very expensive and the operation requires specialist nurses. An alternative to IMV is a non-invasive ventilation (NIV) which was deemed necessary during the pandemic. Continuous positive airway pressure (CPAP) is a NIV applied through a face mask and does not require specialist nurses. Due to low cost and simple operation, CPAP drew attention during COVID-19 pandemic. This paper presents the design and development of a CPAP ventilation device. The designed CPAP is a microcontroller based electro-mechanical device for supportive care of patients with respiratory problem. © 2021 IEEE.

A comparative study of cardiac involvement of kawasaki disease and multisystem inflammatory syndrome post COVID (MISC) in children

Background and Aim: Kawasaki Disease remains an enigma to the world to this day since first described by Dr. Tomisaku Kawasaki in 1967. In the last half a century there has been wide-spread global research elaborating the clinical aspects and patho-genesis of this disease entity. Multisystem Inflammatory Syndrome post Covid (MISC) is a relatively new disease which was described in literature in mid 2020. The striking resemblance as well as differences in spectrum of cardiac involvement of both the conditions has been elaborated in this study from a tertiary care centre in Eastern India. Method(s): The study was conducted over a period of 3 years from June 2018 to June 2021. Fiftyone patients with Kawasaki disease (including atypical and incomplete cases) and sixty children diag-nosed with MISC were included in the study. Echocardiography details were noted by a single observer. Data regarding the patient particulars, clinical aspects, lab parameters, imaging details and treatment particulars were collected and analysed. Patients were followed up for a minimum period of six months to one year. Result(s): In the Kawasaki group(51), infants(20) presented with multiple (and larger) aneurysms. Older children (gt;5 years) had more of single coronary involvement, (mostly LAD) and also had more atypical presentation(18) associated with infections like Dengue, Staphylococcal infection, Scrub Typhus. There were 4 cases of Kawasaki shock syndrome, all below 5 years. In the MISC group (60), there was also multiple coronary involvement in infants (11). But LV dysfunction was more common in older children and adolesecents (20), of whom 18 (90%) presented with severe dysfunction (LVEFlt;35%). Those with coronary involve-ment had normal function and those with dysfunction had no coronary involvement. Mild to moderate aneurysmal dilation of coronaries was found in children one to five years of age. No giant aneurysm was found in MISC. Overall, LMCA with LAD was the commonest pattern of involvement in both the conditions. Conclusion(s): KD and MISC had similar pattern of coronary involve-ment, but absence of giant aneurysm and significantly severe dys-function in older children in MISC indicates a likely different pathogenesis for myocardial involvement in MISC.

THE LONG SHADOW OF EPIDEMICS1

Mortality shocks associated with pandemics differentially affect economies. In advanced countries, where human capital is a key input in aggregate production, an adverse mortality shock not only results in loss of lives, but also results in loss of productive assets (intangible human capital). In poorer economies, one the other hand, where production depends more on tangible inputs like land and physical capital, the effect of mortality shocks is muted: loss of lives is not necessarily accompanied by loss of assets. At the same time, weak health infrastructure, high population density and limited flexibility in production organization in poorer countries imply faster spread of the disease and, therefore, a shock of greater magnitude. These two counteracting mechanisms imply a non-monotonic relationship between disease and growth dynamics. We develop a model of endogenous growth to understand this relationship and highlight the short- and long-term effects of the Covid-19 epidemic shock. © 2022 selection and editorial matter, Rajib Bhattacharyya, Ananya Ghosh Dastidar and Soumyen Sikdar;individual chapters, the contributors.

Corona Virus Disease 2019 (COVID-19) Diagnostic Tests: A Glimpse.

Mass testing for COVID-19 infection is one of the core measures in tackling the global spread of the disease. Testing is vital to diagnose and estimate cases, attack rates and case fatality rates- critical data for policy-making. As COVID-19 continues to spread globally, the demand for more extensive laboratory testing and innovative technology increases. However, countries around the world have been struggling to keep up pace with the worldwide demand to expand testing strategy. The pandemic evolves, so does our knowledge and understanding of diagnostic tests of COVID-19. Here we aim to review major challenges related to COVID-19 diagnostic tests and future development. So, the ongoing urgency and demand for tests would certainly steer the rapid uptake of novel techniques, which in turn would boost our understanding of diagnostic tests for COVID-19.

Supporting ultra-poor children with cerebral palsy and their families with integrated microfinance/livelihood and community-based rehabilitation program -a cluster randomized controlled trial

Introduction: This trial aimed to test the efficacy of an integrated microfinance/livelihood and community-based rehabilitation (CBR) (IMCBR) program in improving health-related quality of life (HRQoL) and motor function of children with cerebral palsy (CP) from ultra-poor families and social capital gain to those families from such intervention in rural Bangladesh. Patients and Methods: This was an open-label cluster randomized controlled trial among children with CP aged ≤5 years randomly allocated in three arms;Arm-A: livelihood support and CBR (IMCBR), Arm-B: CBR only and Arm-C: care-as- usual. The CBR was stopped 2.5 months post-enrollment due to the COVID-19 pandemic and was replaced with phone follow-up followed by home-based CBR. The primary outcome was HRQoL of children while Gross Motor Function Classification System (GMFCS) level of children and social capital of their families were the secondary outcomes. Intention-to- treat analysis was performed. Results: Twenty-four clusters including 251 children-primary caregivers' dyads were assigned to three arms;Arm-A = 80, Arm-B = 82 and Arm-C = 89. Between baseline and endline, the percentage change in mean HRQoL was highest in Arm-A (30.0%) with significant mean differences between Arm-A and Arm-B (p = 0.015). The GMFCS level significantly changed both in Arm-A (p = 0.007) and Arm-C (p = 0.011). Also, the improvement in mean total social capital score was significantly higher in Arm-A compared to Arm-B (p <0.001) and Arm-C (p <0.001). Conclusion: The findings suggest that IMCBR could improve HRQoL and motor functions of children with CP and social capital of their ultra-poor families. Long-term follow- up of the trial participants and/or future exploration of such interventions are essential.

Supporting ultra-poor children with cerebral palsy and their families with integrated microfinance/livelihood and community-based rehabilitation: A cluster randomized controlled trial

Objective: This study aimed to test the effectiveness of an 'integrated microfinance/livelihood and community-based rehabilitation (CBR)' (IMCBR) program in improving quality of life and physical ability of children with cerebral palsy (CP), mental health of primary caregivers and social/economic capital of ultra-poor families of children with CP in rural Bangladesh. Design: Open-label pragmatic randomized controlled trial (registration: ACTRN12619001750178). Method: Children with CP aged ≤5 years were recruited in three arms: Arm-A: IMCBR, Arm-B: CBR, and Arm-C: control (i.e. care as usual). Each arm had eight clusters of 10-14 child-caregiver dyads. Caregivers recruited in the Arm-A received livelihood support (e.g., goat/lamb/poultry) and their children with CP received CBR once a week. The child-caregiver dyads in Arm-B received CBR only. The control Arm did not receive any intervention. However, CBR was stopped at 2.5 months of intervention due to COVID-19 pandemic and weekly phone follow-up was completed for home-based CBR. TNO-AZL Preschool children Quality of Life (TAPQoL), Gross Motor Function Classification System (GMFCS) and Communication Function Classification System (CFCS) were used to assess quality of life, motor function and communication of children, respectively. Depression, Anxiety, Stress Scale-Short Form-21 (DASS-21) was used to assess depression, anxiety and stress of primary caregivers. Results: Out of 251 children with CP and their caregivers recruited at baseline, 233 children and primary caregivers (Arm-A: n = 74, Arm-B: n = 77, and Arm-C: n = 82 dyads) completed the 12 month trial. The mean values of livelihood items given per family in Arm A increased from ∼USD66 to ∼USD79 between 0month(m) and 12m (p = 0.066), respectively. The mean TAPQoL score for physical functioning significantly increased between 0m and 12m in all three Arms (p < 0.001, p = 0.017 and p < 0.001 in Arm A, Arm B and Arm C, respectively), however, the improvement in the score was highest in Arm A. Similarly, significant improvement in the GMFCS level was observed between 0m and 12m in all three Arms with the highest improvement in Arm A (p < 0.001). Children's CFCS levels deteriorated slightly at 12m follow up in all three Arms. The depression, anxiety and stress levels among primary caregivers of children reduced significantly between the 0m and 12m in all three Arms (p ≤ 0.001 for all). Conclusion: Our findings suggest that the IMCBR is effective in enhancing quality of life and motor functions of children with CP, mental health of primary caregivers and economic status of ultra-poor families.

Adaptation and development of IR services in response to the COVID-19 pandemic: preliminary results of a focused survey

Purpose: The cyclic nature of active and recovery phases of the COVID-19 pandemic, has demanded fast adaptations and preparation for health care workers world-wide. We aimed to assess how interventional radiologists are handling the pandemic during active and recovery phases with regard to work and team structures, as well as mental health and how the pandemic could have increased the awareness of minimally-invasive therapies as alternatives to postponements of non-urgent procedures. Material and methods: 7125 CIRSE members were invited to participate. For this interim report, responses were collected between 23 November 2021 and 17 December 2021. Results: 114 responses were obtained for this preliminary report, of which 102 were complete. 94% (n=99) of respondents were interventional radiology specialists. Most respondents reported having established a routine to handle different waves of the pandemic (89.5%;n=102). Compared to active phases, fewer respondents indicated at least one pandemic-associated measure in their department during recovery phases (46%-71% vs 13%). 56% reported an increase in ambulatory care patients either during active and/or recovery phases. 54% reported more referrals during active and/or recovery phases. 25% reported increased hours at the hospital during recovery phases, 52% indicated increased sick leave, care leave, quarantine, and burn-out of team members and only 39% reported to get enough time to rest during recovery phases. Conclusion: While the COVID-19 pandemic is continuing to burden IR departments and the mental health of IRs, more than half of respondents reported an increase in referrals for minimally-invasive therapies and ambulatory care.

An Analytical Study of COVID-19 Dataset Using Graph-Based Clustering Algorithms

COrona VIrus Disease abbreviated as COVID-19 is a novel virus which is initially identified in Wuhan of China in December of 2019, and now, this deadly disease has spread all over the world. According to World Health Organization (WHO), a total of 3,124,905 people died from 2019 to 2021, April. In this case, many methods, AI-based techniques, and machine learning algorithms, have been researched and are being used to save people from this pandemic. The SARS-CoV and the 2019-nCoV, SARS-CoV-2 virus invade our bodies, causing some differences in the structure of cell proteins. Protein–protein interaction (PPI) is an essential process in our cells and plays a very important role in the development of medicines and gives ideas about the disease. In this study, we performed clustering on PPI networks generated from 92 genes of the COVID-19 dataset. We have used three graph-based clustering algorithms to give intuition to the analysis of clusters. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

The Impact of COVID-19 on Interventional Radiology Practice Worldwide: Results from a Global Survey.

BACKGROUND: The COVID-19 pandemic had an unprecedented impact on clinical practice and healthcare professionals. We aimed to assess how interventional radiology services (IR services) were impacted by the pandemic and describe adaptations to services and working patterns across the first two waves. METHODS: An anonymous six-part survey created using an online service was distributed as a single-use web link to 7125 members of the Cardiovascular and Interventional Radiological Society of Europe via email. Out of 450 respondents, 327 who completed the survey at least partially including 278 who completed the full survey were included into the analysis. RESULTS: Interventional radiologists (IRs) reported that the overall workload decreased a lot (18%) or mildly (36%) or remained stable (29%), and research activities were often delayed (30% in most/all projects, 33% in some projects). Extreme concerns about the health of families, patients and general public were reported by 43%, 34% and 40%, respectively, and 29% reported having experienced significant stress (25% quite a bit; 23% somewhat). Compared to the first wave, significant differences were seen regarding changes to working patterns, effect on emergency work, outpatient and day-case services in the second wave. A total of 59% of respondents felt that their organisation was better prepared for a third wave. A total of 19% and 39% reported that the changes implemented would be continued or potentially continued on a long-term basis. CONCLUSION: While the COVID-19 pandemic has negatively affected IR services in terms of workload, research activity and emotional burden, IRs seem to have improved the own perception of adaptation and preparation for further waves of the pandemic.