Childhood-onset type 1 diabetes in Western Australia: An update on incidence and temporal trends from 2001 to 2022.

OBJECTIVE: To determine the incidence and incidence trends over 2001-2022 of childhood-onset type 1 diabetes (T1D) in Western Australia and assess the impact of the COVID-19 pandemic. METHODS: Children newly diagnosed with T1D aged 0-14 years in Western Australia from 1 January 2001 to 31 December 2022 were identified from the population-based Western Australian Children's Diabetes Database. Annual age- and sex-specific incidence was calculated, and Poisson regression was used to analyse trends by calendar year, month, sex and age group at diagnosis. Pandemic era impacts were also examined using the regression model adjusted for sex and age group. RESULTS: Between 2001 and 2022, 2311 children (1214 boys, 1097 girls) were newly diagnosed with T1D aged 0-14 years, giving an overall mean annual incidence of 22.9 per 100,000 person-years (95% CI: 22.0, 23.9), with no significant difference observed between boys and girls. A significant linear increasing trend was only observed in 10-14 year olds with boys and girls combined (1.2% per year [IRR 1.012 (95% CI: 1.002, 1.022)]). No significant difference in the incidence was observed between the pre- and post-pandemic period. CONCLUSIONS: The incidence of type 1 diabetes in 0-14 year old Western Australian children continues to increase in the oldest age group. Longer term monitoring of the incidence during the COVID-19 pandemic is needed to determine its impact on this globally unique population which experienced a delayed start to the pandemic with severe containment measures remaining in place until January 2022.

Experiences of Caregivers and At-Risk Children Enrolled in a Prospective Pregnancy-Birth Cohort Study into the Causes of Type 1 Diabetes: The ENDIA Study.

BACKGROUND: We sought research experiences of caregivers and their children were enrolled in the Environmental Determinants of Islet Autoimmunity (ENDIA) study. METHODS: ENDIA is a pregnancy-birth cohort investigating early-life causes of type 1 diabetes (T1D). Surveys were sent to 1090 families between June 2021 and March 2022 with a median participation of >5 years. Caregivers completed a 12-item survey. Children ≥ 3 years completed a four-item survey. RESULTS: The surveys were completed by 550/1090 families (50.5%) and 324/847 children (38.3%). The research experience was rated as either "excellent" or "good" by 95% of caregivers, and 81% of children were either "ok", "happy" or "very happy". The caregivers were motivated by contributing to research and monitoring their children for T1D. Relationships with the research staff influenced the experience. The children most liked virtual reality headsets, toys, and "helping". Blood tests were least liked by the children and were the foremost reason that 23.4% of the caregivers considered withdrawing. The children valued gifts more than their caregivers. Only 5.9% of responses indicated dissatisfaction with some aspects of the protocol. The self-collection of samples in regional areas, or during the COVID-19 pandemic restrictions, were accepted. CONCLUSIONS: This evaluation identified modifiable protocol elements and was conducted to further improve satisfaction. What was important to the children was distinct from their caregivers.

Changes in Mass Treatment of the Canine Parvovirus ICU Population in Relation to Public Policy Changes during the COVID-19 Pandemic.

Previous work has indicated that canine parvovirus (CPV) prevalence in the Central Texas region may follow yearly, periodic patterns. The peak in CPV infection rates occurs during the summer months of May and June, marking a distinct "CPV season". We hypothesized that human activity contributes to these seasonal changes in CPV infections. The COVID-19 pandemic resulted in drastic changes in human behavior which happened to synchronize with the CPV season in Central Texas, providing a unique opportunity with which to assess whether these society-level behavioral changes result in appreciable changes in CPV patient populations in the largest CPV treatment facility in Texas. In this work, we examine the population of CPV-infected patients at a large, dedicated CPV treatment clinic in Texas (having treated more than 5000 CPV-positive dogs in the last decade) and demonstrate that societal-behavioral changes due to COVID-19 were associated with a drastic reduction in CPV infections. This reduction occurred precisely when CPV season would typically begin, during the period immediately following state-wide "reopening" of business and facilities, resulting in a change in the typical CPV season when compared with previous years. These results provide evidence that changes in human activity may, in some way, contribute to changes in rates of CPV infection in the Central Texas region.

Community Infrastructuring as Necessary Ingenuity in the COVID-19 Pandemic

We report on how one community builds capacity for disrupting injustice and supporting each other during the COVID-19 crisis. We engaged long-term community partners (parents, their youth, and local community center leaders) in on-going conversation on their experiences with the pandemic. We learned with and from community partners about how and what people in communities most vulnerable in this crisis learn about and respond to COVID-19 in highly contextualized ways, individually and through extended family groups and trusted social networks. We report on how they put understandings towards educated, organized, urgent community infrastructuring actions within informal coalition networks. We explore these actions as necessary localized responses to systemic neglect from dominant institutional infrastructures during a global pandemic.