Consumer coping with Covid-19: an exploratory study of clothing consumption shifts and the effect of consumer resilience

Purpose: This study aims to discover clothing consumption shifts and explore the effect of consumer resilience in changing clothing consumption patterns or establishing new clothing consumption routines after experiencing disruptions caused by the Covid-19 pandemic. Design/methodology/approach: A two-phase multi-method approach was employed. The first phase of qualitative inquiry was conducted to identify clothing consumption shifts using a content mining approach on a text data sample of 17,195 tweets posted from 1 January to 30 September 2020. The second phase of the quantitative study was conducted to explore consumer resilience's effect on clothing consumption shifts based on a collected national sample of 418 respondents through an online survey. Findings: This study identified clothing consumption changes including value shifts, style shifts and spending shifts. It was also found that resilient consumers care about a company's ethical practices and value the quality instead of the number of items in their wardrobe. Consumers spend more time wearing comfortable clothing and are used to the working-from-home lifestyle. Originality/value: This study explored approaches to making use of social media data for a better understanding of consumers' clothing behaviour. Also, this study attempted to explore and understand clothing consumption practices during and post the Covid-19 global pandemic, focusing on identifying shifts that might last longer for fashion businesses to explore growth opportunities. © 2022, Emerald Publishing Limited.

Exploring the Impact of Fatigue on Exercise Tolerance in Post-COVID Individuals

Introduction: After acute COVID infection, individuals experience fatigue and a reduced exercise tolerance, however the relationship between these variables has not been established. Aim(s): This study explored the impact of fatigue severity on exercise tolerance in individuals post-COVID infection. Method(s): This observational cohort analysis of individuals attending COVID-rehabilitation was assessed using the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) questionnaire and Incremental Shuttle Walk Test (ISWT) pre- to post- rehabilitation. Individuals were split into mild and severe fatigue (FACIT-F</>=30) groups. Result(s): 295 individuals were assessed (64% male, mean[SD] age 54[15] years, BMI 30.1[8.7] kg/m ). 193 (65%) individuals were in the severe fatigue group. Baseline ISWT distance was reduced in the severe fatigue group (287[181]m) compared to the mild fatigue group (396[217]m, p<0.05). There was a weak positive correlation between Pre-FACIT-F and baseline ISWT (r=0.28). There was a significant improvement in ISWT following rehabilitation of 90[114]m and 62[77]m for severe and mild fatigue groups respectively but there was no differences between groups (p=0.13)Conclusion: Those with severe fatigue had reduced exercise tolerance compared to those with mild fatigue prior to rehabilitation. Rehabilitation improves exercise tolerance in those with mild and severe fatigue, and there are no differences between groups.

Difficult Conversations Workshop for Trainees in Paediatrics

Aims Effective communication skills are vital for Paediatricians to allow them to establish and develop relationships with children and their families. Whilst there is a significant emphasis on communication skills in the RCPCH curriculum, many trainees receive little dedicated communication skills teaching or feedback during Paediatric training. In addition, COVID undoubtedly had an impact on trainees' experiences and their exposure to difficult conversations. We planned a communication skills workshop involving simulated difficult conversations with actors, aimed at doctors working in General Paediatrics. The workshop aimed to offer the opportunity to practise challenging conversations and manage conflict in a supportive environment. Methods We successfully applied for COVID recovery funding to run a full day workshop for communication skills in Paediatrics. Paediatric and GP trainees working in general paediatrics were surveyed using an anonymous online platform about areas of communication they feared most. We used the areas identified to develop communication scenarios that addressed key capabilities in the RCPCH Progress curriculum. These included raising safeguarding concerns with a family, talking to a family when their child has died, exploring mental health concerns with a young person and dealing with conflict. These are common scenarios that trainees may have missed out on due to redeployment or change in work patterns. The workshop, held in October 2021, involved face-to-face simulated communication scenarios with actors for Paediatric and GP trainees currently working in general paediatrics. Each trainee led a simulated communication scenario with an actor and received a full debrief and feedback with experienced faculty. Scenarios were recorded to create a learning tool to use within the trust as examples of good practice. Trainees completed anonymous feedback online immediately after the session. Results Eight doctors attended, consisting of 2 GP trainees, 4 junior Paediatric trainees (ST2-3), 1 Paediatric ST4 trainee and 1 senior clinical fellow. All attendees rated the session as 5/5 overall on a Likert scale. The average rating for relevance to their work was 4.86/5. All felt the session had improved their communication skills (71% of trainees by 'a lot' and 29% of trainees by 'a little'). 100% would recommend the session to colleagues. Specific comments included * 'The environment felt like a safe space to debrief and discuss situations openly in a non-judgemental manner. Having professional actors involved was invaluable to get the most realistic feel to the scenarios.' * 'The faculty were really supportive, the scenarios were very realistic, the atmosphere was non-judgmental and the actors were amazing.' Conclusion Our workshop allowed trainees to experience difficult conversations relevant to their training. By basing the scenarios on trainees' suggestions, we ensured we targeted their identified learning needs. Using professional actors with experienced faculty allowed trainees to develop vital skills in a safe and realistic environment. Feedback was overwhelmingly positive, and we are planning to run another similar workshop in early 2022. We hope to develop a bank of scenarios that can be used to develop and hone the skills that Paediatricians of the future need to communicate effectively with children, young people and their families.

Prevention and early treatment of the long-term physical effects of COVID-19 in adults: design of a randomised controlled trial of resistance exercise-CISCO-21.

BACKGROUND: Coronavirus disease-19 (COVID-19) infection causes persistent health problems such as breathlessness, chest pain and fatigue, and therapies for the prevention and early treatment of post-COVID-19 syndromes are needed. Accordingly, we are investigating the effect of a resistance exercise intervention on exercise capacity and health status following COVID-19 infection. METHODS: A two-arm randomised, controlled clinical trial including 220 adults with a diagnosis of COVID-19 in the preceding 6 months. Participants will be classified according to clinical presentation: Group A, not hospitalised due to COVID but persisting symptoms for at least 4 weeks leading to medical review; Group B, discharged after an admission for COVID and with persistent symptoms for at least 4 weeks; or Group C, convalescing in hospital after an admission for COVID. Participants will be randomised to usual care or usual care plus a personalised and pragmatic resistance exercise intervention for 12 weeks. The primary outcome is the incremental shuttle walks test (ISWT) 3 months after randomisation with secondary outcomes including spirometry, grip strength, short performance physical battery (SPPB), frailty status, contacts with healthcare professionals, hospitalisation and questionnaires assessing health-related quality of life, physical activity, fatigue and dyspnoea. DISCUSSION: Ethical approval has been granted by the National Health Service (NHS) West of Scotland Research Ethics Committee (REC) (reference: GN20CA537) and recruitment is ongoing. Trial findings will be disseminated through patient and public forums, scientific conferences and journals. TRIAL REGISTRATION: ClinicialTrials.gov NCT04900961 . Prospectively registered on 25 May 2021.

Lactobacillus crispatus DSM25988 as novel bioactive agent to co-aggregate Streptococcus pyogenes and to exclude it by binding to human cells.

Streptococcus pyogenes, a group A streptococcus, is the major bacterial pathogen responsible for acute bacterial infection of the human oropharynx and the causative agent of scarlet fever. Estimates of the global burden of S. pyogenes related diseases revealed 616 million cases of pharyngitis, and at least 517,000 deaths due to severe invasive diseases and sequelae. Here we describe Lactobacillus crispatus DSM25988 that was identified among hundreds of Lactobacillus strains (referring to all organisms that were classified as Lactobacillaceae until 2020) showing ability to prevent adhesion of S. pyogenes to Detroit 562 cells, and to exhibit a masking and co-aggregating effect on S. pyogenes in vitro. L. crispatus DSM25988 also inhibits invasion of cultured human epithelial pharyngeal cells by S. pyogenes. Competitive binding to fibronectin might be involved in the inhibition process. Antiviral activity of the L. crispatus DSM25988 cells were identified in an in vitro cell model demonstrating that L. crispatus effectively excludes viruses from epithelial cells using SARS-CoV2 proteins as a model. This finding points to the potential of DSM25988 to protect cells from virus infection. Biological activity is retained in heat treated cells. The heat-treated Lactobacillus strain was further developed into functional throat lozenges, wherein its biological activity is stably maintained in the formulation. Lozenges containing L. crispatus DSM25988 underwent testing in an uncontrolled, prospective user study in 44 subjects with symptoms of sore throat for a period of up to 14 days. The study data shows promising safety and efficacy of the medical device when used against symptoms of sore throat like scratchy feeling, hoarse voice and swallowing pain.

Benralizumab for corticosteroid-refractory DRESS in two COVID-19 patients

Drug rash with eosinophilia and systemic symptoms (DRESS) is a rare severe drug hypersensitivity reaction. Treatment of DRESS currently consists of systemic corticosteroids. Here, we report benralizumab (Fasenra®) as a treatment for corticosteroid-refractory DRESS occurring in two severely ill COVID-19 patients. Both patients received high-dose intravenous corticosteroids for 4-6 days, but cutaneous symptoms, eosinophilia and signs of related organ damage were deteriorating. Based on its successful use in PDGFRA-independent hypereosinophilia, we decided to treat our patients with benralizumab. The patients showed clinical improvement and a rapid substantial drop in eosinophils. Targeted high-throughput serum proteomics prior vs. after treatment revealed a significant reduction mostly in eosinophil- and T cell response-related proteins (a.e. IL-5, CD8, TNF and PD-L1), thus pointing towards an impact of benralizumab on the (drug-directed) T cell response in DRESS.

Systemic hyperinflammation as a driver of maculopapular drug exanthema in severely ill COVID-19 patients?

Coronavirus disease 2019 (COVID-19) has been associated with cutaneous findings, some being the result of drug hypersensitivity reactions Here, we utilize imaging mass cytometry (IMC) to characterize the cutaneous immune response in maculopapular drug rashes (MDR), including those associated with COVID-19 infection (COVID MDR). For comparison skin from healthy controls and patients with drug rash with eosinophilia and systemic symptoms (DRESS) was analyzed. Results demonstrated that COVID MDR are characterized by a more prominent infiltration of cytotoxic CD8+ T cells and highly activated, phenotypically shifted monocyte/macrophage (Mo/Mac) clusters in comparison to MDR and DRESS. RNA sequencing transcriptome of the affected skin also demonstrated a more robust cytotoxic response in lesional COVID MDR skin Serum proteomic profiling of COVID MDR patients revealed up-regulation of various inflammatory mediators (IL-4, IL-5, IL-8, IL-18, IL-6, TNF and IFN-γ), eosinophil and Mo/Mac -attracting chemokines MCP-2, MCP- 3, MCP-4 and CCL11. Analyses of cytokine networks demonstrated a relatively milder cytokine storm in DRESS compared to COVID MDR while MDR did not exhibit such features. Our results suggest that a massive systemic cytokine storm promotes activation of Mo/Mac and cytotoxic CD8+ T cells, which impacts MDR development in severely ill COVID-19 patients.

"Five-early" model: The magic weapon against covid-19

Background: COVID-19(2019 novel coronavirus disease)has brought tremendous pressure to the prevention and control of the national epidemic due to its concealed onset, strong infectivity and fast transmission speed. Methods: In this retrospective study, 226 patients diagnosed with 2019 novel coronavirus pneumonia (NCP) in the Chongqing University Three Gorges Hospital were included. The patients' clinical data, including general information, initial symptoms at the onset, time of disease diagnosis, time to treatment in hospital, time of nucleic acid conversion to negative, disease classification, total time of hospitalization were collected. The clinical data of the mild and severe patients were compared. Results: Fever, cough, sore throat, poor appetite andfatigue were the main symptoms of the diagnosed patients. The time of diagnosis was significantly shorter in the mild patients (4.96 ± 4.10 days) than severe patients (7.63 ± 9.17 days) (P=0.004). Mild patients had shorter time to treatment in hospital (6.09 ± 4.47 vs. 8.71 ± 9.04 days) and less time of nucleic acid conversion to negative (7.58 ± 2.51 vs. 11.6 ± 4.67 days) compared to the severe patients. Conclusion: The above results can be used as a quantitative basis for the “five-early"(early detection, early screening, early diagnosis, early isolation treatment, and early recovery) model. The government, the masses, and the hospitals' joint prevention and optimization of the "five-early" model will provide important scientific reference for further prevention and control of the epidemics. © 2020, Iranian Journal of Public Health. All rights reserved.