Waste management model for COVID-19: recommendations for future threats.

The change in habits and lifestyle of citizens during health crisis like COVID-19 pandemic has resulted in an unprecedented increase in the struggles for solid waste management across the globe. Not only underdeveloped and developing economies are struggling with the challenges posed by mounting piles of infectious waste but even developed countries are adversely affected in similar manner. The routine waste management strategies followed by various countries are overturned due extremely altered trends in the amount and type of waste generated by households and medical facilities. The aim of this paper is to study and list the best available waste management policies adopted by some developing, developed and underdeveloped economies. The listed case studies were selected due to some unique steps undertaken for solid waste disposal during pandemic. The findings revealed that the guidelines issued by WHO for waste management of corona virus infected waste were followed by these nations and certain additional preventive steps were taken. Due to unavailability of single framework as prescribed by international authorities, various sustainable steps taken by individual countries to curb the pandemic menace can be useful in the present context. Few of these measures can be permanently adopted at global level by other nations for handling the pandemic like situations efficiently in pandemic situations.

Feasibility Assessment of a School Nurse-Led Approach Using Chronic Absenteeism to Establish the School-Based Active Surveillance Process.

This article shares what was learned from the feasibility assessment of a nurse-led school-based active surveillance (SBAS) pilot to track chronic absenteeism using myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as an exemplar. This pilot encompassed a 3-year period with training and feedback from school nurses (SNs) on data collection and ME/CFS. SNs found that the SBAS process helped them effectively identifying undiagnosed conditions. The assessment revealed the importance of focusing outreach efforts and establishing relationships with the school leadership in developing health policies and programs in the school setting. The pilot data were used to develop a manual to guide SNs for the SBAS process. This can be viewed as a model for SNs in establishing a surveillance to identify and track conditions like ME/CFS. With overlapping symptoms of Long COVID to ME/CFS, this assessment may provide insights for additional efforts to understand the impact of Long COVID on students' education.

Association of Initial SARS-CoV-2 Test Positivity With Patient-Reported Well-being 3 Months After a Symptomatic Illness.

Importance: Long-term sequelae after symptomatic SARS-CoV-2 infection may impact well-being, yet existing data primarily focus on discrete symptoms and/or health care use. Objective: To compare patient-reported outcomes of physical, mental, and social well-being among adults with symptomatic illness who received a positive vs negative test result for SARS-CoV-2 infection. Design, Setting, and Participants: This cohort study was a planned interim analysis of an ongoing multicenter prospective longitudinal registry study (the Innovative Support for Patients With SARS-CoV-2 Infections Registry [INSPIRE]). Participants were enrolled from December 11, 2020, to September 10, 2021, and comprised adults (aged ≥18 years) with acute symptoms suggestive of SARS-CoV-2 infection at the time of receipt of a SARS-CoV-2 test approved by the US Food and Drug Administration. The analysis included the first 1000 participants who completed baseline and 3-month follow-up surveys consisting of questions from the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS-29; 7 subscales, including physical function, anxiety, depression, fatigue, social participation, sleep disturbance, and pain interference) and the PROMIS Short Form-Cognitive Function 8a scale, for which population-normed T scores were reported. Exposures: SARS-CoV-2 status (positive or negative test result) at enrollment. Main Outcomes and Measures: Mean PROMIS scores for participants with positive COVID-19 tests vs negative COVID-19 tests were compared descriptively and using multivariable regression analysis. Results: Among 1000 participants, 722 (72.2%) received a positive COVID-19 result and 278 (27.8%) received a negative result; 406 of 998 participants (40.7%) were aged 18 to 34 years, 644 of 972 (66.3%) were female, 833 of 984 (84.7%) were non-Hispanic, and 685 of 974 (70.3%) were White. A total of 282 of 712 participants (39.6%) in the COVID-19-positive group and 147 of 275 participants (53.5%) in the COVID-19-negative group reported persistently poor physical, mental, or social well-being at 3-month follow-up. After adjustment, improvements in well-being were statistically and clinically greater for participants in the COVID-19-positive group vs the COVID-19-negative group only for social participation (ß = 3.32; 95% CI, 1.84-4.80; P < .001); changes in other well-being domains were not clinically different between groups. Improvements in well-being in the COVID-19-positive group were concentrated among participants aged 18 to 34 years (eg, social participation: ß = 3.90; 95% CI, 1.75-6.05; P < .001) and those who presented for COVID-19 testing in an ambulatory setting (eg, social participation: ß = 4.16; 95% CI, 2.12-6.20; P < .001). Conclusions and Relevance: In this study, participants in both the COVID-19-positive and COVID-19-negative groups reported persistently poor physical, mental, or social well-being at 3-month follow-up. Although some individuals had clinically meaningful improvements over time, many reported moderate to severe impairments in well-being 3 months later. These results highlight the importance of including a control group of participants with negative COVID-19 results for comparison when examining the sequelae of COVID-19.

Surviving a Pandemic: The Adaptability and Sustainability of Nonprofit Organizations through COVID-19

Like many other organizations in Canada and globally, nonprofit organizations have not been insulated from the negative effects of the COVID-19 pandemic. It has affected Canadian nonprofit organizations in numerous ways. This ranges from the effects of COVID-19 on the health of workers and clients to its effect on revenue. As predominantly essential service providers, nonprofit organizations have to find ways to continue operations during the COVID-19 pandemic to ensure that no one is left to fall through the cracks in an uncertain economy. © 2021, University of Alberta Library. All rights reserved.

Data Analytics in Improved Bankruptcy Prediction with Industrial Risk

An investigation into the causes of bankruptcy filing by borrowers and the impact it has onto the financial industries is undertaken in this work. One of the major catalysts for bankruptcy filing has been the COVID-19 pandemic that has infected the world from early 2020. With the many applications of data analytics in the financial industry, Bankruptcy Prediction Models (BPM) have seen a rise in popularity to ascertain a customer's financial health and predict if at all the customer is in potential financial distress based on selected key parameters. An in-depth review of bankruptcy prediction models has highlighted several flaws, mainly being a lack of industrial risk parameter to identify the individual borrowers that have been directly affected by their industry on a large scale as seen for the aviation industry during the pandemic. In testing, Random Forest produced the highest accuracy on real-world data. It is observed that the inclusion of the Industry Risk variable can increase the accuracy of the model, but also nonfinancial variables such as socio-economic status are an important contribution to the accuracy of determining if a customer is potential for bankruptcy filing. © 2021 IEEE.

Telework in Canada: Who Is Working from Home during the COVID-19 Pandemic?

This study focuses on the demographic and human capital characteristics of Canadians that are associated with working from home (WFH), before and during the COVID-19 pandemic, or being absent from work, versus those Canadians who continue to work outside the home (i.e., who do not WFH). The results show significant differences in the incidence of WFH during the pandemic: 1) there are no significant differences between females and mates;2) immigrants are less likely to WFH;3) younger workers are more likely to WFH;4) education is positively associated with WFH;and 5) self-reported health is unrelated to WFH. The results from this natural experiment suggest potential policy and organizational implications if the pandemic WFH environment continues for an extended period of time.

Effects of a remote exercise intervention on aerobic endurance in individuals with down syndrome

PURPOSE/HYPOTHESIS: Down syndrome (Ds) or Trisomy 21 is a common genetic birth condition, and those with Ds typically display decreased cardiorespiratory fitness compared to those without Ds, potentially leading to an increased risk for cardiovascular conditions and mortality. Low cardiorespiratory fitness is partially caused by low physical activity levels in this population. The COVID-19 pandemic caused community-based activity programs to shut down, as individuals with Ds are at increased risk for COVID-19 hospitalization and death. Thus, it was vital to explore alternatives of in-person exercise during the pandemic. The purpose of this study was to investigate the effects of a remote 12-week exercise intervention on aerobic endurance in individuals with Ds. NUMBER OF SUBJECTS: Twenty individuals with a medical diagnosis of Down syndrome were recruited and consented to participate. One participant dropped out for reasons unrelated to this study. Data was collected on 19 participants (5 females, 14 males;age: 25.4 ± 4.8 years;height: 156.9 ± 10.5 cm;weight: 72.5 ± 14.6 kg). The participants needed to be generally healthy and sedentary to be included in this study. MATERIALS AND METHODS: Nineteen individuals with Ds completed a structured physical therapist-led 12-week exercise intervention via remote video platform, which consisted of cardiovascular activity, foundational strength exercises targeting core/postural activation and endurance, hip strengthening exercises, and visual-vestibular coordination activities. Using the same platform, aerobic endurance was assessed using the 2 Minute Step Test (2MST). To investigate learning effects of the 2MST, it was performed twice in both the pre- and post-intervention testing sessions. BlandAltman plots were used to assess learning effects and a paired sample t-test was used to assess the effect of the intervention on cardiorespiratory fitness. RESULTS: The Bland-Altman plots showed an increase in the number of steps between first and second execution of 2MST in both pre-intervention (mean difference: -8.9 ± 3.9 = 95% CI [-12.8, -5.04]) and post-intervention testing (mean difference: -5.7 ± 4.5 = 95% CI [-10.2,-1.2]) which suggests a learning effect. Therefore, the second execution of the 2MST was used for pre-post intervention comparisons. A paired sample t-test showed a statistically significant improvement of the 2MST between the pre-intervention (67.6 ± 23.6 steps) and post-intervention (79.4 ± 21.8 steps) measurements (P < 0.01). CONCLUSIONS: This research shows a significant learning effect between the first and second 2MST executions. There was also a significant improvement of cardiorespiratory fitness following the exercise intervention. CLINICAL RELEVANCE: This study shows virtual platforms are an effective mode to deliver an exercise intervention to increase aerobic endurance in those with Ds. The results also support the 2MST as a useful tool to assess aerobic endurance in this population via a virtual platform. It is important to have the participant perform at least 2 trials to account for the learning effect with this test.

Patient perspective of the implementation of virtual medicine in a post-kidney transplant clinic

Purpose: COVID-19 dramatically altered the model of health care delivery for transplant recipients, necessitating the routine use of virtual medicine. This resulted in consequences for patients and providers, with potential changes on the quality and cost of care. In this study, we present survey results examining the patient perspective of virtual follow-up care in a post-kidney transplant clinic across a large geographic area in Canada. Methods: Kidney transplant recipients followed in a multidisciplinary, posttransplant clinic in Vancouver, Canada were surveyed from April 21, 2020 - June 6, 2020, 4 weeks after the implementation of virtual medicine follow up. The survey included questions on the quality of instructions, ease of connection, quality of interaction with care provider, impact on their experience of care as well as time and cost required to attend clinic. Results: 46% of the 169 respondents were between the age of 40 and 59, while 34% were over the age of 60. 38% were within the first year following kidney transplant. The majority were satisfied with the virtual follow up model and thought the quality of the care was improved (Fig 1). 70% of respondents reported a transit time of more than 30 minutes to attend clinic, and 34% reported costs of > $30 per visit prior to the implementation of virtual medicine (Fig 2). Conclusions: Kidney transplant recipients were satisfied with the quality of care provided using a virtual medicine platform in this survey. The use of virtual medicine to provide care for patients decreased personal resources required to attend virtual clinics. Further study is required to determine if virtual medicine is an equally effective follow up modality in this patient population. (Table Presented).

COVID-19 pandemic effect on otolaryngology resident surgical case numbers

Introduction: We recognize the impact of the COVID-19 pandemic on ear, nose, and throat (ENT) resident case volume;identify Accreditation Council for Graduate Medical Education (ACGME) key indicator cases most and least affected by the COIVD-19 pandemic;and compare how reduction in surgical volume varied at different hospital training sites. We are comparing surgical case numbers from the year prior to the beginning of the COVID-19 pandemic to the year following the onset of the pandemic. This comparison required data gathering through February 2021. Methods: Retrospective analysis of ACGME surgical case logs for all residents at a large otolaryngology resident program for the time periods of March 2019 to February 2020 and March 2020 to February 2021 was performed. Case log numbers from the 2 time periods were compared and stratified for level of training, training site, and ACGME key indicator procedures. Results: The total decrease in surgical case numbers from March 2019-February 2020 to March 2020-February 2021 was 46%. Junior residents (postgraduate year [PGY]2/3) had a 28% decrease, while senior residents (PGY4/5) had a 54% decrease. Surgical case numbers decreased at all training sites. The Veteran Affairs Medical Center had the greatest decrease in case volume (69%), while the Children's Hospital had the smallest decrease (23%). The ACGME key indicator procedures with the largest decrease in case volume were oral cavity resection (62%), stapedectomy/ossiculoplasty (60%), and neck dissection (57%). The key indicator procedures with smallest decrease in case volume were parotidectomy (25%), flaps and grafts (27%), and bronchoscopy (27%). Conclusion: There was a substantial decrease in ENT resident surgical case volume following the onset of the COVID- 19 pandemic, affecting all training sites at our institution.

'Phosphenotype', An extended social-distancing sensory modality for the blind

Social-distancing is an effective way to slow down the spread of contagious diseases during a pandemic. The effective implementation of social distancing practices requires sufficient levels of visual acuity. However, persons suffering from full or partial blindness may be more vulnerable to such diseases, due to their sensory limitations affecting their ability to socially distance themselves. Moreover, these limitations make it difficult to identify and remember others who have violated social distance. In order to mitigate these issues, we present a novel hybrid sensory and affectory modality that we call 'Phosphenotype'. Phosphenotype detects approaching persons using sonar proximity sensors and accordingly alerts its user using non-invasive electrically-stimulated phosphenes, thus aiding a partially sighted user to more effectively practice social-distancing. © 2020 IEEE.

Pivots, pirouettes and practicalities: Actions and reactions of work-integrated learning practitioners

One impact of the global pandemic of 2020 was a rapid shift in the delivery of work-integrated learning (WIL) to remote activity among WIL practitioners, students and educators alike. Along with professional practice research in higher degrees, WIL practice, including placements and non-placements, responded actively and sometimes reactively to the challenges of sudden transition to online environments. What strategies - pivots and pirouettes - did WIL practitioners use to weather the storm of Covid-19? What does this tell us about the nature of WIL? This paper captures the seemingly overnight response to shifting work-based learning to online and other spaces. With change came the opportunity to reflect on the varying areas of WIL: from the practical processes of ensuring students are cared for to pivoting to the learning opportunities it presented in building digital literacies and adapting to the global future of work. This study is a Trans-Tasman collaboration of four WIL practitioners exploring their responsiveness to disruption in WIL contexts. We present collective autoethnographic responses to such themes as disruption, becoming resilient, pivoting to change, changing perceptions of WIL and the legacies of the pandemic. These themes apply to learners and educators alike, and our words embody the experiences of both groups. Our responses to phenomena highlighted this need for resilience and agility. Methodologically, the researchers' micro-narrative responses to key themes structure themselves into a macro-narrative that demonstrates the lived experiences of the researchers as educators in the WIL space and explores implications for ongoing and future practice.

Prone positioning to improve oxygenation in COVID-19 patients outside critical care (prone-COVID study)

Introduction: Prone positioning has potential efficacy in improving oxygenation in patients with coronavirus disease (COVID-19). The UK Intensive Care Society has published recommendations for prone positioning in awake patients with COVID-19 but it remains unknown whether it is beneficial in those patients prior to requiring respiratory support, and whether there is applicability for patients with non-COVID-19 pneumonia. Published studies are limited by their retrospective nature, inclusion of minimal time-points for physiological assessment and lack of information on tolerability. This prospective study aimed to assess the tolerability and physiological effects of prone positioning in non-ventilated patients with or without COVID-19 pneumonia. Methods: This interventional case-control study (ClinicalTrials.gov Identifier: NCT04589936) is currently being conducted at a tertiary hospital, with the aim of recruiting 56 patients with pneumonia. Inclusion criteria include those able to provide informed consent and rotate independently through a cycle of supine, lateral (for a duration of 15 minutes) and prone position (for as long as tolerable). The tolerability of each position was qualitatively assessed using a questionnaire and visual analogue scores (VAS). Continuous assessment of oxygenation, respiratory rate, end tidal carbon dioxide and pulse rate will be performed throughout the cycle of position changes. Thirtytwo of these patients will be proned for a longer duration, using a non-invasive positional sensor which will correlate body positions with the tolerability and physiological effects. Statistical analysis of ordinal VAS data was performed using a non-parametric Freidman test and demographic data presented as median (range). Results: The progress of participant recruitment is summarized in figure 1. To date, 73 patients with pneumonia were identified, 22 of whom were approached, of which eleven patients (eight COVID-19 and three non-COVID-19 pneumonia) underwent proning (6 female, 5 male;age, 67 [25-88] years;body mass index, 27.3 [22.8-32.0] kg/m2). There were no significant differences between different positions in the VAS for breathlessness (p=0.41), although the VAS for discomfort worsened between the supine (median score 2) and prone (score 5) position with a trend towards significance (p=0.100). Conclusion: Whilst awake prone positioning is recommended in national guidance, our prospective study to date highlights the challenge in recruiting patients who are suitable and are successfully able to self-prone. Our qualitative data suggests some patients experience discomfort in the prone position. Further detailed characterisation of physiological variables with ongoing recruitment will help inform the feasibility of performing prone positioning in hospitalised patients with pneumonia.