Covid-19 and children's social development: Insights from the life-course perspective

In this chapter, the authors focus on disruptions to children's lives at home and at school (including early childhood care and education programs [ECCE] and primary schooling) as critical settings for healthy development. The Covid-19 pandemic has upended children's lives in myriad ways, including disruptions in the family system due to illness or death, financial instability tied to job loss, and educational disruptions as a result of closures of child care facilities and schools. In considering how the Covid-19 pandemic is shaping children's social development, the authors attend to how interactions with others and socialization processes within families and schools may buffer or exacerbate the pandemic's negative impact. Developmental scientists are well positioned to research how macro-level shocks such as the coronavirus pandemic affect children's developmental trajectories, and the life-course perspective can guide and inform that investigation. © 2022 John Wiley & Sons Ltd.

Realtime Risk Monitoring System using Convolutional Neural Network for COVID19 Pandemic

The COVID19 pandemic has significantly changed the lifestyle of billions of people across the globe. It has greatly affected almost all sectors of business, industry and public life. As per the WHO's guidelines, wearing a face mask has become the new compulsory and precautionary measures for everyone. Currently, all the public and private service providers will expect their stakeholders to wear face mask in an appropriate way to avail any services. Therefore, detection of face mask at public places is a crucial task to help the society to overcome current pandemic. This paper presents a unique approach to not only detect face mask but also calculate the risk of getting infected by COVID-19 using machine learning algorithms. The proposed model detects the various faces present in an input video, identifies if it has a mask present or not. If the mask is not detected, the model calculates the risk of human being getting infected based on their age. Finally, the model generates the output and provides analysis based on the real time data it has processed. As a real-time surveillance system, the model can also classify a face when a person is moving in the live video. The proposed method attained a highest accuracy of 99.57 % against standard datasets under study. The authors experimented and explored various Convolutional Neural Network models like DenseNet, MobileNet_V2, Inception_V3 and YOLO_V4 find the best model, detecting the presence of masks accurately without causing over-fitting. © 2022 IEEE.

Performance of Rapid Diagnostic Testing at Days 4-6 from Diagnosis: Implications for Discharge from Isolation on a University Campus

Background. Omicron rapidly replaced delta as the predominant strain causing COVID-19 related illness in the United States (US) in December 2021, the same month the US CDC reduced the recommended isolation period from 10 to 5 days for asymptomatic individuals or those with resolving symptoms. New evidence suggests some asymptomatic individuals with omicron remain culture positive beyond 5 days from diagnosis. We sought to evaluate the performance of a SARS-CoV-2 antigen rapid diagnostic test (RDT) in predicting persistent potential for transmission at the end of a five-day isolation period among young, fully vaccinated individuals in a university community setting. Methods. A subgroup of participants enrolled in a longitudinal COVID-19 cohort were asked to self-perform RDTs on days 4 to 6 from diagnostic test date in addition to a separate self-collected anterior nasal swab used for culture and RT-PCR, and a daily symptom screen (15 COVID-19 symptom questions on a 4-point scale). We calculated the daily and overall sensitivity and specificity of the RDTs in comparison to SARS-CoV-2 culture result. We also compared the N1 cycle threshold (CT) values and symptom score on each day of the study by RDT results. Results. Of 23 participants, the mean age was 20 years, all had completed their primary COVID-19 vaccine series, and 13 (65.0%) had received a booster vaccine (Table 1). Compared to culture, sensitivity and specificity of the RDTs were 100% and 62% respectively (Table 2). Compared to participants with negative RDTs, median CT values were lower in those with positive RDTs on each day of the study (Figure 1). Participants who had positive RDTs on all three days had higher symptom scores (Figure 2) than those without. Conclusion. RDTs have a high sensitivity in detecting culture positive SARS-CoV-2 on Days 4 to 6 from initial diagnostic test. However, the high false positive rate of 38% means that over a third of culture negative individuals will stay in isolation longer than necessary if RDTs are used in test to release from isolation protocols. Viral loads (CT values) and symptom scores were higher for participants with persistently positive RDT result. An approach that uses a combination of RDTs, CT values and symptom score may prove useful in guiding isolation duration.

Principles of drug use and management in pregnancy

The antenatal and postnatal care of women is becoming increasingly complex, especiallyduring the COVID-19 pandemic. The increased use of medications during pregnancymakes it a challenging area for healthcare professionals. The role of the obstetric clinicalpharmacist has evolved from supply and prescription screening to that of a moreadvanced practitioner. The pharmacist is now required to be actively involved in patientcare by collaborating closely with the multidisciplinary team and adopting an evidence-based approach. The specialised pharmacist also participates in guideline development,research and development, service improvement in the multidisciplinary team setting andcritical evaluations of unlicensed drugs use. With these emerging clinical leadership roles,obstetric clinical pharmacy has become a rewarding and exciting career for pharmacistswho have a special interest in this field and who enjoy working with a dedicated team ofdoctors, midwives, nurses and other healthcare staff.

Design and construction of the Compton and Edrich stands, Lord’s Cricket Ground redevelopment

This paper describes the key design and construction challenges of the Compton and Edrich stands – two striking additions to Lord’s Cricket Ground in London. The new stands increase the capacity of the ground and bring new sponsor boxes and other modern facilities. The design includes steel moment frames and a steel-framed canopy, with a secondary timber beam network, partially covering the stands. The varying geometry of the stands required complex steelwork fabrication. Construction challenges included the programme constraints of working around the cricket seasons, and the onset of the Covid-19 pandemic around six months after work began on site. © 2022, Institution of Structural Engineers. All rights reserved.

Utilisation of a smartphone-enabled video otoscope to train novices in otological examination and procedural skills.

OBJECTIVE: The ai/m of this study was to compare the self-reported confidence of novices in using a smartphone-enabled video otoscope, a microscope and loupes for ear examination and external ear canal procedures. METHOD: Medical students (n = 29) undertook a pre-study questionnaire to ascertain their knowledge of techniques for otoscopy and aural microsuction. Participants underwent teaching on ear anatomy, examination and procedural techniques using a microscope, loupes and smartphone-enabled video otoscopes. Confidence and preference using each modality was rated using a Likert-like questionnaire. RESULTS: After teaching, all modalities demonstrated a significant increase in confidence in ear examination (p < 0.0001). Confidence in using the smartphone-enabled otoscope post-teaching was highest (p = 0.015). Overall, the smartphone-enabled video otoscope was the preferred method in all other parameters assessed including learning anatomy or pathology (51.72 per cent) and learning microsuction (65.51 per cent). CONCLUSION: Smartphone-enabled video otoscopes provide an alternative approach to ear examination and aural microsuction that can be undertaken outside of a traditional clinical setting and can be used by novices.

Emergency urology procedures during CIVID-19 pandemic: A 2 monthly prospective study

Introduction: COVID-19 resulted in Regional tiered restrictions being introduced across the UK with subsequent implications for planned and emergency care. Specific to Merseyside Tier 4 and Tier 2 restrictions were introduced in late 2020. At the onset of the pandemic in the Spring, elective work ceased, and emergency admissions were minimal. The purpose of this study was to examine the volume and nature of all emergency admissions to a Urology unit in Merseyside in the 2nd wave of the pandemic during two different tiers of national restrictions. Method: A prospective audit examining all emergency urological activity was conducted in Whiston Hospital from October 2020 when the Tier 4 restrictions were introduced to Tier 2 was introduced. Data was obtained by identifying patients using the electronic theatre listing system. Results: A total of 52 emergency cases were performed (24 in November Tier 4, 28 in December Tier 2). A total of 12 different procedures were performed. The commonest procedure performed was stent insertion (26), followed by scrotal exploration (7). One patient required transfer to a different hospital. In total 4 calls were made by general surgery and 2 by gynaecology for urological assistance in theatre. Two urology patients returned to theatre. Direct Consultant involvement occurred in 19 cases (37%). Conclusions: Unlike the Spring lockdown acute urology operations presented despite regional restrictions. A total of 52 cases were performed with more occurring in Tier 2. Stent insertion was the commonest procedure with the majority of the cases performed by registrars.

Accuracy of virtual assessment in hand trauma.

A virtual clinic was developed from an existing telemedicine system to manage hand trauma in the Queen Victoria Hospital, East Grinstead, UK, during the first wave of the COVID-19 pandemic. This study evaluates the accuracy of the assessments made and makes comparisons to the traditional face-to-face clinic. The accuracy of assessment was analysed by comparing diagnosis with findings at surgery. One hundred and eighty-nine virtual assessments conducted by telephone with photographic data or by video were compared to 129 face-to-face assessments conducted prior to the pandemic. There was no difference in the accuracy of virtual and face-to-face clinics for patients treated surgically (p=0.27); treatment was correctly predicted for 87% of the virtual group and 78% of the face-to-face group. However, fewer virtual assessments led to a surgical outcome (p=0.0064); 68% of the virtual group had surgical outcomes compared to 82% of the face-to-face group. Most face-to-face assessments were done by a specialty trainee compared to a range of clinicians in the virtual clinic. Accuracy of assessment among trainees was significantly associated with experience for the virtual (p=0.045) but not face-to-face clinics (p=0.94). Virtual assessment by video versus telephone plus photographs were similarly accurate. We conclude that virtual triage serves as a successful alternative to face-to-face appointments. It is robust and succeeds in reducing footfall to the hospital site in line with recent social distancing measures against COVID-19. We have shown that video conferencing triage is no better than telemedicine triage with telephone and photographs.

The use of virtual trauma clinics (VTC) in the assessment of acute hand trauma;a service evaluation

As a UK tertiary referral centre for hand trauma the current COVID outbreak has led to the reconfiguration of trauma services. We evaluate the impact of our newly introduced VTC on our hand trauma service, comparing a cohort of patients who were managed pre-COVID, with our current revised pathway. We carried out a service evaluation of all those patients processed by the VTC over 14 days in April 2020 (n=184). We collected prospective data on timing of referral to assessment and surgery. This data was compared to a matched period in April 2019 (n=162). Post VTC there has been a significant reduction in time to clerking and time to surgery (p=< 0.001), with 98.1% being clerked within 1 day of referral. Post VTC 12.9% of patients were discharged directly from VTC, all other patients had definitive treatment in a single trip. VTC has shown a clear benefit to patients with definitive management provided in a single trip in all cases. Whilst we have been able to clerk patients earlier any improvement in time to surgery depends on theatre staffing and availability, which differed in the two cohorts and certainly will as we move forward into normal services.

The single-use rhinolaryngoscope: an evaluation and cost comparison.

BACKGROUND: This study investigated whether the single-use rhinolaryngoscope is clinically and economically comparable to the conventional reusable rhinolaryngoscope within a tertiary otolaryngology centre in the UK. METHODS: A non-blinded, prospective and single-arm evaluation was carried out over a 5-day period, in which micro-costing was used to compare single-use rhinolaryngoscopes with reusable rhinolaryngoscopes. RESULTS: Overall, 68 per cent of the investigators perceived the single-use rhinolaryngoscope to be 'good' or 'very good', while 85 per cent believed the single-use rhinolaryngoscope could replace the reusable rhinolaryngoscope (n = 59). The incremental costs of reusable rhinolaryngoscope eyepieces and videoscopes in the out-patient clinic, when compared to single-use rhinolaryngoscopes, were £30 and £11, respectively. The incremental costs of reusable rhinolaryngoscope eyepieces and videoscopes in the acute surgical assessment unit, when compared to single-use rhinolaryngoscopes, were -£4 and -£73, respectively. CONCLUSION: The single-use rhinolaryngoscope provides a clinically comparable, and potentially cost-minimising, alternative to the reusable rhinolaryngoscope for use in the acute surgical assessment unit of our hospital.

Leadership and early strategic response to the SARS-CoV-2 pandemic at a COVID-19 designated hospital in South Africa.

While many countries are preparing to face the COVID-19 pandemic, the reported cases in Africa remain low. With a high burden of both communicable and non-communicable disease and a resource-constrained public healthcare system, sub-Saharan Africa is preparing for the coming crisis as best it can. We describe our early response as a designated COVID-19 provincial hospital in Cape Town, South Africa (SA).While the first cases reported were related to international travel, at the time of writing there was evidence of early community spread. The SAgovernment announced a countrywide lockdown from midnight 26 March 2020 to midnight 30 April 2020 to stem the pandemic and save lives. However, many questions remain on how the COVID-19 threat will unfold in SA, given the significant informal sector overcrowding and poverty in our communities. There is no doubt that leadership and teamwork at all levels is critical in influencing outcomes.