Youth recommendations for early intervention responses by governments for future pandemics

Aims: During the pandemic, youth were particularly vulnerable to experiencing financial hardship, education and employment disruption, and mental health impacts. Ensuring governments and services are prepared to support youth during future outbreaks or novel pandemics should be a key priority. This work aimed to explore youth experiences during COVID-19 and gather youth opinions on government responses to inform planning, policy, and decision-making for future pandemics. Method(s): Youth (ages 15-25) from Ireland and two provinces in Canada (British Columbia and Ontario) were interviewed at three time points during the COVID-19 pandemic. A thematic analysis was conducted using an inductive approach. This research was primarily youth-led and developed. Result(s): Across all three time points, youth experienced mental health and service uptake challenges, with mixed views on pandemic response. Opportunities for personal and societal growth were identified, with desire for incorporating youth voices into governmental decision making processes. Youth offered recommendations for effectively communicating accurate information, prevention of misinformation, and expressed needs regarding service accessibility throughout the pandemic and beyond. Conclusion(s): This work provides insights into the opinions of young people on government and information sharing during the progression of the COVID-19 pandemic. Recommendations were developed to ensure youth are consulted and represented in future pandemics.

Continuity, change and new ways of being: an exploratory assessment of farmer's experiences and responses to public health restrictions during the COVID-19 pandemic in a rural Irish community. (Special Issue: Landscapes of support: farmer wellbeing and rural resilience through and beyond crises.)

Farming occupations are, in the Global North, generally solitary, and a growing body of research identifies this as one of the factors that underpins low levels of wellbeing and poor mental health amongst farmers. The primary public health response to the coronavirus disease 2019 (COVID-19) pandemic focused on reducing transmission of the virus by limiting interactions of people. This article seeks to assess the impact of these restrictions on farmer's experience of isolation and how it shaped their wellbeing. Applying a broad socio-ecological framework, we analyse change, continuity and shifts in social and economic relations and their spatial reconfiguration during the COVID-19 pandemic as recounted in semi-structured, qualitative interviews. We found that while COVID-19 has disrupted socio-spatial relations, including key sites of socialisation for farmers and rural communities, occupational isolation was viewed as a positive feature of farming as was working in nature. Familial and informal networks of support were important throughout the pandemic, while novel engagements with communication technologies facilitated both change and continuity of social and economic interaction. Whilst these findings are broadly positive, the reconfiguration of, particularly, economic relations is viewed as accelerating the turn towards service delivery using technology and, consequently, further reducing opportunities for social interaction.

Continuity, change and new ways of being: An exploratory assessment of farmer's experiences and responses to public health restrictions during the COVID-19 pandemic in a rural Irish community

Farming occupations are, in the Global North, generally solitary, and a growing body of research identifies this as one of the factors that underpins low levels of wellbeing and poor mental health amongst farmers. The primary public health response to the coronavirus disease 2019 (COVID-19) pandemic focused on reducing transmission of the virus by limiting interactions of people. This article seeks to assess the impact of these restrictions on farmer's experience of isolation and how it shaped their wellbeing. Applying a broad socio-ecological framework, we analyse change, continuity and shifts in social and economic relations and their spatial reconfiguration during the COVID-19 pandemic as recounted in semi-structured, qualitative interviews. We found that while COVID-19 has disrupted socio-spatial relations, including key sites of socialisation for farmers and rural communities, occupational isolation was viewed as a positive feature of farming as was working in nature. Familial and informal networks of support were important throughout the pandemic, while novel engagements with communication technologies facilitated both change and continuity of social and economic interaction. Whilst these findings are broadly positive, the reconfiguration of, particularly, economic relations is viewed as accelerating the turn towards service delivery using technology and, consequently, further reducing opportunities for social interaction. © 2023 The Authors. Sociologia Ruralis published by John Wiley & Sons Ltd on behalf of European Society for Rural Sociology.

Farming wellbeing through and beyond COVID-19: Stressors, gender differences and landscapes of support

Although there has been a recent surge in research on drivers of poor farmer wellbeing and mental health, there is still a limited understanding of the state of wellbeing in farming communities around the world and how it can be best supported. This special issue seeks to extend our knowledge of how a combination of different stressors can challenge the wellbeing of farmers, farming families and farm workers, as well as how negative impacts can be unevenly distributed between different individuals. We advance the state of the art in research on farmer wellbeing, illustrating how social, economic and environmental policy drivers combine to create multiple points of stress, which are experienced differently by different individuals (e.g., age, gender). We move beyond an exploration of stressors towards a consideration of how landscapes of support for farmer wellbeing, and packages of support interventions, can improve the social resilience of farming communities. To be effective, these landscapes of support need to be accessible, well-funded, joined-up, and adaptable to evolving crises. This special issue explores farmer wellbeing in the context of global agricultural transitions, which are demanding new ways of farming (e.g., digitalisation, net zero, economic restructuring), and in light of shock events, such as the COVID-19 pandemic, in four countries—Ireland, New Zealand, the UK and the US. In exploring the impacts of future shock events and agricultural transitions on wellbeing, the issue concludes with a call to move beyond broad compilations of stressors and interventions and towards nuanced investigations of why and how poor farmer wellbeing occurs and how it can be best supported in specific contexts. The research from these four countries has wide relevance across European countries (similarity in farming systems, noting some differences), but a key message from the issue is that stressors on farmer wellbeing can be highly context-dependent according to place-based social, environmental, economic and political issues. © 2023 The Authors. Sociologia Ruralis published by John Wiley & Sons Ltd on behalf of European Society for Rural Sociology.

A rapid review investigating the potential impact of a pandemic on the mental health of young people aged 12-25 years.

OBJECTIVES: In March 2020, the World Health Organization (WHO) officially declared the spread of coronavirus disease 2019 (COVID-19) as a pandemic. Adolescence and early adulthood are peak times for the onset of mental health difficulties. Exposure to a pandemic during this vulnerable developmental period places young people at significant risk of negative psychological experiences. The objective of this research was to summarise existing evidence on the potential impact of a pandemic on the mental health of 12-25 year olds. METHODS: A rapid review of the published peer-reviewed literature, published between 1985 and 2020, using PsycINFO (Proquest) and Medline (Proquest) was conducted. Narrative synthesis was used across studies to identify key themes and concepts. RESULTS: This review found 3,359 papers, which was reduced to 12 papers for data extraction. Results regarding the prevalence of psychological difficulties in youth were mixed, with some studies finding this group experience heightened distress during an infectious disease outbreak, and others finding no age differences or higher distress among adults. Gender, coping, self-reported physical health and adoption of precautionary measures appear to play a role in moderating the psychological impact of an infectious disease outbreak. Most studies were conducted after the peak of an epidemic/pandemic or in the recovery period. CONCLUSIONS: More longitudinal research with young people, particularly adolescents in the general population, before and during the early stages of an infectious disease outbreak is needed to obtain a clear understanding of how best to support young people during these events.

COVID-19 on an acute psychiatric unit: an interdisciplinary, trauma-informed response

Purpose: There is a high prevalence of trauma among mental health clients, with risk of re-traumatisation when admitted to a Department of Psychiatry (DoP) (Kimberg and Wheeler, 2019). The COVID-19 pandemic poses challenges to therapy service operations in DoPs, with infection control measures impacting opportunities for therapeutic and social engagement. A trauma-informed care (TIC) lens was used when adapting services in Tallaght University Hospital DoP in response to COVID-19. Design/methodology/approach: An interdisciplinary approach was taken to adapt therapy services during early stages of the pandemic. Changes were informed by TIC principles to minimise re-traumatisation while maintaining high-quality services. Changes included expansion of the therapeutic activity programme, changes to groups, addition of COVID-19-specific groups and increased awareness of communication support needs. Findings: The early response to the pandemic, combined with the focus on TIC, resulted in continued, effective therapy services and positive client feedback. With clients’ involvement in their care enhanced, Individual Care Planning goals were achieved through group interventions. Originality/value: The COVID-19 pandemic brought unprecedented changes to mental health services. This paper highlights a response to unique challenges brought by COVID-19 on a DoP. © 2022, Laura Carroll, Hannah Casey, Rory Adams, Stephanie O’Connor and Áine O’Reilly.

Optimising communication with families of patients on acute stroke and geriatric medicine wards in a large tertiary hospital

Background: Good communication with patients and families is important for older adults admitted to acute stroke or geriatric medicine wards, particularly with COVID19-related restricted visiting. These patients often have communication difficulties including aphasia, delirium, cognitive or hearing impairment, limiting their own communication with relatives. Using the Plan, Do, Study, Act (PDSA) approach we undertook a quality improvement project to optimise communication with families of patients on above wards in a large tertiary hospital. Methods: PDSA cycle 1: Staff were surveyed to identify satisfaction level with communication and ways to optimise communication. Inpatients on study wards were identified, we recorded demographic and clinical details and prevalence of communication difficulties. We created a designated folder with individual 'communication sheets' in conjunction with ward doctors and the nurse manager. PDSA cycle 2: We performed a rapid interval audit of the communication folder use. 'Outlier' patients were excluded as their teams did not receive education about folder use. Results: PDSA cycle 1: A total of 90 inpatients on three wards were included, mean age 78y (SD ±14.4y), 47% were male. Three-quarters (73%) had a communication difficulty noted, reported by nursing staff. Two patients were intubated and six had stroke-related aphasia. Half of surveyed staff reported communication with families was suboptimal. Most (86%) suggested a centrally-located communication logbook would be helpful. PDSA cycle 2: Over two weeks, communication sheets were reviewed for all included patients. Median frequency of calls to families was 4 days (range 0- 14). Most (79%) had the name of the primary contact clearly documented. Many (52%) included no contact number. Only 9% had secondary contact information documented. Conclusion: Communication with families of patients on acute stroke and geriatric medicine wards was suboptimal. Over a short interval this improved with regular phone calls using specific centrally-located communication folders. Further optimisation of their use is needed.

Low Frequency of T Cell and Antibody Responses to Vaccination Against Sars-Cov-2 in Patients Post Allogeneic Stem Cell Transplantation in Comparison with Chronic Myeloid Malignancy Patients

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to unprecedented healthcare challenges on a global scale. Impressive efforts have led to rapid development of multiple efficacious vaccines against SARS-CoV-2, however concerns remain over the degree of protection vaccination offers to immunocompromised recipients. To answer this question, we have designed a prospective study to evaluate response to vaccination in patients with haematological malignancies (Harrington, Leukaemia 2021;Harrington, BJHaem, 2021). 103 patients were included with samples collected in 60 patients after first dose and 71 patients following second dose. We have analysed humoral and T cell response to a first dose of vaccine against SARS-CoV-2 in patients post allogeneic stem cell transplantation (HSCT) and compared those to patients with CML or MPN. Methods: ELISA plates were coated with antigen Nuclear (N) protein or the S protein. Serial dilutions of plasma were added to wells and incubated for 2 h at room temperature. Control reagents included N-specific monoclonal antibody, S-specific monoclonal antibody, negative control plasma, positive control plasma and blank wells. Secondary antibody was added and incubated for 1h at room temperature. IgG was detected using goat-anti-human-Fc-AP and plates read at 405 nm. Where an EC50 was not reached at 1:25, a plasma was considered seropositive if the OD at 405nm was 4-fold above background and a value of 25 was assigned. T cell functionality was assessed using intracellular cytokine staining after incubation with SARS-CoV-2 specific peptides covering immunogenic domains of the Spike (S) protein. A response was considered positive if there was a 3-fold increase in pro-inflammatory cytokine expression from baseline, and above a threshold of 0.01. Specific peptides (0.25 µg/ml), anti-CD28 and BFA were added to cells. Unstimulated cells were utilised as negative controls. Cells were stained with viability dye, then with antibodies directed against surface markers, and fixed and permeabilised prior to staining for intracellular cytokines TNFa and IFNg. Gating on lymphocytes, single cells, live cells, CD3+ cells, CD4+ cells and CD4- (CD8+) was performed. Results: Of the 103 patients included in this study, post vaccination evaluation on 56 patients have been analysed so far, including 37 patients with chronic myeloid malignancies (MPN n=21 and CML n=16) and 19 patients post HSCT. From the latter group, median time since transplant was 53.9 months (18.7 to 76.8) with 12 participants on extracorporeal photopheresis (ECP) therapy for graft versus host disease (GvHD) with median frequency of 24.5 days (14-42). BNT162b2 vaccine was administered to 48 patients (85.7%). An anti-S IgG response was observed after a first dose in 16/21 (76.1%) of the MPN group and 14/16 (87.5%) of CML patients, but in only 7/19 (36.8%) of post HSCT patients (Fishers Exact Test - p=0.02/0.002, Fig 1a). Of the latter group a low positive value where an EC50 was not reached was observed in 4/19 (21.1%) and a moderate response in 3/19 patients (15.8%). Of the 12 patients with active GvHD on ECP, a positive response was observed in 4 patients (33.3%), however only one patient recorded a response where an EC50 was measurable. A T cell response was observed in 16/20 (80%) of the MPN group and 14/15 (93.3%) of those with CML after a single dose, with a polyfunctional T cell response (>1 cytokine) observed in 65% and 80% respectively. In comparison only 5/19 patients (38.5%) post HSCT mounted a T cell response (p=0.027/p=0.002, Fig 1b), with a CD4+ response in 4 (30.8%) and a CD8+ response in 3 (23.1%). In this group, a polyfunctional T cell response was found in 4/19 patients (30.8%). 33.3% of patients with GVHD requiring ECP had a T cell response, compared with 42.9% in post HSCT without GVHD. Summary: Despite encouraging results of antibody and T cell response to a first vaccination dose in patients with chronic myeloid malignancies, these results raise concerns regarding the humoral and T cell respo ses to vaccination in patients post HSCT, recognised as a particularly immunosuppressed group. Further longitudinal data is required to determine if these results translate into a reduction in cases and severity of infection in these groups. We are currently analysing the response to a second vaccine injection and responses to sequential doses of vaccination across the whole cohort will be presented. [Formula presented] Disclosures: Harrington: Bristol Myers Squibb: Research Funding;Incyte: Honoraria. Radia: Blueprint Medicines Corporation: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Study steering group member, Research Funding;Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Education events;Cogent Biosciences Incorporated: Other: Study Steering Committee;EXPLORER and PATHFINDER studies: Other: Member of the Response Adjudication Committee. Kordasti: Beckman Coulter: Honoraria;Celgene: Research Funding;Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding;Alexion: Honoraria. Dillon: Menarini: Membership on an entity's Board of Directors or advisory committees;Novartis: Membership on an entity's Board of Directors or advisory committees, Other: Session chair (paid to institution), Speakers Bureau;Astellas: Consultancy, Other: Educational Events, Speakers Bureau;Abbvie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Research Support, Educational Events;Amgen: Other: Research support (paid to institution);Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: educational events;Jazz: Other: Education events;Shattuck Labs: Membership on an entity's Board of Directors or advisory committees. Harrison: Promedior: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;AOP Orphan Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Incyte Corporation: Speakers Bureau;Gilead Sciences: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Constellation Pharmaceuticals: Research Funding;Galacteo: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Geron: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;BMS: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau;Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau;Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Sierra Oncology: Honoraria;Roche: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Shire: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;CTI BioPharma: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Keros: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. de Lavallade: Bristol Myers Squibb: Research Funding;Incyte: Honoraria, Research Funding;Novartis: Speakers Bureau.

Telephone consultation in the covid-19 era: An occupational health perspective

With the advent of the Covid-19 pandemic and resulting exponentially increased workload for occupational and other health departments worldwide;telemedicine has been brought to the fore at rapid pace. Healthcare and the management of services have seen a drive to innovate and reinvent the way we conduct our communication with colleagues and patients alike. It is imperative that healthcare professionals (occupational health physicians included), continue to uphold standards and maintain the utmost in professional levels of communication to preserve the doctor patient relationship in these challenging times. Occupational health in particular is responsible for the health and wellbeing of so many staff, most notably the hard working,-and most at risk-health care staff.