Utilizing Community Based Participatory Research Methods in Black/African American and Hispanic/Latinx Communities in the US: The CDC Minority HIV Research Initiative (MARI-Round 4).

The Centers for Disease Control and Prevention Minority HIV Research Initiative (MARI) funded 8 investigators in 2016 to develop HIV prevention and treatment interventions in highly affected communities. We describe MARI studies who used community-based participatory research methods to inform the development of interventions in Black/African American and Hispanic/Latinx communities focused on sexual minority men (SMM) or heterosexual populations. Each study implemented best practice strategies for engaging with communities, informing recruitment strategies, navigating through the impacts of COVID-19, and disseminating findings. Best practice strategies common to all MARI studies included establishing community advisory boards, engaging community members in all stages of HIV research, and integrating technology to sustain interventions during the COVID-19 pandemic. Implementing community-informed approaches is crucial to intervention uptake and long-term sustainability in communities of color. MARI investigators' research studies provide a framework for developing effective programs tailored to reducing HIV-related racial/ethnic disparities.

PPE effect on Hearing, Speech, Breathing and work performance in Health care workers

Using Personal protective equipment has become an integral part of work for all health care workers during the COVID19 pandemic however they do have an effect on their work performance. Aim(s):This study aimed to determine the effect of Personal Protective Equipment(PPE) on hearing, speech, and breathing on the work performance among the healthcare workers(HCWs) involved in treating COVID patients. Material(s) and Method(s): This is a descriptive cross-sectional survey conducted among the health care workers(HCWs) in a COVID designated hospital in Pondicherry, South India. A semi-structured questionnaire was constructed, and 384 eligible health care workers participated in the study. Their responses were collected in an excel sheet, and the data were analyzed. Result(s): Our survey showed that 79.7% of participants (n=306) had donned PPE for a total of 6 hours, and their work performance was significantly affected by the following factors, such as difficulty in hearing (p=0.053), difficulty in understanding speech (p=0.048), increased efforts in talking to patients and coworkers (p= 0.004) and increased measures of breathing(p=0.057). Conclusion(s): The use of personal protective equipment significantly impairs communication between coworkers and patients.PPE also increases the burden of breathing, and both these entities seem to influence the work performance of the HCWs. Hence we suggest that alternate communication strategies be taught and employed and formulate newer protocols with user-friendly PPEs to decrease the burden on breathing and for better communication for effective work performance. Copyright © 2022, Anka Publishers. All rights reserved.

Drivers of COVID-19 policy stringency in 175 countries and territories: COVID-19 cases and deaths, gross domestic products per capita, and health expenditures.

Background: New data on COVID-19 may influence the stringency of containment policies, but these potential effect are not understood. We aimed to understand the associations of new COVID-19 cases and deaths with policy stringency globally and regionally. Methods: We modelled the marginal effects of new COVID-19 cases and deaths on policy stringency (scored 0-100) in 175 countries and territories, adjusting for gross domestic product (GDP) per capita and health expenditure (% of GDP), and public expenditure on health. The time periods examined were March to August 2020, September 2020 to February 2021, and March to August 2021. Results: Policy response to new cases and deaths was faster and more stringent early in the COVID-19 pandemic (March to August 2020) compared to subsequent periods. New deaths were more strongly associated with stringent policies than new cases. In an average week, one new death per 100 000 people was associated with a stringency increase of 2.1 units in the March to August 2020 period, 1.3 units in the September 2020 to February 2021 period, and 0.7 units in the March to August 2021 period. New deaths in Africa and the Western Pacific were associated with more stringency than in other regions. Higher health expenditure as a percentage of GDP was associated with less stringent policies. Similarly, higher public expenditure on health by governments was mostly associated with less stringency across all three periods. GDP per capita did not have consistent patterns of associations with stringency. Conclusions: The stringency of COVID-19 policies was more strongly associated with new deaths than new cases. Our findings demonstrate the need for enhanced mortality surveillance to ensure policy alignment during health emergencies. Countries that invest less in health or have a lower public expenditure on health may be inclined to enact more stringent policies. This new empirical understanding of COVID-19 policy drivers can help public health officials anticipate and shape policy responses in future health emergencies.

Communication Factors Influencing Behavioral Intention of Prevention and Community Engagement during COVID-19 in the United States

This study examined how internal (uncertainty, susceptibility, severity, anxiety, and fear) and external motivators (descriptive norms, parasocial interaction, and identification) account for information seeking, message reception, and behavioral intention of COVID-19 prevention and community engagement. A total of500 US adults' responses were collected and analyzed. Results found that both internal and external motivators positively predicted COVID-19 information seeking. External motivators were significantly related to message reception, whereas internal motivators were not. The results imply that external motivators and self-efficacy interacting with internal motivators can be catalysts for the behavioral intention of COVID-19 prevention and community engagement. Study results suggest that emphasizing social influence and public figures' messages in health campaigns may be effective communication strategies for COVID-19 prevention and community engagement.

Has Telemedicine come to Fruition? Parents' and Physicians' Perceptions and Preferences Regarding Telemedicine

Introduction The SARS-Cov-2 pandemic boosted the use of telemedicine for both COVID-infected patients as well as for patients with acute or chronic dis-ease. The aim of our study was to evaluate both patient and physician perceptions, preferences, and acceptability regarding the use of the dif-ferent modalities of telemedicine for various health problems. Methods We conducted a cross-sectional survey in Geneva in 2021. Parents in wait-ing rooms of a paediatric emergency room were invited to answer an online questionnaire, while physicians working in private and public set-tings were asked to answer a similar questionnaire by email. The ques-tionnaire focused on digital literacy, acceptability, preferences, as well as barriers and facilitators concerning a variety of telemedicine modalities for different health concerns. Results 222 parents and 45 pediatricians participated (78% women, 42% physi-cians working in private practice and 58% physicians employed by public institutions). After face-to-face consultations, most parents preferred the telephone to other modalities for health issues such as simple medical ad-vice (64%), discussion of parameters (64%), acute or chronic problems (64% and 57%), and psychological support (62%). They valued emails for communication of blood tests (62%) and renewal of medication (57%). A large majority of pediatricians considered the phone and e-mail to be an acceptable modality for all the issues mentioned above. Video was con-sidered acceptable for follow-up of patients with both acute and chronic diseases (30%). Parents' main reasons for using telemedicine were avoid-ing travel (67%) and saving time (59%). Disadvantages were lack of physi-cal examination (68%), technical problems (38%), and unsuitability (44%). Physicians feared the potential negative impact of telemedicine on the therapeutic relationship and insisted on the need for a facilitated access and a user-friendly format of online platforms. Conclusion The use of telemedicine has increased since the pandemic but both doc-tors and parents continue to prefer face-to-face consultations. Telephone remains more acceptable than video in most medical situations.

Drivers of COVID-19 policy stringency in 175 countries and territories: COVID-19 cases and deaths, gross domestic products per capita, and health expenditures (preprint)

Objective: To understand the associations of COVID-19 cases and deaths with policy stringency globally and regionally. Methods: We modeled the marginal effects of new COVID-19 cases and deaths on policy stringency (scored 0-100) in 175 countries and territories, adjusting for gross domestic product (GDP) per capita and health expenditure (% of GDP). Time periods examined were March-August 2020, September 2020-February 2021, and March-August 2021. Results: Policy response to new cases and deaths was faster and more stringent early in the COVID-19 pandemic (March-August 2020) compared to subsequent periods. New deaths were more strongly associated with stringent policies than new cases. In an average week, 1 new death per 100,000 people was associated with a stringency increase of 2.1 units in March-August 2020, 1.3 units in September 2020-February 2021, and 0.7 units in March-August 2021. New deaths in Africa and the Western Pacific were associated with more stringency than in other regions. Higher health expenditure was associated with less stringent policies. GDP per capita did not have consistent patterns of associations with stringency. Conclusions: Our findings demonstrate the need for enhanced mortality surveillance to ensure policy alignment during health emergencies. Countries that invest less of their GDP in health are inclined to enact stringent policies during health emergencies than countries with more significant health expenditure.

Teaching Elaborative Reminiscing to Support Autobiographical Memory and Relationships in Residential and Community Aged Care Services.

Memories of the past are critically important as we age. For older adults receiving formal care in a range of settings, reminiscing with care staff may provide frequent opportunities for recalling autobiographical memories with a supportive conversational partner. Importantly, prior research suggests that some reminiscing conversations are more supportive than others. In the developmental literature, a long tradition of sociocultural memory research has shown how children's autobiographical memory is scaffolded and supported by parents during reminiscing, when parents use a particular kind of conversational technique, known as "elaborative reminiscing". In the current project, we aimed to examine whether we could enhance conversations between staff and older people receiving aged care by teaching care staff about these beneficial conversational techniques and supporting them to reminisce more often with residents/clients. We also aimed to determine whether staff members' use of elaborative reminiscing techniques was associated with autobiographical memory details recalled by residents/clients during routine conversations. We conducted a workshop with 16 staff within a residential aged care and community care setting. We followed this with a 4-week training-and-feedback period during which staff recorded their conversations with residents and clients. Staff feedback indicated successful use of the scaffolding techniques overall, and benefits as well as barriers to their use in day-to-day practice. Analysis of the conversations demonstrated that the use of particular elaborative reminiscing techniques by staff was associated with increased recall of episodic and semantic autobiographical memory details by residents/clients. Overall, findings suggest that the principles of elaborative reminiscing may apply across the lifespan, and that the benefits of elaborative reminiscing for autobiographical memory may be particularly important in times of cognitive need. Practically, training aged care staff in specific and practical conversational tools can facilitate reminiscing for people receiving aged care.

Cross-Reactive Antibodies to SARS-CoV-2 and MERS-CoV in Pre-COVID-19 Blood Samples from Sierra Leoneans.

Many countries in sub-Saharan Africa have experienced lower COVID-19 caseloads and fewer deaths than countries in other regions worldwide. Under-reporting of cases and a younger population could partly account for these differences, but pre-existing immunity to coronaviruses is another potential factor. Blood samples from Sierra Leonean Lassa fever and Ebola survivors and their contacts collected before the first reported COVID-19 cases were assessed using enzyme-linked immunosorbent assays for the presence of antibodies binding to proteins of coronaviruses that infect humans. Results were compared to COVID-19 subjects and healthy blood donors from the United States. Prior to the pandemic, Sierra Leoneans had more frequent exposures than Americans to coronaviruses with epitopes that cross-react with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), SARS-CoV, and Middle Eastern respiratory syndrome coronavirus (MERS-CoV). The percentage of Sierra Leoneans with antibodies reacting to seasonal coronaviruses was also higher than for American blood donors. Serological responses to coronaviruses by Sierra Leoneans did not differ by age or sex. Approximately a quarter of Sierra Leonian pre-pandemic blood samples had neutralizing antibodies against SARS-CoV-2 pseudovirus, while about a third neutralized MERS-CoV pseudovirus. Prior exposures to coronaviruses that induce cross-protective immunity may contribute to reduced COVID-19 cases and deaths in Sierra Leone.

COVID-19 PANDEMIC AND THE RESULTING LIFESTYLE RESTRICTIONS: THE EFFECT ON CLASSROOM

According to new rules, the environment of a classroom is not the same friendly as it was until before the outburst of the pandemic. First and foremost is what have we learned about the crucial skills that build on student's autonomy. Some adolescents are more affected than others but the good thing is that at this age children are resilient and what supports them is feeling connected to their school and family (CDC, 2021). [...]today countries whose economies where characterized as emerging have been distancing themselves from important scientific areas such as IT or other similar sectors that will lead the next industrial revolution.

COVID-19 modifications of offseason and preseason training for NFL athletes are associated with increased risk of regular season injuries.

OBJECTIVES: COVID-19 altered National Football League (NFL) player and team training during the 2020 offseason. All preseason games were cancelled resulting in absence of game play before the first week of the regular season. Thus, concerns exist regarding injury susceptibility of players during regular season games. The purpose of this study was to evaluate and compare injury rates during the 2020 NFL season versus injury rates from the unaffected 2017-2019 seasons. We hypothesized there would be an increased injury rate and an increased rate of season ending injuries during the modified 2020 season. METHODS: The NFL's public injury database was queried to identify players placed on the injury lists throughout the 2017-2020 seasons. All players listed as "out" and on the injured reserve due to physical injury were included in the data set. For further stratification, injury incidence was separated based on position. Time missed due to COVID-19 illness was not included. Injury rates were expressed as injuries per 1000 athlete exposures (AE). RESULTS: Overall, 893 individual players missed games due to injury during the 2020 NFL regular season compared to an average of 743 over the 2017-2019 seasons. Defensive players at all positions had a statistically significant increase in injury incidence from an average of 7.54 to 10.20 injuries per 1000 AE. Defensive backs were most affected with a 46% increase in players injured. There was no statistically significant difference in season ending injuries for any position. CONCLUSIONS: The COVID-19 stricken 2020 NFL regular season saw an increased rate and incidence of injuries. Specifically, defensive players had a higher incidence of injury overall with defensive backs experiencing the greatest increase in injury rates.

COVID-19, THE PATHS OF NATURAL SELECTION AND THE DAY AFTER

According to the theory of natural selection the goal for every living species is to survive and develop descendants, dictated by nature itself. Regarding the fact that extinction really plays a major role in our world as we know it, if one only considers the fossils or those rare species representatives found living in the most secluded areas of the world obviously most likely accidentally-hidden from the life-threatening game of survival, can explain the abovementioned hypothesis of the triumph of only a number of the strongest offshoot. Climate risks and fossil fueled equipment, new technologies and cyber resilience, capital markets and financial literacy (Kassapi, 2020), public health innovation are some of the issues arising for the day after.

ECONOMIC GROWTH IN THE SUBURBS: POLYCENTRICITY VS MONOCENTRICITY

[...]the concentration of human capital follows a certain power law pattern and cannot be infinite;otherwise we would be experiencing massive population gatherings in certain areas of the world. Summary Urban areas with high density and a number of firms clustering within their respective central business district appeal a lot. Innovation that comes from "interacting with a neighbor" will take a completely new meaning and firms who would like to enjoy high quality business services of i.e. companies in marketing, accounting and legal, will not be guided to cluster their headquarters in the same city to share their service, as communication along with the transportation costs will be minimized.

Recommendations for developing clinical care protocols during pandemics: From theory and practice.

In 2019, a novel coronavirus called the severe acute respiratory syndrome coronavirus 2 led to the outbreak of the coronavirus disease 2019, which was deemed a pandemic by the World Health Organization in March 2020. Owing to the accelerated rate of mortality and utilization of hospital resources, health care systems had to adapt to these major changes. This affected patient care across all disciplines and specifically within the perioperative services. In this review, we discuss the strategies and pitfalls of how perioperative services in a large academic medical center responded to the initial onset of a pandemic, adjustments made to airway management and anesthesia specialty services - including critical care medicine, obstetric anesthesiology, and cardiac anesthesiology - and strategies for reopening surgical caseload during the pandemic.

Behaviour adoption approaches during public health emergencies: implications for the COVID-19 pandemic and beyond.

Human behaviour will continue to play an important role as the world grapples with public health threats. In this paper, we draw from the emerging evidence on behaviour adoption during diverse public health emergencies to develop a framework that contextualises behaviour adoption vis-à-vis a combination of top-down, intermediary and bottom-up approaches. Using the COVID-19 pandemic as a case study, we operationalise the contextual framework to demonstrate how these three approaches differ in terms of their implementation, underlying drivers of action, enforcement, reach and uptake. We illustrate how blended strategies that include all three approaches can help accelerate and sustain protective behaviours that will remain important even when safe and effective vaccines become more widely available. As the world grapples with the COVID-19 pandemic and prepares to respond to (re)emerging public health threats, our contextual framework can inform the design, implementation, tracking and evaluation of comprehensive public health and social measures during health emergencies.

Evaluation of SARS-CoV-2 serology assays reveals a range of test performance.

Appropriate use and interpretation of serological tests for assessments of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure, infection and potential immunity require accurate data on assay performance. We conducted a head-to-head evaluation of ten point-of-care-style lateral flow assays (LFAs) and two laboratory-based enzyme-linked immunosorbent assays to detect anti-SARS-CoV-2 IgM and IgG antibodies in 5-d time intervals from symptom onset and studied the specificity of each assay in pre-coronavirus disease 2019 specimens. The percent of seropositive individuals increased with time, peaking in the latest time interval tested (>20 d after symptom onset). Test specificity ranged from 84.3% to 100.0% and was predominantly affected by variability in IgM results. LFA specificity could be increased by considering weak bands as negative, but this decreased detection of antibodies (sensitivity) in a subset of SARS-CoV-2 real-time PCR-positive cases. Our results underline the importance of seropositivity threshold determination and reader training for reliable LFA deployment. Although there was no standout serological assay, four tests achieved more than 80% positivity at later time points tested and more than 95% specificity.

Point-of-care serological assays for delayed SARS-CoV-2 case identification among health-care workers in the UK: a prospective multicentre cohort study.

BACKGROUND: Health-care workers constitute a high-risk population for acquisition of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Capacity for acute diagnosis via PCR testing was limited for individuals with mild to moderate SARS-CoV-2 infection in the early phase of the COVID-19 pandemic and a substantial proportion of health-care workers with suspected infection were not tested. We aimed to investigate the performance of point-of-care and laboratory serology assays and their utility in late case identification, and to estimate SARS-CoV-2 seroprevalence. METHODS: We did a prospective multicentre cohort study between April 8 and June 12, 2020, in two phases. Symptomatic health-care workers with mild to moderate symptoms were eligible to participate 14 days after onset of COVID-19 symptoms, as per the Public Health England (PHE) case definition. Health-care workers were recruited to the asymptomatic cohort if they had not developed PHE-defined COVID-19 symptoms since Dec 1, 2019. In phase 1, two point-of-care lateral flow serological assays, the Onsite CTK Biotech COVID-19 split IgG/IgM Rapid Test (CTK Bitotech, Poway, CA, USA) and the Encode SARS-CoV-2 split IgM/IgG One Step Rapid Test Device (Zhuhai Encode Medical Engineering, Zhuhai, China), were evaluated for performance against a laboratory immunoassay (EDI Novel Coronavirus COVID-19 IgG ELISA kit [Epitope Diagnostics, San Diego, CA, USA]) in 300 samples from health-care workers and 100 pre-COVID-19 negative control samples. In phase 2 (n=6440), serosurveillance was done among 1299 (93·4%) of 1391 health-care workers reporting symptoms, and in a subset of asymptomatic health-care workers (405 [8·0%] of 5049). FINDINGS: There was variation in test performance between the lateral flow serological assays; however, the Encode assay displayed reasonable IgG sensitivity (127 of 136; 93·4% [95% CI 87·8-96·9]) and specificity (99 of 100; 99·0% [94·6-100·0]) among PCR-proven cases and good agreement (282 of 300; 94·0% [91·3-96·7]) with the laboratory immunoassay. By contrast, the Onsite assay had reduced sensitivity (120 of 136; 88·2% [95% CI 81·6-93·1]) and specificity (94 of 100; 94·0% [87·4-97·8]) and agreement (254 of 300; 84·7% [80·6-88·7]). Five (7%) of 70 PCR-positive cases were negative across all assays. Late changes in lateral flow serological assay bands were recorded in 74 (9·3%) of 800 cassettes (35 [8·8%] of 400 Encode assays; 39 [9·8%] of 400 Onsite assays), but only seven (all Onsite assays) of these changes were concordant with the laboratory immunoassay. In phase 2, seroprevalence among the workforce was estimated to be 10·6% (95% CI 7·6-13·6) in asymptomatic health-care workers and 44·7% (42·0-47·4) in symptomatic health-care workers. Seroprevalence across the entire workforce was estimated at 18·0% (95% CI 17·0-18·9). INTERPRETATION: Although a good positive predictive value was observed with both lateral flow serological assays and ELISA, this agreement only occurred if the pre-test probability was modified by a strict clinical case definition. Late development of lateral flow serological assay bands would preclude postal strategies and potentially home testing. Identification of false-negative results among health-care workers across all assays suggest caution in interpretation of IgG results at this stage; for now, testing is perhaps best delivered in a clinical setting, supported by government advice about physical distancing. FUNDING: None.