Using Absorbable Suture For Traumatic Wound Closure To Avoid Additional Hospital Visit For Suture Removal During The Covid 19 Pandemic: A Randomized Controlled Trial

Introduction: The COVID-19 pandemic worldwide forced governments to undertake intervention measures to encourage social distancing. Meanwhile, traumatic skin lacerations require multiple hospital visits for dressing, changings, and suture removal since they are usually repaired with non-absorbable sutures. In a matter of fact, these visits can be avoided by using absorbable sutures instead. However, absorbable sutures carry the theoretical risk of wound infection. In this study, our aim was to determine whether absorbable sutures are better than non-absorbable sutures in repairing lacerations during the COVID-19 pandemic. The first and second objectives were to assess the rate of infection and the number of postoperative hospital visits. Method(s): A sample of 469 patients with traumatic skin lacerations were analysed during the COVID-19 pandemic in April-July 2020. In the control group, wounds were repaired using non-absorbable sutures, while rapid-onset absorbable sutures were used in the treatment group. By conducting a phone call follow-up after 21 days, several parameters regarding infection signs and hospital visits were compared between both groups. Result(s): No statistically significant difference was observed between both groups regarding wound infection (p-value= 0.623). Using absorbable sutures resulted in fewer postoperative hospital visits than non-absorbable sutures (p-value= 0.001). This study is limited because the assessment of wound infection was subjective to the patient by a phone call follow-up. Conclusion(s): Using absorbable sutures to close traumatic skin lacerations is safe. They should be considered during a pandemic to reduce hospital visits for suture removal, which will subsequently enhance social distancing and relieve hospital load.

Nimble-footed Zimbabwean migrants: (im)mobility and the porousness of borders between South Africa and Zimbabwe during the Covid-19 national lockdown

This ethnographic study highlights the impact of Covid-19 border closures on the migration patterns of Zimbabwean cross-border migrants. Data in this study were collected using qualitative techniques, one-on-one telephonic interviews and social media platforms from 20 participants over a period of five months. The data were analysed using the theoretical framework of conviviality. Our findings indicate that Zimbabwean cross-border migrants managed to cross into South Africa and back despite restrictions, which suggests that border closures had a limited impact on migration. By drawing on the narratives of Zimbabwean cross-border migrants, we illustrate how migrants, goods and remittances managed to move and how social networks such as hushamwari [friendship] played a significant role in facilitating illegal border jumping, revealing the permeability and porousness of state borders to many diverse types of incursions. The closure of national borders during lockdowns highlights the differences between migrants and border jumpers, the latter of which chose to smuggle goods in novel ways, even though they possess legal documentation and economic status. (English) [ FROM AUTHOR] Este estudo etnográfico destaca o impacto do fechamento de fronteiras durante a pandemia de Covid-19 nos padrões de migração dos migrantes transfronteiriços do Zimbábue. Os dados deste estudo foram coletados usando técnicas qualitativas, entrevistas telefônicas individuais e plataformas de mídia social com 20 participantes durante um período de cinco meses. Os dados foram analisados a partir do referencial teórico da convivialidade. Nossas descobertas indicam que os migrantes transfronteiriços do Zimbábue conseguiram entrar e voltar da África do Sul apesar das restrições, o que sugere que o fechamento das fronteiras teve um impacto limitado na migração. A partir das narrativas dos migrantes transfronteiriços do Zimbábue, ilustramos como migrantes, bens e remessas conseguiram circular e como as redes sociais como hushamwari [amizade] desempenharam um papel significativo na facilitação do salto ilegal de fronteira, revelando a permeabilidade e a porosidade das fronteiras dos Estados aos mais diversos tipos de incursões. O fechamento das fronteiras nacionais durante o confinamento destaca as diferenças entre migrantes e saltadores de fronteira, tendo estes últimos optado por contrabandear mercadorias de novas maneiras, embora possuam documentação legal e status econômico. (Portuguese) [ FROM AUTHOR] Copyright of Anthropology Southern Africa (2332-3256) is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Meeting the mental health needs of students in a pandemic: A quantitative analysis of the impact of school-based mental health services on student outcomes

Intervention following alternative events is essential for continued cognitive development. Prior research has cognitive growth models and the effect of alternative stimuli on youth when given similar foundations. Following the return to school after a national pandemic and extended school closure following the COVID-19 outbreak of 2020, it is vital to determine factors to increase positive post-secondary outcomes for students. This research study examined the potential impact of student mental health on academic achievement in response to school closure following a pandemic. The research study consisted of 92 individual students and was a quasi-experimental quantitative study. Data consisted of two nominal independent variables and one scale dependent variable. The independent variables were participation in school based mental health or non-participation and the dependent variables were STAR 360 benchmark assessments in reading and math. Scaled Score and Normal Curve Equivalent were analyzed utilizing SPSS to calculate statistical significance within the data set. The data from this study indicated statistically significant growth in reading and math post-school closure as well as statistical significance in between all benchmark assessments in relation to time but no statistical significance due to school based mental health. The findings represent students who were presented with alternative stimuli and required intervention to return to commensurate cognitive growth. Following the pandemic closure, schools needed to develop additional levels of support that reconnected students to school and furthered social and emotional learning practices. Analysis of pre- and post-extended school closure data as well as the main effect of time in posttest analysis suggests that universal support over time may correlate to increased academic achievement and growth. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Global Evidence of Pandemic Effects on Educational Disruption

The article provides a vivid illustration of the challenges faced by the education sector during the pandemic. Education disruptions have increased stress and anxiety in students and their families. In addition to this, schools in rural areas and underdeveloped countries failed to provide the necessary equipment and facilities to help the students proceed with online classes. These articles have relied on secondary data and information to understand various concepts and theories. In order to combat these consequences, a worldwide initiative called REDS was formed to analyze the opinion of students and individuals connected with the education sector and remodel the system for combating the challenges posed by the pandemic. The study proceeded with the help of thematic analysis. © 2023 EDP Sciences. All rights reserved.

The stock market and NO2 emissions effects of COVID‐19 around the world

In this paper, we study the impact of the coronavirus disease 2019 pandemic in estimated panel vector autoregression models for 92 countries. The large cross‐section of countries allows us to shed light on the heterogeneity of the responses of stock markets and nitrogen dioxide emissions as high‐frequency measures of economic activity. We quantify the effect of the number of infections and four dimensions of policy measures: (1) containment and closure, (2) movement restrictions, (3) economic support, and (4) adjustments of health systems. Our main findings show that a surprise increase in the number of infections triggers a drop in our two measures of economic activity. Propping up economic support measures, in contrast, raises stock returns and emissions and, thus, contributes to the economic recovery. We also document vast differences in the responses across subsets of countries and between the first and the second wave of infections.

Relative Effectiveness of Vaccination and Non-Pharmaceutical Interventions on COVID-19 Infection and Deaths in the US

Objectives: To examine the relative effectiveness of vaccination and non-pharmaceutical interventions (NPIs) on COVID-19 infection, reproduction rate, and deaths in the US. Method(s): Retrospective national-level US data were obtained from the Oxford COVID-19 Government Response Tracker (OxCGRT dataset). We performed time-trend analyses from December 2020 to December 2022 to observe how the values of policy variables and the number of COVID-19 new cases and deaths changed over time. The policy variables included (1) the number of people fully vaccinated per 100 of the total population (referred to as vaccination rate) and (2) the stringency index (a proxy for NPIs since it is a composite measure based on nine response indicators including school closures, workplace closures, stay-at-home requirements, and travel bans). We also performed multivariable linear regression to examine the associations between the policy variables and the COVID-19 reproduction rate. Result(s): Based on the time-trend analyses, the number of people vaccinated started to rise since March 2021, while the stringency index had steadily declined since early January 2021. A decrease in new COVID-19 cases and deaths was also observed during these three months (January to March 2021). However, despite a higher vaccination rate than in early 2021, new COVID-19 cases and deaths peaked in late 2021 and early 2022, suggesting that some NPIs might still be needed. The multivariable linear regression analysis showed that the reproduction rate of COVID-19 was negatively associated with the stringency index (coefficient = -0.010, 95% CI -0.013 to -0.005) and vaccination rate (coefficient = -0.005, 95% CI -0.009 to -0.001), after controlling for time covariates. Conclusion(s): The study highlighted the importance of NPIs in reducing new COVID-19 cases and deaths even when vaccination was in progress. Further research accounting for other factors is needed to disentangle the effects of NPIs and other measures from vaccination campaigns.Copyright © 2023

Zero Suicide Quality Improvement: Developmental and Pandemic-Related Patterns in Youth at Risk for Suicide Attempts

The Zero Suicide (ZS) approach to health system quality improvement (QI) aspires to reduce/eliminate suicides through enhancing risk detection and suicide prevention services. This first report from our randomized trial evaluating a stepped care for suicide prevention intervention within a health system conducting ZS-QI describes (1) our screening and case identification process, (2) variation among adolescents versus young adults, and (3) pandemic-related patterns during the first COVID-19 pandemic year. Between April 2017 and January 2021, youths aged 12-24 years with elevated suicide risk were identified through an electronic health record (EHR) case-finding algorithm followed by direct assessment screening to confirm risk. Eligible/enrolled youth were evaluated for suicidality, self-harm, and risk/protective factors. Case finding, screening, and enrollment yielded 301 participants showing suicide risk indicators: 97% past-year suicidal ideation, 83% past suicidal behavior;and 90% past non-suicidal self-injury (NSSI). Compared to young adults, adolescents reported more past-year suicide attempts (47% vs. 21%, p <.001) and NSSI (past 6 months, 64% vs. 39%, p <.001);less depression, anxiety, posttraumatic stress, and substance use;and greater social connectedness. Pandemic onset was associated with lower participation of racial-ethnic minority youths (18% vs. 33%, p <.015) and lower past-month suicidal ideation and behavior. Results support the value of EHR case-finding algorithms for identifying youths with potentially elevated risk who could benefit from suicide prevention services, which merit adaptation for adolescents versus young adults. Lower racial-ethnic minority participation after the COVID-19 pandemic onset underscores challenges for services to enhance health equity during a period with restricted in-person health care, social distancing, school closures, and diverse stresses.Copyright © 2023 Society of Clinical Child and Adolescent Psychology.

The impact of the COVID-19 pandemic on children's learning and wellbeing: Evidence from India.

We study the impact of the COVID-19 pandemic and associated school closure on primary school children's learning and mental wellbeing in Assam, India. Using a comprehensive dataset that tracked and repeatedly surveyed approximately 5000 children across 200 schools between 2018 and 2022, we find that children lost the equivalent of nine months of learning in mathematics and eleven months in language, during the pandemic. Children lacking resources and parental support experienced the largest losses. Regular practice, teacher interaction, and technology were associated with less learning loss. Over the same period, children's psychological wellbeing improved. Our research provides valuable insights for designing post-emergency programs.

Socio-emotional, cognitive, affective disorders and substance use in a sample of students in first- and second-grade high school in Italy: A comparison among students', parents', and teachers' perceptions

The closure of schools, social hubs, and extracurricular activities due to lockdown measures imposed to curb the spread of SARS-CoV-2, has increased the risk factors for students' mental health. This cross-sectional study, conducted from March 2020 to March 2021, aimed to estimate socio-emotional, cognitive, and affective disorders and substance use in a sample of first- and second-grade high school students in Northern Italy. This study compared data from 284 Italian students' self-perceptions along with the perceptions of their parents and teachers through a web-based survey. The differences in the perceptions of the three groups (students, parents, and teachers) were analyzed using an analysis of variance test, applying a Bonferroni correction. The chi(2) test was used to assess the comparison between students, parents, and teachers in the substance use questions. The results showed statistically significant differences among the three groups. The most important outcomes were sociality, scholastic performance, extracurricular activity, emotional symptoms, affective disorders (depression and anxiety), and substance use. These findings could be interesting for the promotion of mental health and prevention of psychopathological risks in students.

India and Covid-19: decisive but controversial actions seem to be working

A disclaimer to start with: in a federal union of 1.3 billion persons comprising 17 per cent of humankind, 36 states and territories, multiple languages and ethnic groups, few if any observations are valid across the whole country. Democracies find it hard to make tough decisions and to adapt when they need to improvise without precedents;pre-emption to tackle a problem before it becomes a crisis is never a democratic strength, especially in a federation. India took relatively early steps against Covid-19: visas were rescinded on March 18;international flights stopped on March 22;and domestic flights were terminated on March 24. Prime Minister Narendra Modi called for a 12-h nation-wide voluntary curfew on 22 March, marked with high observance, which was a dress rehearsal for a full lock-down from 24 March for 21 days with relaxations for medicines, media, banks and groceries. The national closure was the most comprehensive in history. At that stage, India had registered 500 cases and 10 deaths. The trade-off was to lose lives to Covid-19, or gain time to prepare health services and risk the economic consequences. Modi acted quickly although it caused hardship to millions. By and large, the lockdown was observed, justifying the theory that Indians react best in emergency mode.

(Re)defining the Teaching-Learning Process During the COVID-19 Pandemic: The Portuguese Experience

In mid-March 2020, following the decision reached by the European Centre for Disease Prevention and Control facing the COVID-19 pandemic, the Portuguese government ordered the closure of schools. This resolution presented a great challenge: to transform classroom activities into online sessions using digital technologies for thousands of students in primary, secondary and higher education. If we can consider that this challenge was met, proving the ‘visionary' character of Connectivism, it is necessary to highlight the adaptation of teachers and students to the new world of virtual classes. In order to assess the ‘Teaching Practices in the Time of the Pandemic, ' as well as the opinion of teachers on face-to-face, blended or online classes, a Likert-type questionnaire was applied. The results are presented and discussed here. The main conclusions reaffirm the preference for the face-to-face model, articulated with distance learning practices. The lack of contact with students and colleagues, the heavier workload and stress, the worsening of inequalities among students and inhibition of collaborative work are the most focused problems with online teaching. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Impact of the Covid-19 Pandemic on Electrophysiology Procedural Volume in the United States: A Nationwide Analysis

Background: The COVID-19 pandemic has had an unprecedented impact on the United States health system and its ability to deliver care. In particular, surgical and interventional procedures suffered a significant decline in the early stages of the pandemic for a multitude of reasons including, PPE and personnel shortages, the deference of elective procedures, and governmental bans on elective procedures. The impact of these factors on electrophysiology (EP) procedural rates in the United States is unknown. Objective(s): To study the impact of the COVID-19 pandemic on EP procedural volume in the United States (2019-2020). Method(s): We analyzed the National inpatient sample (2019-2020) to identify hospitalizations involving EP procedures using ICD-10-PCS codes. Weighted analysis was performed to determine the number of procedures performed on a monthly basis. The US census data was employed to ascertain procedure rates per million population, the trends of which are displayed in Figure 1. Result(s): A total of 236,991 EP procedures were performed in 2020 - a 9% decrease from 2019 (n= 260,615). This included an annualized 11.25% decrease in device implantations (ICD and PPM), a 7.7% drop in AF ablations, and a 5.4% decrease in VT ablations as compared to 2019. Interestingly rates of left atrial appendage occlusion (LAAO) procedures saw an annualized 3.7% increase in 2020. The maximal per-month decline in procedural volume was noted in April 2020. An overall decline of 48% in EP procedures was noted, with the most precipitous drop with LAAO (90%), followed by AF Ablation (65%), PPM (4.3%), ICD (3.8%), and least with VT ablation (2.5%). Conclusion(s): The COVID-19 pandemic has had a significant and heterogonous impact on EP procedural volume. Despite a precipitous 48% decline in April 2020, overall, 2020 procedure rates have recovered to a 9% drop from 2019. [Formula presented]Copyright © 2023

Glaukomflecken: The classic and uncommon ocular sign after acute primary angle closure attack.

The widespread of upper respiratory tract symptoms caused by COVID-19 infections has increased the prescription and usage of antitussive and nasal decongestants. We presented a case of ocular acute primary angle closure attack with increased intraocular pressure after COVID-19 therapy. Glaukomflecken, the classic and uncommon ocular sign after acute primary angle closure attack, was demonstrated in this visual case discussion.

Study on the Distribution of Fresh Food Support System—An Example of Shanghai during the Epidemic Closure of 2022

One of the key indicators to measure the sustainability and resilience of a city during a public health crisis is how well it can meet the daily needs of its residents. During the COVID-19 lockdown in Shanghai in 2022, e-commerce shopping and delivery became the most important method for ensuring the city's material supplies. This article uses the distribution data of a fresh e-commerce platform's pre-warehouse and static population distribution data to establish a basic material supply system evaluation model for the city and explore its resilience potential. Focusing on the central urban area of Shanghai, this study uses a population heat map with geographic coordinates to reflect the static distribution of residents and obtains the distribution data of the e-commerce pre-warehouses. Using kernel density analysis, the relationship between the pre-warehouses and the residents' needs is established. Through analysis, it was found that the supply capacity of fresh food in different areas of Shanghai during the lockdown could be categorized as insufficient, adequate, or excessive. Based on these three categories, improvement strategies were proposed. Finally, this article suggests establishing a scientific supply security system to promote urban sustainability and prepare for future challenges.

The Negative Impact of the Succession of Crises and the Ineffectiveness of the E-learning System on Tertiary Education in Sudan from (2018) to Present

This study attempts to determine the social, economic, and psychological impacts of the 2018 temporary closure of educational institutions in Sudan amid several internal incidents and the ongoing closure due to the COVID-19 pandemic on students, teachers, and families. Most educational systems worldwide were temporarily closed and negatively affected. Nevertheless, it seemed as if the crises in Sudan extremely damaged the process of the overall educational system simply because the closure of the institutions initially began as a result of several internal incidents by the end of the academic year 2017-2018. The closure lasted until August 2019, when schools were reopened, and within almost six months;again, a decision was made in February 2020 for the entire closure of educational institutions due to the COVID-19 pandemic and continued for more than one and a half years. The impact of total closures of universities and colleges in Sudan affected students' academic achievement in different ways because the situations in Sudan were primarily different before the spread of COVID-19. Therefore, the negative implications of the long–term closure were greater not only on the students' academic achievement but also on the teachers' sources of income, which resulted in economic issues for many families. To undertake this study, both quantitative and qualitative research methodologies were used. The researchers designed and distributed a questionnaire to a sample of 39 Sudanese university teachers to examine their attitudes towards the impact of the several internal incidents behind the closure of the entire educational institutions on overall academic achievement and online education as an alternative to face-to-face or traditional teaching. Although very few universities launched e-learning units during the last two decades, it seemed as if their purposes were very limited and mainly designed to serve a few students under certain conditions. Additionally, the researchers observed the efficient application of the e-learning educational system during the COVID-19 pandemic, represented by the Blackboard platform at both Qassim University and Prince Sattam Bin Abdulaziz University. The data analysis resulted in some significant findings, among which are the following: First, students were regularly paying the price of the poor infrastructure that contributed to preventing the application of an effective e-learning system in Sudan. Second, the long–term closure throughout 2018 has resulted in the accumulation of several student batches and generally complicated the scene. Third, the long–term closure influenced university students in different ways: academically, socially, economically, and psychologically. © The Author(s) 2023.

COVID-19 and Urban Futures: Impacts on Business Closures in Miami-Dade County

The COVID-19 pandemic altered the local economic geographies of many U.S. cities, and it remains unclear how long these changes will persist. This study analyzed the sociospatial dynamics of business closures in Miami-Dade County, Florida, from August 2020 to August 2021 with an explicit focus on reconciling the pandemic's effects in the context of location theory. We found that traditional urban centers and transit-concentrated areas experienced disproportionately higher rates of business closures during the study period, suggesting a potential wave of commercial suburbanization in Miami. Middle-class and working-class Hispanic neighborhoods suffered the most business closures. The results of correlation analysis and spatial regression models suggested a positive association between the incidence of COVID-19 cases and business closures at both zip code and individual business levels. These results also beckon a revaluation of the role of certain urban externalities in traditional location theory. The importance of automobile accessibility and agglomeration effects are poised to persist beyond the pandemic, but the benefits of proximity to the public transport system might decline. The trends observed in Miami suggest that the pandemic could generate more automobile-reliant employment subcenters in U.S. cities and amplify problems of intraurban inequality and urban sprawl. (English) [ FROM AUTHOR] La pandemia del COVID-19 alteró las geografías económicas locales de muchas ciudades de los Estados Unidos, y aún no hay claridad por cuánto tiempo más persistirán estos cambios. Este estudio analizó la dinámica socioespacial del cierre de negocios en el Condado de Miami-Dade, Florida, de agosto del 2020 hasta agosto del 2021, centrándose explícitamente en reconciliar los efectos de la pandemia dentro del contexto de la teoría locacional. Descubrimos que los centros urbanos tradicionales y las áreas de tránsito concentrado experimentaron tasas desproporcionadamente más altas de cierres de negocios durante el período del estudio, lo cual sugiere una ola potencial de suburbanización comercial en Miami. Los vecindarios hispánicos de clase media y de la clase trabajadora sufrieron al máximo de cierres de negocios. Los resultados del análisis de los modelos de correlación y regresión espacial sugirieron una asociación positiva entre la incidencia de los casos de COVID-19 y los cierres de negocios, tanto al nivel de los códigos zip como de los negocios individuales. Estos resultados también invitan a la revaluación del papel de ciertas externalidades urbanas en la teoría locacional tradicional. La importancia de la accesibilidad al automóvil y los efectos de la aglomeración muestran disposición a persistir más allá de la pandemia, opero los beneficios de la proximidad del sistema de transporte público podría declinar. La tendencia observada en Miami sugiere que la pandemia podría generar más subcentros de empleo dependientes del automóvil en las ciudades americanas y ampliar los problemas de desigualdad intraurbana y la dispersión urbana. (Spanish) [ FROM AUTHOR] COVID-19疫情改变了美国许多城市的地方经济地理。目前, 尚不清楚这些变化会持续多久。本研究分析了2020年8月至2021年8月期间佛罗里达州迈阿密-戴德县商业倒闭的社会空间变化, 根据区位理论探讨了对疫情影响的缓解。我们发现, 在此期间, 传统的城市中心和交通密集地区经历了不成比例的更高的商业倒闭率, 这表明迈阿密可能会出现商业郊区化浪潮。西班牙裔中产阶级和工人阶级社区出现了最多的商业倒闭。相关性分析和空间回归模型结果表明, 在邮政编码尺度和个体尺度, COVID-19发病率与商业倒闭都存在着正相关性。这些结果也呼吁, 需要重新评估某些城市外部特性在传统区位理论中的作用。汽车可及性和聚集效应的重要性将会一直持续到疫情之后, 但公共交通系统的临近优势可能会下降。迈阿密的趋势表明, COVID-19可能会在美国城市产生更多依赖于汽车的就业分中心, 加剧城市内部不平等、城市扩张等问题。 (Chinese) [ FROM AUTHOR] Copyright of Annals of the American Association of Geographers is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Effects of Public Health Interventions against Covid-19 in France

Background: Non-pharmaceutical interventions (NPIs) and vaccines have been used by many countries to manage the dynamics of the COVID-19 pandemic. Despite numerous studies, considerable uncertainty remains about the effects of these public health interventions due to data quality issues and methodological challenges to estimating effects. However, producing accurate and precise estimates of the effects of these interventions is of utmost importance for the preparedness of any new epidemic. Method(s): We developed a population-based mechanistic compartmental model that includes the effect of NPIs on SARS-CoV-2 transmission and the effect of vaccination on the transmission and the rate of hospitalization. Our statistical approach estimated all parameters in one step, thus accurately propagating uncertainty, and representing spatial heterogeneity. We fitted the model to all available epidemiological data (hospital admissions and occupancy, cases, and deaths) from March 2020 to October 2021 in France. Hence, we estimated the time-varying transmission rate, and derived the effect of NPIs through an integrated regression model. We simulated counterfactual scenarios of the interplay of NPIs and vaccine availability and rollout with the same model. Result(s): We found that the first lockdown reduced transmission by 84% (95% CI [83-85]) and was more effective than the second and third lockdowns (reduction of 75% [72-77] and 9% [6-13], respectively). A 6pm curfew was more effective than an 8 pm curfew (transmission reduction of 69% [67-70] vs. 50% [48-53]). School closures had a smaller effect on transmission (15% [12-19]). By the end of the study period, the protection conferred by vaccines against hospitalization and against infection, considering viral variants and population vaccine coverage, ranged between 69-92% and 29-40%, respectively. In a scenario without vaccines, we predicted 209% (95% PI [34-520]) more deaths and 346% [101-798] more hospitalizations throughout the study period. Conversely, if an effective vaccine had been available after 100 days, 65% [36-80] deaths and 72% [45-84] hospitalizations could have been averted. Conclusion(s): Our results provide reliable effect and uncertainty estimates of each NPI and demonstrate that NPIs and vaccination synergistically reduced COVID-19 transmission, hospitalization, and deaths. This emphasizes the importance of stringent NPIs and a high vaccination rate to prevent further epidemic resurgences and control other emerging respiratory infectious diseases.

Risk factors associated with overweight and obesity in children and adolescents during the COVID-19 pandemic in Chile.

The COVID-19 pandemic has caused changes in people's lifestyles, mainly in healthy eating habits and behaviors. Therefore, our objective was to evaluate the association of eating habits, family eating behaviors, lifestyles, and perception of nutritional status with the risk of overnutrition in children and adolescents during the COVID-19 pandemic. A cross-sectional study was conducted on a sample of 661 Chilean children and adolescents. The study tool was an online self-report questionnaire taken during the COVID-19 lockdown. We observed overnutrition in 37.5%. Habits such as sleeping the recommended number of hours by age group and having healthy family behaviors decreased the risk of overnutrition by 49.0% (OR= 0.510, p= <0.001) and 10.8% (OR= 0.892, p= 0.01), respectively. Parents' perception of weight gain during the pande-mic, the distortion of nutritional status and the health risk of their children's nutritional status increased 4.8 (OR= 4.846, p= <0.001), 8.5 (OR= 8.580, p= <0.001) and 3.8 (OR= 3.826, p= <0.001) times, respectively, the risk of overnutrition in children and adolescents. In conclusion, the COVID-19 lockdown and school closures may have affected lifestyles. In addition, the role of parents in the perception of nutritional status and family eating behaviors is fundamental since they could be a predictor of the risk of overnutrition. These findings propose further research to design plans and programs to avoid the consequences related to overweight and obesity.Copyright © 2023, Sociedad Chilena de Nutricion Bromatologia y Toxilogica. All rights reserved.

Impact of elexacaftor/tezacaftor/ivacaftor on Pseudomonas aeruginosa acquisition and chronic infection at a single pediatric cystic fibrosis center

Background: As cystic fibrosis (CF) lung disease progresses, the airways become colonized with opportunistic pathogens such as Pseudomonas aeruginosa secondary to airway surface liquid depletion. Acquisition of P. aeruginosa is associated with decline in lung function and increase in treatment burden and mortality. In October 2019, the Food and Drug Administration approved elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA), a highly effective modulator therapy (HEMT) for individuals aged 12 and older with one copy of the F508del CFTR mutation. ELX/TEZ/IVA increases the amount of and function of CF transmembrane conductance regulator (CFTR) in the respiratory epithelium, increasing mucociliary clearance (MCC) and reducing static airway mucous, a major trigger for chronic infection and inflammation. Method(s): A retrospective analysis of inhaled tobramycin (iTOB) prescriptions prescribed between January 1, 2016, and December 31, 2021, was performed. This captured data before and after ELX/TEZ/IVA approval at Children's Mercy Kansas City (CMKC). The number of individuals with new P. aeruginosa acquisition was determined by identifying electronic prescriptions for iTOB eradication courses. An eradication course was defined as a first lifetime prescription for iTOB or a new prescription for iTOB submitted at least 1 year after a previous prescription. The number of individuals considered chronically infected with P. aeruginosa was determined by identifying individuals receiving chronic iTOB prescriptions and confirmed by respiratory cultures indicating chronic infection based on the Leeds criteria (P. aeruginosa recovered in >=50% of airway cultures in the previous 12 months). Result(s): Eradication courseswere prescribed to 34 individuals in 2016 (15% of people receiving care at CMKC). The number of eradication prescriptions declined in 2020 and 2021, with only 15 (7%) individuals prescribed eradication therapy in 2020 and 12 (5%) in 2021. A similar pattern was observed for prescriptions for chronic infection. In 2016, 57 individuals (25% of our patient population) were receiving iTOB for chronic P. aeruginosa infection. Reductions were seen in 2020 and 2021, with 28 (13%) and 20 (9%) individuals prescribed chronic therapy, respectively. The number of individuals prescribed iTOB for P. aeruginosa eradication and chronic infection per year is represented in Figure 1.(Figure Presented)Conclusions: CMKC experienced a decrease in the number of courses of iTOB prescribed over the last 6 years. HEMT use is associated with greater MCC and anti-inflammatory effects affecting the airway microbiome. The decrease in respiratory cultures growing P. aeruginosa likely reflects these phenomena. A confounding factor is the SARS-CoV-2 pandemic and widespread use of HEMT. Clinic closures and implementation of telemedicine limited in-person patient visits during 2020 and 2021. Despite limited in-person visits, the average number of respiratory cultures per individual at CMKC in 2020 was 3.5, which is consistent with previous years.Wewere able to obtain frequent surveillance cultures through implementation of a drive-through respiratory specimen collection process. Hence, the decrease in number of iTOB courses cannot be attributed to a decrease in frequency of respiratory cultures, although we cannot assess the impact of school closures and a decrease in social gatherings on new P. aeruginosa acquisition or chronic infection. Looking at all these variables, the widespread use of HEMT likely played a significant role in reducing new P. aeruginosa acquisition and chronic P. aeruginosa infection.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Measuring caregiver stress and perceived self-efficacy during a worldwide pandemic

Background: Anxiety and depression levels are significant in caregivers of young people with cystic fibrosis (PwCF) [1]. Literature also shows that perceived self-efficacy (a person's beliefs about their capabilities) is lower in caregivers of children with chronic illness;particularly with increased stress, lack of resources, or ambiguity related to illness course [2,3]. There are few studies looking at the effects of the pandemic on self-efficacy in caregivers and children. Given the national distress, school closures, and uncertainty of the COVID-19 pandemic, our team aimed to investigate effects on caregivers of young PwCF (<=18) at our CF center, particularly their perceived stress, anxiety, and self-efficacy. Method(s): An anonymous survey using REDCap was developed to look at descriptive features of caregiver demographics, number of children in the home with CF, and perceptions related to COVID-19 and how it affected their lifestyle. Caregivers completing the survey rated their current stress, anxiety, and depression levels. The PROMIS self-efficacy tool, a validated measure of perceived self-efficacy, was incorporated into the survey. Most response options were on a Likert scale. The survey was available electronically through hyperlink and a QR scan code. Result(s): Of 17 caregivers who responded to our initial survey, 82% reported that COVID-19 had significantly affected their lives, 41% experienced financial hardship, 53% were feeling "more" or "much more" anxious, 76% were feeling angrier, and 94% reported "more" or "much more" stress than before the pandemic (Figure 1). Many respondents were worried about spreading illness to their children or being unable to care for their child. Perceived self-efficacy scores were average to high in most caregivers, indicating confidence in their abilities to manage difficult situations. Respondents were more likely to be female and well educated and have private insurance. (Figure Presented) Figure 1. Responses to difference in current perceived stress level before and durring the pandemic Conclusion(s): This is the first known descriptive study to look at effects of a worldwide pandemic on caregivers of young PwCF. It also is one of few studies examining caregiver perceived self-efficacy in CF. It was limited by the number of responses, skewed demographics of those who responded, and being administered at a single CF center. We found that caregivers of PwCF at our center are experiencing higher rates of stress, anxiety, and anger. This did not seem to affect their perceived self-efficacy, although therewas no pre-pandemic measurement.We learned thatwe need to find ways to reach a larger demographic and those who are underrepresented. This study shows the need to better understand caregiver emotional distress, especially during times of ambiguity. Understanding caregiver stress and perceived self-efficacy has the potential to provide insight for the medical team on supportive ways to abate negative outcomes in young PwCFCopyright © 2022, European Cystic Fibrosis Society. All rights reserved