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As a critical influencing factor of learning engagement, teacher expectation plays a vital role in ensuring the quality of online teaching under COVID-19. This paper investigates the relationship between teacher expectations (three dimensions of teacher support, teaching interaction, and academic feedback) on students' online English learning engagement (three dimensions of cognitive engagement, behavioral engagement, and emotional engagement) in e-learning through a questionnaire survey of 513 college students. Pearson correlation analysis and multiple regression analysis were applied as research methods. The results manifest that college students' online English learning engagement was above average, but emotional engagement needs improvement. In addition, teacher expectations of teaching interaction positively and significantly predict English e-learning engagement. Based on this, the article puts forward suggestions on the future of online teaching from the aspects of online teaching design, feedback quality of teachers and students, innovative teaching practice of technology empowerment to effectively play the role of teachers as scaffolding and improve the effectiveness of online English teaching. © 2023 IEEE.
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Aims: Trauma is particularly prevalent amongst Early Intervention (EI) patients and is associated with adverse clinical and prognostic outcomes. To determine the feasibility of a large-scale randomized controlled trial (RCT) of an 'EMDR for psychosis' intervention for trauma survivors with active psychotic symptoms supported by EI services, we conducted a single-blind RCT comparing 16 sessions of EMDRp + TAU versus TAU only. Method(s): EMDRp therapy and trial assessments were completed both in-person and remotely during the COVID-19 pandemic, and key feasibility outcomes (recruitment & retention, therapy attendance/ engagement, adherence to EMPRp treatment protocol, and the 'promise of efficacy' of EMDRp on relevant clinical outcomes) were examined at 6- and 12-month post-randomization assessments. Results and Conclusion(s): 60 participants (100% of the recruitment target) received TAU or EMDR + TAU. The feasibility criteria examined in this trial were fully met, and EMDRp was associated with promising signals of efficacy on a range of valuable post-treatment outcomes, including improved psychotic symptoms (PANSS), subjective recovery (QPR), post-traumatic symptoms (PCL-5;ITQ), depression (PHQ-9), anxiety (GAD-7) and general health status (EQ-5D-VAS) at the 6-month assessment. Signals of efficacy at 12-month were less pronounced, but remained robust for trauma symptoms and general health status. The findings will be discussed with relevance to future clinical trials of trauma-focused therapy in clients with early psychosis, and the provision of more tailored trauma therapies for EI service users.
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Objectives: The prospective, longitudinal, community-based CONTACT study aimed to improve our understanding of COVID-19 immunity, and other characteristics related to SARS-CoV-2 long-term, including the assessment of health-related quality of life (HRQoL) at baseline and over time by infection status. Method(s): Participants living or working in Lake County, IL were recruited between November 2020 and January 2021. At baseline and follow up visits (3-, 6-, and 9-Months-M-), participants self-reported their occupational exposure, COVID-19 vaccination status and provided nasal and blood serum specimens for molecular (RT-PCR) and serologic (IgG) testing to detect current or previous SARS-CoV-2 infection. HRQoL questionnaires EQ-5D-5L were completed online approximately within two weeks post-testing (at 0.5, 3.5, 6.5, and 9.5 months) after results were communicated. EQ-5D-5L information was described and stratified by COVID-19 status at baseline, 3M, 6M and 9M - software: SAS-v9.4. Result(s): Data from 1008 participants were analyzed. Participants testing positive to COVID-19 were 56/952, 48/751, 40/693, and 19/654, respectively, at baseline, 3M, 6M, and 9M. Of the five domains of EQ-5D-5L, a higher percentage of participants who tested positive for COVID-19 reported having no anxiety or depression versus those who tested negative: at baseline (55.4% [31/56] vs 50.5% [481/952]);3M (68.8% [33/48] vs. 56.3% [423/751]);6M (67.5% [27/40] vs. 56.3% [390/693]);and 9M (73.7% [14/19] vs. 60.4% [395/654]). Median Visual Analogue Scale (VAS) score was at least 2 points higher at all time- points for participants who tested positive except at last visit (baseline: 89.0 vs. 87.0;3M: 88.0 vs. 86.0;6M: 87.5 vs. 85.0;9M: 85.0 vs. 87.0) Conclusion(s): This analysis provides insight into participant HRQoL burden at enrollment and over time when a positive test to COVID-19 was communicated. At all time-points, anxiety or depression was experienced by more participants who tested negative versus those who didn't.Copyright © 2023
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Purpose: Organic food consumption decreases the risk of becoming obese or overweight. This study intends to see the influence of customer perceived value, COVID-19 fear, food neophobia, effort and natural content on the intention to purchase organic food (IPOF) that leads to the actual purchase of organic food (APOF). Moreover, organic food availability is a moderator between IPOF and APOF. Design/methodology/approach: PLS-SEM is used for hypothesis testing. A purposive sampling technique was followed to gather data from organic food consumers in Lahore, Gujranwala and Islamabad and a total of 479 questionnaires were part of the analysis. Findings The outcomes show that customer perceived value, effort and natural content is positively related to IPOF. Despite this, COVID-19 fear and food neophobia are negatively associated with IPOF. IPOF and organic food availability are positively related to APOF. Finally, organic food availability significantly moderated between IPOF and APOF. Practical implications: This study outcome reveals that companies of organic food can recognize customer perceived value, COVID-19 fear, food neophobia, effort, natural content and organic food availability in their decision-making if they determine the actual purchase of organic food. This study offers a valuable policy to companies of organic food to enhance customer's behavior in purchasing organic food in Pakistan. Besides, practitioners and academicians can benefit from this study finding. Originality/value: This initial research integrates customer perceived value, COVID-19 fear, food neophobia, effort, natural content, IPOF and organic food availability to determine APOF in the COVID-19 pandemic. Moreover, consumption value theory is followed to develop the framework.
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Background and purpose: The present study investigated the effect of six weeks of endurance and resistance training on pulmonary indices, physical performance, and quality of life in COVID-19 patients after discharge from hospital. Materials and methods: Thirty six patients with COVID-19 (mean age: 38.76+or-0.98 years, mean weight: 81.86+or-2.88 kg) were selected. At the beginning and end of the study, pulmonary (FEV1, FVC, FEV1/FVC, and MVV), physical (6-minute walk test), quality of life (SF-36), and anthropometry tests were performed. The patients were divided into three groups: Endurance training (45 minutes at 60-75% estimated HR), Resistance training (45 minutes at 40-70% of I-RM), and controls. The intervention was conducted for 6 weeks (3 sessions). One-way ANOVA test was used for statistical analysis. Results: Findings indicated a significant increase in FEV1 (P=0.029), FVC (P=0.047), FEV1/FVC (P=0.043) in the endurance training group compared to the control group, while difference was observed in MVV (P=0.041) and FEV1/FVC (P=0.022) between endurance training and resistance training groups. The 6-minute test distance increased in the endurance training (P=0.0001) and resistance training (P=0.001) groups compared to the control group, but no difference was observed between the training groups (P=0.48). Endurance and resistance training programs induced significant improvements in physical performance (P=0.024 and P=0.09, respectively) and general health (P=0.022 and P=0.015, respectively) dimensions compared to the control group. Conclusion: Moderate-intensity endurance training can improve pulmonary function, physical performance, and quality of life in patients with COVID-19 after discharge from hospital and can be used in rehabilitation programs of these patients.
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Aim: Coronavirus disease 2019 (COVID-19) is complex multisystem disease. After 4 weeks of persistent symptoms, it is termed as Long COVID-19. Long COVID-19 causes a decrease in health-related quality of life (HRQoL). In this study, it was aimed to determine which symptoms were associated with lower HRQoL in Long COVID-19 in this study. Material(s) and Method(s): This cross-sectional study was conducted in a tertiary research hospital. Patients who have positive RT-PCR results at least 28 days and at most 180 days ago were selected for the study. Online survey was applied to 266 patients who had positive PCR test results for COVID-19. The EuroQoL 5D-3L scale was used to measure the HRQoL as a dependent variable. Socio-demographic features and symptoms were assessed by the survey as independent variables. Due to heteroscedasticity, a robust standard error regression analysis was conducted to make inferences on the effects of persistent symptoms on HRQoL. Result(s): Of the total 266 participants, 163 were females (63.3%). The mean age was 41.2 +/- 11.8 years. One hundred forty-two patients (53.3%) did not report any ongoing symptom. Female gender and lower education level as socio-demographic variables, visual problems and myalgia as persistent symptoms were identified as risk factors for reduced HRQoL in Long COVID-19 patients. Discussion(s): Long COVID-19 patients experience lower levels of HRQoL, especially those with visual problems and/or myalgia. Interventions to raise the HRQoL of Long COVID-19 patients should first target visual problems and myalgia.Copyright © 2023, Derman Medical Publishing. All rights reserved.
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Evusheld is a combination injection of tixagevimab/cilgavimab for pre-exposure COVID-19 prophylaxis and was made available to UK private clinics from October 2022. NICE review is ongoing. Whilst efficacy analysis of Evusheld has focused on the risk-reduction of contracting COVID-19, anecdotal reports suggest additional psychological benefits from Evusheld, although supportive objective data are lacking. In this study, we used 4 well-established psychological health questionnaires to assess different psychological parameters (EQ5D-3 L quality of life (QoL) score, DSM5 Agoraphobia score, Duke's Social Support Index (DSSI) and the hospital anxiety and depression score (HADS)) in blood cancer patients treated with Evusheld at the Genesis Care (GC) Clinic, Cambridge. Patient data (pre-and post-Evusheld) were compared with a control group of GC blood cancer patients who had not received Evusheld. The study was approved by GC and all patients had consented to email contact. Questionnaire replies were anonymised and free-text comments were invited. Questionnaires were completed by 29/40 Evusheld and 54/100 control patients. With EQ5D, Evusheld did not impact mobility, self-care and pain/discomfort scores and patient/ control groups scored at similar levels. EQ5D scores for 'usual activities' and 'anxiety/depression' improved post-Evusheld (patients reporting 'normal activities' increased from 52% to 76% (control = 78%);patients reporting 'no anxiety/ depression' increased from 45% to 66% (control = 65%)). The mean global EQ5D QoL score improved post-Evusheld [69.4% to 72.9% (control = 75.7%)]. With the DSM5 agoraphobia score, Evusheld treatment improved agoraphobia parameters, reducing the mean score from 15.7 to 5.1 (control = 3.7;max = 40) with certain striking changes;72% of pretreatment patients avoided crowded situations all of/most of the time, reducing to 14% post-Evusheld (control = 11%). The DSSI score assessed social/work interactions with external household contacts and post-Evusheld the mean number of interactions over 3 weeks increased from 1.48 to 3.37 (control = 3.77). Pre-Evusheld, 52% of patients had no interactions outside their household, dropping to 20% in the 3 weeks post-Evusheld (control = 17%). Using the HADS 14-point analysis of depression and anxiety revealed on average that each parameter was 25.3% 'significantly improved' and 25.4% 'a little improved' post-Evusheld. Accepting limitations of a small study and potential biases associated with a self-funding patient cohort, Evusheld treatment broadly improved all psychological scores assessed. Free-text comments clearly indicate that Evusheld had a major positive impact on QoL/social mobility for specific patients. The Evusheld patients had higher baseline scores for social isolation, anxiety, depression and agoraphobia compared with control patients, yet Evusheld treatment appeared to improve these parameters to a level similar to control patients.
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Purpose: The nutritional and anthropometric status can be essential in determining their immune response to vaccines. The purpose of this paper was to investigate the association between diet quality and anthropometric indices with the side effects of the Pfizer-BioNTech COVID-19 vaccine and the SARS-CoV-2 immunoglobulin G titer among Kurdish adults. Design/methodology/approach: This cross-sectional survey-based study was conducted between December 2021 and February 2022. This paper included data on 115 adults, 20-89 years old, from the Kurdistan region. Dietary information was collected using a short food frequency questionnaire, and diet quality was assessed using a plant-based healthy diet score. A blood test was performed to measure the SARS-CoV-2 immunoglobin G (IgG) titer after the vaccination's first and second doses. Findings: Overweight and obese subjects reported more local pain, myalgia, headache, local bruising and local reactions after receiving the first dose of the vaccine (p = 0.04). People on a less healthy diet reported more local pain, myalgia and headache (p = 0.04) and more local bruising and reactions (p = 0.01) after receiving the second dose of the vaccine. On the other hand, the authors observed that those with healthy dietary habits had more IgG titer after the first and second doses of vaccination than those with less healthy dietary habits (p = 0.001). Originality/valueThe results showed that participants with a healthy diet and normal weight status had fewer side effects of the Pfizer-BioNTech COVID-19 vaccine than obese people and those with a less healthy diet.
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Purpose: The pandemic of COVID-19 led to considerable challenges with respect to people's health, dietary behavior and satisfaction with life. This study aims to investigate perceived stress levels, in relation to diet quality and life satisfaction in Greek adults, during the COVID-19 lockdown. Design/methodology/approach: This is a cross-sectional study which took place in Greece in the course of the strict lockdown period, in the third COVID-19 wave. A sample of 2,029 adults aged 18 years and above participated in an online survey. The questionnaire consisted of questions on sociodemographic and anthropometric characteristics. The Perceived Stress Scale, the Satisfaction with Life Scale and the Mediterranean Diet Assessment Tool were also used. Findings: Linear regression has shown that women (p < 0.0001), younger individuals (p < 0.0001), obese individuals (p = 0.047), those with lower levels of satisfaction with life (p < 0.0001) and lower adherence to Mediterranean diet (p = 0.0001) were positively associated with higher levels of stress. Originality/value: To the best of the authors' knowledge, this is the first study conducted in Greece aiming at investigating concurrently, levels of perceived stress, with respect to levels of satisfaction with life and diet quality in adults, during the lockdown period of the COVID-19 pandemic.
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Bu çalışma işletme ve sosyal bilimler öğrencilerinin kültürel boyutlar ve akademik yeterlilikleri arasındaki ilişkide benlik saygısının düzenleyici rolünü incelemektedir. Bu araştırma Covid-19 pandemisi sürecinde üniversitede eğitim gören çoğunlukla işletme ve sosyal bilimler öğrencilerinin belli kültürel boyutlardan (güç aralığı, belirsizlik ve bireyselcilik/toplumsalcılık) hayata bakış açılarını ve başarı durumlarını belirleyen benlik saygısı ve akademik öz yeterlilikleri arasındaki ilişkiyi incelemek amacıyla yapılmıştır. Sayısal yöntem ve ilişkisel tasarımla yüksek eğitim gören 215 öğrenciden toplanan veriler incelenerek yapılmıştır. Araştırma bulguları öğrencilerin güç aralığının düşük olduğunu, belirsizliklerle baş edemediklerini ve kuralcı olduklarını göstermiştir. Bireyselcilik ve toplumsalcılık boyutu açısından da arada kaldıkları anlaşılmaktadır. Benlik saygısı ve akademik yeterlilik açısından öğrencilerin kendilerine güvendiği anlaşılmaktadır. Benlik saygısı tek başına akademik öz yeterliliği büyük ölçüde etkilemekte ve cinsiyete göre farklılık göstermemektedir. Akademik öz yeterlilik kavramının algılanmasında kız öğrenciler lehine;kültürel boyutlar algılamasında ise erkek öğrencilerin lehine bir fark bulunmuştur. Ancak, bu sonuç kız öğrencilerin eşitsizliğe daha az katlandıklarını ve belirsizle mücadelede de erkek öğrencilere kıyasla nispeten daha başarılı olduklarını işaret etmektedir. Araştırma bulgularının mezuniyetlerinden sonra iş başvurusu yaptıklarında işletmelerin insan kaynakları uzmanlarına da yol gösterebileceği düşünülmüştür.Alternate :The aim of the study is to examine the relationship between self-esteem and academic self-efficacy, which determines the perspective of life and success of business administration and social sciences students studying at universities during the Covid-19 pandemic, from Hofstede's three cultural dimensions (power gap, uncertainty and individualism/collectivism). This study was carried out by examining the data collected from 215 university students. The research was done by using quantitative method and relational design. The research findings showed that the students' power-distance, and uncertainty range were low, consequently they could not cope with uncertainties and they were prescriptive. It is understood that they are in between in terms of individualism and socialism. However, it shows that students are self-confident in terms of self-esteem and academic self-efficacy. The concept of self-esteem strongly affects academic self-efficacy and does not differ by gender. While the perception of the concept of academic self-efficacy was resulted in favor of female student, in terms of cultural dimensions, a difference was found in favor of male students. This finding indicates that while female students tolerate inequality less and are relatively more successful in dealing with uncertainty compared to male students. It is thought that the research findings can guide the human resources specialists of the enterprises when they apply for a job after their graduation.
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Introduction: Covid-19 was classed as a global pandemic by the World Health Organization (WHO) in March 2020. This had an overwhelming effect on the National Health Services (NHS) in the United Kingdom resulting in the disruption and subsequent prioritization of the elective recovery services. Despite the various limitations of delivering services during a pandemic, Barts Neuromodulation Centre maintained the importance of multidisciplinary assessment in the selection of patients suitable for this form of therapy. We present the data on our continued activity through pandemic, dependent on the performance feasibility. The aim of this effectiveness project was to evaluate the post SCS outcome data during covid-19 pandemic. Method(s): This was a telephone and in person data collection of patient responses to standardized and validated pain outcome questionnaires following SCS implant performed at St Bartholomew's Hospital, London during January-December 2021. Data was collated from a tertiary Neuromodulation center at Barts Health NHS Trust, UK. Patients completed the questionnaires prior to SCS implant and post implant 1, 3, 6, and 12 month follow- up appointments with our neuromodulation specialists Results: Two hundred and fifteen patients underwent face to face or telephonic consultation during January to December 2021 for the follow ups. Total 178 patients registered their responses with F:M being 63%:37% and the average age 55 years. At each time point, the following number of patients completed: baseline n= 52;1 month n= 27;3 months n=28;6-month n= 21 and 12 months, n= 26. We demonstrate that NRS pain scores reduced by 43%, ODI disability improved by 35%, HADS anxiety reduced by 45%, depression reduced by 46%, PSQ sleep improved by 77% and EQ5D quality of life improved by 66% at 12 months when compared to baseline. There were no serious adverse events reported through this time. Conclusion(s): To our knowledge, this is one of the first reported real-world post SCS outcome data of prospective follow ups. We demonstrate safe delivery of services and data collection feasibility through pandemic. Moreover, our patient cohort showed improvement in the all dimensions of chronic refractory pain following SCS therapy despite clinical burden of COVID-19. Disclosure: Alia Ahmad: None, Angie Alamgir, PHD: None, Sanskriti Sharma: None, Joanne Lascelles, Clinical nurse specialist: None, Amin Elyas, FRCS: None, Helen Bonar: None, Serge Nikolic, MD: None, Habib Ellamushi: None, Vivek Mehta: None, Kavita Poply, PHD: NoneCopyright © 2023
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Academic online social work (SW) education has developed over the decades, fully transitioning to it following the COVID-19 pandemic. Studies have examined the emotional responses, coping strategies and resilience of faculty and students to this transition. Our aim is to examine online education experiences and their meaning for faculty and SW students following the COVID-19 pandemic. Semi-structured qualitative interviews were audio-recorded, transcribed verbatim and analysed based on principles of thematic analysis. Interviewees included fifteen SW students and fifteen faculty members at schools of SW (n = 30) from universities and colleges throughout Israel, who also participated in a quantitative survey addressing online SW education. Findings include two themes: (i) Between the illusion of intimacy and the illusion of anonymity: Is it so? (ii) Experiences of difficulty, acceptance and choice relating to online education interactions. Both themes refer to interpersonal dimensions of communication and contact between faculty and students and among students. The desire to preserve a traditional education format versus openness to the online platform is discussed using critical reflexivity. Alternative education programmes combining the two should be developed. The unique and deceptive interplay between intimacy and anonymity in the online space should be considered in courses relying on interpersonal interaction and self-disclosure. The COVID-19 pandemic at the beginning of 2020 has dramatically changed lives in all domains, including the format of social work (SW) education, which shifted from face-to-face encounters to online. Although online education had been developed in SW education before the COVID-19 pandemic, it was restricted to SW courses on theory and policy and was never fully employed to include courses teaching SW practice skills. Accordingly, our aim is to examine online education experiences and their meaning for faculty and SW students following the COVID-19 pandemic. Semi-structured qualitative interviews were audio-recorded, transcribed verbatim and analysed. Participants included fifteen SW students and fifteen faculty members at schools of SW (n = 30) from universities and colleges throughout Israel. Students and faculty addressed the illusion of intimacy and anonymity in the online space, revealing its complexity, including difficulties, acceptance and choice relating to online education interactions. Findings refer to interpersonal dimensions of communication and contact between faculty and students and among students. We discuss preserving a traditional education format versus openness to online platforms and suggest developing alternative education programmes combining the two. Furthermore, the unique and deceptive interplay between intimacy and anonymity in the online space should be considered in courses requiring interpersonal interaction and self-disclosure.
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Background: COVID-19 patients may experience lon-lasting symptoms from weeks to even months. Aim: To evaluate long-term cognitive impairment based on the severity of symptoms of COVID-19 infection in a primary health system setting. Material and methods: From a database of 363 patients, 83 cases aged 47 +or- 15 years, (58% females) were selected from June to August 2020. In patients who survived the virus, 24 infection-related symptoms were collected to create three severity clusters (mild, moderate, and severe). The follow-up time was at least seven months. Comparing the first two clusters with the severe cluster, the existence of brain fog and risk factors (obesity, hypertension, diabetes, chronic lung disease, and hypothyroidism) were analyzed. Results: Thirty-one patients (37%) had persistent symptoms lasting up to 240 days. Fifty-one patients (61%) experienced brain fog. Concentration was affected by symptom severity (odds ratio [OR] 3.63, 95% confidence interval [CI] 1.26-10.46, p = 0.02). Short- or long-term memory loss was not affected. Moreover, symptom severity was related to brain fog (OR 3.16, 95% CI 1.05-9.51, p = 0.04). Patients with persistent symptoms had a concentration impairment associated with severity patterns (OR 24.3, 95% CI 1.73-340.11, p = 0.03). Conclusions: Brain fog is associated with symptom severity in COVID-19 survivors and lasts for more than eight months.
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This article provides an initial assessment of the many risks posed by the COVID-19 pandemic on the conduct of genuine and transparent elections in Manipur. It begins with explaining why elections are a vital part of democracy and then using the notion of the electoral cycle, constructs a risk matrix that assesses the relative impact and likelihood of risks to the cycle, as well as proposes a number of potential mitigations to these risks. The root cause of the by-elections in Manipur is to be the election of the Rajya Sabha which held on June 19, 2020 by indulging in cross voting in favour of BJP candidate. There is a clear that the rise of Covid-19 cases be increased during the democratic process of by-elections such as, mass rallies, congregation etc. without maintaining SOPs. The number of elections dimensions of the electoral cycle that can be disrupted and the need for solution raises significant questions about the future of democracy itself.Copyright © 2020 Ubiquity Press. All rights reserved.
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Global pandemic due to the spread of COVID-19 has post challenges in a new dimension on facial recognition, where people start to wear masks. Under such condition, the authors consider utilizing machine learning in image inpainting to tackle the problem, by complete the possible face that is originally covered in mask. In particular, autoencoder has great potential on retaining important, general features of the image as well as the generative power of the generative adversarial network (GAN). The authors implement a combination of the two models, context encoders and explain how it combines the power of the two models and train the model with 50,000 images of influencers faces and yields a solid result that still contains space for improvements. Furthermore, the authors discuss some shortcomings with the model, their possible improvements, as well as some area of study for future investigation for applicative perspective, as well as directions to further enhance and refine the model. © 2023 SPIE.
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Background/Aims Advances in rational drug design and recent clinical trials are leading to emergence of a range of novel therapies for SLE and therapeutic options in clinical practice are expected to broaden rapidly. The optimal real-world place of emerging and established agents will be guided by understanding their differential efficacy on specific SLE manifestations as well as efficacy for more resistant disease. Anifrolumab, a type-I interferon receptor blocking monoclonal antibody, showed efficacy in SLE in phase III trials with a notable effect on mucocutaneous disease although specific lesion subtypes and chroncicity were not explored. Severe refractory mucocutaneous SLE such as scarring discoid lesions are an important and common clinical challenge in current practice. We therefore prospectively evaluated the real-world efficacy and quality of life impact of anifolumab for active mucocutaneous SLE, recalcitrant to multiple biologic and immunosuppressant therapies. Methods Seven patients commenced anifrolumab (300mg by monthly iv infusion) following application to the manufacturer's early access programme (NCT 04750057). Prior biologic therapies were discontinued at least 5 half-lives in advance. Mucocutaneous disease activity was captured by Cutaneous Lupus Disease Area and Severity Index (CLASI) activity score and medical photography. Patient reported health-related quality of life comprising the Dermatology Life Quality Index (DLQI);Lupus-QoL and EQ5D-5L were evaluated at baseline, three and six months. Results Seven female patients with active mucocutaneous SLE (Discoid LE n=5, chilblain LE n=1, subacute cutaneous LE n=1) and median disease duration of 17 years were evaluated. Median baseline CLASI activity score was 17 (range 10-26;higher scores indicating severe disease). Median number of previously failed therapies was 7 and included rituximab in 6/7, belimumab in 2/7 and thalidomide in 4/7. Rapid resolution of scale and erythema in DLE was established within 1 month of anifrolumab treatment. Improvements to chilblain lupus were evident by three months. CLASI activity score was improved >=75% in all patients at 3 months. Clinical responses were associated with significant improvements in DLQI (p<0.001) and EQ5D-VAS (p=0.002) by three months. Lupus-QoL trended toward improvement across all domains but most strongly for fatigue (p=0.01) and pain (p=0.002) by 6 months. One patient discontinued treatment after 4 months due to polydermatomal shingles complicated by sensorineural hearing loss. Infection coincided with background prednisolone dose >15mg daily, recent COVID-19 infection and new on-treatment hypogammaglobulinaemia (IgG <5g/L). Prolonged aciclovir treatment was required for lesion resolution. Conclusion We report rapid real-world efficacy and quality of life impact of anifrolumab on highly refractory mucocutaneous SLE, which exceeded that anticipated from existing clinical trial data. Findings suggest a unique role for emerging interferon targeting therapies in management of mucocutaneous SLE but emphasize need for enhanced VZV precautions among higher risk patients.
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Stormwater harvesting via managed aquifer recharge in retrofitted infrastructure has been posited as a method for resource augmentation in Cape Town. However, the existing guidelines on stormwater retrofits are technically inclined, occidental, and generally misaligned with the realities and socio-economic contexts of developing nations like South Africa. Water and urban practitioners from developing nations cannot just 'copy and paste' existing guidelines as different socio-economic dimensions and colonial histories typically hinder 'traditional' approaches. This paper assesses how a transdisciplinary team navigated these realities in a case study of a retrofitted pond in Mitchells Plain, Cape Town. A decolonial thinking framework was applied for reflection and thematic content analysis. The framework was used to unpack how the team encountered, addressed, and learned from the challenges during the retrofit process. The research team found that the retrofit process within a context of under-resourced South African communities can be viewed as developmental work with a strong emphasis on continuous community engagement. Thus, it is suggested that in the South African context, water practitioners should consider, at the fore, interaction with local communities, including awareness of racialised histories, to ensure projects are successfully implemented and completed.
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Intro: Patients affected with COVID-19 have been reported to have persistent symptoms even months after the acute episode, most commonly fatigue, breathlessness, and symptoms of anxiety and depression. These residual symptoms have been shown to compromise the quality of life and lead to significant impairment in both the mental and physical health of these patients. Method(s): A prospective observational cohort study was carried out and patients were followed for a month after discharge. Residual symptoms were noted, quality of life (QoL) assessment was done using EQ-5D-5L, and anxiety/depression was evaluated using WHO-SRQ 20 scores. Appropriate statistical tests were applied to compare improvement in QoL and residual symptoms between first and the last visit. Finding(s): A total of 110 patients were included. Mean age of the patients was 53.7 (SD+/- 13) years. Most common symptoms at 1st follow up were shortness of breath (66%) and fatigue (65%) which reduced in frequency on the last visit to (43%) and (46%) respectively. Significant improvement was seen in SpO2 levels recorded at both visits (p=0.000). An overall improvement in QoL was seen (p=0.000). WHO-SRQ 20 score above 8 was noted in 20% patients and mean score was 5.91. On further categorization into mild, moderate, severe and critical disease on admission, patients showed improvement in symptoms at four weeks irrespective of categories. For QoL assessment, mean utility score showed improvement in all disease categories on the 2nd visit except for patients with mild disease on admission. Conclusion(s): Our study showed a significant improvement in residual symptoms and overall quality of life when followed over a period of time in majority of the patients. Symptoms of anxiety and depression were also not frequent. However, our findings emphasize the need of a multidisciplinary approach towards rehabilitation of COVID-19 patients for earlier improvement in their quality of life.Copyright © 2023
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Smart transformative services such as digital contact tracing apps are a means to offer transformative and economic value by selfmonitoring contacts and improving the well-being of users, while also reducing concerns when using services during pandemics such as COVID-19. In this study, we identify significant factors as well as communication and promotion strategies to encourage digital contact tracing app nonusers to use such apps in order to benefit from their value-creating potential. This research contributes to transformative service literature by identifying digital contact tracing apps as a means to regain confidence in using services during a pandemic, thereby offering transformative and economic value. By integrating two trust dimensions as meaningful mediators, this research sheds light on the conditions under which social influence and Internet privacy concerns influence nonusers' usage intention. Moreover, the results not only identify significant factors influencing intended app usage but also reveal strategies for increasing actual app usage. © 2023 C.H.BECK oHG. All rights reserved.
ABSTRACT
Background: Whether early antiviral therapy reduces the risk of Long COVID is not known. The combination SARS-CoV-2 monoclonal antibodies amubarvimab+romlusevimab (A+R) were highly effective in reducing 28-day all-cause hospitalization/death among high-risk adults with mild-to-moderate COVID-19 in the randomized, placebo-controlled ACTIV-2/A5401 trial. We assessed the impact of A+R on late outcomes including Long COVID in ACTIV-2. Method(s): A long-term (LT) symptom diary and 2 health-related quality of life questionnaires (EQ-5D-5L and SF-36v2) were completed at week 36. The primary analysis compared the proportion of participants with the composite outcome of self-reported Long COVID (having any COVID-19 symptoms present on a global assessment question in LT diary) at week 36, or hospitalization or death by week 36 between A+R and placebo using regression models with inverse probability weighting to account for incomplete outcome data;supplemental analysis compared the proportion with Long COVID among those alive. Other analyses were restricted to observed data only. Result(s): 807 were randomized and received A+R (n=405) or placebo (n=402) from Jan-July 2021. At entry, median age was 49 years, 51% were female, >99% cis-gender, 17% Black/African American, 50% Hispanic/Latino, and 9% previously received COVID vaccination. 70 (17%) on A+R and 93 (23%) on placebo met the primary outcome;113 (14%) had incomplete data for determining the outcome (Figure 1). Accounting for incomplete data, weighted Risk Ratio [wRR]=0.74;95% CI: 0.56, 0.97;p=0.03. The difference was driven by fewer hospitalizations/deaths in the A+R arm (5%) than placebo arm (15%), particularly by day 28. Excluding 12 participants who died by week 36, frequency of Long COVID was similar in the arms, 16% for A+R and 14% for placebo (wRR=1.09;95%CI: 0.75, 1.58;p=0.64). There were no differences in the proportions reporting return to pre-COVID health (global assessment) or individual symptoms, or in number of symptoms reported or distribution of worst symptom severity. RRs favored the A+R arm on several EQ-5D-5L domains, but none met statistical significance. No differences were observed on SF-36v2 assessments. Conclusion(s): While A+R was highly effective in preventing all-cause hospitalizations and deaths in high-risk outpatients with mild-to-moderate COVID-19, there was no meaningful effect of treatment on measures of Long COVID at 36 weeks. Additional interventions are needed for Long COVID prevention. (Figure Presented).