Assessing the impact of forced and voluntary behavioral changes on economic-epidemiological co-dynamics: A comparative case study between Belgium and Sweden during the 2020 COVID-19 pandemic (preprint)

During the COVID-19 pandemic, governments faced the challenge of managing population behavior to prevent their healthcare systems from collapsing. Sweden adopted a strategy centered on voluntary sanitary recommendations while Belgium resorted to mandatory measures. Their consequences on pandemic progression and associated economic impacts remain insufficiently understood. This study leverages the divergent policies of Belgium and Sweden during the COVID-19 pandemic to relax the unrealistic -- but persistently used -- assumption that social contacts are not influenced by an epidemic's dynamics. We develop an epidemiological-economic co-simulation model where pandemic-induced behavioral changes are a superposition of voluntary actions driven by fear, prosocial behavior or social pressure, and compulsory compliance with government directives. Our findings emphasize the importance of early responses, which reduce the stringency of measures necessary to safeguard healthcare systems and minimize ensuing economic damage. Voluntary behavioral changes lead to a pattern of recurring epidemics, which should be regarded as the natural long-term course of pandemics. Governments should carefully consider prolonging lockdown longer than necessary because this leads to higher economic damage and a potentially higher second surge when measures are released. Our model can aid policymakers in the selection of an appropriate long-term strategy that minimizes economic damage.

Acceptabilité et faisabilité d'un module TCD-A multi-familles « tolérance à la détresse » proposé à des adolescents ayant un trouble de la personnalité borderline ou des troubles de la régulation émotionnelle

Le trouble de la personnalité borderline est un trouble psychiatrique fréquent qui apparaît à l'adolescence. La thérapie comportementale dialectique adaptée aux adolescents (TCD-A) a montré son efficacité dans la prise en charge psychothérapeutique des adolescents souffrant de conduites suicidaires ou d'auto-agressivité associées au trouble de la personnalité borderline. Au travers de notre étude nous avons souhaité explorer la faisabilité et l'acceptabilité, pour des adolescents présentant un TPL diagnostiqué ou des troubles de la régulation des émotions, d'un module TCD intitulé « tolérance à la détresse » proposé sur le mode d'un groupe multi-familles. Pour ce faire nous avons mis en place un groupe multi-familles de six adolescents et de leurs parents. L'acceptabilité et la faisabilité du protocole étaient excellentes. Les témoignages des adolescents et de leurs parents nous apportent des informations précieuses sur l'intérêt d'un tel groupe et sur les améliorations à introduire. La mise en place d'un tel groupe est une première en France et nous souhaitions montrer par notre étude pilote, sa faisabilité, son acceptabilité et ses effets afin de promouvoir son développement et son implémentation dans le contexte pédopsychiatrique français. Borderline personality disorder is a common psychiatric disorder emerging in adolescence. Dialectical Behavioral Therapy adapted to adolescents (DBT-A) has proven to be effective as a psychotherapeutic treatment for adolescents suffering from borderline-related behaviors, such as suicidal or self-aggressive behaviors. In our study, we were interested in exploring the feasibility and acceptability of a DBT-A module entitled "distress tolerance", which reduces borderline-related behaviors in borderline adolescents or undiagnosed adolescents who experience difficulties in regulating their emotions. To do this, we set up a pilot study with one multi-family treatment group of six adolescents and their parents. The treatment was fully accepted by all adolescents and parents with an excellent acceptability. Comments from adolescents and parents gave us valuable information about the great interest of a multi-family treatment group and potential improvements for its implementation. This is the first study exploring a DBT-A multi-family treatment group in France. It highlights its feasibility, acceptability and potential positive effects. Further studies are needed to promote the implementation and development of such interventions in the context of child and adolescent psychiatry in France. [ FROM AUTHOR] Copyright of Neuropsychiatrie de l'enfance & de l'Adolescence is the property of Elsevier B.V. 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.)

Implementation During a Pandemic: Findings, Successes, and Lessons Learned from Community Grantees.

Funding communities through mini-grant programs builds community capacity by fostering leadership among community members, developing expertise in implementing evidence-based practices, and increasing trust in partnerships. The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) implemented the Community Health Intervention Program (CHIP) mini-grants initiative to address cancer-related health disparities among high-risk populations in rural areas of the state. One community-based organization and one faith-based organization were funded during the most recent call for proposals. The organizations implemented National Cancer Institute evidence-based strategies and programs focused on health and cancer screenings and physical activity and promotion of walking trails. Despite the potential for the COVID-19 pandemic to serve as a major barrier to implementation, grantees successfully recruited and engaged community members in evidence-based activities. These initiatives added material benefits to their local communities, including promotion of walking outdoors where it is less likely to contract the virus when socially distanced and provision of COVID-19 testing and vaccines along with other health and cancer screenings. Future mini-grants programs will benefit from learning from current grantees' flexibility in program implementation during a pandemic as well as their intentional approach to modifying program aspects as needed.

Acute Bronchiolitis in Term Newborns Following Relaxation in COVID-19 Appropriate Behavior

Objective Neonatal bronchiolitis is not well characterized. We studied the profile of acute bronchiolitis in term newborns during a respiratory syncytial virus (RSV) surge following relaxation in coronavirus disease 2019 (COVID-19) appropriate behavior.Methods This was a retrospective descriptive study performed in the neonatology division of a tertiary care pediatric hospital at Srinagar, Jammu and Kashmir, India. Term neonates (born at =37 completed gestational weeks) from 7 up to 28 days of life admitted with bronchiolitis over a 1-month period (November 2021) were included.Results Out of total 480 neonatal admissions over a month, 35 (7%) had acute bronchiolitis. Eight neonates were excluded. Out of 27 included neonates, 13 were males. Mean age at presentation was 20 days. All neonates were born at term (=37 completed gestational weeks). Cough (26), rapid breathing (20), and lower chest indrawing (20) were the predominant presenting features. Median SPO2 was 87% (interquartile range 85-92%). Fourteen (52%) neonates needed admission to neonatal intensive care unit. Respiratory support was needed in the form of oxygen through nasal prongs in 24 (89%) newborns. Heated humidified high-flow nasal cannula (HHHFNC) and bubble continuous positive airway pressure were used in five neonates each. Two neonates were mechanically ventilated. The mean duration of the hospital stay was 6.2 days. All neonates survived.Conclusion A series of 27 term neonates with bronchiolitis during an RSV surge is reported in the aftermath of lifting of COVID-19 restrictions. Many of these neonates were sick enough to require significant respiratory support. The outcome was good in all neonates.

Validating a dynamic input-output model for the propagation of supply and demand shocks during the COVID-19 pandemic in Belgium (preprint)

This work validates a dynamic production network model, used to quantify the impact of economic shocks caused by COVID-19 in the UK, using data for Belgium. Because the model was published early during the 2020 COVID-19 pandemic, it relied on several assumptions regarding the magnitude of the observed economic shocks, for which more accurate data have become available in the meantime. We refined the propagated shocks to align with observed data collected during the pandemic and calibrated some less well-informed parameters using 115 economic time series. The refined model effectively captures the evolution of GDP, revenue, and employment during the COVID-19 pandemic in Belgium at both individual economic activity and aggregate levels. However, the reduction in business-to-business demand is overestimated, revealing structural shortcomings in accounting for businesses' motivations to sustain trade despite the pandemic's induced shocks. We confirm that the relaxation of the stringent Leontief production function by a survey on the criticality of inputs significantly improved the model's accuracy. However, despite a large dataset, distinguishing between varying degrees of relaxation proved challenging. Overall, this work demonstrates the model's validity in assessing the impact of economic shocks caused by an epidemic in Belgium.

Family Bonds with Pets and Mental Health during COVID-19 in Australia: A Complex Picture.

The COVID-19 pandemic has drawn attention to the health-promoting features of human-animal relationships, particularly for families with children. Despite this, the World Health Organization's (1986) Ottawa Charter remains human-centric. Given the reciprocal health impacts of human-animal relationships, this paper aims to (i) describe perceived pet-related benefits, worries, and family activities; and to (ii) examine differences in perceived benefits, worries, and activities for parents and children with and without clinical mental health symptoms. We recruited 1034 Australian parents with a child < 18 years and a cat or dog via a national online survey between July and October 2020. Most parents reported their pet was helpful for their own (78%) and their child's mental health (80%). Adjusted logistic regression revealed parents with clinical psychological distress were 2.5 times more likely to be worried about their pet's care, well-being, and behaviour (OR = 2.56, p < 0.001). Clinically anxious children were almost twice as likely to live in a family who engages frequently in pet-related activities (e.g., cooked treats, taught tricks, OR = 1.82, p < 0.01). Mental health and perceived benefits of having a pet were not strongly associated. Data support re-framing the Ottawa Charter to encompass human-animal relationships, which is an often-neglected aspect of a socioecological approach to health.

The COVID-19 pandemic impact on independent and provider-based rural health clinics' operations and cancer prevention and screening provision in the United States.

INTRODUCTION: The COVID-19 pandemic has disrupted cancer care, but it is unknown how the pandemic has affected care in Medicare-certified rural health clinics (RHCs) where cancer prevention and screening services are critical for their communities. This study examined how the provision of these cancer services changed pre- and peri-pandemic overall and by RHC type (independent and provider-based). METHODS: We administered a cross-sectional survey to a stratified random sample of RHCs to assess clinic characteristics, pandemic stressors, and the provision of cancer prevention and control services among RHCs pre- and peri-pandemic. We used McNemar's test and Wilcoxon signed rank tests to assess differences in the provision of cancer prevention and screening services pre- and peri-pandemic by RHC type. RESULTS: Of the 153 responding RHCs (response rate of 8%), 93 (60.8%) were provider-based and 60 (39.2%) were independent. Both RHC types were similar in their experience of pandemic stressors, though a higher proportion of independent RHCs reported financial concerns and challenges obtaining personal protective equipment. Both types of RHCs provided fewer cancer prevention and screening services peri-pandemic-5.8 to 4.2 for provider-based and 5.3 to 3.5 for independent (P<.05 for both). Across lung, cervical, breast, and colorectal cancer-related services, the proportion of both RHC groups providing services dropped peri-pandemic. DISCUSSION: The pandemic's impact on independent and provider-based RHCs and their patients was considerable. Going forward, greater resources should be targeted to RHCs-particularly independent RHCs-to ensure their ability to initiate and sustain evidence-based prevention and screening services.

Methodological rigor and reporting quality of clinical practice guidelines for adults hospitalized with bacterial pneumonia: a scoping review protocol.

OBJECTIVE: This scoping review will present a profile of methodological rigor and reporting quality of clinical practice guidelines for adults hospitalized with bacterial pneumonia. INTRODUCTION: An ideal clinical practice guideline is evidence-based and the product of a rigorous and robust literature-vetted process, yet reports show that rigor is not being achieved. Moreover, a new vulnerable population has been identified due to COVID-19, increasing the need for high quality clinical practice guidelines. Preliminary searches yielded no scoping or systematic reviews on methodological rigor and reporting quality of clinical practice guidelines used for managing bacterial pneumonia in hospitalized adults. INCLUSION CRITERIA: This review will consider current national and international clinical practice guidelines for management of hospitalized adult patients with either suspected or confirmed primary bacterial pneumonia. The review will include adult patients with multiple diagnoses if there is a clearly delineated clinical practice guideline for pneumonia. METHODS: A 3-step search strategy will be conducted using JBI methodology for scoping reviews. After an initial MEDLINE search for keywords, a broad search of 7 databases, 1 simultaneous platform, gray literature, specialty organizations, and international guideline groups will be conducted from 2017 to the present, in any language. Reference lists will be screened for additional sources. A 2-step screening process will be used to identify eligible clinical practice guidelines. Three reviewers will independently extract data using a standardized form. Domain scores will be analyzed and presented as percentages, and the results will be interpreted as map trends. DETAILS OF THIS REVIEW PROJECT ARE AVAILABLE AT: Open Science Framework https://osf.io/eucqy/.

Diagnostics of messenger ribonucleic acid (mRNA) severe acute respiratory syndrome-corona virus­2 (SARS-CoV­2) vaccination-associated myocarditis-A systematic review.

Background: During the recent pandemic with the severe acute respiratory syndrome-corona virus­2 the first messenger ribonucleic acid (mRNA) vaccines were approved. To facilitate mass vaccination, confidence of the general population in these new vaccines is mandatory, which is in turn strongly dependent on the availability of reliable data on complications. Objective: Summary of the current knowledge on mRNA vaccination-associated myocarditis as a potentially fatal side effect. Methods: Systematic literature review. Results: Diagnostic algorithm for the postmortem diagnosis of mRNA vaccination-associated myocarditis. Conclusion: Autopsy series of fatalities following mRNA SARS-CoV­2 vaccination up to 6 weeks with subsequent sophisticated and interdisciplinary work-up are necessary to complement clinical data on vaccination-associated myocarditis, especially regarding the incidence of fatal courses. Supplementary Information: The online version of this article (10.1007/s00194-022-00587-9) includes a PDF file with supplemental clinical features.

Mobility and the spatial spread of sars-cov-2 in Belgium.

We analyse and mutually compare time series of covid-19-related data and mobility data across Belgium's 43 arrondissements (NUTS 3). In this way, we reach three conclusions. First, we could detect a decrease in mobility during high-incidence stages of the pandemic. This is expressed as a sizeable change in the average amount of time spent outside one's home arrondissement, investigated over five distinct periods, and in more detail using an inter-arrondissement "connectivity index" (CI). Second, we analyse spatio-temporal covid-19-related hospitalisation time series, after smoothing them using a generalise additive mixed model (GAMM). We confirm that some arrondissements are ahead of others and morphologically dissimilar to others, in terms of epidemiological progression. The tools used to quantify this are time-lagged cross-correlation (TLCC) and dynamic time warping (DTW), respectively. Third, we demonstrate that an arrondissement's CI with one of the three identified first-outbreak arrondissements is correlated to a substantial local excess mortality some five to six weeks after the first outbreak. More generally, we couple results leading to the first and second conclusion, in order to demonstrate an overall correlation between CI values on the one hand, and TLCC and DTW values on the other. We conclude that there is a strong correlation between physical movement of people and viral spread in the early stage of the sars-cov-2 epidemic in Belgium, though its strength weakens as the virus spreads.

COVID-19 in people with neurofibromatosis 1, neurofibromatosis 2, or schwannomatosis.

PURPOSE: People with pre-existing conditions may be more susceptible to severe COVID-19 when infected by SARS-CoV-2. The relative risk and severity of SARS-CoV-2 infection in people with rare diseases such as neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2), or schwannomatosis (SWN) is unknown. METHODS: We investigated the proportions of people with NF1, NF2, or SWN in the National COVID Cohort Collaborative (N3C) electronic health record data set who had a positive test result for SARS-CoV-2 or COVID-19. RESULTS: The cohort sizes in N3C were 2501 (NF1), 665 (NF2), and 762 (SWN). We compared these with N3C cohorts of patients with other rare diseases (98-9844 individuals) and the general non-NF population of 5.6 million. The site- and age-adjusted proportion of people with NF1, NF2, or SWN who had a positive test result for SARS-CoV-2 or COVID-19 (collectively termed positive cases) was not significantly higher than in individuals without NF or other selected rare diseases. There were no severe outcomes reported in the NF2 or SWN cohorts. The proportion of patients experiencing severe outcomes was no greater for people with NF1 than in cohorts with other rare diseases or the general population. CONCLUSION: Having NF1, NF2, or SWN does not appear to increase the risk of being SARS-CoV-2 positive or of being a patient with COVID-19 or of developing severe complications from SARS-CoV-2.

COVID-19 and Cardiovascular Disease.

Coronavirus disease 2019 (COVID-19) is a global pandemic affecting 185 countries and >3 000 000 patients worldwide as of April 28, 2020. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2, which invades cells through the angiotensin-converting enzyme 2 receptor. Among patients with COVID-19, there is a high prevalence of cardiovascular disease, and >7% of patients experience myocardial injury from the infection (22% of critically ill patients). Although angiotensin-converting enzyme 2 serves as the portal for infection, the role of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers requires further investigation. COVID-19 poses a challenge for heart transplantation, affecting donor selection, immunosuppression, and posttransplant management. There are a number of promising therapies under active investigation to treat and prevent COVID-19.

The Prevalence And Risk Factors Of COVID-19 Among Taibah University's Medical Students And Their Families

Background: The incidence rate of COVID-19 infection among medical students may vary owing to diverse factors such as increased opportunities for contact, their medical background, and their behavior during the pandemic, which may reflect the incidence in their families. Methods: a retrospective cohort study comparing medical and non-medical students (244 for each group). Results: The incidence of COVID-19 in medical students was 20.5%, and 41% of the medical students surveyed reported one or more COVID- 19 infections in their families, compared to 23.8% and 45.9% of non-medical students, and their families, respectively. 4.7% of medical students had severe symptoms compared to non-medical (8.2%). Regarding the risk factors for infection, there were no significant differences between any of the groups except in PPE use. Medical students and their families had a shorter duration of illness. Conclusion: COVID-19 infection in medical students is most often transmitted by a family member. Medical students and their families are not more likely than others to contract COVID-19 infection, but they may have fewer symptoms, a shorter duration of illness, and less need for hospitalization.

COVID-19 in people with neurofibromatosis 1, neurofibromatosis 2, or schwannomatosis

Purpose People with pre-existing conditions may be more susceptible to severe Coronavirus disease 2019 (COVID-19) when infected by severe acute respiratory syndrome coronavirus- 2 (SARS-CoV-2). The relative risk and severity of SARS-CoV-2 infection in people with rare diseases like neurofibromatosis (NF) type 1 (NF1), neurofibromatosis type 2 (NF2), or schwannomatosis (SWN) is unknown. Methods We investigated the proportions of SARS-CoV-2 positive or COVID-19 patients in people with NF1, NF2, or SWN in the National COVID Collaborative Cohort (N3C) electronic health record dataset. Results The cohort sizes in N3C were 2,501 (NF1), 665 (NF2), and 762 (SWN). We compared these to N3C cohorts of other rare disease patients (98 - 9844 individuals) and the general non-NF population of 5.6 million. The site- and age-adjusted proportion of people with NF1, NF2, or SWN who tested positive for SARS-CoV-2 or were COVID-19 patients (collectively termed positive cases) was not significantly higher than in individuals without NF or other selected rare diseases. There were no severe outcomes reported in the NF2 or SWN cohorts. The proportion of patients experiencing severe outcomes was no greater for people with NF1 than in cohorts with other rare diseases or the general population. Conclusion Having NF1, NF2, or SWN does not appear to increase the risk of being SARS-CoV-2 positive or of being a COVID-19 patient, or of developing severe complications from SARS-CoV-2.

How to Increase the Attractiveness of the Public Health Service in Germany as a Prospective Employer? Part II of the OeGD-Studisurvey.

The Public Health Service (PHS) in Germany has had difficulties in recruiting enough qualified staff for years, but there is limited research on what factors drive decisions to (not) join the PHS workforce. We explored reasons for this perceived (lack of) attractiveness. We conducted two cross-sectional surveys among medical students (MS), public health students and students from other PHS-relevant fields (PH&ONM) in Germany before (2019/2020) and during the COVID-19 pandemic (2021). Both waves surveyed self-reported reasons for why students did (not) consider working in the PHS as attractive and how this could be improved, using open-question items. Qualitative and quantitative content analyses were conducted according to Mayring. In total, 948 MS and 445 PH&ONM provided valid written responses. Reasons for considering the PHS as attractive were, among others, the perception of a good work-life balance, high impact, population health focus, and generally interesting occupations. Suggestions to increase attractiveness included reducing bureaucracy, modernization/digitalization, and more acknowledgement of non-medical professionals. Among MS, reasons against were too little clinical/patient-related activities, low salary, and occupations regarded as boring. Our findings indicate areas for improvement for image, working conditions in, and institutional structures of the PHS in Germany to increase its attractiveness as an employer among young professionals.

What Factors Influence the Interest in Working in the Public Health Service in Germany? Part I of the OeGD-Studisurvey.

As in many European countries, the Public Health Service (PHS) in Germany has had considerable difficulties in attracting well-qualified personnel for decades. Despite ongoing political and societal debate, limited empirical research on possible causes and explanations is available. To identify areas of action, we explored reasons for the (lack of) interest in working in the PHS by conducting two cross-sectional surveys among 3019 medical students (MS), public health students, and students from other PHS-relevant fields (PH&ONM) in Germany right before (wave 1, 2019/2020) and during the COVID-19 pandemic (wave 2, 2021). While interest in working in the PHS among MS was low, it was considerably higher among PH&ONM. The prevalent underestimation of the importance of public health and low levels of knowledge about the PHS were identified as potential barriers. Although core activities of the PHS were often considered attractive, they were repeatedly not attributed to the PHS. A negative perception of the PHS (e.g., it being too bureaucratic) was prevalent among students with and without PHS interest, indicating that both a negative image and potentially structural deficits need to be overcome to increase attractiveness. Based on the findings, we propose approaches on how to sustainably attract and retain qualified personnel.

Vaccination against COVID-19 as prevention of occupational disease in University of Defence members in the Czech Republic - motivation for vaccination and reasons for hesitancy.

OBJECTIVES: The aim of this cross-sectional study was to investigate the determinants of COVID-19 vaccine acceptance in University of Defence members. BACKGROUND: Vaccination is the most important method of prevention against COVID-19 and achieving sufficient vaccination rate is thus essential to maintain the military capability. METHODOLOGY: An online questionnaire was distributed electronically to 2,408 respondents in autumn 2021. The survey was designed to collect demographic predictors of vaccination, data on motivation and reasons for refusing vaccination. RESULTS: A total of 626 completed questionnaires were analyzed, of which 557 (89 %) were vaccinated and 69 (11 %) were unvaccinated respondents. The most significant predictors of vaccine acceptance were: concern about COVID-19 (OR 2.44, p < 0.001), history of COVID-19 (OR 0.39, p = 0.001). The most frequently cited motives for vaccination were health protection (74.7 %) and an easier social life (69.1 %), while concerns about vaccine safety and vaccine adverse effects (79.1 %) followed by lack of confidence in vaccine efficacy (68.7 %) were the main reasons for vaccine refusal. CONCLUSION: To increase the vaccination rate it is necessary to target the younger population and increase awareness of vaccine safety and efficacy. If these measures are not sufficient to encourage voluntary vaccine acceptance, consideration should be given to making vaccination mandatory for selected professional groups (Tab. 5, Fig. 1, Ref. 25).