Airborne fungal communities are more susceptible to anthropogenic activities than bacteria.

Airborne microorganisms (AM) have significant environmental and health implications. Extensive studies have been conducted to investigate the factors influencing the composition and diversity of AM. However, the knowledge of AM with anthropogenic activities has not reach a consensus. In this study, we took advantage of the dramatic decline of outdoor anthropogenic activities resulting from COVID-19 lockdown to reveal their associations. We collected airborne particulate matter before and during the lockdown period in two cities. The results showed that it was fungal diversity and communities but not bacteria obviously different between pre-lockdown and lockdown samples, suggesting that airborne fungi were more susceptible to anthropogenic activities than bacteria. However, after the implementation of lockdown, the co-occurrence networks of both bacterial and fungal community became more complex, which might be due to the variation of microbial sources. Furthermore, Mantel test and correlation analysis showed that air pollutants also partly contributed to microbial alterations. Airborne fungal community was more affected by air pollutants than bacterial community. Notably, some human pathogens like Nigrospora and Arthrinium were negatively correlated with air pollutants. Overall, our study highlighted the more impacts of anthropogenic activities on airborne fungal community than bacterial community and advanced the understanding of associations between anthropogenic activities and AM.

Impact of the COVID-19 pandemic on the quality of care for juvenile idiopathic arthritis patients: insights from Thailand.

BACKGROUND: The COVID-19 pandemic has significantly impacted individuals with chronic conditions. This investigation assessed the quality of care provided to pediatric and adolescent patients with juvenile idiopathic arthritis (JIA) during the pandemic in Thailand. METHODS: This cross-sectional analysis enrolled JIA patients aged ≤ 18 years at an academic tertiary care facility from April 2022 to March 2023. Retrospective reviews were performed, complemented by patient and caregiver questionnaires to assess the pandemic's impact on care quality. RESULTS: Seventy JIA patients (37 males, 33 females) with a mean age of 13.5 ± 3.1 years were included. A total of 41.4% of the caregivers reported negative impacts on JIA care due to the pandemic and the lockdown, and 31.4% of the patients experienced pandemic-related anxiety. A comparison between the pandemic and prepandemic periods revealed a higher incidence of active disease, although the difference was statistically nonsignificant (37.1% vs 14.2%, p = 0.106). Nonadherence significantly predicted active disease status (adjusted OR 15.04, 95% CI 2.48-91.15, p = 0.03). COVID-19 vaccinations were administered to 85.7% of patients; 52.8% of whom contracted mild COVID-19. Most patients (71.4%) postponed clinic visits; 36% due to lockdowns and 28% due to concerns about COVID-19 exposure in healthcare settings. The majority of patients received telephone JIA management advice from rheumatologists during the lockdown (91.4%). CONCLUSIONS: The COVID-19 pandemic and associated lockdown measures affected the care of JIA patients, impacting both physical and mental health. Nonadherence was a critical factor in disease flare-ups. Telemedicine is indispensable for patient care.

Falls in focus: an analysis of the rate of falls in 25 Australian residential aged care facilities from 2019 to 2021, pre- and during COVID-19 lockdowns.

INTRODUCTION: During 2020-2021 Australia maintained comparatively low rates of COVID-19 in the community and residential aged care facilities (RAC) due to stringent public health measures such as lockdowns. However, the public health measures implemented may have had unintended impacts on critical RAC resident health outcomes, such as falls, due to routine care disruptions and aged care resident isolation. We utilised a longitudinal data to assess the association between COVID-19 lockdowns and the rate of falls in RAC settings. METHODS: A longitudinal cohort study was conduct using routinely collected data from 25 RAC facilities from one non-profit aged care provider in Sydney, Australia. The study included 2,996 long term residents between March 2019 and March 2021. The outcome measures were all falls, injurious falls, and falls assessed as requiring hospitalisation. Generalised estimating equations (GEE) were applied to determine the association between COVID-19 lockdown periods and fall-related outcomes while adjusting for confounders and seasonality. RESULTS: During the study period 11,658 falls were recorded. Residents frequently experienced at least one fall during the study period (median: 1, interquartile range: 0-4). During Lockdown 1 (March-June 2020) the rate of all falls increased 32% (IRR 1.32, 95% CI 1.19-1.46, p < 0.01) and the rate of injurious falls increased by 28% (IRR 1.28, 95% CI 1.12-1.46, p < 0.01) compared to pre-pandemic rates. The rate of falls assessed as requiring hospitalisation remained unchanged during Lockdown 1 (IRR 1.07, 95% CI 0.86-1.32, p = 0.519). During Lockdown 2 (Dec 2020-Jan 2021) the rate of all falls, injurious falls, and falls assessed as requiring hospitalisation did not change significantly compared to pre-pandemic rates. CONCLUSION: These findings suggest that the consequences of stringent COVID-19 restrictions, as seen in Lockdown 1, produced changes in residents' care which contributed to more falls and associated harm. The subsequent lockdown, which were less restrictive and occurred after staff had gained experience, was associated with no significant increase in falls rate. The nature and extent of lockdowns implemented for infection control in RAC need to balance multiple potential adverse effects. Factors which facilitated resilience during this period require exploration in future research.

What impact did the COVID-19 pandemic have on psychosis and the delivery of early intervention psychosis services?

BACKGROUND: In Australia, the first nationwide COVID-19 lockdown occurred in March 2020 bringing challenges for early intervention psychosis (EIP) services. Limited evidence exists on the impacts of the pandemic on treatment outcomes among EIP clients. METHODS: This prospective cohort study analysed routine data from 15 headspace Early Psychosis centres in Australia. Participants were 12 to 25 years, meeting criteria for First Episode Psychosis (FEP) or Ultra High Risk of psychosis (UHR) comparing those who commenced treatment 'pre-COVID-19' (between 16th August 2018 and 15th August 2019), and 'during-COVID-19' (between 1st March 2020 and 15th September 2020). Clinical symptoms at treatment commencement were assessed using the Brief Psychiatric Rating Scale (BPRS) and the Kessler Psychological Distress Scale (K10). with outcomes after 6 months compared between cohorts using linear mixed-effects regression, controlling for confounders. RESULTS: Of 1246 young people analysed (653 FEP, 596 UHR), significant improvements were observed with treatment in both groups (5 to 13-point reduction in BPRS score per 6-months treatment). Treatment effectiveness reduced during-COVID-19 for psychosis symptoms, with the FEP BPRS treatment effect lower by 4.3 points (95%CI: 0.5, 8.1). UHR clients had lower BPRS negative symptoms during-COVID-19 (p = 0.020). Service contacts increased during-COVID-19, with increased telehealth services (p < 0.001). CONCLUSIONS: Early intervention remained effective for FEP and UHR, despite the pandemic and transition of EIP services to virtual service delivery. Reduced treatment efficacy in FEP psychosis symptoms may indicate potential limitations of telehealth. Further research to examine longer term clinical and functional outcomes due to the pandemic is required.

The Contribution of Legionella anisa to Legionella Contamination of Water in the Built Environment.

Legionella bacteria can proliferate in poorly maintained water systems, posing risks to users. All Legionella species are potentially pathogenic, but Legionella pneumophila (L. pneumophila) is usually the primary focus of testing. However, Legionella anisa (L. anisa) also colonizes water distribution systems, is frequently found with L. pneumophila, and could be a good indicator for increased risk of nosocomial infection. Anonymized data from three commercial Legionella testing laboratories afforded an analysis of 565,750 water samples. The data covered July 2019 to August 2021, including the COVID-19 pandemic. The results confirmed that L. anisa commonly colonizes water distribution systems, being the most frequently identified non-L. pneumophila species. The proportions of L. anisa and L. pneumophila generally remained similar, but increases in L. pneumophila during COVID-19 lockdown suggest static water supplies might favor its growth. Disinfection of hospital water systems was effective, but re-colonization did occur, appearing to favor L. pneumophila; however, L. anisa colony numbers also increased as a proportion of the total. While L. pneumophila remains the main species of concern as a risk to human health, L. anisa's role should not be underestimated, either as a potential infection risk or as an indicator of the need to intervene to control Legionella's colonization of water supplies.

Intensification mechanisms and moisture dynamics of super cyclonic storm 'Amphan' over the Bay of Bengal: Implications for aerosol re-distribution.

The present research investigates the dynamics and underlying causes contributing to the exceptional intensity of Super Cyclonic Storm (SuCS) Amphan (16th to 21st May 2020) over the Bay of Bengal (BoB), as well as its impact on aerosol redistribution along the four cities of eastern coast and north-eastern India. Notably, the SuCS was formed during the first phase of the COVID-19 lockdown in India, giving it a unique aspect of study and analysis. Our analysis based on 30 years of climatology data from Modern-Era Retrospective Analysis for Research and Applications, Version 2 (MERRA-2) reanalysis reveals 'positive' monthly anomalous winds (0.8 to 1.6 m/s) prevailed over the central BoB for May 2020. The present study further found the evolution of 'barrier layer thickness'(BLT) leading up to landfall, noting a thickening trend from 8 to 3 days before landfall, contributing to maintaining warmer sea surface temperatures near the coast. Additionally, utilizing European Centre for Medium-Range Weather Forecasts (ECMWF), reanalysis version-5 (ERA-5) data, a mean positive sea surface temperature (SST) anomaly of 0.8 to 1 °C was observed 'before' cyclone period (10-15 May 2020) near the cyclogenesis point. A detailed examination of Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) vertical cross-section plots during the cyclone's intensification stage reveals the presence of high-altitude clouds composed primarily of ice crystals. Further, analysis also indicates that the cyclone transported Sea-salt PM2.5 aerosols from the ocean, dispersing them in the landfall region.The aerosol optical Depth (AOD) data obtained from the National Aeronautics and Space Administration's (NASA) 'Clouds and the Earth's Radiant Energy System (CERES)' mission and MERRA-2 were also analysed, revealing that the cyclone redistributed aerosols over the Bengal basin region (mainly over 'Kolkata') and three other nearby cities along the track of the cyclone (i.e., Bhubaneswar (Odisha) Agartala (Tripura) and Shillong (Meghalaya) respectively).

Navigating the challenges: exploring the association between COVID-19 lockdowns and eating behavior in university students: a systematic review and investigation of factors impacting ed levels.

INTRODUCTION: The COVID-19 pandemic has significantly impacted the mental and physical well-being of individuals globally, with university students being particularly susceptible to mental health issues. Factors such as the transition to adulthood, economic hardships, and academic responsibilities, compounded by pandemic-related disruptions like lockdowns and remote learning, have elevated stress levels and altered daily routines. The pandemic has given rise to post-traumatic stress symptoms in certain individuals, including university students which may contribute to the emergence of emotional eating or adopting unhealthy eating patterns as a coping mechanism, leading to excessive consumption or unhealthy dietary choices. This review aims to investigate the influence of COVID-19 restrictions on eating disorders among university students and identifying the contributing factors. CONTENT: Out of 59 identified articles, 10 met the inclusion criteria, involving 23,542 participants (70.2 % women, 29.35 % men, 0.42 % gender fluid/undisclosed). The lockdown led to increased prevalence and severity of eating disorders among university students, particularly in women. SUMMARY: The review highlights a notable increase in eating disorders among university students during the COVID-19 pandemic. Mental health issues, reduced physical activity, and economic stress were significant contributors to this trend, with women being disproportionately affected. OUTLOOK: To mitigate the impact of future pandemics or similar disruptions, universities should implement early screening, provide mental health counseling, virtual support groups, nutritional guidance, and opportunities for physical activity. Encouraging students to seek professional help is crucial for managing mental health and eating habits in such scenarios.

Source apportionment of particle-bound polycyclic aromatic hydrocarbons (PAHs), oxygenated PAHs (OPAHs), and their associated long-term health risks in a major European city.

Many studies have drawn attention to the associations of oxygenated polycyclic aromatic hydrocarbons (OPAHs) with harmful health effects, advocating for their systematic monitoring alongside simple PAHs to better understand the aerosol carcinogenic potential in urban areas. To address this need, this study conducted an extensive PM2.5 sampling campaign in Athens, Greece, at the Thissio Supersite of the National Observatory of Athens, from December 2018 to July 2021, aiming to characterize the levels and variability of polycyclic aromatic compounds (PACs), perform source apportionment, and assess health risk. Cumulative OPAH concentrations (Σ-OPAHs) were in the same range as Σ-PAHs (annual average 4.2 and 5.6 ng m-3, respectively). They exhibited a common seasonal profile with enhanced levels during the heating seasons, primarily attributed to residential wood burning (RWB). The episodic impact of biomass burning was also observed during a peri-urban wildfire event in May 2021, when PAH and OPAH concentrations increased by a factor of three compared to the monthly average. The study period also included the winter 2020-2021 COVID-19 lockdown, during which PAH and OPAH levels decreased by >50 % compared to past winters. Positive matrix factorization (PMF) source apportionment, based on a carbonaceous aerosol speciation dataset, identified PAC sources related to RWB, local traffic (gasoline vehicles) and urban traffic (including diesel emissions), as well as an impact of regional organic aerosol. Despite its seasonal character, RWB accounted for nearly half of Σ-PAH and over two-thirds of Σ-OPAH concentrations. Using the estimated source profiles and contributions, the source-specific carcinogenic potency of the studied PACs was calculated, revealing that almost 50 % was related to RWB. These findings underscore the urgent need to regulate domestic biomass burning at a European level, which can provide concrete benefits for improving urban air quality, towards the new stricter EU standards, and reducing long-term health effects.

Impact of campus closure during COVID-19 on lifestyle, educational performance, and anxiety levels of college students in China.

BACKGROUND: Higher education students exhibit heightened sensitivity to environmental changes as they navigate the critical transition from adolescence to adulthood. The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to universities worldwide, exemplifying a crisis that profoundly affects the learning outcomes and psychological status of college students. Although it is known that campus lockdown has triggered dramatic changes in lifestyles, learning outcomes, and psychological statuses, in-depth knowledge of the causal relationships among these changes remains largely unclear. METHODS: Here, we conducted a cross-sectional survey designed to assess the impact of campus closure during COVID-19 on lifestyle, educational performance, and anxiety levels among college students. We surveyed over 3,500 junior college, undergraduate and graduate participants from 94 colleges/universities across 30 provinces, municipalities, and autonomous regions in China.We employed structural equation modeling (SEM) to explore the relationships between changes in lifestyle, educational performance, and levels of anxiety associated with campus open or closure regulations during the COVID-19 pandemic. RESULTS: Our results discovered that sleep duration, physical activity involvement, and social connections were crucial for sustaining students' learning outcomes and mental health. The shift to online learning and campus lockdown exacerbated stressors, contributing to heightened anxiety (ß = 0.066), disrupted sleep patterns, and enhanced physical activity (ß = 0.070) and reduced learning effect (ß = -0.059). Sleep patterns were disrupted by the campus lockdown, an effect mediated by the degradation of relationships among classmates. Nonetheless, the best-fitting SEM uncovered the intricate relationships among lifestyle changes, learning outcomes, and psychological status in response to sudden environmental changes (Fisher's C = 80.949, P = 0.328). These results highlight the critical role of adaptable, supportive campus policies tailored to meet the diverse needs and interests of students during and beyond crises (Fisher's C = 59.568, P = 0.809). CONCLUSIONS: Our study advocates for a holistic approach that addresses the multifaceted aspects of student life to cultivate a resilient academic community. This approach contributes to a deeper understanding of the effects of sudden environmental changes on students' psychological well-being and academic performance in the post-pandemic era.

Geospatial analysis of contagious infection growth and cross-boundary transmission in non-vaccinated districts of North-East Indian states during the COVID-19 pandemic.

Background: During the initial phase of the COVID-19 pandemic, the Government of India implemented a nationwide lockdown, sealing borders across states and districts. The northeastern region of India, surrounded by three international borders and connected to mainland India by a narrow passage, faced particular isolation. This isolation resulted in these states forming a relatively closed population. Consequently, the availability of population-based data from Indian Council of Medical Research, tracked through national identification cards, offered a distinctive opportunity to understand the spread of the virus among non-vaccinated and non-exposed populations. This research leverages this dataset to comprehend the repercussions within isolated populations. Methods: The inter-district variability was visualized using geospatial analysis. The patterns do not follow any established grounded theories on disease spread. Out of 7.1 million total data weekly 0.35 million COVID-19-positive northeast data was taken from April 2020 to February 2021 including "date, test result, population density, area, latitude, longitude, district, and state" to identify the spread pattern using a modified reaction-diffusion model (MRD-Model) and Geographic Information System. Findings: The analysis of the closed population group revealed an initial uneven yet rapidly expanding geographical spread characterized by a high diffusion rate α approximately 0.4503 and a lower reaction rate ß approximately 0.0256, which indicated a slower growth trajectory of case numbers rather than exponential escalation. In the latter stages, COVID-19 incidence reached zero in numerous districts, while in others, the reported cases did not exceed 100. Interpretation: The MRD-Model effectively captured the disease transmission dynamics in the abovementioned setting. This enhanced understanding of COVID-19 spread in remote, isolated regions provided by the MRD modelling framework can guide targeted public health strategies for similar isolated areas. Funding: This study is Funded by Indian Council of Medical Research (ICMR).

Impact of COVID-19 Lockdown on NO2 Pollution and the Associated Health Burden in China: A Comparison of Different Approaches.

So far, a large number of studies have quantified the effect of COVID-19 lockdown measures on air quality in different countries worldwide. However, few studies have compared the influence of different approaches on the estimation results. The present study aimed to utilize a random forest machine learning approach as well as a difference-to-difference approach to explore the effect of lockdown policy on nitrogen dioxide (NO2) concentration during COVID-19 outbreak period in mainland China. Datasets from 2017 to 2019 were adopted to establish the random forest models, which were then applied to predict the NO2 concentrations in 2020, representing a scenario without the lockdown effect. The results showed that random forest models achieved remarkable predictive accuracy for predicting NO2 concentrations, with index of agreement values ranging between 0.34 and 0.76. Compared with the modelled NO2 concentrations, on average, the observed NO2 concentrations decreased by approximately 16 µg/m3 in the lockdown period in 2020. The difference-to-difference approach tended to underestimate the influence of COVID-19 lockdown measures. Due to the improvement of NO2 pollution, around 3722 non-accidental premature deaths were avoided in the studied population. The presented machine learning modelling framework has a great potential to be transferred to other short-term events with abrupt pollutant emission changes.

Spatio-temporal analysis of COVID-19 lockdown effect to survive in the US counties using ANN.

This study aims to quantify the effectiveness of lockdown as a non-pharmacological solution for managing the COVID-19 pandemic. Daily COVID-19 death counts were collected for four states: California, Georgia, New Jersey, and South Carolina. The effectiveness of the lockdown was studied and the number of people saved during 7 days was evaluated. Five neural network models (MLP, FFNN, CFNN, ENN, and NARX) were implemented, and the results indicate that FFNN is the best prediction model. Based on this model, the total number of survivors over a 7-day period is 211, 270, 989, and 60 in California, Georgia, New Jersey, and South Carolina, respectively. The coefficients and weights of the FFNN for each state differ due to various factors, including socio-demographic conditions and the behavior of citizens towards lockdown laws. New Jersey and South Carolina have the most lockdowns and the least.

Remote Exercise Training Intervention During the COVID-19 Pandemic: Randomized Controlled Trial.

BACKGROUND: Societal measures to contain the spread of COVID-19 (eg, lockdown and contact restrictions) have been associated with decreased health and well-being. A multitude of prepandemic studies identified the beneficial effects of physical exercise on both physical and mental health. OBJECTIVE: We report on the feasibility of a remote physical exercise intervention and its stress-buffering potential in 2 untrained cohorts: a pre-COVID-19 cohort that completed the intervention in 2019 and a lockdown cohort that started the intervention shortly before pandemic-related restrictions were implemented. METHODS: In a randomized controlled trial, participants were assigned to either an intervention group (IG; pre-COVID-19 cohort: n=7 and lockdown cohort: n=9) or a control group (CG; pre-COVID-19 cohort: n=6 and lockdown cohort: n=6). IG participants received weekly individualized training recommendations delivered via web-based support. The intervention period was initially planned for 8 weeks, which was adhered to in the pre-COVID-19 cohort (mean 8.3, SD 0.5 weeks) but was extended to an average of 17.7 (SD 2.0) weeks in the lockdown cohort. Participants' health parameters were assessed before and after the intervention: aerobic capacity was measured as peak oxygen uptake (VO2peak) via cardiopulmonary exercise testing. Depressive symptoms were scored via the depression subscale of the Brief Symptom Inventory-18. RESULTS: Dropout rates were low in both cohorts in the IG (pre-COVID-19 cohort: n=0, 0% and lockdown cohort: n=2, 16.7%) and the CG (pre-COVID-19 cohort: n=0, 0% and lockdown cohort: n=2, 20%). The mean adherence to the training sessions of the IG for both cohorts was 84% (pre-COVID-19 cohort: SD 5.5% and lockdown cohort: SD 11.6%). Aligned rank transform ANOVAs in the lockdown cohort indicated deterioration of VO2peak and depressive symptoms from before to after the intervention in the CG but no longitudinal changes in the IG. Analyses in the pre-COVID-19 cohort revealed significant increases in VO2peak for the IG compared to the CG (P=.04) but no intervention effects on depressive symptoms. CONCLUSIONS: With low dropout rates and high adherence, the remote intervention was feasible for healthy adults under regular conditions and in the face of pandemic-related stressors. Moreover, our results hint at a stress-buffering effect as well as a buffering of a lockdown-induced deconditioning of remote physical exercise interventions in the pandemic scenario, which can be used in future studies to overcome equally stressful periods of life. However, due to limited statistical power, these findings should be replicated in similar scenarios. TRIAL REGISTRATION: German Clinical Trials Register DRKS00018078; https://drks.de/search/en/trial/DRKS00018078.

Qualitative comparative analysis of policies implemented by 26 European countries during the 2020 great lockdown.

Introduction: During the first wave of the COVID-19 pandemic in Europe, from March 1 to April 15, 2020, significant variations emerged among countries regarding the implementation of lockdown policies. During this period, viewed strictly from an epidemiological perspective, lockdown measures are considered the most effective means of containing a pandemic. However, the adoption of such measures varied, raising questions about whether the reluctance or failure of countries to implement lockdown policies reflected a disregard for epidemiological knowledge or stemmed from an inability to enforce these measures. Methods: This article employs Qualitative Comparative Analysis (QCA) with 26 European countries as case studies to investigate under what combination of conditions a country would implement lockdown policies. Results: The QCA results identify three distinct combinations of conditions that lead countries to implement lockdown measures. First, countries with relatively concentrated political power are more likely to implement lockdown policies. Among the 10 countries governed by a majority party or majority coalition within a two-party or moderate multi-party system, seven implemented lockdown policies. Second, in cases of relatively dispersed political power, countries facing state fragility risks are more likely to implement lockdown policies. Among the eight countries that meet both conditions, five implemented lockdown policies. Finally, factors such as political heritage, severity of the pandemic, demographic composition, healthcare access, quality standards, and the ruling party's ideology play a lesser role in the decision to enact lockdown measures. Discussion: This article offers a novel perspective on the dynamics of party politics and state capacity in the context of decision-making during the COVID-19 pandemic. It contributes to a deeper understanding of the intricate relationship between political systems and public health crisis management, highlighting how various political and governance factors influence the adoption of public health interventions during crises.

Effect of COVID-19 lockdowns on quality-of-life and health services access by socio-economic status in Australia.

This study examined changes in physical and mental health quality-of-life and health services access before and after the onset of the COVID-19 pandemic among individuals of lower and higher socio-economic status (SES) in Australia. Difference-in-differences and logistic regression models were undertaken using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey and government data on COVID-19 lockdowns between January 2020 and February 2021. Individuals from higher SES reported larger decreases in mental health quality-of-life scores than those from lower SES after the onset of the pandemic. Those from lower SES reported less disruption with any health services (24.2% vs 30.4%; OR = 0.68; p < 0.001), specifically dental services (8.2% vs 15.4%; OR = 0.51; p < 0.001) and allied health services (5.9% vs 8.5%; OR = 0.60; p < 0.001), compared with those from higher SES. Additional days under lockdown were associated with reduced access to all health services (OR = 1.19). Furthermore, long-term health conditions (higher SES: OR = 1.54) and scores indicative of poorer physical (lower SES: OR = 1.17; higher SES: OR = 1.07) and mental health (lower SES: OR = 1.16; higher SES: OR = 1.12) were associated with increased health services disruption. While individuals from higher SES were more likely than those from lower SES to experience greater relative declines in mental health and increased disruption with health services access, individuals with a greater apparent need for health services, regardless of SES, may have faced inequalities in accessing these services during the COVID-19 pandemic.

The impact of the COVID-19 lockdown on social and economic welfare in Uganda.

BACKGROUND: As a measure to slow down the transmission of Coronavirus disease (COVID-19), governments around the world placed their countries under various stringent lockdown measures. Uganda is one of the countries that had a strict lockdown in Africa. This qualitative study explored the social and economic impacts of the COVID-19 lockdown in both an urban (Kampala) and rural (Wakiso) setting in Central Uganda. METHODS: The study used focus group discussions (FGDs), household interviews, and key informant interviews (KIIs). 14 FGDs were conducted among several stakeholders including community health workers, health professionals, and members of the community. 40 household interviews were conducted among low, middle, and high-income households, while 31 KIIs were held among policy makers, non-governmental organisations, and the private sector. Data were analysed thematically in NVivo 2020 (QSR International). RESULTS: Findings from the study are presented under six themes: family disruption; abuse of children's rights; disruption in education; food insecurity; impact on livelihoods; and violation of human rights. The study found that the COVID-19 lockdown led to family breakups, loss of family housing, as well as increased both caring responsibilities and gender-based violence especially towards females. Children's welfare suffered through increased child labour, sexual exploitation, and early marriages. The extended closure of schools led to delayed educational milestones, poor adaptation to home-based learning, and increased school drop-out rates. Increased food insecurity led to changes in feeding patterns and reduced food varieties. Livelihoods were negatively affected hence people depleted their savings and capital. Unlawful detention and beating by law enforcement officers increased during the lockdown. CONCLUSION: Future pandemic planning needs to consider the consequences of lockdown on the social and economic wellbeing of communities hence put in place appropriate mitigation measures during and after the outbreak.

Deterioration of people with Parkinson's symptoms during COVID-19 lockdown: results of a web-based survey in Northwestern Italy.

OBJECTIVES: COVID-19 lockdowns were introduced to control the pandemic, however, they resulted in a global disruption of daily life and of individual and global health. Reduced accessibility of health services, unavailability of food and drugs, and mental health challenges had a huge impact on older people and on people living with disabling conditions such as Parkinson's disease (PD). We assessed whether and to what extent the more disabled and vulnerable people with Parkinson's (PwP) were affected by lockdowns. METHOD: We analysed responses collected through a web-based survey of PwP according to their self-sufficiency [self-sufficient (SS); nearly self-sufficient (nSS); non-self-sufficient, cared for by family (NSS/F); non-self-sufficient, needs professional care (NSS/PC)]. RESULTS: Fears due to COVID-19 and difficulties with food supply were highest in NSS/F PwP. Difficulties with the supply of Parkinson's medication or other drugs were apparently not an issue, while problems accessing primary care physicians and neurologists were similar across all patient groups. On the contrary, difficulties with daily and motor activities were higher in NSS/F and NSS/PC PwP. PwP symptoms worsened in all groups, with NSS/F and NSS/PC participants experiencing the worst deterioration. Notably, the deterioration of PwP symptoms was specifically related to changes in daily and motor activities, with participants who reported less engagement in daily and motor activities experiencing the worst deterioration. CONCLUSION: Findings strongly support the need for decision-makers and healthcare providers to carefully re-evaluate the risk-benefit ratio of limiting healthcare accessibility for PwP, since evidence shows that lockdown measures primarily impact the groups who are most fragile and vulnerable.

Frequency of Non-strabismic Binocular Vision Anomalies among Optometrists in a Tertiary Eye Care Center in Southern India.

Purpose: Lifestyle in the modern era has drastically changed across the globe, and the healthcare profession was no exception. The increased time spent in the virtual space for various purposes, including online classes and webinars, is hypothesized to increase the risk of vision-related disorders such as asthenopia, dry eyes, and visual fatigue. The purpose of this study was to evaluate fusional vergence and ocular accommodation among optometry professionals in a tertiary eye care center during the immediate post-coronavirus disease 2019 (post-COVID-19) lockdown period. Methods: Optometrists posted in the general out-patient department, specialty clinics, and the ocular diagnostics department were included in the study. A total of 65 optometrists were included in the study. All optometrists underwent a comprehensive binocular vision assessment. Convergence Insufficiency Symptom Survey questionnaires were administered to all optometrists at the beginning of the assessment. Results: Out of 65 optometrists, 48 (73.8%) were women. The mean (standard deviation) age of the participants was 24 (3) years. Eleven (16.9%) optometrists had normal binocular vision parameters, and the rest 54 (83.1%) had non-strabismic binocular vision anomalies. Reduced accommodative facility and convergence insufficiency were seen among 43 (66.2%) optometrists, whereas 30 (46.2%) had reduced accommodative facility alone. Twelve (18.5%) participants were symptomatic as per the convergence insufficiency symptom survey. Conclusion: This study highlights the fact that a large proportion of optometrists have undetected non-strabismic binocular vision anomalies in a tertiary eye care center. It is important for eye care professionals to undergo regular binocular vision assessments in association with ophthalmic examinations and relevant management. This will ensure that these dysfunctions do not impede work productivity and overall quality of life.

Impact of pandemics on primary care: changes in general practitioner antidepressant prescriptions and mental health referrals during lockdowns in England, UK.

OBJECTIVES: In recent times, the world has witnessed unprecedented challenges, with the COVID-19 pandemic being a major disruptor to various aspects of daily life. This article delves into the profound impact of pandemics on primary care, specifically focussing on changes in antidepressant prescriptions and mental health referrals before, during, and after lockdowns in England, UK. METHODS: In this retrospective study, we used anonymised individual-level electronic health record data from general practitioner (GP) practices in the North of England, UK. We applied a negative binomial-logit hurdle model and a multinominal logit regression model to assess the impact on antidepressant prescriptions and GP referral types, respectively. RESULTS: The initiation of antidepressant prescriptions showed a notable decrease during and post lockdowns, with a minor uptick in ongoing antidepressant prescriptions during the lockdown periods. Over the course of lockdowns and beyond, there was a growing trend of patients being referred to social prescribing interventions. Notably, individuals from ethnic minorities were more inclined to receive fewer medical treatments and more social prescribing interventions. CONCLUSION: The increase in antidepressant prescriptions during the pandemic-related lockdowns was expected due to these challenging circumstances. Reduced referrals to secondary mental health services occurred as online counselling services were deemed inappropriate by some doctors, and patients were hesitant to seek face-to-face help. Notably, there was a rise in social prescribing referrals, emerging as a valuable resource for psychological support amid heightened mental health strain. Additionally, ethnic minority patients were less likely to receive medical treatments but more likely to be referred to social prescribing services. Despite the inevitable negative impacts of the COVID-19 pandemic, these findings highlight the active role of non-clinical support in a social model of health, addressing unmet needs and reducing barriers to mental health care for certain groups.

Anthropogenic impacts on polycyclic aromatic hydrocarbons in surface water: Evidence from the COVID-19 lockdown.

The lockdown restrictions against coronavirus disease 2019 (COVID-19) have led to unprecedented reductions in global anthropogenic activities. Polycyclic aromatic hydrocarbons (PAHs) are carcinogenic combustion-induced pollutants, but the influence of anthropogenic responses to COVID-19 on PAH contamination remains largely unknown. Here we quantified the impacts of lockdown restrictions on 16PAH pollution based on the data in concentrations dissolved in the water phase and absorbed on the suspended particulate matter (SPM) in the Elbe River from 2015 to 2021 and determined the changes in source contributions classified by individual years and stations. Results show that the annual average PAH concentrations in water and SPM were determined as 0.055 µg·L-1 and 3.77 mg·kg-1 from 2015 to 2021, respectively. Pronounced declines in PAH on SPM (up to -18 %) were observed during the three lockdowns in Germany from 2020 to 2021. However, dramatic rebounds of anthropogenic activities during the removal of the lockdown led to increases (up to 29 %) in ∑16PAH concentrations compared to the same period in previous years. Through the source apportionment method, vehicle and coal emissions were the two most predominant sources of PAHs in the river. Vehicle contribution decreased during the lockdown, while coal emissions increased by 5 %. Health risks for three age groups were assessed as potential low risk and decreased by 18 % from 1.54 × 10-4 in 2015 to 1.27 × 10-4 in 2019, and rebounded to 1.40 × 10-4 in 2020-2021. The findings of this study highlight the strong consistency between PAH concentrations and anthropogenic intensity, implying that source control from improved cleaner production is an effective pathway for mitigating PAH contamination in the aquatic environment.