Research priorities to reduce the impact of COVID-19 in low- and middle-income countries.

Background: The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs. Methods: The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity. Results: Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients' needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts. Interpretation: Health policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs.

Impact of Coronavirus Disease 2019 (COVID-19) Outbreak Quarantine, Isolation, and Lockdown Policies on Mental Health and Suicide.

The novel coronavirus disease (COVID-19) pandemic has made a huge impact on people's physical and mental health, and it remains a cause of death for many all over the world. To prevent the spread of coronavirus infection, different types of public health measures (social isolation, quarantine, lockdowns, and curfews) have been imposed by governments. However, mental health experts warn that the prolonged lockdown, quarantine, or isolation will create a "second pandemic" with severe mental health issues and suicides. The quarantined or isolated people may suffer from various issues such as physical inactivity, mental health, economic and social problems. As with the SARS outbreak in 2003, many suicide cases have been reported in connection with this current COVID-19 pandemic lockdown due to various factors such as social stigma, alcohol withdrawal syndrome, fear of COVID infection, loneliness, and other mental health issues. This paper provides an overview of risk factors that can cause suicide and outlines possible solutions to prevent suicide in this current COVID-19 pandemic.

Infrared Thermal Imaging for Evaluation of Clubfoot After the Ponseti Casting Method-An Exploratory Study.

Background: Conservative treatment, Ponseti method, has been considered as a standard method to correct the clubfoot deformity among Orthopedic society. Although the result of conservative methods have been reported with higher success rates than surgical methods, many more problems have been reported due to improper casting, casting pressure or bracing discomfort. Nowadays, infrared thermography (IRT) is widely used as a diagnostic tool to assess musculoskeletal disorders or injuries by detecting temperature abnormalities. Similarly, the foot skin temperature evaluation can be added along with the current subjective evaluation to predict if there is any casting pressure, excessive manipulation, or overcorrections of the foot, and other bracing pressure-related complications. Purpose: The main purpose of this study was to explore the foot skin temperature changes before and after using of manipulation and weekly castings. Methods: This is an explorative study design. Infrared Thermography (IRT), E33 FLIR thermal imaging camera model, was used to collect the thermal images of the clubfoot before and after casting intervention. A total of 120 thermal images (Medial region of the foot-24, Lateral side of the foot-24, Dorsal side of the foot-24, Plantar side of the foot-24, and Heel area of the foot-24) were collected from the selected regions of the clubfoot. Results: The results of univariate statistical analysis showed that significant temperature changes in some regions of the foot after casting, especially, at the 2nd (M = 32.05°C, SD = 0.77, p = 0.05), 3rd (M = 31.61, SD = 1.11; 95% CI: 31.27-31.96; p = 0.00), and 6th week of evaluation on the lateral side of the foot (M = 31.15°C, SD = 1.59; 95% CI: 30.75-31.54, p = 0.000). There was no significant temperature changes throughout the weekly casting in the medial side of the foot. In the heel side of the foot, significant temperature changes were noticed after the third and fourth weeks of casting. Conclusion: This study found that a decreased foot skin temperature on the dorsal and lateral side of the foot at the 6th week of thermography evaluation. The finding of this study suggest that the infrared thermography (IRT) might be useful as an adjunct assessment tool to evaluate the thermophysiological changes, which can be used to predict the complications caused by improper casting, over manipulative or stretching and casting-pressure related complications.

Chinese Martial Art Training Failed to Improve Balance or Inhibit Falls in Older Adults.

This randomized controlled trial explored the effects of a Ving Tsun (VT) Chinese martial art training program on reactive standing balance performance, postural muscle reflex contraction latency, leg muscle performance, balance confidence and falls in community-dwelling older adults. We randomly assigned 33 healthy older adults to either a VT group (mean age = 67.5 years) or a control group (mean age = 72.1 years). The VT group received two 1-hour VT training sessions per week for three months (24 sessions). Primary outcome measures collected before and after the intervention period were electromyographic muscle activation onset latencies of the hamstring and gastrocnemius and the center of pressure path, length and movement velocity in standing (reactive balance performance). Secondary outcome measures included isometric peak force and time to isometric peak force of the knee extensors and flexors, the Activities-Specific Balance Confidence Scale score, and fall history. Results revealed that the mean gastrocnemius muscle activation onset latency was significantly longer (22.53 ms) in the VT group after the intervention. The peak force of the knee flexors significantly increased (by 1.58 kg) in the control group over time but not in the VT group. The time to reach peak force in the knee flexors was significantly longer (by 0.51 s) in the control group (but not the VT group) at posttest compared with the pretest value. No other significant group, time, or group-by-time interaction effects were noted. We discussed possible reasons for the failure of three months of martial art training to benefit fall risks among these older adults.

Balance control, agility, eye-hand coordination, and sport performance of amateur badminton players: A cross-sectional study.

In this study, balance performance, agility, eye-hand coordination, and sports performance were compared between amateur badminton players and active controls.Thirty young adult badminton players and 33 active controls participated in the study. Static single-leg standing balance (with eyes closed) was measured using a force platform, and dynamic balance was measured using the Y Balance Test (lower quarter). Agility was measured using a hexagon agility test, and eye-hand coordination was measured using a computerized finger-pointing task. Sports performance was quantified by the number of times a shuttlecock fell in a designated area following a badminton serve.The badminton players had superior accuracy in badminton serving (P < .001) relative to the active controls. However, no significant between-group differences were noted in all other outcome variables (P > .05).Amateur badminton players had more favorable sports performance, but not balance performance, agility, or eye-hand coordination, than controls.

Validation of the virtual-reality prospective memory test (Hong Kong Chinese version) for individuals with first-episode schizophrenia.

This study was performed to examine the psychometric properties of a Virtual-Reality Prospective Memory Test (Hong Kong Chinese version; VRPMT-CV). The VRPMT was administered to 44 individuals with first-episode schizophrenia. The test was administered again 2 weeks later to establish test-retest reliability. The concurrent validity of the VRPMT was evaluated by examining the correlations between the VRPMT score and the score on the Chinese version of the Cambridge Prospective Memory Test (CAMPROMPT-CV). The performance of individuals with schizophrenia on the VRPMT was also compared with that of 42 healthy control subjects to examine the test's sensitivity and specificity. The intraclass correlation for test-retest reliability of the total VRPMT-CV score was 0.78 (p = .005). A significant correlation was found between the total VRPMT-CV score and the total CAMPROMPT-CV score (r = 0.90; p < .001). Comparison with the healthy control subjects revealed that the total VRPMT-CV score was a sensitive (92.9%) and specific (75%) measure of prospective memory deficits in individuals with schizophrenia. The VRPMT-CV is an assessment of prospective memory that has good construct validity, test-retest reliability, sensitivity and specificity in the context of first-episode schizophrenia.

Ponseti method in the management of clubfoot under 2 years of age: A systematic review.

BACKGROUND: Congenital talipes equinovarus (CTEV), also known as clubfoot, is common congenital orthopedic foot deformity in children characterized by four components of foot deformities: hindfoot equinus, hindfoot varus, midfoot cavus, and forefoot adduction. Although a number of conservative and surgical methods have been proposed to correct the clubfoot deformity, the relapses of the clubfoot are not uncommon. Several previous literatures discussed about the technical details of Ponseti method, adherence of Ponseti protocol among walking age or older children. However there is a necessity to investigate the relapse pattern, compliance of bracing, number of casts used in treatment and the percentages of surgical referral under two years of age for clear understanding and better practice to achieve successful outcome without or reduce relapse. Therefore this study aims to review the current evidence of Ponseti method (manipulation, casting, percutaneous Achilles tenotomy, and bracing) in the management of clubfoot under two years of age. MATERIALS AND METHODS: Articles were searched from 2000 to 2015, in the following databases to identify the effectiveness of Ponseti method treatment for clubfoot: Medline, Cumulative Index to Nursing and Allied Health Literature (CINHAL), PubMed, and Scopus. The database searches were limited to articles published in English, and articles were focused on the effectiveness of Ponseti method on children with less than 2 years of age. RESULTS: Of the outcome of 1095 articles from four electronic databases, twelve articles were included in the review. Pirani scoring system, Dimeglio scoring system, measuring the range of motion and rate of relapses were used as outcome measures. CONCLUSIONS: In conclusion, all reviewed, 12 articles reported that Ponseti method is a very effective method to correct the clubfoot deformities. However, we noticed that relapses occur in nine studies, which is due to the non-adherence of bracing regime and other factors such as low income and social economic status.

Developing a Three-Dimensional (3D) Assessment Method for Clubfoot-A Study Protocol.

Background: Congenital talipes equinovarus (CTEV) or clubfoot is a common pediatric congenital foot deformity that occurs 1 in 1,000 live births. Clubfoot is characterized by four types of foot deformities: hindfoot equinus; midfoot cavus; forefoot adductus; and hindfoot varus. A structured assessment method for clubfoot is essential for quantifying the initial severity of clubfoot deformity and recording the progress of clubfoot intervention. Aim: This study aims to develop a three-dimensional (3D) assessment method to evaluate the initial severity of the clubfoot and monitor the structural changes of the clubfoot after each casting intervention. In addition, this study explores the relationship between the thermophysiological changes in the clubfoot at each stage of the casting intervention and in the normal foot. Methods: In this study, a total of 10 clubfoot children who are <2 years old will be recruited. Also, the data of the unaffected feet of a total of 10 children with unilateral clubfoot will be obtained as a reference for normal feet. A Kinect 3D scanner will be used to collect the 3D images of the clubfoot and normal foot, and an Infrared thermography camera (IRT camera) will be used to collect the thermal images of the clubfoot. Three-dimensional scanning and IR imaging will be performed on the foot once a week before casting. In total, 6-8 scanning sessions will be performed for each child participant. The following parameters will be calculated as outcome measures to predict, monitor, and quantify the severity of the clubfoot: Angles cross section parameters, such as length, width, and the radial distance; distance between selected anatomical landmarks, and skin temperature of the clubfoot and normal foot. The skin temperature will be collected on selected areas (forefoot, mid foot, and hindfoot) to find out the relationship between the thermophysiological changes in the clubfoot at each stage of the casting treatment and in the normal foot. Ethics: The study has been reviewed and approved on 17 August 2016 by the Sydney Children's Hospitals Network Human Research Ethics Committee (SCHN HREC), Sydney, Australia. The Human Research Ethics Committee (HREC) registration number for this study is: HREC/16/SCHN/163.