Transmission of SARS-CoV-2 from Children and Adolescents

A better understanding of SARS-CoV-2 transmission from children and adolescents is crucial for informing public health mitigation strategies. We conducted a retrospective cohort study among household contacts of primary cases defined as children and adolescents aged 719 years with laboratory evidence of SARS-CoV-2 infection acquired during an overnight camp outbreak. Among household contacts, we defined secondary cases using the Council of State and Territorial Epidemiologists definition. Among 526 household contacts of 224 primary cases, 48 secondary cases were identified, corresponding to a secondary attack rate of 9% (95% confidence interval [CI], 7%-12%). Our findings show that children and adolescents can transmit SARS-CoV-2 to adult contacts and other children in a household setting.

How large must a treatment effect be before it matters to practitioners? An estimation method and demonstration.

INTRODUCTION AND AIMS: Treatment research is sometimes criticised as lacking in clinical relevance, and one potential source of this friction is a disconnection between statistical significance and what clinicians regard to be a meaningful difference in outcomes. This report demonstrates a novel methodology for estimating what substance abuse practitioners regard to be clinically important differences. DESIGN AND METHODS: To illustrate the estimation method, we surveyed 50 substance abuse treatment providers participating in the National Institute on Drug Abuse (NIDA) Clinical Trials Network. Practitioners identified thresholds for clinically meaningful differences on nine common outcome variables, indicated the size of effect that would justify their learning a new treatment method and estimated current outcomes from their services. RESULTS: Clinicians judged a difference between two treatments to be meaningful if outcomes were improved by about 10 - 12 points on the percentage of patients totally abstaining, arrested for driving while intoxicated, employed or having abnormal liver enzymes. A 5 percentage-point reduction in patient mortality was regarded as clinically significant. On continuous outcome measures (such as percentage of days abstinent or drinks per drinking day), practitioners judged an outcome to be significant when it doubled or halved the base rate. When a new treatment meets such criteria, practitioners were interested in learning it. DISCUSSION AND CONCLUSIONS: Effects that are statistically significant in clinical trials may be unimpressive to practitioners. Clinicians' judgements of meaningful differences can inform the powering of clinical trials.

The pretreatment social networks of women with alcohol dependence.

OBJECTIVE: Research indicates that the social networks of women differ from those of men. Although studies indicate that social support greatly affects alcohol use, little attention has been paid to gender differences in this area. The objective of the current study is to examine the pretreatment social networks of women seeking conjoint treatment for an alcohol-use disorder. METHOD: As part of a larger randomized clinical trial, 102 women in committed heterosexual relationships who were seeking treatment for an alcohol-use disorder at an outpatient clinic were interviewed before treatment entry. Participants completed the Important People and Activities Instrument to assess the size and composition of the women's social networks. Pretreatment drinking was assessed using the Timeline Followback interview. RESULTS: Participants in this study reported fairly large supportive networks. Drinking quantity and frequency in the 3 months before treatment were examined in light of social network connection. Women with moderate/heavy drinking partners reported more drinking days but drank fewer drinks per drinking day than women with light drinking/abstaining partners. In addition, we found a positive association between the number of drinkers in the social network and the participant percentage of drinking days. CONCLUSIONS: The main findings of this study were the significant interrelationships between moderate or heavy drinking among social network members and the drinking patterns of women with alcohol-use disorders.