Factors associated with COVID-19 in children aged 0 to 15 in Niger, 2020.

On January 30, 2020, the WHO declared COVID-19 a global health emergency. Children were affected in less severe forms. Niger had implemented measures in a context where children were a source of contamination. The aim was to determine the factors associated with COVID-19 in children in Niger from February to August 2020 through an analysis of the national database. We conducted an analytical cross-sectional study including all COVID-19 suspects in the database. We used Excel and Epi Info 7.2.4. software for data extraction and analysis. Frequencies and proportions were calculated, and in a logistic regression, we estimated the ORs of association with their 95% confidence intervals, the factors associated with COVID-19 at the threshold of p<0.05. Of 572 notified cases of suspected COVID-19 in children aged 0-15, 11.36% were positive. The median age of infected children was 10 years [IQR: 5- 13 years]. The male/female sex ratio was 2.1. Children aged 11 to 15 accounted for 49.2%, 61.5% lived in Niamey, 4.6% had comorbidities. The notion of travel was 12.3% and 40% had a notion of contact, 24.4% had a fever, 23.2% had a cough, 18% were hospitalized, and a case-fatality rate of 1.5%. In etiological analysis, the factors associated with COVID-19 were sex ORa=0.51 [0.28-0.93] p=0.028, presence of symptoms ORa=2.29 [1.23-4.25] p=0.008 and notion of contact ORa=0.32 [0.13-0.77] p=0.011. Exposed children were sensitive to COVID-19, and all age groups were affected, with a predominance of males. We recommend barrier measures adapted to young people, and early detection and management of infected children.

Perceived Readiness for Gerontological Social Work: Insights from Recent Graduates During COVID-19.

An online qualitative survey explored perceived training, readiness, and needs of recent SW graduates serving older adults. Over half (N = 14) held a master's in social work, with 70% having taken an introductory aging course. Nearly halfcompleted other aging-specific coursework, and 80% did fieldwork with older adults. Participants indicated moderate proficiency in assessing issues like lossestransitions (46.7%), and physical health (53.3%), and advanced expertise in cognitive assessments (60.0%) and caregiver stress management (53.3%). Training deficiencies were noted in disaster readiness, telehealth, and resource coordination. Findings underscore the need for educationfor early-career social workers, ensuring their effective support to older adults.

Aging with her garden: Mutual care across species and generations.

What can caring for, and being cared for by, a garden teach us about aging well? This article is a narrative exploration of care, aging, and wellbeing in later life through conversations with an older woman and her garden in Toronto, Canada during the months of the COVID-19 pandemic. The focus is on the interconnectedness of care across generations and species. Moving away from conventional generational scripts, the article expands notions of care and aging with an intersectional, feminist and decolonial approach to relationality across time and space. The article uses interviews, photovoice-inspired sessions, and autoethnography, to look at aging and wellbeing as relational and more-than-human relationality. It extends the ethics of care beyond traditional boundaries, embracing perspectives that challenge normative assumptions of gender, age, and interspecies relations. The article aims to contribute to the current debates around colonial research logics, though a critical feminist understanding of relationality and embodied learning. It emphasizes the importance of connecting across generations, seeing land as a way to restore human and more-than-human relations while prefiguring a more care-full present.

Effectiveness against severe COVID-19 of a seasonal booster dose of bivalent (original/Omicron BA.4-5) mRNA vaccines in persons aged ≥60 years: Estimates over calendar time and by time since administration during prevalent circulation of different Omicron subvariants, Italy, 2022-2023.

Evaluating how a COVID-19 seasonal vaccination program performed might help to plan future campaigns. This study aims to estimate the relative effectiveness (rVE) against severe COVID-19 of a seasonal booster dose over calendar time and by time since administration. We conducted a retrospective cohort analysis among 13,083,855 persons aged ≥60 years who were eligible to receive a seasonal booster at the start of the 2022-2023 vaccination campaign in Italy. We estimated rVE against severe COVID-19 (hospitalization or death) of a seasonal booster dose of bivalent (original/Omicron BA.4-5) mRNA vaccines by two-month calendar interval and at different times post-administration. We used multivariable Cox regression models, including vaccination as time-dependent exposure, to estimate adjusted hazard ratios (HR) and rVEs as [(1-HR)X100]. The rVE of a seasonal booster decreased from 64.9% (95% CI: 59.8-69.4) in October-November 2022 to 22.0% (95% CI: 15.4-28.0) in April-May 2023, when the majority of vaccinated persons (67%) had received the booster at least 4-6 months earlier. During the epidemic phase with prevalent circulation of the Omicron BA.5 subvariant, rVE of a seasonal booster received ≤90 days earlier was 83.0% (95% CI: 79.1-86.1), compared to 37.4% (95% CI: 25.5-47.5) during prevalent circulation of the Omicron XBB subvariant. During the XBB epidemic phase, rVE was estimated at 15.8% (95% CI: 9.1-20.1) 181-369 days post-administration of the booster dose. In all the analyses we observed similar trends of rVE between persons aged 60-79 and those ≥80 years, although estimates were somewhat lower for the oldest group. A seasonal booster dose received during the vaccination campaign provided additional protection against severe COVID-19 up to April-May 2023, after which the incidence of severe COVID-19 was much reduced. The results also suggest that the Omicron XBB subvariant might have partly escaped the immunity provided by the seasonal booster targeting the original and Omicron BA.4-5 strains of SARS-CoV-2.

Investigating Health and Well-Being Challenges Faced by an Aging Workforce in the Construction and Nursing Industries: Computational Linguistic Analysis of Twitter Data.

BACKGROUND: Construction and nursing are critical industries. Although both careers involve physically and mentally demanding work, the risks to workers during the COVID-19 pandemic are not well understood. Nurses (both younger and older) are more likely to experience the ill effects of burnout and stress than construction workers, likely due to accelerated work demands and increased pressure on nurses during the COVID-19 pandemic. In this study, we analyzed a large social media data set using advanced natural language processing techniques to explore indicators of the mental status of workers across both industries before and during the COVID-19 pandemic. OBJECTIVE: This social media analysis aims to fill a knowledge gap by comparing the tweets of younger and older construction workers and nurses to obtain insights into any potential risks to their mental health due to work health and safety issues. METHODS: We analyzed 1,505,638 tweets published on Twitter (subsequently rebranded as X) by younger and older (aged <45 vs >45 years) construction workers and nurses. The study period spanned 54 months, from January 2018 to June 2022, which equates to approximately 27 months before and 27 months after the World Health Organization declared COVID-19 a global pandemic on March 11, 2020. The tweets were analyzed using big data analytics and computational linguistic analyses. RESULTS: Text analyses revealed that nurses made greater use of hashtags and keywords (both monograms and bigrams) associated with burnout, health issues, and mental health compared to construction workers. The COVID-19 pandemic had a pronounced effect on nurses' tweets, and this was especially noticeable in younger nurses. Tweets about health and well-being contained more first-person singular pronouns and affect words, and health-related tweets contained more affect words. Sentiment analyses revealed that, overall, nurses had a higher proportion of positive sentiment in their tweets than construction workers. However, this changed markedly during the COVID-19 pandemic. Since early 2020, sentiment switched, and negative sentiment dominated the tweets of nurses. No such crossover was observed in the tweets of construction workers. CONCLUSIONS: The social media analysis revealed that younger nurses had language use patterns consistent with someone experiencing the ill effects of burnout and stress. Older construction workers had more negative sentiments than younger workers, who were more focused on communicating about social and recreational activities rather than work matters. More broadly, these findings demonstrate the utility of large data sets enabled by social media to understand the well-being of target populations, especially during times of rapid societal change.

COVID-19 vaccine confidence, concerns, and uptake in children aged 5 and older in Calgary, Alberta: a longitudinal cohort study.

Objectives: Beginning early in the pandemic, there was a worldwide effort to develop effective vaccines against the SARS-CoV-2 virus. Before and after the approval and implementation of vaccines, there were concerns about their need as well as their safety and rapid development. We explored child demographic characteristics and parental concerns to identify factors associated with the decision to vaccinate. Methods: A cohort of 1035 children from Calgary was assembled in 2020 to participate in 5 visits every 6 months for survey completion and blood sampling for SARS-CoV-2 antibodies. Visits 1 to 2 occurred before approval of vaccines for children; Visits 3 to 5 occurred after vaccine approval for different age groups. We described vaccine concerns and utilized logistic regression to examine factors associated with the decision to vaccinate in children ≥5 years of age. Results: Children ≥12 years of age, of non-white or non-black ethnicity, and who had received previous influenza vaccines had higher odds of being vaccinated against SARS-CoV-2. Children with previous SARS-CoV-2 infection had lower odds of being vaccinated. The most common concerns in early 2021 were about vaccine safety. By summer 2022, the most common concern was a belief that vaccines were not necessary. Through the study 88% of children were vaccinated. Conclusions: Age, ethnicity, previous infections, and vaccine attitudes were associated with parental decision to vaccinate against SARS-CoV-2. For children who remained unvaccinated, parents continued to have safety concerns and questioned the necessity of the vaccine. Complacency about the need for vaccination may be more challenging to address and overcome than concerns about safety alone.

Quality Assurance and Prevention of COVID-19 Before Admission in Geriatric Rehabilitation Unit in Long-Term Care Facilities.

Background: This quality assurance study was conducted during the COVID-19 pandemic to describe the profile of patients aged 65 years and older admitted to a transition unit in a long-term care (LTC) facility and to evaluate the impact of admission modalities, compliance with screening and hand hygiene practices, risk of COVID-19, and time to access a geriatric rehabilitation unit (GRU). Methods: A prospective study was conducted using administrative and medical records from three Montreal public LTC facilities offering a rehabilitation program for 312 patients admitted between May 2020 and February 2021. The results are reported for the entire sample and compared according to the mode of admission. Results: The incidence of COVID-19 during the transition unit stay was estimated to be 11 cases or 3.5% in 14 days. Assessment of screening compliance showed deficiencies for 41.3% of patients, and the frequency of hand hygiene audits was not strictly adhered to. More COVID-19 cases were recorded in patients admitted to the transition unit by bed availability than in the cohort mode. The time to access a rehabilitation unit was 7.2 days or 23.5% shorter for patients admitted by bed availability. Conclusions: The study, conducted from a continuous practice improvement perspective, showed that the implementation of a transition unit in the LTC facilities helped control the transmission of COVID-19, but also revealed flaws in screening and hand hygiene practices.

Association between yoga and related contextual factors with moderate-to-vigorous physical activity among children and youth aged 5 to 17 years across five Indian states.

Physical inactivity is one of the four key preventable risk factors, along with unhealthy diet, tobacco use, and alcohol consumption, underlying most noncommunicable diseases. Promoting physical activity is particularly important among children and youth, whose active living behaviours often track into adulthood. Incorporating yoga, an ancient practice that originated in India, can be a culturally-appropriate strategy to promote physical activity in India. However, there is little evidence on whether yoga practice is associated with moderate-to-vigorous physical activity (MVPA) accumulation. Thus, this study aims to understand how yoga practice is associated with MVPA among children and youth in India. Data for this study were obtained during the coronavirus disease lockdown in 2021. Online surveys capturing MVPA, yoga practice, contextual factors, and sociodemographic characteristics, were completed by 5 to 17-year-old children and youth in partnership with 41 schools across 28 urban and rural locations in five states. Linear regression analyses were conducted to assess the association between yoga practice and MVPA. After controlling for age, gender, and location, yoga practice was significantly associated with MVPA among children and youth (ß = 0.634, p < 0.000). These findings highlight the value of culturally-appropriate activities such as yoga, to promote physical activity among children and youth. Yoga practice might have a particularly positive impact on physical activity among children and youth across the world, owing to its growing global prevalence.

COVID-19 outbreaks in residential aged care facilities: an agent-based modeling study.

Introduction: A disproportionate number of COVID-19 deaths occur in Residential Aged Care Facilities (RACFs), where better evidence is needed to target COVID-19 interventions to prevent mortality. This study used an agent-based model to assess the role of community prevalence, vaccination strategies, and non-pharmaceutical interventions (NPIs) on COVID-19 outcomes in RACFs in Victoria, Australia. Methods: The model simulated outbreaks in RACFs over time, and was calibrated to distributions for outbreak size, outbreak duration, and case fatality rate in Victorian RACFs over 2022. The number of incursions to RACFs per day were estimated to fit total deaths and diagnoses over time and community prevalence.Total infections, diagnoses, and deaths in RACFs were estimated over July 2023-June 2024 under scenarios of different: community epidemic wave assumptions (magnitude and frequency); RACF vaccination strategies (6-monthly, 12-monthly, no further vaccines); additional non-pharmaceutical interventions (10, 25, 50% efficacy); and reduction in incursions (30% or 60%). Results: Total RACF outcomes were proportional to cumulative community infections and incursion rates, suggesting potential for strategic visitation/staff policies or community-based interventions to reduce deaths. Recency of vaccination when epidemic waves occurred was critical; compared with 6-monthly boosters, 12-monthly boosters had approximately 1.2 times more deaths and no further boosters had approximately 1.6 times more deaths over July 2023-June 2024. Additional NPIs, even with only 10-25% efficacy, could lead to a 13-31% reduction in deaths in RACFs. Conclusion: Future community epidemic wave patterns are unknown but will be major drivers of outcomes in RACFs. Maintaining high coverage of recent vaccination, minimizing incursions, and increasing NPIs can have a major impact on cumulative infections and deaths.

Disparities in access to Dolutegravir in West African children, adolescents and young adults aged 0-24 years living with HIV. A IeDEA Pediatric West African cohort analysis.

Introduction: We describe the 24-month incidence of Dolutegravir (DTG)-containing antiretroviral treatment (ART) initiation since its introduction in 2019 in the pediatric West African IeDEA cohorts. Methods: We included all patients aged 0-24 years on ART, from nine clinics in Côte d'Ivoire (n=4), Ghana, Nigeria, Mali, Benin, and Burkina Faso. Baseline varied by clinic and was defined as date of first DTG prescription; patients were followed-up until database closure/death/loss to follow-up (LTFU, no visit ≥ 7 months), whichever came first. We computed the cumulative incidence function for DTG initiation; associated factors were explored in a shared frailty model, accounting for clinic heterogeneity. Results: Since 2019, 3,350 patients were included; 49% were female;79% had been on ART ≥ 12 months. Median baseline age was 12.9 years (IQR: 9-17). Median follow-up was 14 months (IQR: 7-22). The overall cumulative incidence of DTG initiation reached 35.5% (95% CI: 33.7-37.2) and 56.4% (95% CI: 54.4-58.4) at 12 and 24 months, respectively. In univariate analyses, those aged <5 years and females were overall less likely to switch. Adjusted on ART line and available viral load (VL) at baseline, females >10 years were less likely to initiate DTG compared to males of the same age (aHR among 10-14 years: 0.62, 95% CI: 0.54-0.72; among ≥15 years: 0.43, 95% CI: 0.36-0.50), as were those with detectable VL (> 50 copies/mL) compared to those in viral suppression (aHR: 0.86, 95% CI: 0.77-0.97) and those on PIs compared to those on NNRTIs (aHR after 12 months of roll-out: 0.75, 95% CI: 0.65-0.86). Conclusion: Access to paediatric DTG was incomplete and unequitable in West African settings: children <5years, females ≥ 10 years and those with detectable viral load were least likely to access DTG. Maintained monitoring and support of treatment practices is required to better ensure universal and equal access. Key messages: What is already known on this topic?: Dolutegravir (DTG)-based ART regimens are recommended as the preferred first-line ART regimens recommended by the World Health Organisation in all people living with HIV since 2018, with a note of caution for pregnant women, then confirmed in all children with approved DTG dosing and adolescents since 2019.Deployment of universal DTG access in adults in West Africa has faced challenges such as infrastructure challenges, and healthcare system disparities, and was hindered by initial perinatal safety concerns affecting greatly women of childbearing age.Specific data on access to DTG in children, adolescents and young adults in West Africa is limited.What this study adds ?: This study describes the dynamic of the DTG roll-out over the first 24 months and its correlates since 2019 in a large West African multicentric cohort of children, adolescents and youth.We observed a rapid scale-up of DTG among children, adolescents and young adults living with HIV in West Africa, despite the COVID-19 pandemic.However, DTG access after 24 months was incomplete and unequitable, with adolescent girls and young women being less likely to initiate DTG compared to males, as were those with a detectable viral load (> 50 copies/mL) compared to those in success.Younger children < 5 years were also less likely to initiate DTG, explained by the later approval of paediatric formulations and their low availability.How this study might affect research, practice or policy?: Maintained monitoring, training and updating guidance for healthcare workers is essential to ensure universal access to DTG, especially for females, for whom inequity begins age 10 years.Efforts to improve access to universal DTG in West Africa require multifaceted interventions including healthcare infrastructure improvement and facilitation of paediatric antiretroviral forecasting and planification.

Effectiveness of nirmatrelvir/ritonavir in children and adolescents aged 12-17 years following SARS-CoV-2 Omicron infection: A target trial emulation.

Currently there is a lack of randomized trial data examining the use of the antiviral nirmatrelvir/ritonavir in paediatric patients with SARS-CoV-2 infection. This target trial emulation study aims to address this gap by evaluating the use of nirmatrelvir/ritonavir in non-hospitalized paediatric patients aged 12-17 years with SARS-CoV-2 Omicron variant infection. Among paediatric patients diagnosed between 16th March 2022 and 5th February 2023, exposure was defined as outpatient nirmatrelvir/ritonavir treatment within 5 days of symptom onset or COVID-19 diagnosis. Primary outcome was 28 day all-cause mortality or all-cause hospitalization, while secondary outcomes were 28 day in-hospital disease progression, 28 day COVID-19-specific hospitalization, multisystem inflammatory syndrome in children (MIS-C), acute liver injury, acute renal failure, and acute respiratory distress syndrome. Overall, 49,378 eligible paediatric patients were included. Nirmatrelvir/ritonavir treatment was associated with reduced 28 day all-cause hospitalization (absolute risk reduction = 0.23%, 95%CI = 0.19%-0.31%; relative risk = 0.66, 95%CI = 0.56-0.71). No events of mortality, in-hospital disease progression, or adverse clinical outcomes were observed among nirmatrelvir/ritonavir users. The findings confirmed the effectiveness of nirmatrelvir/ritonavir in reducing all-cause hospitalization risk among non-hospitalized pediatric patients with SARS-CoV-2 Omicron variant infection.

The Benefits of Technology for Engaging Aging Adults: Findings From the PRISM 2.0 Trial.

Background and Objectives: Technology has potential for providing support for aging adults. This study evaluated the Personal Reminder Information and Social Management 2.0 (PRISM 2.0) software, in terms of enhancing social engagement and quality of life, and decreasing loneliness among older adults. Research Design and Methods: The randomized field trial conducted in diverse living contexts (rural locations, senior housing, and assisted living communities [ALC]). Two hundred and forty-five adults, aged 64 to 99 years, were randomly assigned to the PRISM 2.0 (integrated software system designed for aging through an iterative design process) or a Standard Tablet (without PRISM) Control condition, where participants received the same amount of contact and training as those in the PRISM 2.0 condition. Primary outcomes included measures of loneliness, social support, social connectedness, and quality of life. Secondary outcomes included measures of social isolation, mobile device proficiency, and technology readiness. Data were collected at baseline and 6 and 9 months postrandomization. This article focuses on the 6-month outcomes due to coronavirus disease 2019-related data challenges at 9 months. Results: Contrary to our hypothesis, participants in rural locations and senior housing in both conditions reported less loneliness and social isolation, and greater social support and quality of life at 6 months, and an increase in mobile device proficiency. Participants in the ALCs in both conditions also evidenced an increase in mobile device proficiency. Improvements in quality of life and health-related quality of life were associated with decreases in loneliness. Discussion and Implications: This study provides compelling evidence about the benefits of technology for older adults in terms of enhancing social outcomes and quality of life. However, the findings also underscore that for technology applications to be successful, they need to be adapted to the abilities and needs of the user group and instructional support needs to be provided. Clinical Trials Registration #: NCT03116399.

Long-term outcomes of older adults with acute COVID-19 following inpatient geriatric rehabilitation: a prospective cohort study from the Republic of Ireland.

BACKGROUND: There is a paucity of research reporting the long-term outcomes of older adults who have completed geriatric rehabilitation following COVID-19. AIM: The primary aim of this study is to describe the long-term functional outcomes of a cohort of older adults with acute COVID-19 who have completed inpatient geriatric rehabilitation. METHODS: This is a subgroup analysis of Irish data from a pan-European prospective cohort study. Functional ability, patient reported symptoms, and quality of life were measured using the Barthel index, the COVID-19 Yorkshire Rehabilitation Screen, and the EQ-5D-5L, respectively. RESULTS: Thirty patients enrolled in the study. The rate of mortality was 23.3% at 6 months after discharge from rehabilitation. Patients achieved a return to pre-admission functional ability but reported a significant increase in patient reported symptoms and their quality of life did not return to pre-admission levels when assessed at 6 months after discharge from rehabilitation. CONCLUSIONS: Multidisciplinary rehabilitation for older adults with acute COVID-19 infection can assist patients to return to their premorbid functional ability. On discharge from rehabilitation, ongoing follow-up of older adults is recommended to assist them to negotiate and manage ongoing symptomatology such as breathlessness or fatigue.

Comparison of death anxiety symptoms between generalized anxiety disorder and somatization disorder in geriatric patients attending a psychiatric outpatient clinic for the first time.

Somatic complaints are among the important complaints frequently seen in Generalized Anxiety Disorder (GAD) and Somatic Symptom Disorder (SSD). Death anxiety has also increased significantly with the Covid-19 pandemic, especially in the elderly population. In this study, we compared the difference of the death anxiety level among patients with GAD, SSD and healthy controls. This cross-sectional study which was carried out in Artvin State Hospital's Psychiatric Outpatient Clinic included 59 participants (GAD = 21, SSD = 18, HC = 20). Three groups were subjected to detailed psychiatric examination by the same psychiatrist. Subsequently, anxiety, somatic symptoms and death anxiety were assessed using standardized tools (GAD-7, Templer Death Anxiety Scale, Somatic Symptom Scale). The GAD-7 Scale mean of the GAD group was significantly higher than SSD (p = 0.001) and Healthy Control (HC) (p = 0.001) groups. Death anxiety and Somatic Symptom levels in GAD and SSD groups were significantly higher than in healthy controls. (GAD, p = 0.001; SSD, p = 0.001) with no significant difference between GAD and SSD groups (p = 1). Healthy controls exhibited significantly lower scores in the three scales mean scores compared to the SSD and GAD groups (p = 0.001). Irrespective of specific psychiatric diagnoses, these findings highlight elevated death anxiety in the elderly, underscoring the need for tailored mental health interventions.

The safety, immunogenicity, and efficacy of heterologous boosting with a SARS-CoV-2 mRNA vaccine (SYS6006) in Chinese participants aged 18 years or more: a randomized, open-label, active-controlled phase 3 trial.

Continuous emergence of new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), enhanced transmissibility, significant immune escape, and waning immunity call for booster vaccination. We evaluated the safety, immunogenicity, and efficacy of heterologous booster with a SARS-CoV-2 mRNA vaccine SYS6006 versus an active control vaccine in a randomized, open-label, active-controlled phase 3 trial in healthy adults aged 18 years or more who had received two or three doses of SARS-CoV-2 inactivated vaccine in China. The trial started in December 2022 and lasted for 6 months. The participants were randomized (overall ratio: 3:1) to receive one dose of SYS6006 (N = 2999) or an ancestral receptor binding region-based, alum-adjuvanted recombinant protein SARS-CoV-2 vaccine (N = 1000), including 520 participants in an immunogenicity subgroup. SYS6006 boosting showed good safety profiles with most AEs being grade 1 or 2, and induced robust wild-type and Omicron BA.5 neutralizing antibody response on Days 14 and 28, demonstrating immunogenicity superiority versus the control vaccine and meeting the primary objective. The relative vaccine efficacy against COVID-19 of any severity was 51.6% (95% CI, 35.5-63.7) for any variant, 66.8% (48.6-78.5) for BA.5, and 37.7% (2.4-60.3) for XBB, from Day 7 through Month 6. In the vaccinated and infected hybrid immune participants, the relative vaccine efficacy was 68.4% (31.1-85.5) against COVID-19 of any severity caused by a second infection. All COVID-19 cases were mild. SYS6006 heterologous boosting demonstrated good safety, superior immunogenicity and high efficacy against BA.5-associated COVID-19, and protected against XBB-associated COVID-19, particularly in the hybrid immune population.Trial registration: Chinese Clinical Trial Registry: ChiCTR2200066941.

The relationship between comprehensive geriatric assessment on the pneumonia prognosis of older adults: a cross-sectional study.

BACKGROUND: The mortality of pneumonia in older adults surpasses that of other populations, especially with the prevalence of coronavirus disease 2019 (COVID-19). Under the influence of multiple factors, a series of geriatric syndromes brought on by age is one of the main reasons for the poor prognosis of pneumonia. This study attempts to analyze the impact of geriatric syndrome on the prognosis of pneumonia. METHODS: This is a prospective cross-sectional study. Patients over 65 years old with COVID-19 and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative community-acquired pneumonia (SN-CAP) were included in the research. General characteristics, laboratory tests, length of stay (LOS), and comprehensive geriatric assessment (CGA) were collected. Multivariate regression analysis to determine the independent predictors of the severity, mortality, and LOS of COVID-19. At the same time, the enrolled subjects were divided into three categories by clustering analysis of 10 CGA indicators, and their clinical characteristics and prognoses were analyzed. RESULTS: A total of 792 subjects were included in the study, including 204 subjects of SN-CAP (25.8%) and 588 subjects (74.2%) of COVID-19. There was no significant difference between non-severe COVID-19 and SN-CAP regarding mortality, LOS, and CGA (P > 0.05), while severe COVID-19 is significantly higher than both (P < 0.05). The Barthel Index used to assess the activities of daily living was an independent risk factor for the severity and mortality of COVID-19 and linearly correlated with the LOS (P < 0.05). The cluster analysis based on the CGA indicators divided the geriatric pneumonia patients into three groups: Cluster 1 (n = 276), named low ability group, with the worst CGA, laboratory tests, severity, mortality, and LOS; Cluster 3 (n = 228), called high ability group with the best above indicators; Cluster 2 (n = 288), named medium ability group, falls between the two. CONCLUSION: The Barthel Index indicates that decreased activities of daily living are an independent risk factor for the severity, mortality, and LOS of geriatric COVID-19. Geriatric syndrome can help judge the prognosis of pneumonia in older adults.

Intervenciones para adultos con dependencia funcional y sus cuidadores durante la pandemia de COVID-19 / Interventions for functionally dependent adults and their caregivers during the COVID-19 pandemic

La pandemia de COVID-19 ha afectado a la población, perjudicando especialmente a los miembros de aquellos grupos sociales en situación de mayor vulnerabilidad. Estas poblaciones específicas, como aquellas con alguna dependencia funcional, podrían verse más afectadas por los efectos de la pandemia del COVID-19. Por lo tanto, el objetivo de este artículo fue describir las intervenciones para preservar la salud general, mantener la función y la independencia y prevenir la infección por COVID-19 para los adultos con dependencia funcional (ADF). Se realizó una búsqueda sistemática en bases de datos. Se revisaron los títulos y los resúmenes de cada publicación para determinar su relevancia. Dos revisores independientes accedieron a los artículos de texto completo para determinar su elegibilidad después de la selección inicial. Las búsquedas se realizaron en septiembre de 2021 y se actualizaron en enero y julio de 2022. La información encontrada se clasificó en 3 categorías: 1) ADF durante la pandemia de COVID-19; 2) ADF durante la pandemia de COVID-19 según una condición específica (condiciones neurológicas, discapacidades/deficiencias sensoriales y deterioro cognitivo), y 3) Adultos mayores con dependencia funcional. Los adultos con dependencia enfrentaron dificultades y barreras durante la pandemia por COVID-19. Las autoridades de cada país deben garantizar que los ADF tengan acceso a los servicios de rehabilitación en tiempos de crisis sanitaria. Además, es necesario aumentar la capacidad de los servicios de rehabilitación en tiempos de crisis como pandemias. De igual manera, se sugiere el fortalecimiento de estrategias como la telerehabilitación para evitar el deterioro o agravamiento de la funcionalidad de las personas dependientes. (AU)

The COVID-19 pandemic has affected the world population, especially people from social groups in a situation of greater vulnerability among people with some functional dependency. Therefore, the aim of this review was to describe interventions during the pandemic to preserve general health, maintain function and independence, and prevent COVID-19 infection for functionally dependent adults (FDA). A systematic search in databases was carried out. Titles and abstracts of each publication were reviewed for relevance. Full-text articles were accessed by two independent reviewers. The information found was classified into three categories: 1) FDA during the COVID-19 pandemic, 2) FDA during the COVID-19 pandemic according to a specific condition (neurological conditions, sensory disabilities/impairments, and cognitive impairment), and 3) Older adults with functional dependence. The FDAs have faced difficulties and barriers during the COVID-19 pandemic. Strengthening strategies such as telerehabilitation is suggested to avoid deterioration or aggravation of the functionality of dependent people. (AU)

Determinants of default from completion of child immunization among children aged 15-23 months in Kacha Bira district, Kembata Tembaro zone, South Ethiopia: a case-control study.

Background: Child immunization is crucial to protect children from vaccine-preventable diseases. However, if a child defaults from completing immunization, they are at a greater risk of contracting such diseases. Previous studies have evaluated various factors that contribute to defaulting from immunization, but they did not consider the fear of COVID-19 as a variable. Additionally, there is inconsistency in the factors identified across different areas. This study aimed to examine the determinants of defaulting from child immunization among children aged 15-23 months in Kacha Bira district, Kembata Tembaro zone, South Ethiopia. Methods: A study was conducted using a community-based unmatched case-control design to identify the determinants of child immunization completion. The study included 255 children aged 15-23 months in the Kacha Bira district from 3 May 2022 to 1 June 2022, using a multi-stage sampling technique. Face-to-face interviews of mothers or immediate caretakers of the child were conducted using a mobile device, and the questionnaire was developed using the Kobo Toolbox. The data collected were analyzed using SPSS version 25. Multivariable logistic regression was used to identify the determinants, and the adjusted odds ratio with 95% CI and a p < 0.05 were considered statistical significant. Results: The multivariable logistic regression analysis identified four independent predictors of immunization defaulting. Antenatal care (ANC) follow-up [AOR = 5.40, 95% CI (2.24-13.52)], postponing vaccination schedule [AOR = 2.28, 95% CI: (1.05-4.93)], parity of the mother [AOR = 3.25, 95% CI: (1.45-7.27)], and knowledge of the mother about vaccination [AOR = 6.77, 95% CI: (2.33-19.64)] were determinants of immunization defaulting. Conclusion: In this study, lack of ANC follow-up, postponement of the vaccination schedule, mothers with parity of greater than four, and poor knowledge of the mothers about immunization were identified as determinants of immunization defaulting.

Understanding the experiences of PHC nurses in caring for older patients in the post-fifth wave of the COVID-19 pandemic: an exploratory qualitative study.

Objective: To ensure the best possible care, the perspective of PHC nurse work experience during the COVID-19 pandemic should be considered when developing nursing care protocols for older patients who receive PHC services. Method: This exploratory qualitative study was conducted with 18 nurses working continuously in PHC between the first and fifth waves of the pandemic. Semi-structured thematic interviews were undertaken. Qualitative thematic content analysis was conducted to identify and group the themes that emerged from the discourse. Interviews were transcribed and analyzed using thematic analysis. Results: The first topic describes the nurses' experiences of physical and mental suffering in caring for older patients in response to the pandemic. The second topic covers the experience of reorganizing PHC work. The third topic focuses on the difficulties of caring for older patients. The final topic includes issues of support needs for nurses in PHC work. Conclusion: The experience and understanding of PHC nurses in caring for older people during the COVID pandemic should lead to significant changes in the system of nursing care for geriatric patients and in the cooperative role within geriatric care specialist teams. Drawing on the experience of COVID-19, it is necessary to work on the weak points of PHC exposed by the pandemic in order to improve the quality of care and life for geriatric patients.

Association between combination COVID-19-influenza vaccination and long COVID in middle-aged and older Europeans: A cross-sectional study.

The potential impact of combined COVID-19 and influenza vaccination on long COVID remains uncertain. In the present cross-sectional study, we aimed to investigate the plausible association between them in middle-aged and older Europeans based on the Survey of Health, Ageing, and Retirement in Europe (SHARE). A total of 1910 participants were recruited in the analyses. The study outcome was long COVID. Participants were divided into 4 groups through the self-reported status of COVID-19 and influenza vaccination. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. 1397 participants experienced long COVID. After multivariable adjustment, those vaccinated with neither COVID-19 nor influenza vaccine had higher risk of long COVID (OR, 1.72; 95% CI, 1.26-2.35) compared to those vaccinated with both vaccines. Furthermore, adding the 4 statuses of COVID-19 vaccination/influenza vaccination to conventional risk model improved risk reclassification for long COVID (continuous net reclassification improvement was 16.26% [p = .003], and integrated discrimination improvement was 0.51% [p = .005]). No heterogeneity was found in the subgroup analyses (all p-interaction ≥0.05). Our study might provide a strategy for people aged 50 and over to reduce the occurrence of long COVID, that is, to combine the use of the COVID-19 vaccine and influenza vaccines.