Revisiting longitudinal qualitative studies in social work: considerations for design and methodological insights.

This paper undertakes an analysis and discussion of the methodological challenges and insights derived from three longitudinal qualitative studies, all conducted in Chile during the COVID-19 pandemic and subject to comprehensive theoretical-methodological reflection processes centred on their respective designs. This analysis makes a significant contribution to interdisciplinary discussions within social research, with a particular emphasis on longitudinal trajectories. First, we present a comparative analysis of three studies in social work, utilising Saldaña's questions addressing changes and learning in longitudinal studies. The first study explores the labour trajectories of researchers, the second focuses on the educational trajectories of students, and the last examines therapeutic alliance trajectories between social workers and families within the child protection system. Following this, we delve into the methodological decisions made by the research group during the execution of these longitudinal studies. This encompasses an examination of participant involvement, temporal definitions of the adopted designs, and the most suitable methodological tools for analysing change processes over time. The outcomes of this comparative analysis reveal the distinctive characteristics of the three longitudinal studies, providing insights into how the time dimension is explored within them. We highlight key criteria essential for consideration in longitudinal qualitative research, particularly regarding participants and methodology. In conclusion, we advocate for an expanded reflection within the realm of longitudinal qualitative methodology, encompassing aspects such as design choices, approaches to data analysis, integration of technology in information processing, and strategies for maintaining participant engagement.

Socio-economic differences in remote schoolwork during the COVID-19 pandemic: a trend analysis of the 2020 and 2021 school-closure periods using the UK Understanding Society data.

In the United Kingdom, the COVID-19 pandemic in 2020 and 2021 led to two extended periods of school closures. Research on inequality of learning opportunity as a result of these closures used a single indicator of socio-economic status, neglecting important determinants of remote learning. Using data from the Understanding Society (USoc) COVID-19 surveys we analysed the levels and differentials in the uptake of remote schoolwork using parental social class, information technology (IT) availability in the home and parental working patterns to capture the distinct resources that families needed to complete remote schoolwork. This is also the first study to assess the extent to which the differentials between socio-economic groups changed between the first and second school-closure periods caused by the pandemic. We found that each of the three factors showed an independent association with the volume of remote schoolwork and that their effect was magnified by their combination. Children in families where the main parent was in an upper-class occupation, where both parents worked from home and where the children had their own IT spent more time doing remote schoolwork than other groups, particularly compared to children of single parents who work from home, children in families where the main parent was in a working-class occupation, where the child had to share IT, and where the parents did not work regularly from home. The differentials between socio-economic groups in the uptake of schoolwork were found to be stable between the two school-closure periods.

Nursing students' engagement in online learning.

Reliance on digital technology may have implications for our social and economic wellbeing, including factors such as health, environmental quality, social interaction, and educational levels. Although there may be concerns, it is important to acknowledge that digital technology also offers immediate, cost-effective and accessible solutions that are transforming various services. The COVID-19 pandemic, through the disruption of educational systems worldwide, has accelerated the transformation of higher education, leading to changes in the way it is perceived. However, there is a lack of understanding regarding the relationship between digital poverty, digital literacy, and students' online experiences. This article aims to explore the engagement of nursing students in online learning post COVID.

[Research progress on the impact of public health and social measures on influenza during the COVID-19 pandemic].

Public health and social measures (PHSMs) are one of the most important measures in the prevention and control of COVID-19 and have also been effective in suppressing the spread of influenza viruses, but their effectiveness has not been fully investigated. This study aimed to review the progress of research on the impact of PHSMs on influenza during the COVID-19 pandemic based on the latest evidence of the effectiveness of various PHSMs in controlling transmission of influenza viruses, to provide scientific evidence for optimizing influenza prevention and control strategies.

[Clinical characteristics of acute macular neuroretinopathy in China associated with COVID-19 infection].

Objective: To investigate the clinical features of acute macular neuroretinopathy (AMN) following coronavirus disease 2019 (COVID-19). Methods: This retrospective case series study included 15 patients (28 eyes) diagnosed with AMN at the Department of Ophthalmology, Peking University Third Hospital, from November 2022 to January 2023. The AMN group comprised 4 males and 11 females, with a mean age of (31.36±8.08) years. A control group of 15 individuals [5 males, 10 females; mean age (33.20±5.10) years] who had COVID-19 but did not develop AMN was also included. Data collected for all patients included best-corrected visual acuity (BCVA), slit-lamp examination, dilated fundus examination, color fundus photography, fluorescein fundus angiography (FFA), and optical coherence tomography (OCT) results. Serum cytokine levels, including interleukins (ILs), interferons (IFNs), and tumor necrosis factor-alpha (TNF-α), were measured for both groups. Results: Among the 28 eyes, severe vision loss (BCVA≤0.3) was observed in 3 eyes (10.7%), moderate vision loss (BCVA>0.3 and≤0.5) in 2 eyes (13.3%), and mild vision loss (BCVA>0.5 and≤1.0) in 23 eyes (82.1%). OCT findings in all 28 eyes revealed hyperreflectivity of the outer nuclear layer and disruption of outer retinal structure. Additionally, 3 eyes (10.7%) exhibited cotton wool spots in the posterior pole, 2 eyes (7.1%) showed mild cystoid macular edema with intraretinal hyperreflective dots, and 1 eye (3.6%) presented with paracentral acute middle maculopathy. FFA indicated retinal vasculitis in 2 cases (4 eyes, 14.3%). Serum levels of IL-4, IL-5, IFN-α, and IFN-γ were significantly higher in the AMN group compared to the control group: IL-4 [4.49 (3.66, 6.08) vs. 1.40 (0.62, 1.68) pg/ml], IL-5 [7.34 (5.04, 14.06) vs. 0.17 (0.11, 1.86) pg/ml], IFN-α [8.42 (6.31, 14.89) vs. 0.50 (0.30, 0.83) pg/ml], and IFN-γ [17.93 (12.75, 32.44) vs. 7.43 (0.00, 14.74) pg/ml], with all differences being statistically significant (all P<0.05). Conclusion: AMN following COVID-19 can present with wedge-shaped dark red lesions in the macular area, often accompanied by cotton wool spots and retinal vasculitis. Additionally, there is a significant elevation in various inflammatory cytokines in the serum.

Prevalence of depressive and anxiety symptoms and perceived stress in hospitalised patients with COVID-19.

BACKGROUND: COVID-19 infection is associated with significant depressive and anxiety symptoms and stress. We examined the prevalences of depressive and anxiety symptoms and perceived stress among patients with COVID-19. METHODS: Clinically stable patients with COVID-19 aged 18 to 60 years who were admitted between April 2021 and September 2021 to the MES Medical College in Kerala, India were prospectively recruited. They were assessed using the Montgomery-Asberg Depression Rating Scale, the Hamilton Anxiety Scale, and the Perceived Stress Scale. RESULTS: Of 112 patients screened, 103 were included in the analysis. Depression scores were higher in patients of lower socio-economic status (p = 0.04), of unemployed (p = 0.01), and with longer hospital stays (p < 0.001). Anxiety scores were higher in patients aged 31 to 40 years (p = 0.04), of lower socio-economic status (p = 0.01), with a history of psychiatric illness (p = 0.006), and with a history of self-harm (p = 0.019). Perceived stress scores were higher in patients of lower socio-economic status (p = 0.02), with a history of psychiatric illness (p = 0.001), and with a history of self-harm (p = 0.022). CONCLUSION: Socio-economic status, employment status, a history of psychiatric illness, and duration of hospital stay are associated with depression, anxiety, and stress among patients with COVID-19.

Patients with schizophrenia in Morocco during the COVID-19 pandemic: a longitudinal observational study.

BACKGROUND: During the COVID-19 pandemic, social-distancing and confinement measures were implemented. These may affect the mental health of patients with mental disorders such as schizophrenia. This study examined the clinical course of patients with schizophrenia at a public hospital in Morocco during the COVID-19 pandemic. METHODS: This longitudinal observational study was conducted across three periods in 15 months: 1 April 2020 (start of strict home confinement) to 30 June 2020 (T1), 1 July 2020 to 31 January 2021 (corresponding to the Delta wave) [T2], and 1 February 2021 to 30 June 2021 (corresponding to the Omicron wave) [T3]. Patients aged 18 to 65 years with a diagnosis of schizophrenia or schizoaffective disorder (based on DSM 5) made before the pandemic who presented to the Faculty of Medicine and Pharmacy of Rabat were invited to participate. Psychotic symptomatology was evaluated using the Positive and Negative Syndrome Scale (PANSS). Severity and improvement of mental disorder were evaluated using the Clinical Global Impression (CGI)-Severity and -Improvement subscales. Depressive symptoms were assessed using the Calgary Depression Scale (CDS). Adherence to treatments was assessed using the Medication Adherence Rating Scale (MARS). All assessments were made by psychiatrists or residents face-to-face (for T1) or via telephone (for T2 and T3). RESULTS: Of 146 patients recruited, 83 men and 19 women (mean age, 39 years) completed all three assessments. The CGI-Severity score was higher at T2 than T1 and T3 (3.24 vs 3.04 vs 3.08, p = 0.041), and the MARS score was higher at T1 and T2 than T3 (6.80 vs 6.83 vs 6.35, p = 0.033). Patient age was negatively correlated with CDS scores for depressive symptoms at T1 (Spearman's rho = -0.239, p = 0.016) and at T2 (Spearman's rho = -0.231, p = 0.019). The MARS score for adherence was higher in female than male patients at T1 (p = 0.809), T2 (p = 0.353), and T3 (p = 0.004). Daily tobacco consumption was associated with the PANSS total score at T3 (p = 0.005), the CGI-Severity score at T3 (p = 0.021), and the MARS score at T3 (p = 0.002). Patients with a history of attempted suicide had higher CDS scores than those without such a history at T1 (p = 0.015) and T3 (p = 0.018) but not at T2 (p = 0.346). CONCLUSION: Home confinement during the COVID-19 pandemic had limited negative impact on the mental health of patients with schizophrenia in Morocco.

Democracy, citizenship and health in Brazil: challenges to strengthening the Unified Health System (SUS). / Democracia, cidadania e saúde no Brasil: desafios para o fortalecimento do Sistema Único de Saúde (SUS).

Relations among democracy, citizenship and health have shaped the Unified Health System (SUS) over the past four decades. Until 2016, democracy was strengthened and social rights extended, despite structural difficulties, conflicts between projects, and unevenly over time. The SUS has allowed advances in access and improvements to health conditions. Between 2016 and 2022, there were significant reversals in economic, social, and health policies. Since 2020, the situation has been aggravated by the multidimensional crisis associated with the COVID-19 pandemic. The work of the SUS, universities and public scientific institutions was fundamental in tackling the crisis. From 2023 onwards, Brazil has faced enormous challenges in restoring a democratic national project focused on social welfare. Strengthening the SUS depends on the character of social policies and democracy, and on transforming relations among State, market and society, to overcome constraints that have persisted even during progressive governments. The SUS, a universal policy rooted in a broad concept of health and democratic values, is fundamental to establishing a pattern of development aimed at reducing inequalities and building a more just society.

As relações entre democracia, cidadania e saúde permearam a conformação e a trajetória do Sistema Único de Saúde (SUS) nas últimas quatro décadas. Em que pesem dificuldades estruturais, conflitos entre projetos e diferenças entre momentos, até 2016 observou-se o fortalecimento da democracia e a expansão de direitos sociais. O SUS permitiu avanços no acesso e melhorias nas condições de saúde. Entre 2016 e 2022, os retrocessos nas políticas econômicas, sociais e de saúde foram expressivos. A situação foi agravada pela crise multidimensional associada à pandemia de COVID-19 a partir de 2020. A atuação do SUS, de universidades e de instituições científicas públicas foi fundamental para o enfrentamento da crise. A partir de 2023, os desafios de retomada de um projeto nacional democrático e voltado ao bem-estar social são imensos. O fortalecimento do SUS depende do caráter das políticas sociais e da democracia, e de transformações nas relações Estado-mercados-sociedade, para superar limites que persistiram mesmo durante governos progressistas. O SUS, como política universal ancorada em uma concepção ampla de saúde e em valores democráticos, é um pilar fundamental para a consolidação de um padrão de desenvolvimento orientado para a redução das desigualdades e a construção de uma sociedade mais justa.

End-of-life care and grief: study conducted with family members of COVID-19 victims. / Cuidados no final de vida e luto: estudo com familiares de vítimas da COVID-19.

This article aims to investigate the implications of grief among family members of COVID-19 victims; verify the prevalence of prolonged grief symptoms; and identify family members' expectations regarding end-of-life care for their loved ones affected by COVID-19. Descriptive, cross-sectional research, with a quantitative-qualitative approach. Data collection was performed using an online questionnaire, guided by the PG-13 instrument. Descriptive and inferential statistics were applied. The results were presented descriptively and with the aid of tables. The study sample included 142 family members, mostly female, who presented emotional, physical, social, and financial implications as a result of grief. A prevalence of prolonged grief symptoms was observed in 11.4% of the mourners with more than six months and 29.6% of those with less than six months. Three thematic categories were identified: transparency in communicating the health situation, access to moments of farewell, and promotion of comfort in care actions. The symptoms of Prolonged Grief Disorder have a significant association with the degree of kinship. In final care, family members' expectations were classified as: permission for a dignified farewell, effective communication, and promotion of comfort and care.

O objetivo deste artigo é investigar implicações do luto em familiares de vítimas da COVID-19; verificar a prevalência de sintomas de luto prolongado; identificar expectativas dos familiares acerca do cuidado em fim de vida de seus entes acometidos por COVID-19. Pesquisa descritiva, transversal, com abordagem quanti-qualitativa. Coleta de dados mediante questionário on-line, norteado pelo instrumento PG-13. Aplicou-se estatística descritiva e inferencial. Os resultados foram apresentados de forma descritiva e com auxílio de tabelas. Amostra de 142 familiares, maioria do sexo feminino, que apresentaram implicações emocionais, físicas, sociais e financeiras em decorrência do luto. Houve prevalência de sintomas de luto prolongado em 11,4% dos enlutados com mais de seis meses e 29.6% dos que tinham menos de seis meses. Foram identificadas três categorias temáticas: transparência na comunicação da situação de saúde, acesso a momentos de despedida e promoção de conforto nas ações de cuidado. Os sintomas de Transtorno de Luto Prolongado possuem associação significativa com o grau de parentesco. Nos cuidados finais as expectativas dos familiares foram classificadas em: permissão para despedida digna, comunicação efetiva e promoção de conforto e cuidado.

Telecare in the Brazilian Unified Health System: where we are and where we are heading. / Teleassistência no Sistema Único de Saúde brasileiro: onde estamos e para onde vamos?

This article explores telecare from telehealth developments and the recent acceleration of the digital health transformation caused by the COVID-19 pandemic, focusing on the Brazilian Unified Health System (SUS). It addresses terminological issues, the scope of actions, the potential use for healthcare, and constraints and contingencies for telecare in Brazil, focusing on teleconsultations and interactions between health professionals and patients. Finally, it presents a set of propositions for the development of telecare policies and practices in Brazil, considering SUS principles, in two central themes: organizational political guidelines and operational propositions to organise services and healthcare delivery. The importance of clarifying the scope and limits of new technologies is highlighted in the attempt to avoid idealizations with proposed solutions to complex health problems. Telecare solutions should be compatible with SUS principles and with the recommended model of care, with the healthcare network coordinated and organised by primary care, ensuring access to health services and integrated and quality healthcare for the Brazilian society.

O artigo explora a teleassistência a partir dos desenvolvimentos da telessaúde e da aceleração da transformação digital na saúde provocada pela pandemia de COVID-19, com foco no Sistema Único de Saúde (SUS). Aborda questões terminológicas, escopo de ações, potencialidades do uso para atenção à saúde e condicionantes e contingências para a utilização da teleassistência no Brasil, concentrando-se nas teleconsultas e nas interações entre profissionais de saúde e pacientes. Por fim, apresenta um conjunto de proposições para o desenvolvimento das políticas e práticas de teleassistência no Brasil, tendo em vista os princípios do SUS, organizados em dois eixos estratégicos centrais: diretrizes político organizacionais e proposições operacionais e de organização dos serviços e do cuidado. Destaca-se a importância de ponderar e elucidar os alcances e os limites das novas tecnologias para evitar idealizações e deslumbramentos com suas propostas de solução para os complexos problemas de saúde. As soluções de teleassistência devem ser compatíveis com princípios e diretrizes do SUS e com o modelo de atenção preconizado, que prevê a organização da rede a partir da atenção primária, para garantir acesso, integralidade e qualidade da atenção à saúde para a sociedade brasileira.

The protective and destructive critical processes of female labor in small-scale fishing in coast Pernambuco, Brazil. / Processos críticos protetores e destrutivos no trabalho das pescadoras artesanais do litoral Pernambucano, Brasil.

This study aims to analyze the protective and destructive critical processes of 34 water women in the municipalities of Cabo de Santo de Agostinho and Ipojuca, Pernambuco, Brazil, from February/21 to August/22. The work process stages were systematized by the work flowchart, and we employed Breilh's critical processes matrix to organize the data. The destructive processes identified in the general domain were injustice and socio-environmental vulnerability, such as the economic development model, the Suape Industrial Port Complex, the 2019 oil spill crime disaster, the COVID-19 pandemic, and the difficult access to public policies; in the particular domain: overloads and extended working hours, use of rudimentary equipment and tools, and unequal gender, class, and race relationships; in the singular domain: physical and mental illnesses and deaths. The protective processes identified in the general domain were sustainable development objectives, public health, and social assistance policies; in the particular domain, group work and processing, consumption for subsistence; in the singular domain, fishing as a therapeutic, pleasurable, and sharing process. The study highlighted the central issues of the water women and the need to establish public policies targeting their care.

Objetivou-se analisar os processos críticos, protetores e destrutivos do trabalho de 34 mulheres das águas nos municípios de Cabo de Santo de Agostinho e Ipojuca (PE), de fevereiro de 2021 a agosto de 2022. As etapas do processo de trabalho foram sistematizadas pelo fluxograma do trabalho e organizadas na matriz de processos críticos de Breilh. Os processos destrutivos, no domínio geral, foram: injustiça e vulnerabilização socioambiental como modelo de desenvolvimento econômico, o Complexo Industrial Portuário de Suape, o desastre-crime de petróleo ocorrido em 2019, a pandemia de COVID-19 e dificuldade de acesso às políticas públicas; no particular: jornadas e sobrecargas de trabalho, uso de equipamentos e ferramentas rudimentares e relações desiguais de gênero, classe e raça; no singular: adoecimentos físicos, mentais e mortes. Os processos protetores, no domínio geral: os objetivos de desenvolvimento sustentável, políticas públicas de saúde e assistência social; no particular: trabalho e beneficiamento em grupo, consumo para subsistência; no singular: a pesca como processo terapêutico, prazeroso e de partilha. O estudo destacou os problemas centrais das mulheres das águas e a necessidade do estabelecimento de políticas públicas voltadas ao seu cuidado.

Solidarity as politics: Global Health and democracy. / Solidariedade como política: Saúde Global e democracia.

Ensuring democracy in establishing Global Health (GH) requires including health perspectives and actions of what is conventionally called "local". Edging closer to the references of the Meeting of Knowledges to those of Coloniality, we address the implementation of Solidary Greengrocers by the initiative of small-scale fishermen in the South of Bahia, Brazil, in facing socioeconomic and health issues related to the COVID-19 pandemic. The triangulation of methods characterized the fieldwork based on ethnography, action research, and partnership with local stakeholders in analyzing the material. The search for simultaneous health, socioeconomic, environmental, and educational effects allowed for overcoming the risks in GH actions such as humanitarianism, controlism, neoliberalism, and colonialism. The initiative was managed by the political organization of the residents of the reserve, who raised and managed State and civil society resources with autonomy and solidarity, combining traditional knowledge with institutional and technological knowledge of the territory. So-called local experiences contain a complete vision of the world that should not be submitted to a totalizing category. Global Health can benefit from considering the several worlds underlying its object.

Garantir a democracia na constituição do campo da Saúde Global (SG) requer a inclusão de perspectivas e ações sanitárias do que se convencionou chamar de "local". Aproximando os referenciais do Encontro de Saberes ao de Colonialidade, abordamos a implementação de Quitandas Solidárias por iniciativa de pescadores artesanais, no sul da Bahia, no enfrentamento de questões socioeconômicas e de saúde ligadas à pandemia de COVID-19. A triangulação de métodos caracterizou os trabalhos de campo, baseados na etnografia, pesquisa-ação e parceria com agentes locais na análise do material. A busca de efeitos simultaneamente sanitários, socioeconômicos, ambientais e educativos possibilitou relativa superação dos riscos presentes nas ações de SG como os de humanitarismo, controlismo, neoliberalismo e colonialismo. A iniciativa foi gerida pela organização política dos moradores da reserva, que captaram e manejaram recursos do Estado e da sociedade civil com autonomia e solidariedade, aliando os saberes tradicionais aos conhecimentos institucionais e tecnológicos do território. As experiências ditas locais contêm uma visão completa de mundo que não devem ser submetidas a uma categoria totalizante. A Saúde Global pode se beneficiar da consideração dos diversos mundos que constituem o seu objeto.

Care resignification in the pandemic context. / A ressignificação do cuidado no contexto de pandemia.

This essay discusses the care process of health professionals in the context of COVID-19 from the perspectives of psychoanalysis, under the prism of Donald Winnicott's transitional space, and of collective health, under the prism of the practical wisdom of José Ricardo Ayres, the micropolitics of live work in action by Emmerson Merhy, and prudent care by Ruben Mattos. It suggests elaborating a care perspective to propose a possible resignification of illness in a pandemic, where health is marked with calamity, health catastrophe, and suffering and anguish, whether in the body or subjectively. In this way, understanding the manifestation of care by health professionals in a pandemic context brought about with narcissistic and heroic meanings and feelings of impotence and helplessness contributes to elaborating a creative conception of care. We conclude that the perspective of expanded care favors the creative possibility of new productions of meaning and support for professionals, resignifying their life experiences through love, creativity, practical wisdom, prudent care, live work in action, and motor imaginary.

Esse ensaio discute o processo de cuidado de profissionais de saúde no contexto da COVID-19 a partir das perspectivas da psicanálise, sob o prisma do espaço transicional de Donald Winnicott, e da saúde coletiva, sob o prisma da sabedoria prática de José Ricardo Ayres, da micropolítica do trabalho vivo em ato de Emmerson Merhy, e do cuidado prudente de Ruben Mattos. Propõe a elaboração de uma perspectiva de cuidado que se apresenta enquanto proposta de ressignificação possível ao adoecimento no contexto de pandemia, onde a saúde foi marcada com sentidos de calamidade e catástrofe sanitária, e expressões de sofrimento e angústia, no corpo e/ou mesmo subjetivamente. Desse modo, uma compreensão sobre a manifestação do cuidado do profissional de saúde, no contexto de pandemia, trazido com sentidos narcísicos e heroicos, e com sentidos de impotência e desamparo, contribui para a elaboração de uma concepção criativa do cuidado. Conclui-se que a perspectiva de um cuidado ampliado favorece a possibilidade criativa de novas produções de sentido e de sustentação para os profissionais, ressignificando suas experiências de vida, através do amor, da criatividade, da sabedoria prática, do cuidado prudente, do trabalho vivo em ato e do imaginário motor.

Recommendations for Recovery of the COVID-19 Pandemic-related Diagnostic, Screening, and Procedure Backlog in Ontario: A Survey of Healthcare Leaders.

PURPOSE: The COVID-19 pandemic has resulted in a significant diagnostic, screening, and procedure backlog in Ontario. Engagement of key stakeholders in healthcare leadership positions is urgently needed to inform a comprehensive provincial recovery strategy. METHODS: A list of 20 policy recommendations addressing the diagnostic, screening and procedure backlog in Ontario were transformed into a national online survey. Policy recommendations were rated on a 7-point Likert scale (strongly agree to strongly disagree) and organized into those retained (≥75% strongly agree to somewhat agree), discarded (≥80% somewhat disagree to strongly disagree), and no consensus reached. Survey participants included a diverse sample of healthcare leaders with the potential to impact policy reform. RESULTS: Of 56 healthcare leaders invited to participate, there were 34 unique responses (61% response rate). Participants were from diverse clinical backgrounds, including surgical subspecialties, medicine, nursing, and healthcare administration and held institutional or provincial leadership positions. A total of 11 of 20 policy recommendations reached the threshold for consensus agreement with the remaining 9 having no consensus reached. CONCLUSION: Consensus agreement was reached among Canadian healthcare leaders on 11 policy recommendations to address the diagnostic, screening, and procedure backlog in Ontario. Recommendations included strategies to address patient information needs on expected wait times, expand health and human resource capacity, and streamline efficiencies to increase operating room output. No consensus was reached on the optimal funding strategy within the public system in Ontario or the appropriateness of implementing private funding models.

The type of COVID-19 vaccination does not affect reproductive function and pregnancy outcomes in infertile couples.

Introduction: Studies on the effect of vaccine type and two other vaccines other than inactivated vaccines approved in China on in vitro fertilization (IVF) pregnancy outcomes are rare. To complement and confirm the existing findings, this research aimed to investigate whether there are adverse effects of different vaccine types in females and males on reproductive function and clinical pregnancy. Methods: This retrospective study enrolled 6,455 fresh embryo transfer cycles at the First Affiliated Hospital of Zhengzhou University between May 1, 2021, and October 31, 2022. The primary outcome is the clinical pregnancy rate (CPR). At the same time, the secondary results are the number of oocytes retrieved, two pronuclei (2PN) rate, blastocyst formation rate, high-quality blastocyst rate, and semen parameters (volume, density, sperm count, forward motility rate, total motility rate, immobility rate, and DNA fragment index (DFI) rate). Results: In the comparison of ovarian stimulation indicators, no statistically significant differences (P > 0.05) were found in Gn days, endometrial thickness, 2PN rate, metaphase 2 (MII) rate, high-quality embryo rate, and blastocyst formation rate. No significant differences (P>0.05) were found in age, body mass index (BMI), education level, and semen parameters (volume, density, sperm count, forward motility rate, total motility rate, immobility rate, and DFI rate) in these four groups. The multivariate regression model showed that neither the types of vaccines nor the vaccination status of both infertile couples significantly affected clinical pregnancy. Discussion: The type of vaccine does not appear to have an unfavorable effect on ovarian stimulation, embryo development, semen parameters, and clinical pregnancy.

COPD Exacerbations Before and During COVID-19 in France, Germany, Italy, the UK and the US.

Background: Exacerbations of chronic obstructive pulmonary disease (COPD) were reported less frequently during the COVID-19 pandemic. We report real-world data on COPD exacerbation rates before and during this pandemic. Methods: Exacerbation patterns were analysed using electronic medical records or claims data of patients with COPD before (2017-2019) and during the COVID-19 pandemic (2020 through early 2022) in France, Germany, Italy, the United Kingdom and the United States. Data from each country were analysed separately. The proportions of patients with COPD receiving maintenance treatment were also estimated. Results: The proportion of patients with exacerbations fell 45-78% across five countries in 2020 versus 2019. Exacerbation rates in most countries were reduced by >50% in 2020 compared with 2019. The proportions of patients with an exacerbation increased in most countries in 2021. Across each country, seasonal exacerbation increases seen during autumn and winter in pre-pandemic years were absent during the first year of the pandemic. The percentage of patients filling COPD prescriptions across each country increased by 4.53-22.13% in 2019 to 9.94-34.17% in 2021. Conclusion: Early, steep declines in exacerbation rates occurred in 2020 versus 2019 across all five countries and were accompanied by a loss of the seasonal pattern of exacerbation.

Loss to Follow-Up: Patients with Type 1 Diabetes During the SARS-CoV-2 Pandemic.

The SARS-CoV-2 (severe acute respiratory syndrome related coronavirus 2) pandemic revealed many flaws in our health care system. This review aims to explore the significance of loss to follow-up on patients with type 1 diabetes during the pandemic, the morbidity and mortality associated, and strategies to prevent loss to follow-up or to re-engage patients in longitudinal care. [Pediatr Ann. 2024;53(7):e254-e257.].

COVID-19 and Type 1 Diabetes.

The coronavirus disease 2019 (COVID-19) pandemic brought about several challenges for pediatric patients that were considerably different than those for adult patients. While adult patients had severe illness with associated respiratory and multiorgan failure and subsequent death, pediatric patients typically had milder disease. There were increases in postinfection complications, including an increased incidence of new-onset type 1 diabetes (T1D) following COVID-19 infection, particularly in adolescent patients. Currently, there is increasing concern that COVID-19 infection may be contributing to the development of T1D. This review will provide an overview of COVID-19, T1D, and the increased incidence noted during the pandemic, and the proposed mechanism of development of T1D in this specific patient demographic. Future studies will be needed to understand the long-term impact of the COVID-19 pandemic on T1D in children and adolescents. [Pediatr Ann. 2024;53(7):e244-e248.].

COVID-19 and Diabetes: An Epidemiologic Overview.

Past literature on the development of type 1 diabetes (T1D) and type 2 diabetes (T2D) has emphasized the influence of exogenous factors, including viral infections, in the development of these conditions. The coronavirus disease 2019 (COVID-19) pandemic again highlighted the complicated connection between viral infection and the development of diabetes. The complex interplay of proinflammatory, genetic, and socioeconomic factors can help explain the increased incidence of T1D and T2D during the pandemic. Proposed pathophysiological mechanisms connecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to T1D include the expression of angiotensin enzyme 2 receptors on pancreatic islet cells, resultant proinflammatory states, and potential transient damage caused by viral entry. The intricate web of genetic factors, social determinants of health (including the rise of obesity), and the impact of proinflammatory states during SARS-CoV-2 infection on insulin resistance suggests mechanisms linking SARS-CoV-2 infection to the development of diabetes. [Pediatr Ann. 2024;53(7):e258-e263.].

Changes in Pediatric Type 2 Diabetes During the COVID-19 Pandemic.

Type 2 diabetes (T2D) is a growing concern among the pediatric population. During the coronavirus disease 2019 (COVID-19) pandemic, the incidence of pediatric T2D increased. This was more notable among males and Black people. Increased rates of T2D may be due to rising obesity rates observed during the pandemic, behavioral and nutritional changes due to the lockdown, and decreased structure typically provided by in-person schooling. New-onset T2D presentations are more severe than in years prior to the pandemic, with higher initial hemoglobin A1C levels and increased rates of diabetic ketoacidosis. Increased severity in presentation may be due to hesitation in seeking care, increased virtual care, and limited access to health care resources. The pathophysiology of the relationship between T2D and COVID-19 in youth is not clear at this time. More studies are needed to understand the true long-term impact of the COVID-19 pandemic on T2D in youth. [Pediatr Ann. 2024;53(7):e249-e253.].