The effectiveness of an education program based on healthcare transition in adolescents with asthma: A randomized controlled trial.

BACKGROUND: Adolescents diagnosed with asthma make a transition to adult care when they reach a certain age. Besides, these adolescents need specialized education for them to become autonomous, competent, and adult patients and gain the necessary knowledge and skills related to their disease. In this study, by using a prospective randomized controlled trial design, we evaluated the effectiveness of an education program based on healthcare transition provided to adolescents diagnosed with asthma. METHODS: After obtaining the consent of adolescents and their parents, 52 adolescents aged between 14 and 18 years who were diagnosed with asthma were randomly assigned to the intervention group (individual four face-to-face and six online education sessions) or the control group (standard care). The primary outcome was the differences between the Transition Readiness Assessment Questionnaire (TRAQ) scores of the two groups. The secondary outcomes included the differences between the Self-Efficacy Scale for Children and Adolescents with Asthma and Mind the Gap scores of the two groups. The outcomes were measured at two different time points: baseline (first assessment; Week 0) and immediately after the intervention (last assessment; Week 12). RESULTS: In the initial evaluations, there was no significant difference between the groups in terms of the primary or secondary outcomes (p > .05). In the final assessments, the TRAQ (Z = -4.740, p < .001) and Self-Efficacy Scale for Children and Adolescents with Asthma (t = 6.344, p < .001) scores of the intervention group were found to be significantly higher than the scores of the control group, while their Mind the Gap Scale scores were significantly lower (t = 6.146, p < .001). CONCLUSION: It was determined that the educational intervention integrated with pediatric care based on readiness for transition from pediatric care to adult care was effective in increasing the transition readiness and self-efficacy of the adolescents. The study was registered at ClinicalTrials.gov with the ID code NCT05550922.

Skills-adjusted human capital shows rising global gap.

Human capital, broadly defined as the skills acquired through formal education, is acknowledged as one of the key drivers of economic growth and social development. However, its measurement for the working-age populations, on a global scale and over time, is still unsatisfactory. Most indicators either only consider the quantity dimension of education and disregard the actual skills or are demographically inconsistent by applying the skills of the young cohorts in school to represent the skills of the working-age population at the same time. In the case of rapidly expanding or changing school systems, this assumption is untenable. However, an increasing number of countries have started to assess the literacy skills of their adult populations by age and sex directly. Drawing on this literacy data, and by using demographic backprojection and statistical estimation techniques, we here present a demographically consistent indicator for adult literacy skills, the skills in literacy adjusted mean years of schooling (SLAMYS). The measure is given for the population aged 20 to 64 in 185 countries and for the period 1970 to 2015. Compared to the conventional mean years of schooling (MYS)-which has strongly increased for most countries over the past decades, and in particular among poor countries-the trends in SLAMYS exhibit a widening global skills gap between low- and high-performing countries.

Years of good life is a well-being indicator designed to serve research on sustainability.

Sustainable development (SD) as popularized by the Brundtland Commission and politically enshrined in the Sustainable Development Goals has been the explicit focus of sustainability science. While there is broad agreement that the trend of human well-being (W) over time should serve as a sustainability criterion, the literature so far has mostly addressed this in terms of its determinants rather than focusing on W itself. There is broad agreement that an indicator for W should have multiple constituents, clearly going beyond gross domestic product. Here, we propose a tailor-made indicator to serve precisely this purpose following a set of specified desiderata, including its applicability to flexibly defined subnational populations by gender, place of residence, ethnicity, and other relevant characteristics. The indicator, years of good life (YoGL), reflects the evident fact that in order to be able to enjoy any quality of life, one has to be alive and thus is primarily based on life expectancy. However, since mere survival is not considered good enough, life years are counted conditional on meeting minimum standards in two dimensions: the objective dimension of capable longevity (consisting of being out of absolute poverty and enjoying minimal levels of physical and cognitive health) and the subjective dimension of overall life satisfaction. We illustrate the calculation of this indicator for countries and subpopulations at different stages of development and with different degrees of data availability.

White Tears: A Phenomenological Study of Perinatal Loss.

Perinatal loss is a traumatic experience for parents. This research was conducted to evaluate the experiences and needs of parents after perinatal loss. An interpretative phenomenological study was carried out between January 2021 and July 2022 with 6 parental pairs (12 people in total, 6 mothers and 6 fathers) who experienced a perinatal loss. Participants were reached by snowball sampling method. Data were collected using semi-structured audio recording interviews that were transcribed and analyzed using thematic analysis. The themes of this study were determined as "attributing meaning to loss", "fragmented parenting roles and expectations", "changing relationships", "expectations from healthcare professionals", and "emotional responses". Five sub-themes were created from the emotional responses theme which included. These are sadness and pain, denial, anger, guilt and fear. In the study, it was concluded that the experience of perinatal loss may have negative consequences on the psychological health of the parents. Therefore, specific, professional, adequate nursing support and continuity of support are needed to help parents cope with perinatal losses.

Hospital classroom experiences of hospitalized school-age pediatric oncology patients: A qualitative study.

PURPOSE: In this study, it was aimed to examine the hospital classroom experiences of school-age children who received treatment and care at a pediatric oncology-hematology clinic in Turkey. METHODS: The study was conducted using the in-depth interview method with the participation of 17 children who were hospitalized in the pediatric oncology-hematology clinic of a research and training hospital in the Ankara province of Turkey. The data were collected using a "Semi-Structured Interview Form". The interviews started with the question "How do you perform the assignments given by your teacher while you are hospitalized?", and the interviews were recorded as audio with the consent of the children and their parents. RESULTS: As a result of the interviews, three main themes, (1) Learning, (2) Maintaining normalcy, and (3) Expectations, and 9 subthemes (teacher, continuation of learning, learning through play, feeling good, continuation of routines, peer interaction, communication with the school-teacher, basic sport activity, and tablet/internet access) were generated from the data. CONCLUSIONS: Hospital classrooms had a significant role in increasing the children's adaptation to hospital conditions and ensuring the continuation of school/learning. PRACTICE IMPLICATIONS: Pediatric nurses can refer children with long and repeated hospitalizations (e.g., pediatric oncology patients and children with chronic diseases) to hospital classrooms. Thus, children can adapt more easily to the procedures performed in the hospital.

Remdesivir treatment for patients with moderate to severe COVID-19.

BACKGROUND: Remdesivir, which was first developed for the treatment of Ebola disease but failed to meet expectations, has become hope in the fight against the COVID-19 pandemic. This study aimed to evaluate risk factors for mortality and prognosis of adult moderate/severe COVID-19 patients treated with remdesivir, and safety and tolerability of 5 days of remdesivir treatment. METHODS: This multicenter prospective observational study was conducted in 14 centers in Turkey. Pregnancy or breastfeeding, multiorgan failure, or usage of vasopressors for septic shock, ALT > 5 × the upper limit of the normal range, or eGRF <30 mL/min or dialysis and receiving favipiravir were the exclusion criteria of the study. RESULTS: Among 500 patients, 494 patients were included in the study. On admission, 392 (79.3%) patients had moderate and 102 (20.6%) patients had severe COVID-19. The 28-day mortality was 10.1%. The median of the scores of the seven-category ordinal scale assessed on days 0, 3, 5, 7 were 4 and 3 on day 14. When the survival status of the patients was evaluated according to the time between the remdesivir start date and the end date of the symptoms, no statistically significant difference was found between the medians of the groups (p = 0.404). In multivariable analysis, age (OR, 1.05; 95%CI, 1.02-1.08; p = 0.003), SpO2 level on admission (OR, 3.03; 95%CI, 1.35-6.81; p = 0.007), heart rate (OR, 2.48; 95%CI, 1.01-6.07; p = 0.047), follow-up site at the hospital (clinic/ICU) (OR, 26.4; 95%CI, 11.6-60.17; p < 0.001) were independently associated with increased mortality. Grade 3 adverse event (AE) was observed in 4 (0.8%) patients. None of the patients experienced grade 4 or 5 AEs. DISCUSSION: Remdesivir is a safe and well-tolerated drug and older age, low SpO2 level on admission, tachycardia, and ICU admission are independently associated with increased mortality among patients with moderate/severe COVID-19 receiving remdesivir treatment.

Biosorption of 2,4 dichlorophenol Onto Turkish Sweetgum Bark in a Batch System: Equilibrium and Kinetic Study.

In this study, Turkish Sweetgum bark was used as a new biosorbent to investigate the removal of hazardous 2,4 dichlorophenol (2,4-DCP) from aqueous solutions in batch biosoption experiments. The effective usage of Turkish sweetgum bark is a meaningful work for environmental utilization of agricultural residues. The effects of experimental parameters like solution pH, contact time, initial concentration of adsorbate and amount of bisorbent dosage were investigated in a series of batch studies at 25 °C. Taguchi's Orthogonal Array (OA) analysis was used to find the best experimental parameters for the optimum design process in this study. The functional groups and surface properties of biosorbent were characterized by using Fourier transformer infrared (FTIR) and scanning electron microscopy (SEM) techniques. The experimental data were fitted to Langmuir isotherm and Freundlich isotherm models. There is a good agreement between the parameters and this confirms the monolayer adsorption of 2,4-DCP onto sweetgum bark. As a result of kinetic studies, the pseudo-second-order kinetic model was found to be suitable for all the data. Also, the results of the study show that Turkish Sweetgum bark can be potential as a low-cost alternative commercial adsorbents for removal 2,4 dichlorophenol from aqueous solutions.

A novel assessment tool for clinical care of patients with autoinflammatory disease: juvenile autoinflammatory disease multidimensional assessment report.

OBJECTIVES: To develop and test a new multidimensional questionnaire for assessment of children with auto-inflammatory disease (AID) such as FMF, PFAPA, HIDS, TRAPS in standard clinical care. METHODS: The juvenile auto-inflammatory disease multidimensional assessment report (JAIMAR) includes 16 parent or patient-centered measures and four dimensions that assess functional status, pain, therapeutic compliance and health-related quality of life (physical, social, school, emotional status) with disease outcome. It is proposed for use as both a proxy-report and a patient self-report, with the suggested age range of 8-18 years for use as a self-report. RESULTS: 250 children with FMF were included in the study. Total of 179 forms were filled up by parents and patients, and 71 forms were filled up by parents having children less than 8 years. Completing and scoring the JAIMAR can be done in 15 minutes. For the JAIMAR's dimensions, the Cronbach's alpha coefficient for internal consistency was between 0.507-0.998. There was a significant and a positive correlation between the test-retest scale scores (ICC=0.607-0.966). Concerning construct validity, all factors loadings were above 0.30. For the criterion validity, the correlation level between each dimension and the related scale ranged from medium (r=0.329, p<0.0001) to large (r=0.894, p<0.0001). The parents' proxy-reported and children's self-reported data were outstandingly concordant (r=0.770-0.989). CONCLUSIONS: The development of the JAIMAR introduces a new and multi-dimensional approach in paediatric rheumatology practice. It is a new tool for children with auto-inflammatory dis-ease and it may help enhance their quality of care.

The invisible part of the iceberg: qualitative aspects of childhood vasculitis.

OBJECTIVES: The aim of this study was to develop a multidimensional assessment instrument named 'Juvenile Vasculitis Multidimensional Assessment Report' (J-VAMAR) to measure all the domains of the vasculitis. In this qualitative study, it is primarily aimed to enrich the item generation for the J-VAMAR. METHODS: Twelve children with vasculitis and their mothers (n=12) were enrolled in this study. The data were collected using both a demographic data form and a semi-structured interview form. The study was performed on individual patient face-to face interview. Data were analysed by grounded theory and the N Vivo 9 software program. RESULTS: Four categories were obtained. These categories were (i) physical effects of the illness, (ii) emotional effects of the illness, (iii) social effects of the illness and (iv) experienced challenges related to treatment process. In the physical effect category severe pain, physical limitations, weakness and fatigue; in emotional effect category thought of death, hopelessness and dissatisfaction about body image; in the social effects category decrease in academic performance, absenteeism to school and concealing the sickness from friends were the most common features. In the fourth category, subjects complained of lifelong drug use and frequency of daily drug consumptions. CONCLUSIONS: These results provide evidence-based data for the assessment of children with vasculitis by several domains including physical, emotional and social aspects as well as treatment protocols. The study provides the basis and/or justification for selecting the domains that the developing multidimensional instrument should include.

Differentials in receiving postpartum care of infants and its determinants in Turkey.

The aim of this paper was to analyze the differentials in receiving postpartum care of infants in Turkey and the determinants of receiving postpartum care by infants in Turkey, using data from the 2008 Turkey Demographic and Health Survey and multivariate logistic analyses accounting for the complex sample design. The descriptive analyses indicated that the majority of infants receive postpartum care in Turkey, although there are disadvantaged groups. Analysis of the determinants of receiving postpartum care of infants indicated that the variables having the most explanatory power are bio-demographic or health-related variables that are directly related to health and/or birth. Following these variables, economic characteristics such as maternal health coverage and maternal educational level were observed to be effective, and additionally the demographic region.

Determining Knowledge and Opinions of Neonatal Intensive Care Unit Nurses on Wet-Nursing and Human Milk Banks: A Cross-Sectional Study in Türkiye.

BACKGROUND: Wet nursing and human milk banks are vital sources of human milk for infants unable to breastfeed. RESEARCH AIM: This study aims to determine the knowledge and opinions of neonatal intensive care unit nurses regarding wet-nursing and human milk banks in Türkiye. METHODS: This descriptive cross-sectional study was conducted with 219 neonatal intensive care unit nurses using an online survey comprising 20 questions. The data were collected between August and September 2021. RESULTS: Among the participants, 64.4% (n = 141) expressed that they would be a wet-nurse and 59.8% (n = 131) would search for a wet-nurse if necessary. Some, 47.0% (n = 103) of participants did not know if there were any human milk banks in Türkiye, 53.9% (n = 118) would like to be a donor if human milk banks were established, and 71.7% (n = 157) stated that the establishment of human milk banks should be supported. Religious concerns were the basis for reluctance to donate milk to human milk banks for 60% (n = 51) of the participants. Knowledge was greater and opinions about wet-nursing and human milk banks were more positive for participants with higher education, more time in the neonatal intensive care unit, or work at a tertiary care center. CONCLUSION: The approaches of neonatal intensive care unit nurses towards personally being wet-nurses and milk sharing were generally positive, although more information about human milk banks is needed. Religious beliefs are an important consideration when providing information about milk sharing.

Determination and speciation of methyl mercury and total mercury in fish tissue samples by gold-coated W-coil atom trap cold vapor atomic absorption spectrometry.

A sensitive analytical technique was developed where gaseous mercury formed by sodium tetrahydroborate reduction is transported to and trapped on a resistively heated gold-coated Tungsten-coil atom trap for in situ preconcentration. This technique was applied successfully for determination and speciation of methyl mercury and total mercury in some fish tissue samples (liver, muscle and gill) obtained from Mugla province. The analytical parameters were optimized both for trap and no-trap studies. Under the optimized conditions, a limit of detection (LOD) of 6.0 ng/L was obtained. The precision was evaluated by relative standard deviation (RSD%) corresponding to 4.1% (n = 11). Accuracy of the proposed method was evaluated by analyzing "DOLT:5 Dogfish Liver", "NIST SRM 1640a Trace elements in natural water" and "NIST 1946 Lake Superior fish tissues". The measurements of the certified reference materials were in good agreement with the certified values at the 95% confidence level.

Removal of Ni(II), Cu(II), Pb(II), and Cd(II) from Aqueous Phases by Silver Nanoparticles and Magnetic Nanoparticles/Nanocomposites.

The intake of heavy metals into the body, even at very low concentrations, may cause a decrease in central nervous system functions; deterioration of blood composition; and liver, kidney, and lung damage. Therefore, heavy metal ions must be removed from water. In this study, silver, magnetic iron/copper, and iron oxide nanoparticles were synthesized using Lathyrus brachypterus extract and then Fe/Cu-AT, Fe3O4-AT, Fe/Cu-CS, and Fe3O4-CS magnetic nanocomposite beads were synthesized using alginate and chitosan. The removal of Cd(II), Pb(II), Ni(II), and Cu(II) ions from aqueous phases using synthesized nanoadsorbents was investigated by single and competitive (double and quaternary) adsorption techniques. The kinetic usability of the magnetic iron oxide chitosan (Fe3O4-CS) nanocomposite beads with the highest removal efficiency was evaluated. Based on experimental results, the order of removal was found to be 98.39, 75.52, 51.54, and 45.34%, and it was listed as Pb(II) > Cu(II) > Cd(II) > Ni(II), respectively. The Dubinin-Radushkevich, Freundlich, Langmuir, and Temkin isotherm models were used, and experimental results revealed that the experimental data fit the Langmuir model better. The maximum adsorption capacities (qm) obtained from the Langmuir isotherm model of Fe3O4-CS were found to be 8.71, 23.75, 18.57, and 12.38 mg/g for Ni(II), Pb(II), Cu(II), and Cd(II) ions, respectively. When the kinetic data were applied to the Lagergren, Ho-McKay, and Elovich models, it was observed that the adsorption kinetics mostly conformed to the Ho-McKay second-order rate equation. The binary and quaternary competitive adsorption data showed that Fe3O4-CS were selective toward Cu(II) and Pb(II). The reusability of the Fe3O4-CS nanoadsorbent was performed as three cycles with the same concentration. The adsorption capacities were found to be 95.81, 70.65, 50.50, and 42.75%, in turn for Pb(II), Cu(II), Cd(II), and Ni(II) ions after three cycles, which revealed that the Fe3O4-CS nanoadsorbent can be used after three cycles without losing its efficiency.

Quantifying the impact of COVID-19 on immigration in receiving high-income countries.

Previous studies have examined the impact of COVID-19 on mortality and fertility. However, little is known about the effect of the pandemic on constraining international migration. We use Eurostat and national statistics data on immigration and ARIMA time-series models to quantify the impact of COVID-19 on immigration flows in 15 high-income countries by forecasting their counterfactual levels in 2020, assuming no pandemic, and comparing these estimates with observed immigration counts. We then explore potential driving forces, such as stringency measures and increases in unemployment moderating the extent of immigration change. Our results show that immigration declined in all countries, except in Finland. Yet, significant cross-national variations exist. Australia (60%), Spain (45%) and Sweden (36%) display the largest declines, while immigration decreased by between 15% and 30% in seven countries, and by less than 15% in four nations where results were not statistically significant. International travel restrictions, mobility restrictions and stay-at-home requirements exhibit a relatively strong relationship with declines in immigration, although countries with similar levels of stringency witnessed varying levels of immigration decline. Work and school closings and unemployment show no relationship with changes in immigration.

Triangle technique: An effective tool for improving nursing students' ability to calculate safe pediatric medication dosages.

Calculating the correct medication dosage for pediatric patients can be difficult for nurses to determine, as the pediatric dose is typically a small fraction of the adult dosage. This study aims to examine the impact of the Triangle Technique on the ability of nursing students to calculate low and high safe dosage ranges in children. To evaluate how this educational tool could improve a nurse's skill in this area, a quasi-experimental pre-/post-test research design was employed including one hundred fifty-eight third-year nursing students. The Pediatric Medication Administration Form and Pediatric Safe Dosage Calculations Quiz (PSDCQ) were used to measure the effectiveness of the Triangle Technique. While <50% (n < 79) of students gave correct answers to each question in PSDCQ before this intervention, all of the participants (N = 158, 100%) gave a correct answer to one question, and >89.2% (n > 141) of the students correctly answered the other four questions of PSDCQ. The change in scores (pre-PSDCQ median score = 0, IQR = 60; post-PSDCQ median score = 100, IQR = 0) post-intervention was statistically significant (z = 10.633, p ≤ .001), indicating that this teaching technique was effective for improving students' ability to calculate pediatric safe dose ranges. Nursing students (n = 144, 91.1%) were satisfied with using Triangle Technique. Using the Triangle Technique can increase nursing students' understanding of how they calculate safe pediatric medication dosages.

Development of a Sensitive Method for Cadmium Determination in Fish Tissue and Drinking Water Samples by FAAS Using SQT In Situ Atom Trapping.

A sensitive and robust trap method was developed for the determination of cadmium (Cd) by using a slotted quartz tube. Using this method at a sample suction rate of 7.4 mL/min for 4.0 min collection, a 1467-fold increase in sensitivity was obtained compared to the flame atomic absorption spectrometry method. Under the optimized conditions, a limit of detection of 0.075 ng mL-1 was obtained for the trap method. The interference effects of hydride-forming elements, transition metals, and some anions on the Cd signal were investigated. The developed method was evaluated by analyzing "Sewage Sludge-industrial origin (BCR no: 146R)", "NIST SRM 1640a Trace elements in natural water", and "DOLT: 5 Dogfish Liver". There was a good agreement between the certified and found values at the 95% confidence level. This method was applied successfully for the determination of Cd in drinking water and some fish tissue samples (liver, muscle, and gill) obtained from Mugla province.

Pulmonary functions and life quality assessment results two years after COVID-19 comparison with the sixth month results.

INTRODUCTION: We aimed to investigate the effects of COVID-19 on patients 24 months after severe COVID-19 pneumonia. METHODOLOGY: Fifty-four patients with severe COVID-19 pneumonia were evaluated on the 24th month after discharge from the hospital. Spirometry and short form of health-related quality of life scale (SF-36) were used. Chest computed tomography (chest-CT) was performed and the findings were grouped according to lung involvement. RESULTS: Forced expiratory volume in 1 second (FEV1) % values of 19 patients (35.18%) and forced vital capacity (FVC) % values of 23 patients (42.54%) were found lower than expected on the 24th month. Physical function, energy-vitality, social functionality and general health parameters were found lower than normal on the SF-36 scale. 27 (50.00%) patients had a chest-CT abnormality. There was a correlation between FEV1% and FVC% values and group 3: medium-lower lobe dominant, reticulation + traction, 10-50% surface area. Chest-CT of 6 patients was fully recovered. No correlation was found between chest-CT findings on the 24th month and BMI, length of hospitalization, white blood cell (WBC), lymphocyte, C-reactive protein (CRP), ferritin and D-dimer values at the time of hospitalization. CONCLUSIONS: Functional and radiological abnormalities were detected in a significant number of patients on the 24th month. A systematic monitoring plan must be established to assess and properly manage the long-term problems that may arise.

Do Attitude, Awareness and Intention to Perform Female Genital Mutilation or Cutting for Their Daughters of Women Healthcare Providers Differ from Mothers in Somalia?

Aim: This study aimed to determine whether there were differences in attitude, awareness, and intention to perform female genital mutilation or cutting for their daughters in the future between female healthcare providers and mothers. Methods: A comparative cross-sectional study design was used. Results: A total of 508 women were included in the study. Of the participants, 68.7% (n = 349) were mothers (Group I) who visited the hospital and 31.3% (n = 159) were women healthcare professionals (Group II) [27% (n = 137) nurses and 4.3% (n = 22) doctors]. It was found that 8 (1.6%) of the participants did not have FGM/C and the FGM/C ratio was lower in group II (95%) than in group I (100%) (p < 0.001). In group I, 99.7% (n = 299) of the participants and 30.6% (n = 19) of those in group II reported intending to perform FGM for their daughters in the future (p < 0.001). The reasons for FGM/C most cited by participants were a traditional rite of passage into womanhood (78%), religious requirement (69.3%), and preservation of their virginity until marriage (59.3%). "Stop FGM" was given as a message on FGM/C by 60% of the participants (n = 79) who answered (n = 127, 100%) to open-ended questions. Conclusion: The results of this study show that female health professionals with higher education and monthly income had less positive perception of their FGM/C and less intention to allow their daughters to undergo FGM/C.

Observational study comparing long-term safety and efficacy of Deferasirox with Desferrioxamine therapy in chelation-naïve children with transfusional iron overload.

OBJECTIVES: An observational study was conducted to explore postmarketing safety and efficacy of Deferasirox (DFX) in comparison with conventional Desferrioxamine (DFO) in chelation-naïve children with transfusional iron overload. METHODS: Transfusion-dependent children (aged ≤ 5 yr) who had serum ferritin above 1000 µg/L and had been prescribed either first-line DFX or DFO for at least 12 months to maintain serum ferritin between 500 and 1000 µg/L were included. Initial DFX dose was 20 mg/kg/d for 7 d a week, and DFO dose was 25-35 mg/kg/d subcutaneously, given for 5 d a week. Dose adjustments were based on serum ferritin changes and safety markers. The primary efficacy endpoint was change in serum ferritin from baseline. The effect of transfusional iron loading rate (ILR) and different doses of chelators on serum ferritin was also assessed. RESULTS: A total of 111 patients were observed for a median of 2.29 yr on DFX (n = 71) and 2.75 yr on DFO (n = 40). Absolute change in serum ferritin from baseline to the last available observation was not significant with DFX (91 µg/L, P = 0.5) but significantly higher with DFO (385 µg/L, P < 0.005). ILR and DFX doses had a major impact on serum ferritin changes in DFX cohort. The height- and weight-standard deviation scores did not differ significantly in both cohorts during the study. Fluctuations in liver enzymes and non-progressive increase in serum creatinine were the most common adverse events (DFX; 9.8%, 18.0% and DFO; 5.0%, 7.5%, respectively). CONCLUSION: DFX is well tolerable and at least as effective as DFO to maintain safe serum ferritin levels and normal growth progression in chelation-naïve children.

Projections of adult skills and the effect of COVID-19.

In this paper, we project Skills in Literacy Adjusted Mean Years of Schooling (SLAMYS) for the working age population in 45 countries and quinquennial time periods until 2050 according to various population scenarios. Moreover, we integrate the effect of school closures due to the COVID-19 pandemic on these projections. Adult skills are projected using the cohort components method. They can help in assessing the potential consequences of the recent trends for the adult population, particularly the workforce, whose skills are essential for the jobs contributing to economic growth and development outlooks. Our projections are novel as they take into account both the amount of schooling and quality of education and also consider the changes in adult skills through lifetime. Projections show that the adult skills gap between countries in the Global North and countries in the Global South will likely continue to exist by 2050, even under very optimistic assumptions-but may widen or narrow depending on the demographic development trajectories specific to each country. Moreover, the loss of learning due to school closures during the COVID-19 pandemic further exacerbates inequalities between countries. Particularly, in countries where schools have been closed for a prolonged period of time and the infrastructure for effective online schooling is lacking, the skills of cohorts who were in school during the pandemic have been severely affected. The fact that the duration of school closures has been longer in many low- and middle-income countries is a serious concern for achieving global human capital equality. The impact of the COVID-19 pandemic is projected to erase decades-long gains in adult skills for affected cohorts unless policies to mitigate learning loss are implemented immediately.