Airborne fungal communities are more susceptible to anthropogenic activities than bacteria.

Airborne microorganisms (AM) have significant environmental and health implications. Extensive studies have been conducted to investigate the factors influencing the composition and diversity of AM. However, the knowledge of AM with anthropogenic activities has not reach a consensus. In this study, we took advantage of the dramatic decline of outdoor anthropogenic activities resulting from COVID-19 lockdown to reveal their associations. We collected airborne particulate matter before and during the lockdown period in two cities. The results showed that it was fungal diversity and communities but not bacteria obviously different between pre-lockdown and lockdown samples, suggesting that airborne fungi were more susceptible to anthropogenic activities than bacteria. However, after the implementation of lockdown, the co-occurrence networks of both bacterial and fungal community became more complex, which might be due to the variation of microbial sources. Furthermore, Mantel test and correlation analysis showed that air pollutants also partly contributed to microbial alterations. Airborne fungal community was more affected by air pollutants than bacterial community. Notably, some human pathogens like Nigrospora and Arthrinium were negatively correlated with air pollutants. Overall, our study highlighted the more impacts of anthropogenic activities on airborne fungal community than bacterial community and advanced the understanding of associations between anthropogenic activities and AM.

Investigating the impact of COVID-19 lockdowns on fragility fracture risk and bone mineral density in a large observational cohort: a cross-sectional study.

Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2 or COVID-19) led to lockdowns predisposing people to sedentary lifestyles and unhealthy behaviours which may have affected bone mineral density (BMD) and fragility fracture risk. However, limited studies describe such an association. We aimed to investigate how COVID-19 lockdowns has affected BMD and fragility fractures in a large cohort. Methods: Patients were referred to our DXA scanner from 2004 to 2024 and were subsequently categorized as pre- or post-March 23, 2020 (pre- and post-COVID-19) to allow analysis between the groups. Demographic, BMD and compositional data were compared between the two populations. A multivariate logistic regression modelled the odds of reporting a fracture including hip and non-hip fracture. A multiple linear regression was used to model how the lockdown has affected bone density. All analyses were adjusted for confounders. Results: Of 43 799 referrals, 6564 were post-COVID-19. Post-COVID-19 patients had higher non-hip fracture rates (42.0% vs 39.8%), were 3 kg heavier, and had lower left femoral T-scores. Patients referred post-COVID-19 had a statistically significant reduction of -0.23 to their T-score after adjusting for confounders as well as increased risk of getting diagnosed with osteoporosis [odds ratio (OR) 1.49, 95% CI 1.40-1.59]. Patients referred after the pandemic had a reduced odds of any fracture (OR 0.83, 95% CI 0.77-0.88), hip (OR 0.74, 95% CI 0.62-0.88) and non-hip fracture (OR 0.78, 95% CI 0.73-0.83). Conclusion: COVID-19 lockdowns may have negatively affected bone; however, this has not translated to an increased fracture risk in our study. Further research is needed with prospective cohorts to corroborate this risk.

Changes in household use of disinfectant and cleaning products during the first lockdown period in France.

BACKGROUND: Few studies evaluated the use of Household Disinfectant and Cleaning Products (HDCPs) during the COVID-19 pandemic, but no population-based cohorts used longitudinal data. We studied changes in HDCPs during the first lockdown, based on longitudinal data from the French population-based NutriNet-Santé and CONSTANCES cohorts. METHODS: Based on standardized questionnaires on household cleaning tasks in 2018-2019 and around the first lockdown in France (March17-May3 2020), we compared the duration of weekly use of HDCPs (< 1 day/week, < 10 min/week; 10-30 min/week; > 30 min/week) and the household cleaning help (yes/no) before and during the lockdown period by Bhapkar and McNemar's tests. Moreover, we assessed self-reported changes in the frequency of HDCPs during the lockdown from before (unchanged/increased). RESULTS: Analyses were carried on 31,105 participants of NutriNet-Santé (48 years, 75% women, 81% ≥ high school diploma) and 49,491 of CONSTANCES (47 years, 51% women, 87% ≥ high school diploma). During the lockdown, compared with 2018-2019, duration of HDCPs use increased (> 30 min; NutriNet-Santé: 44% versus 18%; CONSTANCES: 63% versus 16%) and household help decreased (NutriNet-Santé: 5% versus 40%; CONSTANCES: 3% versus 56%). Regarding the frequency of HDCPs use, 55% of participants of NutriNet-Santé (57% women/49% men) and 83% of CONSTANCES (86% women/81% men) reported an increased use since the beginning of the lockdown, significantly higher among women (p < 0.0001). CONCLUSIONS: The frequency and duration of weekly use of HDCPs has significantly increased since the pandemic. As the use of HDCPs is associated with health issues, further studies are now needed to evaluate the potential health impacts of these changes.

Unveiling public perceptions at the beginning of lockdown: an application of structural topic modeling and sentiment analysis in the UK and India.

BACKGROUND: The appearance of the COVID-19 virus in December 2019, quickly escalated into a global crisis, prompting the World Health Organization to recommend regional lockdowns. While effective in curbing the virus's spread, these measures have triggered intense debates on social media platforms, exposing widespread public anxiety and skepticism. The spread of fake news further fueled public unrest and negative emotions, potentially undermining the effectiveness of anti-COVID-19 policies. Exploring the narratives surrounding COVID-19 on social media immediately following the lockdown announcements presents an intriguing research avenue. The purpose of this study is to examine social media discourse to identify the topics discussed and, more importantly, to analyze differences in the focus and emotions expressed by the public in two countries (the UK and India). This is done with an analysis of a big corpus of tweets. METHODS: The datasets comprised of COVID-19-related tweets in English, published between March 29th and April 11th 2020 from residents in the UK and India. Methods employed in the analysis include identification of latent topics and themes, assessment of the popularity of tweets on topic distributions, examination of the overall sentiment, and investigation of sentiment in specific topics and themes. RESULTS: Safety measures, government responses and cooperative supports are common themes in the UK and India. Personal experiences and cooperations are top discussion for both countries. The impact on specific groups is given the least emphasis in the UK, whereas India places the least focus on discussions related to social media and news reports. Supports, discussion about the UK PM Boris Johnson and appreciation are strong topics among British popular tweets, whereas confirmed cases are discussed most among Indian popular tweets. Unpopular tweets in both countries pay the most attention to issues regarding lockdown. According to overall sentiment, positive attitudes are dominated in the UK whilst the sentiment is more neutral in India. Trust and anticipation are the most prevalent emotions in both countries. In particular, the British population felt positive about community support and volunteering, personal experiences, and government responses, while Indian people felt positive about cooperation, government responses, and coping strategies. Public health situations raise negative sentiment both in the UK and India. CONCLUSIONS: The study emphasizes the role of cultural values in crisis communication and public health policy. Individualistic societies prioritize personal freedom, requiring a balance between individual liberty and public health measures. Collectivistic societies focus on community impact, suggesting policies that could utilize community networks for public health compliance. Social media shapes public discourse during pandemics, with popular and unpopular tweets reflecting and reshaping discussions. The presence of fake news may distort topics of high public interest, necessitating authenticity confirmation by official bloggers. Understanding public concerns and popular content on social media can help authorities tailor crisis communication to improve public engagement and health measure compliance.

Impact of COVID-19 lockdown measures on mother and child health - the case of Ghana.

BACKGROUND: The lockdown measures in response to the coronavirus disease (COVID-19) have led to a wide range of unintended consequences for women and children. Until the outbreak of COVID-19, attention was on reducing maternal and infant mortality due to pregnancy and delivery complications. The aim of this study was to interrogate the impact of lockdown measures on women and children in two contrasting districts in Ghana - Krobo Odumase and Ayawaso West Wuogon. METHODS: This study adopted the mixed-method approach using both qualitative and quantitative data. The qualitative study relied on two data collection methods to explore the impacts of COVID-19 control measures on women and children in Ghana. These were: Focus Group Discussions (FGDs; n = 12) and Key Informant Interviews (KIIs; n = 18). The study complemented the qualitative data with survey data - household surveys (n = 78) which were used to support the nutrition and school closure data; and policy data gathered from government websites consisting of government responses to COVID-19. The qualitative data was analysed using the thematic approach with codes generated apriori with the NVIVO software. The quantitative data used percentages and frequencies. RESULTS: Engagements with participants in the study revealed that the lockdown measures implemented in Ghana had consequences on child and maternal health, and the health care system as a whole. Our study revealed, for example, that there was a decrease in antenatal and postnatal attendance in hospitals. Childhood vaccinations also came to a halt. Obesity and malnutrition were found to be common among children depending on the location of our study participants (urban and rural areas respectively). Our study also revealed that TB, Malaria and HIV treatment seeking reduced due to the fear of going to health facilities since those ailments manifest similar symptoms as COVID 19. CONCLUSION: Government responded to COVID-19 using different strategies however the policy response resulted in both intended and unintended consequences especially for women and children in Ghana. It is recommended that national policy directions should ensure the continuous provision of child and maternal healthcare services which are essential health services during lockdowns.

Adolescent mental well-being in time of crises: The role of social and residential contexts.

BACKGROUND: The extent of the impact and the interconnections among factors within social and residential contexts during the COVID-19 lockdowns on mental well-being remain to be elucidated. We identified latent classes of each of social and residential context during the lockdown and examined their associations with mental well-being among adolescents in France 1-year after the first lockdown. METHODS: We used data collected in 2021 in a cross-sectional school-based pilot study for EXIST, from 387 participants ages 12-15 years. Participants reported retrospectively on characteristics of their social and residential contexts during the lockdown, and their current mental well-being in self-report questionnaires. We used latent class analysis to identify latent classes of social and residential contexts, and linear regression models to examine the associations between these contexts and mental well-being. RESULTS: Four social context classes were identified: class 1 "Low opportunity for social contact at home," class 2 "Moderate opportunity for social contact at home," class 3 "High opportunity for social contact at home," and class 4 "Very high opportunity for social contact at home." Relative to class 4, lower levels of mental well-being were observed among adolescents in class 1 (b = -4.08, 95% CI [-8.06; -0.10]) 1 year after the lockdown. We identified four residential context classes based on proximity to nature, type of residence (e.g., apartment, house), and level of neighborhood deprivation. No association was detected between residential context during the lockdown and adolescent mental well-being one-year later. CONCLUSION: A limited social context may negatively impact adolescent mental well-being during crises.

The Effect of COVID-19 Lockdown Among Adolescents with Type 1 Diabetes: A Systematic Review and Meta-Analysis.

OBJECTIVE: The aim of this study was to assess how the lockdown of the COVID-19 pandemic had affected the glycaemic control of adolescents aged 10-19 with type 1 diabetes. METHODS: A comprehensive search of literature was performed in PubMed, Scopus, Web of Science, and ProQuest. Published articles up to September 2022 were included. The Glucose Monitoring Index (GMI) and HbA1c level were defined as outcome variables. Average glucose level was found to be a common variable in both HbA1c levels and GMI; therefore, HbA1c and GMI were converted to average glucose (mg/dL) using appropriate formulas. Studies reported the outcomes in two or three periods (pre-lockdown, lockdown, and post-lockdown) were included in the analysis. A paired wise meta-analysis was performed among the studies that reported all three periods. Homogeneity across studies was assessed using I2 statistic. RESULT: Fourteen studies were included in the study. The pooled average glucose during the lockdown decreased to 166.9 mg/dL (95% CI, 153.78, 180.02) from 205.793 mg/dL (95% CI, 188.412, 223.173) during the pre-lockdown period, then it increased to 204.23 mg/dL (95% CI, 186.17, 222.29) during the post-lockdown period. A paired wise meta-analysis indicated a reduction in average glucose levels. However, it was not statistically significant, possibly due to the small number of studies that reported data from all three periods. CONCLUSION: Although the descriptive analysis of our study showed that the lockdown had affected (decreased) the average glucose level among adolescents with type 1 diabetes, this was not statistically significant in the pooled analysis.

Coping with COVID-19: a prospective cohort study on young Australians' anxiety and depression symptoms from 2020-2021.

BACKGROUND: Studies have shown that the coronavirus (COVID-19) pandemic negatively impacted the mental health of young Australians. However, there is limited longitudinal research exploring how individual factors and COVID-19 related public-health restrictions influenced mental health in young people over the acute phase of the COVID-19 pandemic. This study aimed to identify risk and protective factors associated with changes in individual symptoms of anxiety and depression among young Australians during the COVID-19 pandemic. METHODS: This prospective cohort study collected data on anxiety and depression symptoms of young Australians aged 15-29 years old using the Depression, Anxiety and Stress Scale short form (DASS-21). We delivered four online questionnaires from April 2020 to August 2021 at intervals of 3, 6, and 12 months after the initial survey. We implemented linear mixed-effects regression models to determine the association among demographic, socioeconomic, lifestyle and COVID-19 public health restrictions related factors and the severity of anxiety and depression symptoms over time. RESULTS: Analyses included 1936 young Australians eligible at baseline. There was a slight increase in DASS-21 anxiety mean scores from timepoint 3 to timepoint 4. DASS-21 depression scores showed slight fluctuations across timepoints with the highest mean score observed in timepoint 2. Factors associated with increases in anxiety and depression severity symptoms included LGBTQIA + identity, financial insecurity both before and during the pandemic, higher levels of loneliness, withdrawal or deferral of studies, spending more time on social media, and difficulties to sleep. Risk factors for only depression symptoms include unemployment during COVID-19 pandemic and being in lockdown. Living with someone was a protective factor for both anxiety and depression symptoms, pre-COVID-19 unemployment for depression symptoms, and older age and unemployment during the pandemic for anxiety symptoms. CONCLUSION: These findings indicate that during the first year of the pandemic in Australia, there were significant changes in young people's mental health which were associated with multiple demographic, socioeconomic, lifestyle, and lockdown factors. Hence, in future public health crises, we suggest more inclusive guidelines that involve young people in their development and implementation ensuring that their unique perspectives and needs are adequately considered.

Weight change and lifestyle modifications implemented during the COVID-19 pandemic lockdown are associated with the development of gastrointestinal symptoms.

INTRODUCTION AND AIMS: Pandemic lockdown measures are a cause of concern, regarding their negative impact on the mental health of individuals. The results of numerous studies have associated the appearance of gastrointestinal symptoms with different psychologic disorders, such as stress, depression, and anxiety, due to gut-brain axis interaction. The aim of the present study was to determine the prevalence of, and factors associated with, gastrointestinal symptom onset related to the COVID-19 pandemic lockdown and various lifestyle modifications. METHODS: An analytic, observational, and cross-sectional study was conducted on an open population that agreed to participate within the time frame of January to May 2021. RESULTS: A total of 298 subjects, 165 of whom were women (55.4%), agreed to participate and the mean patient age was 36.1 ±â€¯12.6 years. There was a significant increase in the frequency of several gastrointestinal symptoms: epigastric burning, early satiety, heartburn, regurgitation, constipation, and diarrhea. Changes in weight and modifications in lifestyle were found to be associated variables. CONCLUSIONS: The results of this study showed a significant increase in a wide variety of gastrointestinal symptoms related to lifestyle changes due to the pandemic lockdown. Weight change, supplement and multivitamin intake, and reduced physical activity were the main associated risk factors. Public healthcare systems should take a multidisciplinary approach into consideration for the care of affected individuals.

Comparative Assessment of the Impact of COVID-19 Lockdown on Air Quality: A Multinational Study of SARS-CoV-2 Hotspots.

In response to the global COVID-19 pandemic, nations implemented lockdown measures to contain the virus. This study assessed air pollution levels during and after lockdowns, focusing on the following heavily affected locations: Oulu and Helsinki in Finland, Paris in France, Madrid in Spain, Milan in Italy, and Wuhan in China. Air Quality Index (AQI) data from these locations over two years were analyzed to understand the effects of lockdowns. The study compared COVID-19 lockdowns in these six cities with SARS-CoV-2 measurements using statistical methods. Variations in outdoor pollutants were evaluated through tests, revealing significant differences. Parametric analyses and regression were employed to study the impacts of lockdown measures on pollution and their relationships. The study comprehensively analyzed the effects of COVID-19 lockdowns on air quality, identifying differences, quantifying changes, and exploring patterns in each city. Pollutant correlations varied among cities during the lockdowns. Regression analysis highlighted the impact of independent variables on pollutants. Decreases in NO2 were observed in Helsinki, Madrid, Oulu, Paris, and Milan, reflecting reduced traffic and industrial activities. Reductions in PM2.5 and PM10 were noted in these cities and in Wuhan, except for O3 levels, which increased. The reduction in human activities improved air quality, particularly for NO2 and PM10. Regional variations underscore the need for tailored interventions. The study observed a substantial decrease in both PM2.5 and NO2 levels during the COVID-19 lockdowns, indicating a direct correlation between reduced human activities, such as transportation and industrial operations, and improved air quality. This underscores the potential impact of environmental measures and suggests the need for sustainable practices to mitigate urban pollution.

Social and Health-related Changes in Hispanic Cancer Patients during the COVID-19 Lockdown.

OBJECTIVE: The current study aimed to explore changes in health-related behaviors and social practices in Hispanic cancer patients during a government-mandated lockdown and their relationship to sociodemographic and clinical characteristics. METHODS: Secondary analyses were conducted on data gathered by a longitudinal cohort study to describe the unmet needs of Hispanic cancer patients living in Puerto Rico exposed to Hurricane Maria in 2017, earthquakes in 2020, and COVID-19. However, our study solely focuses on the data from the COVID-19 pandemic period. RESULTS: Most participants were women (n = 72) with breast cancer (81.2%). Participants exhibited changes in religious practices (60%), physical activity (58.4%), and sedentary behavior (50%); 31.4% experienced changes in eating habits and sleeping patterns. Responses to the study questionnaire involved staying connected with family (85.5%) through phone calls (78.2%); 69.9% of the participants reported observing shifts in the family dynamics. A strong majority endorsed the government-imposed isolation measures (95.6%). Patients not undergoing treatment were likelier (r = -0.324; P = .010) to support the measures. Finally, younger patients experienced more work-related changes (r = -0.288; P = .017) and were less inclined (r = -0.293; P = .011) to find the isolation measures appropriate. CONCLUSION: This paper describes the lockdown related changes in health and social behaviors sustained by cancer patients, changes which could potentially impact their overall health and health-related quality of life. Our results fill an existing gap in our findings and contribute to understanding the experiences of cancer patients (in particular, Hispanic patients) during the COVID-19 pandemic.

Chronotype Differences and Symptom Network Dynamics of Post-Pandemic Sleep in Adolescents and Young Adults.

Background: Social restrictions during the COVID-19 pandemic resulted in altered sleep patterns and mental health challenges, particularly among adolescents and young adults. Our objective was to examine the potential difference in insomnia prevalence and sleep patterns in this population between the first COVID-19 lockdown and the post-lockdown period, with a focus on chronotype. Additionally, we explored the network of sleep-related differences between these two periods. Methods: A total of 946 respondents participated in our online questionnaire. We performed mixed ANOVA, Ising network and Directed Acyclic Graph (DAG) analyses. Results: Respondents reported going to bed earlier, waking up earlier, sleeping less, and feeling less mentally tired than during the lockdown. The severity of insomnia symptoms did not change. The lethargic chronotype reported more insomnia symptoms, depressive feelings, and agitation than others. Mental fatigue was the central symptom in the Ising network and served as the parent node in the DAG. Conclusions: Post-lockdown, adolescents and young adults have shifted to earlier sleep and wake times with reduced overall sleep, and they experience fewer depressive feelings and less agitation, though insomnia symptoms remain unchanged. Participants who reported increased irritability or poorer sleep quality during confinement also reported similar or diminished attentional capacities compared to their usual levels.

Management of COVID-19 in Ophthalmology.

From its outbreak in early 2020, the new SARS-CoV-2 infection has deeply affected the entire eye care system for several reasons. Since the beginning of the COVID-19 pandemic, ophthalmologists were among the "high-risk category" for contracting the SARS-CoV-2 infection based on the notion that the eye was suspected to be a site of inoculation, infection, and transmission. Clinical ophthalmologists have been required to learn and promptly recognize the ocular manifestations associated with the COVID-19 disease, with its treatments and vaccinations. Restriction measures, lockdown periods, guidelines to prevent SARS-CoV-2 infection transmission, and the use of telemedicine and artificial intelligence modalities have induced profound modifications. These changes, which are most likely to be irreversible, influence routine clinical practice, education, and research, thus giving rise to a "new ophthalmology in the COVID era". This book chapter aims to provide several notions regarding COVID-19 in ophthalmology, including the SARS-CoV-2 virus infection and transmission modalities; the ocular manifestation associated with the COVID-19 disease; the drugs and vaccines used for COVID-19; the precautions adopted in the ophthalmic practice to limit the spread of the virus; the consequences of the pandemic on the ophthalmic patients, clinicians, and the entire eye care system; and, the future of ophthalmology in the era of "COVID new normal".

Water quality assessment of Upper Ganga and Yamuna river systems during COVID-19 pandemic-induced lockdown: imprints of river rejuvenation.

Clean river water is an essential and life-sustaining asset for all living organisms. The upper Ganga and Yamuna river system has shown signs of rejuvenation and tremendous improvement in the water quality following the nationwide lockdown due to the coronavirus pandemic. All the industrial and commercial activity was shut down, and there was negligible wastewater discharge from the industries. This article addresses the water quality assessment from the study area, which is based on the original data of physical parameters, major and trace elements, and stable isotopes (hydrogen and oxygen) systematics during the nationwide lockdown. The impact of the lockdown could be seen in terms of an increase in dissolved oxygen (DO). Water samples were collected from the Upper Ganga and Yamuna river basins (Alaknanda, Bhagirathi, and Tons rivers) during an eight-week lockdown in Uttarakhand, India. We discussed the signs of rejuvenation of riverine based on physical parameters, major ions, trace elements, isotopic ratios, and water pollution index (WPI). Results reveal that the water quality of the entire upper basins of the Ganga has significantly improved by 93%, reflecting the signs of self-rejuvenation of the rivers. Multivariate analysis suggests a negative factor loading for an anthropogenic element ( NO 3 - ), implying that they contribute little to the river water during the lockdown. Further, bicarbonate ( HCO 3 - ) is a dominant element in both river basins. The geochemical facies are mainly characterized by the ( Ca 2 + : Mg 2 + : H C O 3 - ) type of water, suggesting that silicate rock weathering dominates with little influence from carbonate weathering in the area. The positive factor loadings of some cations, like HCO 3 - , Ca 2 + , and Mg 2 + reflect their strong association with the source of origin in the lockdown phases. Stable isotopic reveals that the glaciated region contributed the most to the river basin, as evidenced by the low d-excess in riverine water compared to anthropogenic contributions. Rivers can self-rejuvenate if issues of human influence and anthropogenic activities are adequately resolved and underline our responsibility for purifying the ecosystem. We observed that this improvement in the river water quality will take a shorter time, and quality will deteriorate again when commercial and industrial activity resumes.

Falls in focus: an analysis of the rate of falls in 25 Australian residential aged care facilities from 2019 to 2021, pre- and during COVID-19 lockdowns.

INTRODUCTION: During 2020-2021 Australia maintained comparatively low rates of COVID-19 in the community and residential aged care facilities (RAC) due to stringent public health measures such as lockdowns. However, the public health measures implemented may have had unintended impacts on critical RAC resident health outcomes, such as falls, due to routine care disruptions and aged care resident isolation. We utilised a longitudinal data to assess the association between COVID-19 lockdowns and the rate of falls in RAC settings. METHODS: A longitudinal cohort study was conduct using routinely collected data from 25 RAC facilities from one non-profit aged care provider in Sydney, Australia. The study included 2,996 long term residents between March 2019 and March 2021. The outcome measures were all falls, injurious falls, and falls assessed as requiring hospitalisation. Generalised estimating equations (GEE) were applied to determine the association between COVID-19 lockdown periods and fall-related outcomes while adjusting for confounders and seasonality. RESULTS: During the study period 11,658 falls were recorded. Residents frequently experienced at least one fall during the study period (median: 1, interquartile range: 0-4). During Lockdown 1 (March-June 2020) the rate of all falls increased 32% (IRR 1.32, 95% CI 1.19-1.46, p < 0.01) and the rate of injurious falls increased by 28% (IRR 1.28, 95% CI 1.12-1.46, p < 0.01) compared to pre-pandemic rates. The rate of falls assessed as requiring hospitalisation remained unchanged during Lockdown 1 (IRR 1.07, 95% CI 0.86-1.32, p = 0.519). During Lockdown 2 (Dec 2020-Jan 2021) the rate of all falls, injurious falls, and falls assessed as requiring hospitalisation did not change significantly compared to pre-pandemic rates. CONCLUSION: These findings suggest that the consequences of stringent COVID-19 restrictions, as seen in Lockdown 1, produced changes in residents' care which contributed to more falls and associated harm. The subsequent lockdown, which were less restrictive and occurred after staff had gained experience, was associated with no significant increase in falls rate. The nature and extent of lockdowns implemented for infection control in RAC need to balance multiple potential adverse effects. Factors which facilitated resilience during this period require exploration in future research.

[Influence of health care crises on the treatment of cancer pain: a presentation using the example of the COVID-19 pandemic from the provider's perspective]. / Einfluss von Versorgungskrisen auf die Behandlung von Tumorschmerzen: eine Darstellung am Beispiel der COVID-19-Pandemie aus Versorgersicht.

BACKGROUND: The COVID-19 pandemic led to significantly restricted access to pain medicine services. Patients with cancer-related pain are considered a vulnerable group in terms of care deficits. A questionnaire among providers providing treatment to this group was used to assess limitations and solutions in this critical situation. MATERIALS AND METHODS: The online survey, developed by the 'Tumour Pain Working Group' of the German Pain Society using the Delphi method, included questions on site structure, pandemic-related care problems, and burdens experienced by those treating patients. It was distributed several times via the mailing lists of the German Pain Society and the 'Palliative Medicine Working Group' of the German Society of Anaesthesiology and Intensive Care Medicine. RESULTS: In all, 175 fully completed questionnaires were analysed. Over 75% of participants reported pandemic-related staff shortages and closures of pain medicine facilities, with 32% of facilities temporarily not treating elective pain patients and 13% not treating any emergencies. Care was hampered by numerous logistical problems such as very frequent pandemic-related cancellations by patients or in the transmission of prescriptions. Alternative forms of consultation by telephone or telemedicine, rarely used before the pandemic, were reported by 79 and 31% of respondents respectively, but deficiencies were noted. In addition, 52.1% of respondents complained of severe and 26.8% of moderate psychological stress due to the pandemic, and 74.1% evaluated working conditions as moderately to severely difficult. Medical training was still possible for 86% through format changes. CONCLUSION: The COVID-19 pandemic revealed numerous deficits in the care of patients with cancer-related pain, as well as burdens on healthcare providers. The development of new concepts could help to ensure better care in future crisis situations.

Impact of the COVID-19 pandemic on the quality of care for juvenile idiopathic arthritis patients: insights from Thailand.

BACKGROUND: The COVID-19 pandemic has significantly impacted individuals with chronic conditions. This investigation assessed the quality of care provided to pediatric and adolescent patients with juvenile idiopathic arthritis (JIA) during the pandemic in Thailand. METHODS: This cross-sectional analysis enrolled JIA patients aged ≤ 18 years at an academic tertiary care facility from April 2022 to March 2023. Retrospective reviews were performed, complemented by patient and caregiver questionnaires to assess the pandemic's impact on care quality. RESULTS: Seventy JIA patients (37 males, 33 females) with a mean age of 13.5 ± 3.1 years were included. A total of 41.4% of the caregivers reported negative impacts on JIA care due to the pandemic and the lockdown, and 31.4% of the patients experienced pandemic-related anxiety. A comparison between the pandemic and prepandemic periods revealed a higher incidence of active disease, although the difference was statistically nonsignificant (37.1% vs 14.2%, p = 0.106). Nonadherence significantly predicted active disease status (adjusted OR 15.04, 95% CI 2.48-91.15, p = 0.03). COVID-19 vaccinations were administered to 85.7% of patients; 52.8% of whom contracted mild COVID-19. Most patients (71.4%) postponed clinic visits; 36% due to lockdowns and 28% due to concerns about COVID-19 exposure in healthcare settings. The majority of patients received telephone JIA management advice from rheumatologists during the lockdown (91.4%). CONCLUSIONS: The COVID-19 pandemic and associated lockdown measures affected the care of JIA patients, impacting both physical and mental health. Nonadherence was a critical factor in disease flare-ups. Telemedicine is indispensable for patient care.

Impact of COVID-19 pandemic on the elderly in the United Kingdom: A review study.

The coronavirus disease 2019 (COVID-19) pandemic has significantly altered the lives and lifestyles of several older populations in the United Kingdom. It was important to note how it has affected their physical, mental, and social health and well-being during the first wave of the Covid-19 pandemic. To study the impact of the Covid-19 pandemic and the imposed restrictions on the day-to-day lives of the elderly population in the United Kingdom. A review of the published literature on the first wave of the Covid-19 pandemic and its consequences on the older population in the United Kingdom is done. Search engines used for medical databases were Pubmed, Google Scholar, and Internet Explorer. It was found that physical as well as mental well-being was affected in the elderly citizens of the United Kingdom. Mental health studies noted an obvious increase in anxiety and depressive symptoms. Social isolation and reduced access to healthcare services had a deteriorating impact on their social health. Covid-19-related lockdown and pandemic-associated physical, mental, and social well-being effects have been evident in the elderly population in the United Kingdom. The reasons identified for such findings are lack of physical activity, poor social interactions, social isolation, the perceived threat of a pandemic, and poor access to healthcare facilities.

Knowledge and utilization of Integrated Child Development Services among antenatal women during COVID-19 pandemic.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has affected the healthcare delivery system in both developed and developing countries. Many antenatal women skipped their regular antenatal check-ups due to fear of viral contamination and lack of transport facilities. Integrated Child Development Services (ICDS), which plays a major role in antenatal care, also suffered a great deal during the pandemic. Objectives: 1. To assess knowledge and utilization of ICDS services by antenatal women during the COVID-19 pandemic. 2. To determine factors influencing the knowledge and utilization of ICDS services by antenatal women. 3. To determine the barriers to utilization of ICDS services during the pandemic. Methodology: This study was conducted as a descriptive study in a tertiary care center. Antenatal women whose pregnancy period coincided with the second wave of the COVID-19 pandemic were interviewed using a structured questionnaire. The sample size was calculated as 198. Data were entered in Microsoft Excel and analyzed using Statistical Package for Social Sciences (SPSS). Results: Around 61% of the study population had adequate knowledge about ICDS services. The proportion of antenatal women utilizing ICDS services reduced from 87.8% to 69.6% during the pandemic. Only a few of the mothers were followed up by the Anganwadi workers during the pandemic. The main barriers to not utilizing ICDS services were fear of the spread of the pathogen and lack of awareness about the availability of services during the pandemic. Conclusion: There has been a reduction in the utilization of ICDS services by antenatal women during the COVID-19 pandemic. Measures should be taken by the government to ensure undisrupted care for antenatal women during such hard times.

White privilege, ethnic disadvantage, and stigmatized linguistic capital: COVID-19 infection rates and lockdown law enforcement in Hong Kong.

The COVID-19 pandemic has exposed and exacerbated existing disparities in various societies. This study investigates disparities among racial, ethnic, and linguistic groups in Hong Kong's society in COVID-19 infection rates and lockdown enforcement practices that was imposed 545 times from January 2021 to September 2022 and affected 9% of the population. It is found that neighborhoods with more white individuals had lower infection rates than the overall population, while those with more ethnically minoritized groups had higher infection rates. Furthermore, hit rate tests reveal that the government targeted more neighborhoods with a higher share of individuals from linguistically minoritized groups. This novel finding suggests that not only race, but linguistic difference of the same ethnicity can cause bias. The study highlights the positive impact of providing ethnic support services on health outcomes in neighborhoods with a higher share of individuals from ethnically minoritized groups.