Sickness absence during the COVID-19 pandemic

The aim of this research was to perform comparative analysis of the publicly avaiable data of the Social Insurance Institution (ZUS) on sickness absence of insured persons in Poland in 2016-2021 (before the outbreak and during the COVID-19 pandemic). Materials and methods. The research material consisted of data from the Social Insurance Institution for the years 2016-2021 (Q1) concerning the sickness absence of the insured. Due to the publication of data in an aggregated form, quantitative analysis was performed instead of statistical analysis. The data used in the analysis included the number of insured persons, the number of people receiving sickness benefits, the number of issued medical certificates on temporary incapacity to work and the reasons for the incapacity to work. Results and Conclusion. Since the beginning of the COVID-19 pandemic, following numbers have increased compared to 2019: the number of people receiving sickness benefit in Poland (by 10%), the number of days of sickness absence (by 7%) and the number of issued medical certificates of temporary incapacity for work (by 4%). The largest increase in the number of beneficiaries, the number of days of sickness absence and the number of medical certificates was recorded in the Q4 of 2020 (respectively by 21%, 16% and 24% compared to Q4 of 2019). Due to COVID-19, 4.84 million days of sickness absence were used in 2020 – it was the tenth cause of absence. The largest changes in the number of people receiving sickness benefit and the number of days of sickness absence can be observed in Q1 and Q4, which may result from the seasonality of COVID-19 and the subsequent wave of infections. Importantly, COVID-19 is not the only factor contributing overall increase in the number of days of sickness absence in Poland – absence due to non-communicable diseases also increased during the pandemic.

SARS-CoV-2 Genomic Surveillance Reveals Little Spread From a Large University Campus to the Surrounding Community

Background Coronavirus disease 2019 (COVID-19) has had high incidence rates at institutions of higher education (IHE) in the United States, but the transmission dynamics in these settings are poorly understood. It remains unclear to what extent IHE-associated outbreaks have contributed to transmission in nearby communities. Methods We implemented high-density prospective genomic surveillance to investigate these dynamics at the University of Michigan and the surrounding community during the Fall 2020 semester (August 16–November 24). We sequenced complete severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes from 1659 individuals, including 468 students, representing 20% of cases in students and 25% of total cases in Washtenaw County over the study interval. Results Phylogenetic analysis identified >200 introductions into the student population, most of which were not related to other student cases. There were 2 prolonged student transmission clusters, of 115 and 73 individuals, that spanned multiple on-campus residences. Remarkably, <5% of nonstudent genomes were descended from student clusters, and viral descendants of student cases were rare during a subsequent wave of infections in the community. Conclusions The largest outbreaks among students at the University of Michigan did not significantly contribute to the rise in community cases in Fall 2020. These results provide valuable insights into SARS-CoV-2 transmission dynamics at the regional level.

Exploring the Bidirectional Associations Between Short or Long Sleep Duration and Lower Cognitive Function: A 7-Year Cohort Study in China

Background: Sleep duration is linked to cognitive function, but whether short or prolonged sleep duration results from impaired cognition or vice versa has been controversial in previous studies. We aimed to investigate the bidirectional association between sleep duration and cognitive function in older Chinese participants.Methods: Data were obtained from a nationally representative study conducted in China. A total of 7984 participants aged 45 years or older were assessed at baseline between June 2011 and March 2012 (Wave 1), 2013 (Wave 2), 2015 (Wave 3), and 2018 (Wave 4). Nocturnal sleep duration was evaluated using interviews. Cognitive function was examined via assessments of global cognition, including episodic memory, visuospatial construction, calculation, orientation and attention capacity. Latent growth models and cross-lagged models were used to assess the bidirectional association between sleep duration and cognitive function.Results: Among the 7,984 participants who were followed in the four waves of the study, the baseline mean (SD) age was 64.7 (8.4) years, 3862 (48.4%) were male, and 6453 (80.7%) lived in rural areas. Latent growth models showed that both sleep duration and global cognition worsened over time. Cross-lagged models indicated that short or long sleep duration in the previous wave was associated with lower global cognition in the subsequent wave (standardized β = −0.066; 95% CI: −0.073, −0.059; P < 0.001; Wave 1 to 2) and that lower global cognition in the previous wave was associated with short or long sleep duration in the subsequent wave (standardized β = −0.106; 95% CI: −0.116, −0.096; P < 0.001; Wave 1 to 2).Conclusion: There was a bidirectional association between sleep duration and cognitive function, with lower cognitive function having a stronger association with long or short sleep duration than the reverse relationship. Global cognition was likely the major driver in these reciprocal associations.

EP.WE.608Hospital within the Hospital – Renaissance of Elective Surgery Amidst the Pandemic

Aim COVID had an unprecedented effect on the NHS elective surgical care. To overcome the deficit created due to the pandemic, the concept of a ‘COVID protected zone’ gave birth to the ‘hospital within the hospital’. This included 9 elective theatres, 28 ring fenced elective beds, a surgical enhanced care unit, a canteen and a separated entrance. Of the fundamentals of the model were enhanced infection control and PPE guidance for staff. The aim of our study was to evaluate the recovery of elective activity brought about by this elective centre. Methods Theatre activity data was collected weekly (7/20 to 1/21) through the business informatics system. This was used to compare the activity achieved during the recovery phase from COVID after the first and subsequent wave. Results Pre COVID-19, 11 theatres were operating. These managed an average of 263 cases were per week. In the first week of operation of elective centre, 31% of theatre capacity was achieved. By week 7, 106% of pre COVID was recorded and 130% by week 11. During the 2nd wave the capacity was reduced to 42% as opposed to 0% during the first wave. This was only possible due to our model elective centre. Conclusion This model elective centre has enabled elective care to return to above normal levels, with increased efficiencies. This has not only shortened patient waiting times and cleared the back-log but also delivered training to surgical trainees without compromising safety.

Young People’s Rights and Mental Health During a Pandemic: An Analysis of the Impact of Emergency Legislation in Scotland

Emerging evidence indicates that the COVID-19 pandemic and government measures put in place in response to this have had a detrimental impact on young people’s mental health. A children’s human rights-based approach was taken to examine the impact of the legislative and policy measures that were implemented in Scotland in response to the pandemic on children’s rights related to their mental health. Key concerns were identified around children’s rights to access mental health services and information, participation in decision-making and non-discrimination of vulnerable groups. Although the analysis focussed on Scotland, recommendations to protect these rights are likely to be relevant to other countries following similar approaches as lockdown restrictions are eased, or in the event that stricter local or national measures are required again to curb rising infection rates or subsequent wave(s).

Coercion and Coerciveness in the Politics of Cold-War Ukraine and Taiwan

The present study is devoted to an examination of the prison memoirs by the Ukrainian writer, Mykhaylo Osadchy (1936–1994) and the Taiwanese writer Tsai Tehpen (b. 1925) from the perspective of coercion. Osadchy was a member of the Sixtiers, a group of young Ukrainian intellectuals who brought about cultural renaissance in post-Stalin Ukraine. Their writings marked a strong reaction against Moscow’s policy of great-power chauvinism at the onset of the regime change that marked the end of Khrushchev’s liberalizing campaign. Osadchy was one of the victims of the subsequent wave of arrests of dissidents in the Soviet Union, including Ukraine, in 1965. His memoir, Cataract (1971) is a powerfully evocative response to trumped-up charges of subversion, anti-Soviet agitation and bourgeois nationalism, and a riveting description of life in a Mordovian labor camp, a work that posed a strong attack on official Soviet culture.

Determination of Total Petroleum Hydrocarbons Concentration in Coastal Seawater of Teluk Batik Beach, Perak, Malaysia

The study aims to determine Total Petroleum Hydrocarbon (TPH) status in seawater from Teluk Batik beach seawater. In July 2018, fishing vessel sunk two nautical miles off Pematang Damar Laut, a coastal village within the town of George Town, Penang Malaysia, which also impacted the coastline of Perak State. Approximately six tons of diesel and hundreds of liters of fuel oil drifted from the Penang sea to the Perak coast. On further subsequent wave action the TPH concentrations in seawater fluctuated over time. In the coastal water of Teluk Batik Beach, Perak, Malaysia, grab samples were taken from surface seawater for determining the TPH concentrations in November and December 2019. The TPH in seawater was determined by the extractable solvent (Hexane) and the additional petroleum hydrocarbons by the Infrared (IR) method. The values of TPH ranged from 91 to 503 mg/L. Compared to the standards in Malaysian waters, the TPH levels found in this study were high, indicating serious pollution of TPH in the area under study.

Longitudinal Associations Between Changes in Cigarette Smoking and Alcohol Use, Eating Behavior, Perceived Stress, and Self-Rated Health in a Cohort of Low-Income Black Adults

Background Black adults in the U.S. experience significant health disparities related to tobacco use and obesity. Conducting observational studies of the associations between smoking and other health behaviors and indicators among Black adults may contribute to the development of tailored interventions. Purpose We examined associations between change in cigarette smoking and alcohol use, body mass index, eating behavior, perceived stress, and self-rated health in a cohort of Black adults who resided in low-income urban neighborhoods and participated in an ongoing longitudinal study. Methods Interviews were conducted in 2011, 2014, and 2018; participants (N = 904) provided at least two waves of data. We fit linear and logistic mixed-effects models to evaluate how changes in smoking status from the previous wave to the subsequent wave were related to each outcome at that subsequent wave. Results Compared to repeated smoking (smoking at previous and subsequent wave), repeated nonsmoking (nonsmoking at previous and subsequent wave) was associated with greater likelihood of recent dieting (OR = 1.59, 95% CI [1.13, 2.23], p = .007) and future intention (OR = 2.19, 95% CI [1.61, 2.98], p < .001) and self-efficacy (OR = 1.64, 95% CI [1.21, 2.23], p = .002) to eat low calorie foods, and greater odds of excellent or very good self-rated health (OR = 2.47, 95% CI [1.53, 3.99], p < .001). Transitioning from smoking to nonsmoking was associated with greater self-efficacy to eat low calorie foods (OR = 1.89, 95% CI [1.1, 3.26], p = .021), and lower perceived stress (β = −0.69, 95% CI [−1.34, −0.05], p = .036). Conclusions We found significant longitudinal associations between smoking behavior and eating behavior, perceived stress, and self-rated health. These findings have implications for the development of multiple behavior change programs and community-level interventions and policies.

The time is now: role of pragmatic clinical trials in guiding response to global pandemics

Along with its heavy toll of morbidity and mortality, the coronavirus disease 2019 (COVID-19) pandemic exposed several limitations of the current global research response. The slow and inefficient process of carrying out traditional randomized clinical trials led regulatory authorities to hastily approve treatments and tests without sufficient evidence of safety and efficacy.We here outline issues with the current research platform, summarize shortcomings of traditional randomized clinical trials particularly apparent at the time of pandemics, and highlight the advantages of pragmatic clinical trials as an alternative to rapidly generate the needed clinical evidence. We further discuss barriers and challenges to pragmatic clinical trials implementation and explore opportunities for research institutions and regulatory authorities to facilitate widespread adoption of this vital research tool.As a subsequent wave of COVID-19, and/or another epidemic, are all but inevitable in our lifetime, we must ensure that our research infrastructure is conducive to carrying out pragmatic clinical trials to expeditiously generate the needed evidence and blunt the epidemic’s toll on human lives and livelihoods.