Responses of paediatric emergency departments to the first wave of the COVID-19 pandemic in Europe: a cross-sectional survey study

ObjectiveUnderstanding how paediatric emergency departments (PEDs) across Europe adapted their healthcare pathways in response to COVID-19 will help guide responses to ongoing waves of COVID-19 and potential future pandemics. This study aimed to evaluate service reconfiguration across European PEDs during the initial COVID-19 wave.DesignThis cross-sectional survey included 39 PEDs in 17 countries. The online questionnaire captured (1) study site characteristics, (2) departmental changes and (3) pathways for children with acute illness pre and during the first wave of COVID-19 pandemic (January–May 2020). Number of changes to health services, as a percentage of total possible changes encompassed by the survey, was compared with peak national SARS-CoV-2 incidence rates, and for both mixed and standalone paediatric centres.ResultsOverall, 97% (n=38) of centres remained open as usual during the pandemic. The capacity of 18 out of 28 (68%) short-stay units decreased; in contrast, 2 units (7%) increased their capacity. In 12 (31%) PEDs, they reported acting as receiving centres for diverted children during the pandemic.There was minimal change to the availability of paediatric consultant telephone advice services, consultant supervision of juniors or presence of responsible specialists within the PEDs.There was no relationship between percentage of possible change at each site and the peak national SARS-CoV-2 incidence rate. Mixed paediatric and adult hospitals made 8% of possible changes and standalone paediatric centres made 6% of possible changes (p=0.086).ConclusionOverall, there was limited change to the organisation or delivery of services across surveyed PEDs during the first wave of the COVID-19 pandemic.

Representing Women: The Introduction, Context, and Implications of Reserved Seats for Women in the National Union of Public Employees

This paper explores the impact of the decision by the National Union of Public Employees (NUPE) in 1975 to revise its constitution to include elected reserved seats for women on its executive and other bodies. The analysis is situated within the context of women’s employment and trade-union representation in the UK at the time. Reserved seats for women were part of a wider restructuring of NUPE intended to extend democracy, incorporate the emergent system of shop stewards formally into its structure and government, provide for more effective representation and mobilization of different sections of members, and increase the accountability of full-time officials to lay members and their representatives. The initiative was successful; and although women’s participation in NUPE did increase, this was uneven. This was not entirely unexpected given the limited change initiated in just one haltingly democratizing trade union and the wider social and economic forces that constrain women.

Tourism Developments Increase Tsunami Disaster Risk in Pangandaran, West Java, Indonesia

On 17 July 2006, the tourist resort of Pangandaran on Java’s south coast was hit by a tsunami, resulting in 413 fatalities and severe damage to buildings. The tsunami resulted in major rebuilds with a focus on mass tourism. Assessments of the impact of a future tsunami focussed on building development and suggest limited change since 2006. This article presents a case study on the development of (largely domestic) tourism in Pangandaran and how this has increased the tsunami disaster risk. Tourist numbers were stable at about 900,000 visitors a year prior to the tsunami, down to slightly over 250,000 visitors a year in its aftermath, and from 2007 onwards numbers are doubling every three years to about 4 million visitors in 2019. The increase has been most pronounced during weekends. Prior to 2006, Pangandaran was characterized by wooden structures and one- and two-story buildings of clay-brick masonry; by 2019, 14 three to six-story hotels have been erected along the waterfront. With many more visitors, most of whom are unfamiliar with tsunami risks, and shelter facilities for less than a quarter of visitors during peak times, future impacts and the potential cost to life are considerably higher now than in 2006, especially if a tsunami were to hit over a weekend. All tourists upon arrival and throughout their stay should be better informed about the risks of tsunamis, and of the location of tsunami shelters and evacuation routes.

COMING TOGETHER BUT STAYING APART: CONTINUITY AND CHANGE IN THE AUSTRIAN AND SWISS VARIETIES OF CAPITALISM

This chapter assesses institutional continuity and change in the varieties of capitalism in Austria and Switzerland. In the face of growing internationalisation, budgetary constraints and European integration, continuity and change have been determined by prevailing interest configurations and institutional limits in terms of public intervention and private governance. Hence, private employer dominance in Switzerland has fostered ra- pid change in areas where private regulation prevailed, such as corporate gover- nance, whereas institutional veto points have strongly limited change in areas where public intervention was necessary. By contrast, the larger scope of public intervention in Austria and its more majoritarian features have allowed more space for change in welfare reforms while the strong institutionalisation of corporatist institutions in labour market governance, for instance, has made it more resilient to change than Switzerland. In this respect, Austria and Switzerland provide good examples of how institutional change is dependent on the respective share of public regulation and private governance.

505(b) (2) - A smart pathway to differentiate from competitive, low margin environment of generics

Purpose 505(b) (2) application is one of the advantageous ways of regulatory submission. This submission approach can lead to fast-track approval for wide-ranging products, exclusively for those that exemplify a limited change from formerly approved drug. Safety and efficacy evidence in terms of non-clinical and clinical portion of the Reference Listed Drug (RLD), are trusted upon. Additionally, supplementary data essentially required to establish comparability with the RLD, are presented in the dossier. Methods This retrospective analysis is to understand the FDA's expectations and avoid errors in terms of data support approval for a new product submitted under the 505 (b) (2) route. The current script is an analysis on how to architect 505(b) (2) regulatory strategy by developing a different set of documents/information. Results The ultimate goal of this review is to allow drug developers to easily navigate through various 505 (b) (2) submissions and defense strategies for registration processes available to the new drug manufacturers and to understand an effective, safer filing route by facilitating early market launch with a prospect of lower cost. Conclusion Before considering option 505 (b) (2), general companies should have a good understanding of product’s potential productivity, scalability, patent infringement, expensive clinical studies and/or non-clinical studies to appropriately strategize scientific and commercial opportunities. This leverage will potentially quicken the development program and will definitely lower the clinical and regulatory risk of new product entrants.

Abrupt but smaller than expected changes in surface air quality attributable to COVID-19 lockdowns

The COVID-19 lockdowns led to major reductions in air pollutant emissions. Here, we quantitatively evaluate changes in ambient NO2, O3, and PM2.5 concentrations arising from these emission changes in 11 cities globally by applying a deweathering machine learning technique. Sudden decreases in deweathered NO2 concentrations and increases in O3 were observed in almost all cities. However, the decline in NO2 concentrations attributable to the lockdowns was not as large as expected, at reductions of 10 to 50%. Accordingly, O3 increased by 2 to 30% (except for London), the total gaseous oxidant (Ox = NO2 + O3) showed limited change, and PM2.5 concentrations decreased in most cities studied but increased in London and Paris. Our results demonstrate the need for a sophisticated analysis to quantify air quality impacts of interventions and indicate that true air quality improvements were notably more limited than some earlier reports or observational data suggested.

The low-frequency improvement with loading soft magnetic ferrite films for multiband antenna applications

This work presents an easy way to improve the low-frequency properties in a small-size LTE/WWAN smartphone antenna by just loading a soft magnetic ferrite film on the strong radiation area. The base non-magnetic antenna, which only takes up an 11 mm × 30 mm no-ground space, can achieve hexa-band operation covering 822–914/1710–3244 MHz bands by co-designing a meandering strip and a T-shaped feeding strip. With loading a small-size ferrite film (2 mm × 15 mm) at the strong radiation strip, the frequencies can be shifted to cover the range of 692–1191/1698–3020 MHz, which shows a fully covering of octa-band operation, especially including the best long-term-evolution band, LTE700, without enlarging the size of base antenna. In addition, the radiation characteristics of the magnetic antenna with ferrite film loading show a limited change at upper bands (1710–2690 MHz) but an acceptable level at lower bands (698–960 MHz). Both experimental and simulated results have been taken out and shown the consistent tendency. This optimization method of low-frequency properties by introducing a commercial ferrite film on the antenna has provided a simple and convenient way to solve the frequency deviation in the practical smartphone applications.

Homogenization of Endosymbiont Communities Hosted by Equatorial Corals during the 2016 Mass Bleaching Event

Thermal stress drives the bleaching of reef corals, during which the endosymbiotic relationship between Symbiodiniaceae microalgae and the host breaks down. The endosymbiont communities are known to shift in response to environmental disturbances, but how they respond within and between colonies during and following bleaching events remains unclear. In 2016, a major global-scale bleaching event hit countless tropical reefs. Here, we investigate the relative abundances of Cladocopium LaJeunesse & H.J.Jeong, 2018 and Durusdinium LaJeunesse, 2018 within and among Pachyseris speciosa colonies in equatorial Singapore that are known to host both these Symbiodiniaceae clades. Bleached and unbleached tissues from bleaching colonies, as well as healthy colonies, during and following the bleaching event were sampled and analyzed for comparison. The nuclear ribosomal internal transcribed spacer (ITS) regions were separately amplified and quantified using a SYBR Green-based quantitative polymerase chain reaction (qPCR) method and Illumina high-throughput sequencing. We found Cladocopium to be highly abundant relative to Durusdinium. The relative abundance of Durusdinium, known to be thermally tolerant, was highest in post-bleaching healthy colonies, while bleached and unbleached tissues from bleaching colonies as well as tissue from healthy colonies during the event had depressed proportions of Durusdinium. Given the importance of Durusdinium for thermal tolerance and stress response, it is surprising that bleached tissue showed limited change over healthy tissue during the bleaching event. Moreover, colonies were invariably dominated by Cladocopium during bleaching, but a minority of colonies were Durusdinium-dominant during non-bleaching times. The detailed characterization of Symbiodiniaceae in specific colonies during stress and recovery will provide insights into this crucial symbiosis, with implications for their responses during major bleaching events.