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Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Activitat física; Lesió medul·lar Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Actividad física; Lesión de la médula espinal Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Physical activity; Spinal cord injury Context The emergence of COVID-19 caused a new public health crisis, leading to major changes in daily life routines, often including physical activity (PA) levels. The main goal of this study was to analyze the differences in self-reported physical activity of people with complete spinal cord injuries between the time prior to the COVID-19 lockdown and the lockdown period itself. Methods A sample of 20 participants with complete thoracic spinal cord injuries completed the Physical Activity Scale for Individuals with Physical Disabilities before and during the COVID-19 lockdown. Results The results showed differences between the pre-lockdown and lockdown measurements in total self-reported PA (z=−3.92; P

International audience; Background: There have been reports of procoagulant activity in patients with COVID-19. Whether there is an association between pulmonary embolism (PE) and COVID-19 in the emergency department (ED) is unknown. The aim of this study was to assess whether COVID-19 is associated with PE in ED patients who underwent a computed tomographic pulmonary angiogram (CTPA).Methods: A retrospective study in 26 EDs from six countries. ED patients in whom a CTPA was performed for suspected PE during a 2-month period covering the pandemic peak. The primary endpoint was the occurrence of a PE on CTPA. COVID-19 was diagnosed in the ED either on CT or reverse transcriptase-polymerase chain reaction. A multivariable binary logistic regression was built to adjust with other variables known to be associated with PE. A sensitivity analysis was performed in patients included during the pandemic period.Results: A total of 3,358 patients were included, of whom 105 were excluded because COVID-19 status was unknown, leaving 3,253 for analysis. Among them, 974 (30%) were diagnosed with COVID-19. Mean (±SD) age was 61 (±19) years and 52% were women. A PE was diagnosed on CTPA in 500 patients (15%). The risk of PE was similar between COVID-19 patients and others (15% in both groups). In the multivariable binary logistic regression model, COVID-19 was not associated with higher risk of PE (adjusted odds ratio = 0.98, 95% confidence interval = 0.76 to 1.26). There was no association when limited to patients in the pandemic period.Conclusion: In ED patients who underwent CTPA for suspected PE, COVID-19 was not associated with an increased probability of PE diagnosis. These results were also valid when limited to the pandemic period. However, these results may not apply to patients with suspected COVID-19 in general.

Càncer de cap i coll; Radioteràpia; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV Cáncer de cabeza y cuello; Terapia de radiación; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV Head and Neck Cancer; Radiation Therapy; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV Purpose Because of the unprecedented disruption of health care services caused by the COVID-19 pandemic, the American Society of Radiation Oncology (ASTRO) and the European Society for Radiotherapy and Oncology (ESTRO) identified an urgent need to issue practice recommendations for radiation oncologists treating head and neck cancer (HNC) in a time of limited resources and heightened risk for patients and staff. Methods and Materials A panel of international experts from ASTRO, ESTRO, and select Asia-Pacific countries completed a modified rapid Delphi process. Topics and questions were presented to the group, and subsequent questions were developed from iterative feedback. Each survey was open online for 24 hours, and successive rounds started within 24 hours of the previous round. The chosen cutoffs for strong agreement (≥80%) and agreement (≥66%) were extrapolated from the RAND methodology. Two pandemic scenarios, early (risk mitigation) and late (severely reduced radiation therapy resources), were evaluated. The panel developed treatment recommendations for 5 HNC cases. Results In total, 29 of 31 of those invited (94%) accepted, and after a replacement 30 of 30 completed all 3 surveys (100% response rate). There was agreement or strong agreement across a number of practice areas, including treatment prioritization, whether to delay initiation or interrupt radiation therapy for intercurrent SARS-CoV-2 infection, approaches to treatment (radiation dose-fractionation schedules and use of chemotherapy in each pandemic scenario), management of surgical cases in event of operating room closures, and recommended adjustments to outpatient clinic appointments and supportive care. Conclusions This urgent practice recommendation was issued in the knowledge of the very difficult circumstances in which our patients find themselves at present, navigating strained health care systems functioning with limited resources and at heightened risk to their health during the COVID-19 pandemic. The aim of this consensus statement is to ensure high-quality HNC treatments continue, to save lives and for symptomatic benefit.

Background During the COVID-19 crisis it was necessary to generate a specific care network and reconvert operating rooms to attend emergency and high-acuity patients undergoing complex surgery. The aim of this study is to classify postoperative complications and mortality and to assess the impact that the COVID-19 pandemic may have had on the results. Methods this is a non-inferiority retrospective observational study. Two different groups of surgical patients were created: Pre-pandemic COVID and Pandemic COVID. Severity of illness was rated according to the Diagnosis-related Groups (DRG) score. Comparisons were made between groups and between DRG severity score-matched samples. Non-inferiority was set at up to 10 % difference for grade III to V complications according to the Clavien-Dindo classification, and up to 2 % difference in mortality. Results A total of 1649 patients in the PreCOVID group and 763 patients in the COVID group were analysed; 371 patients were matched for DRG severity score 3-4 (236 preCOVID and 135 COVID). No differences were found in relation to re-operation (22.5 % vs. 21.5 %) or late admission to critical care unit (5.1 % vs. 4.5 %). Clavien grade III to V complications occurred in 107 patients (45.3 %) in the PreCOVID group and in 56 patients (41.5 %) in the COVID group, and mortality was 12.7 % and 12.6 %, respectively. During the pandemic, 3 % of patients tested positive for Covid-19 on PCR: 12 patients undergoing elective surgery and 11 emergency surgery; there were 5 deaths, 3 of which were due to respiratory failure following Covid-19-induced pneumonia. Conclusions Although this study has some limitations, it has shown the non-inferiority of surgical outcomes during the COVID pandemic, and indicates that resuming elective surgery is safe. Trial registration Clinicaltrials.gov identifier: NCT04780594.

Coronavirus disease-2019, also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was a disaster in 2020. Accurate and early diagnosis of coronavirus disease-2019 (COVID-19) is still essential for health policymaking. Reverse transcriptase-polymerase chain reaction (RT-PCR) has been performed as the operational gold standard for COVID-19 diagnosis. We aimed to design and implement a reliable COVID-19 diagnosis method to provide the risk of infection using demographics, symptoms and signs, blood markers, and family history of diseases to have excellent agreement with the results obtained by the RT-PCR and CT-scan. Our study primarily used sample data from a 1-year hospital-based prospective COVID-19 open-cohort, the Khorshid COVID Cohort (KCC) study. A sample of 634 patients with COVID-19 and 118 patients with pneumonia with similar characteristics whose RT-PCR and chest CT scan were negative (as the control group) (dataset 1) was used to design the system and for internal validation. Two other online datasets, namely, some symptoms (dataset 2) and blood tests (dataset 3), were also analyzed. A combination of one-hot encoding, stability feature selection, over-sampling, and an ensemble classifier was used. Ten-fold stratified cross-validation was performed. In addition to gender and symptom duration, signs and symptoms, blood biomarkers, and comorbidities were selected. Performance indices of the cross-validated confusion matrix for dataset 1 were as follows: sensitivity of 96% [confidence interval, CI, 95%: 94–98], specificity of 95% [90–99], positive predictive value (PPV) of 99% [98–100], negative predictive value (NPV) of 82% [76–89], diagnostic odds ratio (DOR) of 496 [198–1,245], area under the ROC (AUC) of 0.96 [0.94–0.97], Matthews Correlation Coefficient (MCC) of 0.87 [0.85–0.88], accuracy of 96% [94–98], and Cohen's Kappa of 0.86 [0.81–0.91]. The proposed algorithm showed excellent diagnosis accuracy and class-labeling agreement, and fair discriminant power. The AUC on the datasets 2 and 3 was 0.97 [0.96–0.98] and 0.92 [0.91–0.94], respectively. The most important feature was white blood cell count, shortness of breath, and C-reactive protein for datasets 1, 2, and 3, respectively. The proposed algorithm is, thus, a promising COVID-19 diagnosis method, which could be an amendment to simple blood tests and screening of symptoms. However, the RT-PCR and chest CT-scan, performed as the gold standard, are not 100% accurate.

[Background & Aims] The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic., [Methods] An international survey evaluated the impact of the COVID-19 pandemic on clinical practice and clinical trials from March 2020 to June 2020, as the first phase of a multicentre, international, and observational project. The focus was on patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma, cared for around the world during the first COVID-19 pandemic wave., [Results] Ninety-one centres expressed interest to participate and 76 were included in the analysis, from Europe, South America, North America, Asia, and Africa (73.7%, 17.1%, 5.3%, 2.6%, and 1.3% per continent, respectively). Eighty-seven percent of the centres modified their clinical practice: 40.8% the diagnostic procedures, 80.9% the screening programme, 50% cancelled curative and/or palliative treatments for LC, and 41.7% modified the liver transplantation programme. Forty-five out of 69 (65.2%) centres in which clinical trials were running modified their treatments in that setting, but 58.1% were able to recruit new patients. The phone call service was modified in 51.4% of centres which had this service before the COVID-19 pandemic (n = 19/37)., [Conclusions] The first wave of the COVID-19 pandemic had a tremendous impact on the routine care of patients with liver cancer. Modifications in screening, diagnostic, and treatment algorithms may have significantly impaired the outcome of patients. Ongoing data collection and future analyses will report the benefits and disadvantages of the strategies implemented, aiding future decision-making., [Lay summary] The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems globally. Herein, we assessed the impact of the first wave pandemic on patients with liver cancer and found that routine care for these patients has been majorly disrupted, which could have a significant impact on outcomes.

The COVID-19 pandemic has had major impacts on population health not only through COVID-positive cases, but also via the disruption of healthcare services, which in turn has impacted the diagnosis and treatment of all other diseases during this time. We study changes in all new registered diagnoses in ICD-10 groups during 2020 with respect to a 2019 baseline. We compare new diagnoses in 2019 and 2020 based on administrative records of the public primary health system in Central Catalonia, Spain, which cover over 400,000 patients and 3 million patient visits. We study the ratio of new diagnoses between 2019 and 2020 and find an average decline of 31.1% in new diagnoses, with substantial drops in April (61.1%), May (55.6%), and November (52%). Neoplasms experience the largest decline (49.7%), with heterogeneity in the magnitudes of the declines across different types of cancer diagnoses. While we find evidence of temporal variation in new diagnoses, reductions in diagnoses early in the year are not recouped by the year end. The observed decline in new diagnoses across all diagnosis groups suggest a large number of untreated and undetected cases across conditions. Our findings provide a year-end summary of the impact of the pandemic on healthcare activities and can help guide health authorities to design evidence-based plans to target under-diagnosed conditions in 2021 Catia Nicodemo is supported by the University of Oxford’s COVID-19 Research Response Fund, number 0910204

[Objective] Adults with congenital heart disease (ACHD) may be at a higher risk of a fatal outcome in case of COVID-19. Current risk stratification among these patients relies on personal experience and extrapolation from patients with acquired heart disease. We aimed to provide an expert view on risk stratification while awaiting results from observational studies., [Methods] This study was an initiative of the EPOCH (European Collaboration for Prospective Outcome Research in Congenital Heart disease). Among nine European countries (Austria, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain and Switzerland), 24 experts from 23 tertiary ACHD centres participated in the survey. ACHD experts were asked to identify ACHD-specific COVID-19 risk factors from a list of potential outcome predictors and to estimate the risk of adverse COVID-19 outcomes in seven commonly seen patient scenarios., [Results] 82% of participants did not consider all ACHD patients at risk of COVID-19 related complications. There was a consensus on pulmonary arterial hypertension, Fontan physiology and cyanotic heart disease as risk factors for adverse outcomes. Among different ACHD scenarios, a patient with Eisenmenger syndrome was considered to be at the highest risk. There was a marked variability in risk estimation among the other potential outcome predictors and ACHD scenarios., [Conclusions] Pulmonary arterial hypertension, Fontan palliation and cyanotic heart disease were widely considered as risk factors for poor outcome in COVID-19. However, there was a marked disparity in risk estimation for other clinical scenarios. We are in urgent need of outcome studies in ACHD suffering from COVID-19., EPOCH-ASO is funded by internal grants without support from the pharmaceutical industry.

Background Confinement due to COVID-19 has increased mental ill-health. Few studies unpack the risk and protective factors associated with mental ill-health and addictions that might inform future preparedness. Methods Cross-sectional on-line survey with 37,810 Catalan residents aged 16+ years from 21 April to 20 May 2020 reporting prevalence of mental ill-health and substance use and associated coping strategies and behaviours. Results Weighted prevalence of reported depression, anxiety and lack of mental well-being was, respectively, 23, 26, and 75%, each three-fold higher than before confinement. The use of prescribed hypnosedatives was two-fold and of non-prescribed hypnosedatives ten-fold higher than in 2018. Women, younger adults and students were considerably more likely, and older and retired people considerably less likely to report mental ill-health. High levels of social support, dedicating time to oneself, following a routine, and undertaking relaxing activities were associated with half the likelihood of reported mental ill-health. Worrying about problems living at home, the uncertainty of when normality would return, and job loss were associated with more than one and a half times the likelihood of mental ill-health. With the possible exception of moderately severe and severe depression, length of confinement had no association with reported mental ill-health. Conclusions The trebling of psychiatric symptomatology might lead to either to under-identification of cases and treatment gap, or a saturation of mental health services if these are not matched with prevalence increases. Special attention is needed for the younger adult population. In the presence of potential new confinement, improved mental health literacy of evidence-based coping strategies and resilience building are urgently needed to mitigate mental ill-health.

The European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Social Media (SoMe) Team provides Twitter coverage of the annual congress. During the coronavirus disease 2019 (COVID-19) pandemic, #ERAEDTA20 was the first major Nephrology congress to be delivered virtually. The effect of The SoMe Team and the consequences of the COVID-19 pandemic have not been explored previously. Tweets of the ERA-EDTA congresses 2016–20, using official hashtags, were evaluated. Metadata of each tweet were collected prospectively; original tweets, retweets and evidence-based tweets were identified. The gender of tweet author and location of Twitter activity were established. Network maps were created to ascertain the degree of polarization between the 2019 and 2020 Twitter activity, using Gephi 0.9.2. Between 2016 and 2019, the total number of tweets and the number of tweet authors increased, as did the proportion of female authors (20% versus 27%). In 2019, there were fewer multimedia and evidence-based tweets: 8% versus 20% in 2016. Globally, there were fewer Nephrology conferences in 2020 and the number of tweets per day reduced by 53% from 2019. In 2020, The ERA-EDTA congress saw an increase in authors of 9% and only an 8% reduction in tweets. It was easier to disseminate information in 2020, measured by increased correlation coefficient (0.14 versus 0.12 in 2019). A higher proportion of countries was represented (n = 55 versus n = 48 in 2019) and a higher proportion of tweets came from women. In conclusion, the introduction of SoMe Team was associated with increased usage of Twitter and ease of information dissemination. Compared with #nephtwitter activity as a whole in 2020, SoMe Team has mitigated some of the pandemic's deleterious effects in scientific dissemination, relevant to Nephrology.

Background During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes. Objectives The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome. Methods We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared. Results Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%; p = 0.001) and cardiovascular mortality (1.9% vs. 0.4%; p = 0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p Conclusion Among patients in whom an elective invasive cardiac procedure is cancelled or postponed during COVID-19 pandemic, mortality and cardiovascular mortality is higher in patients with diabetes, irrespectively on other clinical conditions. These procedures should not be cancelled in patients with diabetes.

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus, which has spread all over the world leading to a global pandemic. The fast progression of COVID-19 has been mainly related to the high contagion rate of the virus and the worldwide mobility of humans. In the absence of pharmacological therapies, governments from different countries have introduced several non-pharmaceutical interventions to reduce human mobility and social contact. Several studies based on Anonymized Mobile Phone Data have been published analysing the relationship between human mobility and the spread of coronavirus. However, to our knowledge, none of these data-sets integrates cross-referenced geo-localised data on human mobility and COVID-19 cases into one all-inclusive open resource. Herein we present COVID-19 Flow-Maps, a cross-referenced Geographic Information System that integrates regularly updated time-series accounting for population mobility and daily reports of COVID-19 cases in Spain at different scales of time spatial resolution. This integrated and up-to-date data-set can be used to analyse the human dynamics to guide and support the design of more effective non-pharmaceutical interventions., Measurement(s)COVID-19 cases • mobility • populationTechnology Type(s)Real Time PCR • mobile phoneSample Characteristic - OrganismHomo sapiens • Severe acute respiratory syndrome-related coronavirusSample Characteristic - LocationKingdom of Spain Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.15198123

ObjectivesTo analyse the prevalence of sexual violence (SV) and associated factors in Spanish young adults in the last year and before, during and after the COVID-19 lockdown.DesignCross-sectional study based on the online ‘SV in Young People Survey’ (2020).SettingNon-institutionalised population residing in Spain.Participants2515 men and women aged 18–35 years old. The participants were obtained from a probability based, online closed panel of adults aged 16 or older that is representative of the non-institutionalised population. The sample designed includes quotas by sex, age, region and country of origin.Outcomes measures and analysesSV victimisation by sociodemographics, sexual attraction and couple-related characteristics during the past year and before, during and after the COVID-19 lockdown (March–June 2020). Prevalence ratios were calculated using robust Poisson regression models.ResultsIn Spain, 8.5% of young people experienced SV during the past year. The greatest prevalence was observed in women with bisexual attraction (17.5%) and in men with homosexual attraction (14.2%). During the COVID-19 lockdown, the prevalence of SV victimisation was lower (1.9%), but unwanted intercourses increased, affecting 64.4% of those exposed to SV during the period. People with homosexual or bisexual attraction were more likely to experience SV in all of the studied periods (PRbefore: 2.01; pConclusionsSV victimisation in Spanish youth is high. During COVID-19, there were changes in the magnitude of factors associated with SV. It seems that SV events decreased in people who did not live with their partners, but unwanted intercourses increased. The development of prevention strategies to address SV in youth should take into account social inequalities by sex, sexual orientation and origin.

With the onset of the COVID-19 pandemic and the accelerated spread of the SARS-CoV-2 virus came jurisdictional limitations on mobility of citizens and distinct alterations in their daily routines. Confined to their homes, many people increased their overall internet use, with problematic use of the internet (PUI) becoming a potential reason for increased mental health concerns. Our narrative review summarizes information on the extent of PUI during the pandemic, by focusing on three types: online gaming, gambling and pornography viewing. We conclude by providing guidance for mental health professionals and those affected by PUI (with an outline of immediate research priorities and best therapeutic approaches), as well as for the general public (with an overview of safe and preventative practices)., Comprehensive Psychiatry, 112, ISSN:0010-440X, ISSN:1532-8384

Gender-based violence and domestic violence constitute a huge problem all across countries and continents. The COVID-19 outbreak and the lockdown produced as a consequence of it have contributed to escalating this problem. Many national organisms reported an increase in the data on domestic violence during confinement. Bystander intervention often constitutes one of the most effective mechanisms of attention. The problem is that bystanders do not always dare to intervene. This article aims to provide knowledge on the reasons for this lack of intervention and its connection to domestic violence, while presenting measures to encourage intervention and victim support, offering protection to those most in need during this pandemic. The research was conducted through questionnaires distributed online among social entities in charge of providing care to women suffering from domestic violence during the lockdown. The results have shown that most of these entities have had to intervene in providing support to women during the lockdown. In conclusion, the case of the Unitary Platform Against Gender Violence and the entities, which are members of the platform, acted in situations of domestic violence produced during confinement, based on the mutual support provided by being a group of entities that have the support of the Platform.

The COVID-19 crisis has become the most intense and long-lasting in the history of aviation. There is already a significant literature on the immediate impact of the outbreak, as well as on speculation on the future evolution of the industry. This paper seeks to contribute to this discussion by assessing a year into the crisis the demand related aspects and passenger behavioural impacts of the pandemic. Specifically, the paper aims to identify discrete market segments of air passengers according to their shared attitudes and preferences about air travel in light of the COVID-19 crisis, as well as past behaviour and future travel intentions. To achieve this, we analyse data from a large (n = 2096) online questionnaire survey of air passengers in Norway. The cluster analysis identifies four distinct passenger segments, with each displaying varying attitudes, behaviours, and levels of concern about air travel. One of these groups, described as the 'Apprehensive Elders', were identified as having the highest level of concern about flying, and subsequently showed a sharp decline in their intention to travel in the future. Another group, termed the 'Cautious Commuters', showed similarly enhanced levels of concerns about flying, but maintained a high propensity to fly following the pandemic despite these concerns. Regarding possible interventions to increase confidence in flying in the future, across all segments the data shows a clear preference for more 'traditional' active interventions, including wearing of face masks and enforcement of physical distancing, over and above passive or technological interventions. Norway represents a valuable case as a possible signal for future policy and practice in relation to the recovery of air travel following the pandemic. The findings have important implications for air transport managers and decision makers in terms of managing the perceptions and expectations of different passenger groups as air travel begins to return.

The spread of the novel coronavirus, 'SARS-Cov-2', causing the disease 'COVID-19' has resulted in almost one hundred million cases and two million deaths (World Health Organization 2020). While early research suggested that the virus was not as contagious as SARS and MERS, the rapid increase in human to human transmission showed that the virus was in fact more contagious (Chan et al. 2020; Huang et al. 2020; Wang et al. 2020). On January 23, China announced lockdown in Wuhan to limit people’s movement both within and outside Wuhan (Surveillances 2020). This was the starting point to travel and transport restrictions, which were progressively implemented worldwide, following the virus’ expansion (Hamzelou 2020). In the past few months, research has commenced as part of academics’ rapid response to analyse the impacts and anticipate the consequences of the pandemics for tourism and hospitality (see, for example, Gössling, Scott, and Hall 2020). This paper adds texture to this conversation and critically discusses pandemics’ implications for the hospitality and tourism industries concerning the transport sector.

Due to the dramatic impact of the COVID-19 pandemic, Spain underwent a strict lockdown (March&ndash, May 2020). How the lockdown modified older adults&rsquo, physical activity (PA) has been poorly described. This research assesses the effect of the lockdown on PA levels and identifies predictors of sufficient/insufficient PA in frail older community-dwellers. Community-dwelling participants from the +&Agrave, GIL Barcelona frailty intervention program, suspended during the pandemic, underwent a phone-assessment during the lockdown. PA was measured before and after the lockdown using the Brief Physical Activity Assessment Tool (BPAAT). We included 98 frail older adults free of COVID-19 (mean age = 82.7 years, 66.3% women, mean Short Physical Performance Battery = 8.1 points). About one third of participants (32.2%) were not meeting sufficient PA levels at the end of the lockdown. Depressive symptoms (OR = 0.12, CI95% = 0.02&ndash, 0.55) and fatigue (OR = 0.11, CI95% = 0.03&ndash, 0.44) decreased the odds of maintaining sufficient PA, whereas maintaining social networks (OR = 5.07, CI95% = 1.60&ndash, 16.08) and reading (OR = 6.29, CI95% = 1.66&ndash, 23.90) increased it. Living alone was associated with the reduction of PA levels (b = &minus, 1.30, CI95% = &minus, 2.14&ndash, &minus, 0.46). In our sample, pre-lockdown mental health, frailty-related symptoms and social relationships were consistently associated with both PA levels during-lockdown and pre-post change. These data suggest considering specific plans to maintain PA levels in frail older community-dwellers.

Recent international research has warned of the impact of the COVID-19 lockdown on vulnerable children. However, little is known regarding the in-care population. Objective: To find out how children in residential care perceived the influence of the COVID-19 lockdown in their everyday life, relationships and subjective well-being. Participants and setting: 856 children from 10 to 17 years old (Mage = 15.5, males = 71.2%, females = 28.8%) living in residential centres in Catalonia. Methods: Cross-sectional study. Children responded to an on-line questionnaire administered between June and July 2020. Bivariate analysis and multiple linear regression were used comparing the answers by sex. Results: Better relationships with caregivers (β = 9.156, [4.089–14.22], r2 = 0.244, p < .01) and having a person of trust (ß = 4.588, [2.041–7.134], r2 = 0.244, p < .01) were found to be relevant for children's subjective well-being. For girls, improving their grades (β = 14.86, [8.560–21.15], r2 = 0.234, p < .01) were relevant while boys' subjective well-being was significantly affected by an increase in use of social networks (β = 8.917, [2.733–15.10], r2 = 0.234, p < .01). Conclusions: A gender perspective is needed to help girls in situations of vulnerability. We should continue to listen to children's opinions, giving them the opportunity to participate in improving the children's home and its immediate environment and ensuring they have access to stable adult role models This work was supported by the Direcci ́o General d'Atenci ́o a la Inf`ancia i l'Adolesc`encia (Generalitat de Catalunya) [General Direction for the Attention of Children and Adolescence, Government of Catalonia] Open Access funding provided thanks to the CRUE-CSIC agreement with Elsevier

ObjectivesIn a previously published Delphi exercise the European Pediatric Dialysis Working Group (EPDWG) reported widely variable counteractive responses to COVID-19 during the first week of statutory public curfews in 12 European countries with case loads of 4–680 infected patients per million. To better understand these wide variations, we assessed different factors affecting countermeasure implementation rates and applied the capability, opportunity, motivation model of behaviour to describe their determinants.DesignWe undertook this international mixed methods study of increased depth and breadth to obtain more complete data and to better understand the resulting complex evidence.SettingThis study was conducted in 14 paediatric nephrology centres across 12 European countries during the COVID-19 pandemic.ParticipantsThe 14 participants were paediatric nephrologists and EPDWG members from 12 European centres.Main outcome measures52 countermeasures clustered into eight response domains (access control, patient testing, personnel testing, personal protective equipment policy, patient cohorting, personnel cohorting, suspension of routine care, remote work) were categorised by implementation status, drivers (expert opinion, hospital regulations) and resource dependency. Governmental strictness and media attitude were independently assessed for each country and correlated with relevant countermeasure implementation factors.ResultsImplementation rates varied widely among response domains (median 49.5%, range 20%–71%) and centres (median 46%, range 31%–62%). Case loads were insufficient to explain response rate variability. Increasing case loads resulted in shifts from expert opinion-based to hospital regulation-based decisions to implement additional countermeasures despite increased resource dependency. Higher governmental strictness and positive media attitude towards countermeasure implementation were associated with higher implementation rates.ConclusionsCOVID-19 countermeasure implementation by paediatric tertiary care centres did not reflect case loads but rather reflected heterogeneity of local rules and of perceived resources. These data highlight the need of ongoing reassessment of current practices, facilitating rapid change in ‘institutional behavior’ in response to emerging evidence of countermeasure efficacy.

The unprecedented situation we are facing has strongly disrupted the clinical research rules. Nevertheless, for the scientific community, it may represent the opportunity to learn important lessons. The COVID-19 pandemic suggests that it is possible to alleviate redundancy in clinical trials, and while preserving the rigour of a study, can offer a new, less burdened and more inclusive vision of clinical research for the scientific community of tomorrow. This perspective article describes clinicians’ vision of how the pandemic could change the roles of clinical research. Since the beginning of the SARS-COV2 outbreak in Wuhan, more than 24 million people have been infected all around the world and more than 800 000 have died from the disease so far. In this scenario, Europe is facing one of the worst crises that our National Health Systems have ever encountered in the last 50 years. Six months after the first COVID-19 diagnosis, the lockdown is being eased in European countries and our lives are slowly adapting to ‘a new normality’. Providing care to immunocompromised patients with cancer during this pandemic has been extremely challenging and oncologists face many challenges in providing cancer care during the COVID-19 outbreak. Data from China reported that patients with cancer who are infected with COVID-19 are at 3.5 times the risk of requiring mechanical ventilation or intensive care unit (ICU) admission, compared with the general population.1 Additionally, the limitation of resources in outpatient settings, including administrative staff and specialists, has hindered the routine care of patients.2 National and international cancer societies published priority-driven guidelines for the management of oncohaematological patients on therapy during the COVID-19 pandemic and recommended considering treatment delays and modifications on a case-by-case basis, taking into account the characteristics of the patient and the disease.3 In addition to routine patient care, the imperative of …

Background: Due to the expected increase in child abuse during the period of COVID-19 confinement, it is essential that social researchers and other professionals work together very quickly to provide alternatives that protect children. To respond to this extremely urgent demand, evidence-based actions are presented that are being carried out in nine schools in the autonomous communities of Valencia and Murcia, Spain, during the confinement with the goal of “opening doors” to foster supportive relationships and a safe environment to prevent child abuse. Methods: The research was conducted through the inclusion of teachers who are implementing these actions in dialogue with the researchers to define the study design, analysis, and discussion of the results. Results: Knowledge regarding six evidence-based actions is provided: (1) dialogic workspaces, (2) dialogic gatherings, (3) class assemblies, (4) dialogic pedagogical gatherings with teachers, (5) mixed committees, and (6) dynamisation of social networks with preventive messages and the creation of a sense of community, which are being implemented virtually.

The problems of learning physics have experienced increasingly complex obstacles amid the demands of online learning due to the COVID-19 pandemic. The purpose of this study is to explain the basic physics learning process through an online system during a pandemic, by evaluating the Self-Regulated Learning (SRL) approach to Problem-solving Skills (PSS). Data were collected through distributing questionnaires, interviews and documentation studies, then analyzed. This study shows that the applied SRL has been implemented well, but has not been optimal in improving PSS in online Basic Physics learning. The unpreparedness of technological devices and the competence of educators and students become obstacles that result in difficulties in solving physics problems so that the expected results are not following the expected learning targets. Also, this study shows the difficulty of learning physics online during the pandemic. Thus, a responsive physics learning model is needed with conditions that allow the delivery of physics material to be well understood, even though it is delivered through digital media. This is a demand that needs the attention of all parties so that the achievement of online learning targets remains optimal and effective in increasing the problem-solving skills of students during the COVID-19 pandemic.

Drawn from the stress process model, the pandemic has imposed substantial stress to individual economic and mental well-being and has brought unprecedented disruptions to social life. In light of social distancing measures, and in particular physical distancing because of lockdown policies, the use of digital technologies has been regarded as the alternative to maintain economic and social activities. This paper aims to describe the design and implementation of an online survey created as an urgent, international response to the COVID-19 pandemic. The online survey described here responds to the need of understanding the effects of the pandemic on social interactions/relations and to provide findings on the extent to which digital technology is being utilized by citizens across different communities and countries around the world. It also aims to analyze the association of use of digital technologies with psychological well-being and levels of loneliness. The data will be based on the ongoing survey (comprised of several existing and validated instruments on digital use, psychological well-being and loneliness), open for 3 months after roll out (ends September) across 11 countries (Austria, France, Germany, India, Malta, Portugal, Romania, Spain, Turkey, and UK). Participants include residents aged 18 years and older in the countries and snowball sampling is employed via social media platforms. We anticipate that the findings of the survey will provide useful and much needed information on the prevalence of use and intensities of digital technologies among different age groups, gender, socioeconomic groups in a comparative perspective. Moreover, we expect that the future analysis of the data collected will show that different types of digital technologies and intensities of use are associated with psychological well-being and loneliness. To conclude, these findings from the study are expected to bring in our understanding the role of digital technologies in affecting individual social and emotional connections during a crisis. ispartof: FRONTIERS IN SOCIOLOGY vol:5 ispartof: location:Switzerland status: published

Background European Society for Medical Oncology Women for Oncology (ESMO W4O) research has previously shown under-representation of female oncologists in leadership roles. As early reports suggested disproportionate effects of the COVID-19 pandemic on women, the ESMO W4O Committee initiated a study on the impact of the pandemic on the lives of female and male oncologists. Methods A questionnaire was sent to ESMO members and put on the ESMO website between 8 June 2020 and 2 July 2020. Questions focused on the working (hospital tasks, laboratory tasks, science) and home (household management, childcare, parent care, personal care) lives of oncologists during and after COVID-19-related lockdowns. Results Of 649 respondents, 541 completed the questionnaire. Of these, 58% reported that COVID-19 had affected their professional career, 83% of whom said this was in a negative way (85% of women versus 76% of men). Approximately 86% reported that COVID-19 had changed their personal life and 82% their family life. Women were again significantly more affected than men: personal life (89% versus 78%; P = 0.001); family life (84% versus 77%; P = 0.037). During lockdowns, women reported increased time spent on hospital and laboratory tasks compared with men (53% versus 46% and 33% versus 26%, respectively) and a significantly higher proportion of women than men spent less time on science (39% versus 25%) and personal care (58% versus 39%). After confinement, this trend remained for science (42% versus 23%) and personal care (55% versus 36%). Conclusions The COVID-19 pandemic has adversely affected the professional and home lives of oncologists, especially women. Reduced research time for female oncologists may have long-lasting career consequences, especially for those at key stages in their career. The gender gap for promotion to leadership positions may widen further as a result of the pandemic., Highlights • Female oncologists were significantly more affected than men by COVID-19 in multiple aspects of their working and home life. • Reduced time available to female oncologists for research activities may have long-lasting career consequences. • The gender gap for promotion to leadership positions may widen further as a result of the pandemic. • Greater awareness is needed about gender inequalities in career development in oncology, especially after the pandemic. • Gender transformative policies and strategies are needed due to the impact of COVID-19 and other causes of inequalities.

COVID-19 has driven several global offline communities to go online. Restrictions to the free movement of people in response to the coronavirus pandemic triggered a profound rethinking of jobs, products and services, and among them, the activities of religious communities, which are well consolidated in the offline sphere. In Spain, since the lockdown established by the government in March 2020, the Catholic Church has reinvented its activity, as all the churches and other places of worship have been closed. This constituted a considerable challenge, considering the history and dynamics of the institution. This paper aims to analyze how Catholicism, as one of the most consolidated offline communities, reworked its communication, going online in a matter of days. With this objective, researchers surveyed each and every one of the 70 Spanish dioceses, taking them as representatives of the global Catholic community in the country. Their responses are complemented with an in-depth interview with the Director of Communications at the Spanish Conference of Bishops. The results highlight the huge and unprecedented step towards the digitalization of the community through consistent, creative and efficient action. New methods, platforms and languages have been implemented, even broadening community membership. Despite an offline essence that is still detected in some decisions, this pandemic has brought a new communicative paradigm to the Spanish Catholic community. Digitalization has been consolidated whilst preserving the best aspects of direct contact and action. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

The heterogenous distribution of both COVID-19 incidence and mortality in Catalonia (Spain) during the firsts moths of the pandemic suggests that differences in baseline risk factors across regions might play a relevant role in modulating the outcome of the pandemic. This paper investigates the associations between both COVID-19 incidence and mortality and air pollutant concentration levels, and screens the potential effect of the type of agri-food industry and the overall land use and cover (LULC) at area level. We used a main model with demographic, socioeconomic and comorbidity covariates highlighted in previous research as important predictors. This allowed us to take a glimpse of the independent effect of the explanatory variables when controlled for the main model covariates. Our findings are aligned with previous research showing that the baseline features of the regions in terms of general health status, pollutant concentration levels (here NO and PM ), type of agri-food industry, and type of land use and land cover have modulated the impact of COVID-19 at a regional scale. This study is among the first to explore the associations between COVID-19 and the type of agri-food industry and LULC data using a population-based approach. The results of this paper might serve as the basis to develop new research hypotheses using a more comprehensive approach, highlighting the inequalities of regions in terms of risk factors and their response to COVID-19, as well as fostering public policies towards more resilient and safer environments., Quim Zaldo-Aubanell was supported by AGAUR FI fellowship (DOGC num. 7720, of 5.10.2018). Marc Saez was partially financed by the SUPERA COVID19 Fund, from SAUN: Santander Universidades, CRUE and CSIC, and by the COVID-19 Competitive Grant Program from Pfizer Global Medical Grants. E. David Pino acknowledge the support of the Spanish government project CGL2016-75996-R (MICINN) The funding sources did not participate in the design or conduct of the study, the collection, management, analysis, or interpretation of the data, or the preparation, review, or approval of the manuscript.