The Impact of COVID-19 Pandemic on Spine Surgeons Worldwide: A One Year Prospective Comparative Study

Study Design:Cross-sectional observational cohort study.Objective:To investigate preparation, response, and economic impact of COVID-19 on private, public, academic, and privademic spine surgeons.Methods:AO Spine COVID-19 and Spine Surgeon Global Impact Survey includes domains on surgeon demographics, location of practice, type of practice, COVID-19 perceptions, institutional preparedness and response, personal and practice impact, and future perceptions. The survey was distributed by AO Spine via email to members (n = 3805). Univariate and multivariate analyses were performed to identify differences between practice settings.Results:A total of 902 surgeons completed the survey. In all, 45.4% of respondents worked in an academic setting, 22.9% in privademics, 16.1% in private practice, and 15.6% in public hospitals. Academic practice setting was independently associated with performing elective and emergent spine surgeries at the time of survey distribution. A majority of surgeons reported a >75% decrease in case volume. Private practice and privademic surgeons reported losing income at a higher rate compared with academic or public surgeons. Practice setting was associated with personal protective equipment availability and economic issues as a source of stress.Conclusions:The current study indicates that practice setting affected both preparedness and response to COVID-19. Surgeons in private and privademic practices reported increased worry about the economic implications of the current crisis compared with surgeons in academic and public hospitals. COVID-19 decreased overall clinical productivity, revenue, and income. Government response to the current pandemic and preparation for future pandemics needs to be adaptable to surgeons in all practice settings.

Carpometacarpal (CMC) joint arthroplasty is a common procedure performed by both orthopedic and plastic surgeons to address arthritis of the thumb CMC joint. The purpose of this study was to (1) compare the postoperative outcomes between orthopedic and plastic surgeons and (2) determine how surgeon specialty impacts rates of postoperative complications following CMC arthroplasty. All adult patients (>18 years) undergoing CMC arthroplasty were identified from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2020. Patient demographic data and medical comorbidities were examined. Patients were classified as having a procedure by either an orthopedic surgeon or a plastic surgeon. Univariate analysis and multivariate logistic regression were used to assess the risk of postoperative complications and 30-day readmission based on surgeon specialty. A total of 5,162 patients undergoing CMC arthroplasty were included in our study, with 83.7% of procedures performed by orthopedic surgeons versus 16.3% performed by plastic surgeons. The incidence of surgical complications (p < 0.001), wound complications (p < 0.001), and superficial surgical site infections (SSIs; p < 0.001) was significantly higher when performed by plastic surgery. Additionally, operative time was significantly higher in cases performed by plastic surgeons (p = 0.001). On multivariate logistic regression, plastic surgery was independently associated with an increased risk of all complications (adjusted odds ratio [AORs] 2.70, 95% confidence interval [CI] 1.71–4.26), over four-fold increase in the risk of wound complications (AOR 4.49, 95% CI 2.53–7.97) and superficial SSI (AOR 5.06, 95% CI 2.72–9.39) when compared with orthopedic surgery. Despite similar patient demographics, CMC arthroplasty performed by plastic surgeons is independently associated with an increased risk of total postoperative complications, wound complications, and superficial infections when compared with orthopedic surgeons. Further investigation into perioperative and specialty-specific factors that contribute to discrepancies is warranted to improve outcomes and guide surgeon training. Level III, retrospective cohort study.

Analysis of the impact of COVID-19 pandemic on G20 stock markets

Friday E. Okonofua, Achieving the Millennium Development Goals in Africa: How Realistic? / Réalisation des Objectifs du Développement du Millénium en Afrique: Combien est-il Réaliste?, African Journal of Reproductive Health / La Revue Africaine de la Santé Reproductive, Vol. 9, No. 3 (Dec., 2005), pp. 7-14

AimsThe global health system is facing a serious challenge after the recent outbreak of COVID-19 coronavirus infection which was first identified in Wuhan, China in November 2019 and declared as a pandemic in March 2020 by WHO. There is a wide consensus that this pandemic has negative psychosocial consequences as well as unforeseeable provision of mental health care services and just not on physical health alone. The aim of this research study is to determine the prevalence of psychological distress and to identify the sociodemographic variables with the main attributable factors associated with the psychological distress among healthcare workers and suggestions on how to reduce the impact on the mental health of healthcare workers during the COVID-19 pandemic in different regions of the world.MethodWe performed a cross-sectional study from September-November 2020. We used a self-administered survey tool which was distributed electronically to healthcare workers across the globe. The data were stored on an online database with password protected devices where survey responses were restricted to investigators exclusively.Data collected were: 1) Socio-demographic data (age, gender, marital status, ethnicity, religion, role in the healthcare, region of practice); 2) Psychological General Well-Being Index (PGWBI) questionnaire which contains 22 standardized items. This is a subjective assessment to score the degree of psychological well-being by focusing on 6 domains: depression; anxiety; positive-well-being; self-control; vitality and general health; 3) Subjective assessment from respondents of the main attributable factors causing psychological distress and suggested methods to help reduce the impact on mental health on health care workers.ResultMajority out of the 217 respondents were from a younger age group; females and married/domestic partnership, mainly from Western Pacific Region, South East Asian and the African Region. More than half the respondents were moderate-severely psychologically distressed and the three main attributable factors causing psychological distress were: fear of family/friends contracting COVID-19 followed by lack of PPE and discomfort caused by wearing PPE for long hours. Respondents suggested that the distress would be reduced if: more resources were provided in hospital; protocols and guidelines were implemented and counselling facilities with recreational activities were available to frontline workers.ConclusionThis study showed that the COVID-19 pandemic has affected the mental health of healthcare workers and more support or strategies need to come in place to protect frontline workers at the time of crises.

Cross-sectional survey. The aim of this study was to investigate the impact of COVID-19 pandemic on the clinical practices of spine surgeons within the Asia Pacific region. COVID-19 pandemic had changed spine surgeons' clinical practices and their concerns toward personal and family risk of infection. This cross-sectional survey was carried out from May 4, 2020 to June 4, 2020. The questionnaire was administered using REDCAP. The online questionnaire includes four sections. First section includes surgeon's demographics, background, type of clinical practice, and status of pandemic in their country. Second section includes volume and the type of spine surgery practice before the COVID pandemic. Third section includes changes of clinical practice during the pandemic and the last section was regarding their concern on COVID transmission. Total of 222 respondents from 19 countries completed the questionnaire. During the pandemic, 92.3% of the respondents felt their clinical practice was affected. 58.5% respondents reported reduced outpatient clinic hours and 74.6% respondents reported reduced operation theatre hours due to the enforcement by the hospital administration. The mean reduction of clinic volume for all countries was 48.1%. There was a significant reduction in the number of surgeries performed in Japan, Malaysia, India, Philippines, and South Korea. This was due to reduced patient load. More than 60% of respondents were worried being infected by COVID-19 virus and >68% were worried of transmission to their family members. COVID-19 pandemic has significantly affected the clinical and surgical practice of spine surgeons in the Asia Pacific region. Clinics were closed or the practice hours reduced. Similarly, surgical theaters were closed, reduced, or limited to semi-emergency and emergency surgeries. Spine surgeons were moderately concerned of contracting COVID-19 during their clinical practice but were extremely concerned to transmit this disease to their family members. 4.

Introduction 1.Social backgroundThe COVID-19 pandemic has persisted worldwide since 2020.Due to its high infectivity and pathogenicity, most countries have adopted various measures and policies to avoid infection in crowds 1)2)3) .These measures triggered notable shifts in travel behavior: long-distance commuting via public transit dropped sharply while short-distance local travel increased.Studies of pedestrian behavior have further observed changes such as maintained walking speeds but greater social distancing compared to pre-pandemic norms.The pandemic also led to declines in certain commercial activities -such as cafs, fast-food, and shopping malls during the outbreak.Even as restrictions eased in 2022 to balance economic recovery with public health, many of these behavior changes have persisted.This indicates a lasting awareness of infection risk that still influences people's activities in public spaces.Indirect effects of COVID-19 on stations include altered passenger behavior -changes in how travelers distribute in space, choose routes, maintain social distance, use facilities, and spend time at the station 4) .Public parks, and plazas, especially those situated in front of major transportation hubs like railway stations, have served as vital communal hubs for social interaction, relaxation, and various activities.These spaces have witnessed significant changes in usage patterns due to the pandemic's restrictions and subsequent shifts in public behaviors 5)6) .Importantly, our previous studies confirm that these changes were driven by the pandemic itself rather than by unrelated cityscape developments 7)8) .These findings demonstrate that when the physical environment remains constant, behavioral shifts can be directly attributed to COVID-19.Following the same approach, this study compares Himeji Station Front Plaza North in 2017 and 2022, where the plaza layout was unchanged, thereby allowing the impact of COVID-19 to be isolated with confidence. Related worksSince the outbreak of the COVID-19 pandemic, numerous studies have examined the impact of the COVID-19 on public space use, particularly in transportation hubs, which has been a topic of interest for many researchers.Studies have compared public space usage before and during COVID-19 across global cities using big data and field surveys, consistently showing significant shifts in where and how people spend time outdoors 9) .(1) Urban public space usage changes Researchers noted a significant decline in passenger numbers and an increase in short-time stays and social distancing practices in station areas 6) .Studies on urban parks in Japan and overseas have shown both increases in daily visits and shifts toward more localized and shorterdistance use 10) .Other surveys found that the availability of "third places," such as cafs and community facilities, sharply declined during the pandemic, influencing people's well-being 6) .The relaxation of restrictions in 2022 allowed for some recovery in commercial and business activities, yet the behavioral changes persisted.People continued to maintain social distancing and avoided high-density areas, indicating long-term adaptations to the pandemic conditions 11) .( 2) Crowd and flow analytical tools To capture such changes, diverse methods have been applied.Mobile spatial statistics and behavioral elasticity diagrams have been used Impact of COVID-19 Pandemic on Behavior Changes of People Staying in Station Front Plaza

The WPA Action Plan 2020-2023: an updated report.

The study aims to investigate the impact of the COVID-19 outbreak and vaccinations on market returns in Pakistan. For this purpose, the study considered a sample period of January 2019 to December 22. This study 14 events of the COVID-19 outbreak and 09 events to establish the impact of Covid-19 and vaccination on capital market returns. The study reveals the strong negative impact of COVID-19 proxies such as 1st wave, 2nd wave, travel restrictions, and travel lockdown on market returns. Meanwhile, vaccination has a positive effect on Pakistan's market returns. Future research can be conducted to compare the impact of COVID-19 on different sectors of the stock market.

Paediatric chronic pain was a public health emergency before the novel coronavirus (COVID-19) pandemic, and this problem is predicted to escalate. Pain tends to occur intergenerationally in families, and youth with chronic pain and their parents have high rates of mental health issues, which can further exacerbate pain. Siblings of youth with chronic pain have been largely overlooked in research, as well as the impact of the pandemic on posttraumatic stress disorder (PTSD) symptoms and healthcare utilization. This cross-sectional study examined pain, mental health and healthcare utilization in three groups: youth with chronic pain (n = 357), parents of youth with chronic pain (n = 233) and siblings of youth with chronic pain (n = 156) during the COVID-19 pandemic in Canada. More so than with pain symptoms, the results revealed high levels of mental health symptoms (i.e. anxiety, depressive, and PTSD), particularly in individuals more personally impacted by the pandemic. The largest effect was seen on PTSD symptoms for all groups. For parents with chronic pain, greater personal COVID-19 impact was related to worse pain interference. Reported rates of healthcare utilization were strikingly high, with youth with chronic pain, parents (reporting on behalf of their children with chronic pain), and siblings of youth with chronic pain reporting that most consultations were due to pain. Longitudinal research assessing these outcomes across continued waves of the pandemic is needed to ensure timely, tailored and equitable access to pain and mental health assessment and treatment. This study examined pain, mental health, substance use and healthcare utilization in youth with chronic pain, siblings and parents during the COVID-19 pandemic. Greater personal impact of the pandemic was not largely associated with poorer pain outcomes; however, it was associated with mental health, with the largest effect on PTSD symptoms. The high rates and significant association of COVID-19 impact with PTSD symptoms underscore the importance of including PTSD assessment as part of routine screening practices in pain clinics.

PurposeThe purpose of this paper is to show how the pattern of trade relations between the USA and African countries is gradually shifting toward reciprocity. It therefore demonstrates that the African Growth and Opportunity Act (AGOA) was conceived to be a building block toward future bilateral trade agreements.Design/methodology/approachThis paper adopts a historical approach to the USA’s policy toward Africa in general and in trade matters in particular. It critically reviews the chronology of US involvement in the continent.FindingsAlthough it was designed as a preferential trade arrangement, AGOA was intended to evolve into reciprocal trade agreements. This is what the USA started doing even prior to the entry into force of the AGOA, by entering into Trade and Investment Framework Agreements with individual countries or blocs. It also transpires that the deployment comes as a response to the European Union which is already engaged in the redefinition of its own trade relations with Africa since 2004.Originality/valueThe paper is important in many respects. Not only it is a study of the US practice as preference-granting country, but it is also interested in the typology of trade agreements concluded by the USA in other regions of the world. This is important to indicate and analyze the types of provisions African countries should be expected to face when the time of entering into reciprocal binding trade treaties arrives.

Purpose: The purpose of this study is to investigate the impact of COVID-19 on the education systems in developing countries.
 Methodology: The study adopted a desktop methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library.
 Findings: The findings of the study revealed the existence of a contextual and methodological gap relating to the impact of COVID-19 on the education systems in developing countries. Preliminary empirical review found that in the world, most schools, colleges, and universities are closed to control the spread of the COVID-19.
 Unique Contribution to Theory, Practice and Policy: The Disruption theory, Social Learning theory and the Cognitive Load theory may be used to anchor future studies on the impact of COVID-19 on education systems in developing countries. The COVID-19 pandemic has made all the educational schools across the world to adopt teaching and learning online. So, governments should scale network infrastructure and internet connectivity across urban and rural areas. The countries should design a strategy to scale educational technology, establish zero-rating educational resources on the internet, and prepare digital teaching and learning resources.

Micronesian and Pacific Islander (M&PI) communities were hit the hardest with COVID-19 cases, 154 to 217.7 per 100,000, compared to other racial-ethnic groups, particularly in the western United States. In Oregon, COVID-19 cases and death rates among M&PI were higher than all other racial and ethnic groups. Micronesian Islander Parent Leaders (MIPLs, including parents and caregivers of children) of the expanded Health and Education parent leadership program in Oregon express concern about the COVID-19 impact on their health and M&PI families and learning on children. Investment in leadership development is shown to have often increased acceptance, development, implementation, and translation of interventions within the M&PI communities. The COVID-19 pandemics’ impact on CBPR must be recognized when conducting CBPR. Consequences include interrupted formal education and parents’ mental health as unintentional proxy educators for children as students with distance learning. We report on a qualitative descriptive study on the COVID-19 impact on the learning of MIPLs and their families, with MIPLs being caregivers as key informants. We describe lessons learned as notes from the field from our experience as the Micronesian Islander Community (MIC) non-profit organization and public Washington State University as a community and academic partnership navigating the COVID-19 impact in conducting CBPR. This community and educational partnership had two major responsive pivots in navigating the COVID-19 impact in working with CBPR. The shift in the project was a necessary methodical resilient strategy for the sustainability of the M&PI parent leadership program.

British Journal of NursingVol. 30, No. 16 CommentStoma care services during the COVID-19 pandemicJennie BurchJennie BurchE-mail Address: [email protected]Head of Gastrointestinal Nurse Education, St Mark's HospitalSearch for more papers by this authorJennie BurchPublished Online:11 Sep 2021https://doi.org/10.12968/bjon.2021.30.16.S40AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References COVIDSurg Collaborative. Outcomes from elective colorectal cancer surgery during the SARSCoV-2 pandemic. Colorectal Dis. 2020;00:1–18. https://doi.org/10.1111/codi.15431 Google ScholarD'Antonio D, Pizza F, Tropeano FP, De Palma GD, Marvaso A, Luglio G. COVID-19 outbreak and stoma care on a minor island in Italy: Physically far, virtually near. SN Comprehensive Clinical Medicine. 2020;2(9):1302–1305. https://doi.org/10.1007/s42399-020-00429-3 Crossref, Google ScholarDepartment of Health. New campaign to prevent spread of coronavirus indoors this winter. 2020. https://tinyurl.com/hbdkkfbm (accessed 18 August 2021) Google ScholarFowler A, Abbott TEF, Pearse RM. Can we safely continue to offer surgical treatments during the COVID-19 pandemic? BMJ Qual Saf. 2020;0:1–3. https://doi.org/10.1136/bmjqs-2020-012544 Google ScholarFulham J, Lowther C, Chandler P. Embracing the changes imposed by COVID-19 to shape future stoma care service provision. Br J Nurs. 2020;29(22):S10–S12. https://doi.org/10.12968/bjon.2020.29.22.S10 Link, Google ScholarLancet Oncology (Editorial). Valuing all lives equally: cancer surgery, COVID-19, and the NHS in crisis. Lancet Oncol. 2021;22(2):155. https://doi.org/10.1016/S1470-2045(21)00022-X Crossref, Medline, Google ScholarMarino F, Trompetto M, Gallo G. COVID-19 pandemic: a large boulder on the head of stoma patients. Br J Surg. 2020;107(9):e303. https://doi.org/10.1002/bjs.11754 Crossref, Medline, Google ScholarMorris EJA, Goldacre R, Spata E et al. Impact of the COVID-19 pandemic on the detection and management of colorectal cancer in England: a population-based study. Lancet Gastroenterol Hepatol. 2021 Mar;6(3):199-208. doi: https://doi.org/10.1016/S2468-1253(21)00005-4 Crossref, Medline, Google ScholarNational Institute for Health and Care Excellence. When should I suspect coronavirus infection? 2021. https://cks.nice.org.uk/topics/coronavirus-covid-19/diagnosis/diagnosis/ (accessed 13 August 2021) Google ScholarNHS Website. How to avoid catching and spreading coronavirus (COVID-19). https://tinyurl.com/a65uname (accessed 18 August 2021) Google ScholarPata F, Bondurri A, Ferrara F, Parini D, Rizzo G; Multidisciplinary Italian Study group for STOmas (MISSTO). Enteral stoma care during the COVID–19 pandemic: practical advice. Colorectal Dis. 2020;22(9):985–992. https://doi.org/10.1111/codi.15279 Crossref, Medline, Google ScholarVailas M, Sotiropoulou M, Schizas D, Maroulis I. Psychological implications on stoma patients waiting for reversal in the era of COVID-19 pandemic. Br J Surg. 2021;108(4):e181. https://doi.org/10.1093/bjs/znab022 Crossref, Medline, Google ScholarVural F, Özer Özlü. In the COVID-19 Pandemic Living with a Stoma and Being a Stoma Nurse. Turk J Colorectal Dis 2020;30:231-236. https://doi.org/10.4274/tjcd.galenos.2020.2020-10-3 Crossref, Google ScholarWoodhouse F, Yeung T. Impact of COVID-19 on stoma care: the experience of one team in Oxford. Br J Nurs. 2020;29(16):S4–S6. https://doi.org/10.12968/bjon.2020.29.16.S4 Link, Google ScholarWorld Health Organization. Coronavirus disease (COVID-19): How is it transmitted? 2020. https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-how-is-it-transmitted (accessed 13 August 2021) Google ScholarWorld Health Organization. Naming the coronavirus disease (COVID-19) and the virus that causes it. 2021. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it#:~:text=Official%20names%20have%20been%20announced,%2DCoV%2D2) (accessed 13 August 2021) Google ScholarXu Y, Huang ZH, Zheng CZ, Li C, Zhang YQ, Guo TA, Liu FQ, Xu Y. The impact of COVID-19 pandemic on colorectal cancer patients: a single-center retrospective study. BMC Gastroenterol. 2021; 20;21(1):185. https://doi.org/10.1186/s12876-021-01768-8 Crossref, Google Scholar FiguresReferencesRelatedDetailsCited byCaring during and after a pandemicAna González Díaz, Concepción Capilla Díaz2 June 2022 | Gastrointestinal Nursing, Vol. 20, No. Sup4 9 September 2021Volume 30Issue 16ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 11 September 2021 Published in print 9 September 2021 Information© MA Healthcare LimitedPDF download

Background: Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. The disease spreads very fast and it is highly contagious as it is an airborne infection. Infected patients were showing mild to critical symptoms affecting their respiratory system. The coronavirus pandemic has had a profound impact on everyone, forcing people to isolate, shield and minimize contact with friends and family. As current restrictions gradually lifted, we consider not only the physical impact, but the effect coronavirus has had on mental health and wellbeing. The World Health Organization (WHO) has warned that the impact of COVID-19 on mental and psychosocial wellbeing will be significant and enduring. The pandemic primarily affects physical health yet has made a significant impact on mental health and wellbeing. Method: in this study, both male and female ranging from the age group 18 to 35 were taken. Total 303 data had participated in this study with convenient sampling method. Kessler Psychological Distress Scale was used to analyse the impact of COVID 19 pandemic on mental health in young adults. Data were analysed by using SPSS statistics. Result: From the data analysis, only 29.04% participants show no significant impact on mental health, where as19.80% have reported mild mental disorder: 20.46% Participants have reported Moderate Mental health disorder and 30% Participants have reported to have Severe Mental health disorder. This shows significant affection of the pandemic on mental health in young adults. Conclusion: In this study, findings are suggesting, mental health affection ranging from mild to severe impact on young adults in COVID 19 pandemic due to many physical, financial and mental reasons.