The Hong Kong Government developed the Reference Framework for Preventive Care for Older Adults (RF) to provide evidence-based recommendations for preventive care in the primary care setting. However, no study has systematically evaluated the adoption and awareness of this framework among primary care physicians (PCPs). This study aimed to explore PCPs' perceptions of the RF and identify barriers and facilitators to its adoption in primary care settings. This cross-sectional qualitative study involved interviews with 40 PCPs in Hong Kong to assess their views on the RF's adoption and implementation. The Consolidated Framework for Implementation Research (CFIR) was used to guide the analysis, focusing on five domains: intervention characteristics, outer setting, inner setting, individual characteristics, and implementation process. Relative advantage (65%, n = 26), innovation design (45%, n = 18), and access to knowledge and information (70%, n = 28) were the facilitators that mostly discussed by interviewee. By contrast, interviewees also raised concerns regarding policy and legal (n=29, 73%) and availability of resources (n=29, 73%) in the implementation of the RF. In general, participants acknowledged the RF's evidence-based foundation and comprehensive design, appreciating its potential to improve care for older adults. However, barriers included the complexity and limited personalization of the RF, competing clinical priorities, time constraints, and resource limitations. Government support and policy initiatives facilitated engagement, but clearer integration into existing workflows and stronger promotion were needed. Tailored updates, user feedback, and technological enhancements were seen as essential for improving the RF's usability and ensuring its relevance in clinical practice. This study highlights that while the RF has potential to improve preventive care in Hong Kong's primary care setting, its adoption is constrained by systemic, organizational, and individual barriers. To ensure its successful integration, flexible implementation, institutional support, tailored incentives, and enhanced clinician and patient engagement are essential. These findings offer practical implications for policymakers and healthcare practitioners to refine and promote the RF in routine consultations, and underscore the need for future research to test theory-informed implementation strategies. Furthermore, this study offered novel contributions to the CFIR literatures in systematically investigate physician perspectives on RF for the older adult population within the distinct socio-cultural and structural context of Hong Kong, COVID-19 pandemic impact to the current healthcare system and actionable implementation strategies for Asian populations. Applying the findings from this study, the CFIR-ERIC Matching Tool could be used to address the specific barriers identified in this study and improving implementation outcomes across various healthcare settings.

Impact of COVID-19 pandemic on tuberculosis mortality in Brazil: a time series analysis

Abstract This paper examines the impact of the recent COVID-19 pandemic on Okun’s Law enforcement in the USA. The previous results have revealed an increase in Okun’s coefficient in absolute terms at the country scale (Russnak et al., Russnak et al., Econ Bus Lett 12:165–171, 2023). Our article explores, adopting a regional focus, whether this strengthening has depended on the degree of restrictions imposed, as the USA presents a particularly relevant case study due to the significant differences in measures implemented across states. The results first confirm that Okun’s coefficient increased not only at the national level but also, arguably, in all states—or almost all states, depending on the approach—although with varying intensity. Furthermore, our analysis reveals a direct relationship between the intensity of the restrictions and the increase in Okun’s coefficient: the stricter the anti-COVID controls, the more abrupt the subsequent rise in unemployment for any given output decline. These findings are robust from multiple perspectives: methodologically (using MG and AMG estimators), with regard to the inclusion of state-level differences in industrial structure, the consideration of cross-border policy spillovers, and the combination of restrictions and economic support.

Malaria remains a global health concern, with Plasmodium vivax as predominant species in the Americas. The region has made notable strides in reducing malaria incidence, but challenges persist. Guiana Shield countries share similar malaria ecologies and vector dynamics, yet their progress toward elimination is quite different. Suriname, a low-middle income country, has pursued malaria elimination and became the first Amazonian country to receive malaria-free certification in June 2025. However, the reintroduction through imported cases from neighboring countries with higher endemicity remains a serious threat, as exemplified by the 2019 outbreak in Pelele Tepoe. The response strategy and operational measures implemented to address this P. vivax outbreak are described, along with key lessons for effective outbreak management. This descriptive study examines Suriname's most recent P. vivax outbreak, using surveillance and intervention data from November 2019 to August 2021. It outlines the rationale for employing an adaptive, multi-pronged outbreak management strategy, details implementation of approaches, tailored to evolving outbreak circumstances and evaluates the effectiveness of subsequent interventions. Factors contributing to the outbreak's prolonged duration, including COVID-19 pandemic impact are discussed, along with the resulting adaptations in the targeted responses. The P. vivax outbreak lasted 22 months, resulting in 179 infections among 153 patients. Traditional strategies with corresponding interventions were introduced at onset, including "1-3-7" surveillance, community education and engagement and vector control. Continuous trend monitoring guided the adoption of additional less conventional and innovative measures, including mass screen-and-treat, mass drug administration (MDA), parasite genotyping and targeted treatment. Mass screen-and-treat was less effective in reducing parasite prevalence than MDA. Directly observed treatment reached 95.1% efficacy by day 180, however, relapses appeared to fuel the outbreak. Implementation of the "Radical Cure" marked the end of the outbreak. The described adaptive, integrated, six-pronged approach, combining conventional strategies with targeted accelerator methods and inclusive stakeholder engagement can effectively control outbreaks in low-endemic or near-elimination regions.

Fear from Eating Outside? Assessing The Impact of Covid-19 Pandemic on Consumer’s Willingness to Utilize Catering Services in China

Suicide is a leading cause of adolescent mortality worldwide. Exogenous poisoning-defined as exposure to toxic substances such as medications or chemicals- is a common method, but large-scale epidemiological data in Brazil are limited. This study describes sociodemographic profiles, temporal trends, regional disparities, and the COVID-19 pandemic's impact on adolescent suicide attempts by exogenous poisoning in Brazil from 2018 to 2023. We conducted a study, the SINAN database, on reported suicide attempts by exogenous poisoning in adolescents aged 10-19 years nationwide. Descriptive analyses were performed by sex, age group, toxic agent, and care setting. Temporal trends were evaluated with LOESS decomposition, the Mann-Kendall trend test, and interrupted time-series analysis (ITSA) assessed the impact of COVID-19 on suicide attempt rates. A total of 142 251 attempts were identified; notification was substantially more common among the 15-19 age group (75.4%) and females in both groups. Medications accounted for most reported agents, and most events occurred at home. Nationwide incidence rose steadily from 2018, peaked in 2019, declined significantly in 2020 (p < 0.01), and resumed increasing through 2022. Upward trends were observed in all regions, with the 10-14-year group exhibiting the largest relative increase. The Southeast region maintained the highest cumulative incidence. ITSA indicated underreporting during the pandemic, with a 66.5% decrease in ages 10-14 and a 56.2% drop in ages 15-19. The high and rising incidence of adolescent suicide attempts by exogenous poisoning in Brazil highlights the need for strengthened mental health interventions, enhanced pharmacovigilance, and targeted prevention, especially post-pandemic.

COVID-19 pandemic impact on patients served by the Grady Health System (GHS) PrEP Program

Assessing the impact of COVID-19 pandemic on ATV-related injuries

Background: Congenital Talipes Equino Varus (CTEV) is a common congenital condition that could lead to lifelong disability. Early intervention using the Ponseti method, a low-cost, highly effective treatment, is essential. However, in the 2020 emerged Covid-19 global pandemic which could impacted on CTEV treatments. Purpose: This study explores the Covid-19 pandemic impact on CTEV treatment and the adaptations developed to ensure continued patient care. Method: A systematic review was conducted according to PRISMA guidelines. Database searches were carried out through screening articles from 2019 to 2023. Results: Out of 23 initial studies, 12 met the inclusion criteria. Covid-19 has caused delays in CTEV treatment globally, reducing access to surgeries, tenotomies, and consultations. Patients faced challenges such as travel restrictions, lack of public transportation, financial strain, and increased travel distances. Healthcare providers dealt with limited resources, clinic closures, and redirected efforts toward Covid-19 care, impacting the availability and frequency of CTEV treatment. These challenges were overcome through telemedicine, "barrier casting”, and clinic-based tenotomies under local anaesthesia. Conclusion: The Covid-19 pandemic emphasized the need for robust contingency plans in healthcare, especially for conditions requiring timely interventions like CTEV. The adaptive approaches developed offer valuable insights for future healthcare crises.

Retraction: Impact of COVID-19 pandemic on consumer behavioural intention to purchase green products.

Systemic lupus erythematosus (SLE) is a chronic autoimmune condition that can lead to death. To examine SLE as an underlying and contributing cause of mortality, CDC analyzed 2018-2023 mortality data for persons aged ≥15 years overall and by age, sex, race and ethnicity, and region. Death certificate data for persons aged ≥15 years with any mention of SLE (ICD-10 code M32) were analyzed using CDC WONDER. We calculated age-adjusted death rates and assessed patterns by sex, age, race/ethnicity, and region. Underlying and contributing causes of death were evaluated using ranked cause-of-death lists and ICD sub-chapters. During 2018-2023, 14,936 deaths had any mention of SLE listed on the death certificate. Of these deaths, 6,414 (42.9%) listed SLE as the underlying cause. The age-adjusted SLE mortality rate per million population was greater among females (5.97) than males (1.16), non-Hispanic African American persons (10.70) versus persons of other non-Hispanic racial groups (range: 2.46 to 5.62), Hispanic versus non-Hispanic persons (3.98 versus 3.59), and in the South (4.37) versus other regions. Where SLE was listed as a contributing cause of death, the leading underlying causes were heart disease (0.93), cancer (0.56), and COVID-19 (0.51). The overall age-adjusted SLE mortality rates were significantly higher in 2020 and 2021 versus all other study years indicating the likely impact of COVID-19 pandemic on SLE mortality. Overall management of SLE and co-morbidities and infections in SLE patients, as well as interventions targeting groups (e.g., African American persons) disproportionately impacted by SLE, may reduce overall SLE mortality.

BackgroundThe impact of COVID-19 pandemic on extended-spectrum beta-lactamase inhibitor (ESBL) producing Enterobacteriaceae, Carbapenem-resistant organism (CRO), Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant enterococci (VRE). This study aims to demonstrate the variations in multidrug resistance levels between the pre-COVID, COVID, and post-COVID periods.MethodsThis retrospective cohort study conducted between January 2018-March 2024 at a tertiary hospital in India. January 2018-March 2020 (Pre-COVID), April 2020-July 2022 (COVID) and August 2022-March 2024 (Post-COVID). We systematically collected organism cultures, and analysed multidrug-resistant organism details using descriptive statistics.ResultsDuring the study period, a total of 10,915 isolates were analysed, revealing an increase in multidrug-resistant pathogens during the COVID period. Specifically, the percentages of CRO were increased to 21.1%, VRE was increased to 7.2%, gram-positive was being decreased and yeast has been increased as shown in Table 1.Table 1:Cumulative summary of multidrug-resistant organisms reported during Pre-COVID, COVID and Post-COVIDYEARTOTAL ISOLATESGNB ISOLATESGPC ISOLATESYEAST ISOLATESESBLCROMRSAVREPre-COVID (January2018-March2020)37262584(69.3%)867(23.2%)275(7.3%)1311(50.7%)458(17.7%)285(32.8%)34(3.9%)COVID (April2020-July2022)46113308(71.7%)995(21.5%)308(9.3%)1896(57.3%)701(21.1%)332(33.3%)72(7.2%)Post-COVID (August2022-March2024)25781828(70.9%)496(19.2%)125(4.8%)1014(55.4%)326(17.8%)98(19.7%)24(4.8%)ConclusionThis study indicates a significant increase in multidrug-resistant pathogens, particularly during the COVID-19 period. The prevalence of ESBL-producing organisms, CRO, MRSA, and VRE exhibited notable spikes during this time, highlighting the impact of the pandemic on antimicrobial resistance patterns in the hospital.DisclosuresAll Authors: No reported disclosures

Pneumonia-related mortality in the United States has shown a notable decline. However, epidemiological analyses of the COVID-19 pandemic's impact on these trends are limited. We evaluated pneumonia mortality trends pre-and-post the pandemic. Age-adjusted mortality rates (AAMR) per 100,000 were obtained from the CDC WONDER database through ICD-10 codes. Data were stratified based on sex, region, and state. Temporal trends were assessed with average annual percentage changes (AAPC). A total of 3.54% of all deaths (n = 2,360,261) between 1999 and 2023 were due to pneumonia. Males exhibited a 1.3-fold higher AAMR compared to females (AAMR: 20.4 vs 15.3; p = 0.003). However, pneumonia accounted for a greater proportion of all-cause mortality among females than males (2.42% vs 2.06%). Overall, a significant decline in mortality was observed from 1999 to 2018, followed by a sharp rise. No significant AAMR trends were noted over the full study period (AAPC -0.32%; p = 0.81), but excluding COVID-19 deaths revealed a significant decline (AAPC -3.41%; p < 0.005). Marked geographic disparities were observed, with the highest median AAMR in Arkansas (24.9, IQR 6.8) and the lowest in Florida (9.4, IQR 6.3). The East South-Central region exhibited significantly higher pneumonia mortality rates (p < 0.001). The pre-existing declining trend of pneumonia associated mortality was markedly affected by the COVID-19 pandemic. Our findings underscore the need for tailored public health interventions and further research into demographic and geographic factors influencing pneumonia outcomes.

The accurate quantification of the impact of COVID-19 pandemic on both public health and the economy is essential for informed policy-making. However, the true scope of the pandemic remains challenging to ascertain due to undetected cases, particularly when relying on reported cases, which rely heavily on test availability and strategies. To accurately quantify COVID-19 cases in British Columbia (BC), we develop a Susceptible-Infectious-Recovered multi-event capture-recapture (SIRMECR) model to capture the dynamics of COVID-19. Specifically, we present a time-varying Markov model to estimate the number of undetected COVID-19 cases in five Health Authority Regions in BC, Canada, during the year 2020. We utilize individual-level information available from Population Data BC database to estimate the case detection probability, infection probability, survival probability, and recovery probability by incorporating testing volumes as covariates that improve the estimate of our parameters. We develop a Markov chain Monte Carlo (MCMC) algorithm to estimate SIRMECR model parameters. However, analyzing this big COVID-19 data set prompts a discussion on the computational challenges encountered. Therefore, we developed divide-and-conquer strategies to address the challenges. Our application provides an estimate of the total COVID-19 burden in year 2020 and found the percentage of undetected varying from 77.4 % to 84.0 %. More specifically, we validate our results through a simulation study and N-mixture model for Northern Health Authority Region of BC.

This study aims to examine the impact of the Covid-19 pandemic on various aspects of the personal lives of students of Mymensingh Medical College. This study is descriptive cross-sectional observational study that has been carried out concentrating on the undergraduate and postgraduate students of Mymensingh Medical College, Bangladesh. The location was selected purposively and the "Raosoft sample size calculator" was used in order to determine the size of the sample. The acceptable margin of error for this study is 5.0% at a 95.0% confidence interval, 50.0% response distribution from the total number of 1655 medical students; the calculated minimum total sample size was 312- undergraduate students 218 and postgraduate students 94. Medical students were selected purposively based on inclusion and exclusion criteria. Reliability of the questionnaire has been ensured by measuring Cronbach's α coefficient (0.635) and validity has been established by KMO and Bartlett test. The data collection process started in January 2021 and concluded in December 2021. Correlation analysis indicates a statistically significant impact of the Covid-19 pandemic on the personal lives of the respondents by producing a p-value less than 0.05. The study suggests that most medical students have experienced an increased sense of loneliness and depression regardless of their demographic attributes. Physical health did not improve, although consumption of junk food decreased. On the other hand, students became more religious however, their sense of empathy did not change much and they were currently seized by session jam. The experience of online classes has not been perceived positively by the students.

Impact of COVID-19 pandemic on children's play and friendship

In this study, we examine the impact of COVID-19 pandemic on children's language development and experiences, particularly focusing on a socioeconomically disadvantaged population of Spanish-English emergent bilinguals. Using propensity score matching, we compared pandemic (n = 82) to pre-pandemic cohorts (n = 112) across multiple dimensions of language skills and experiences. Results revealed no significant differences between cohorts in English and Spanish language proficiency measures, English reading abilities, language experiences in school, relative English experience, or English reading frequency. However, pre-pandemic children engaged in Spanish reading more frequently than their pandemic-era counterparts; pandemic-cohort children demonstrated enhanced benefits from more English experience in English reading comprehension, English phonological awareness, and heightened benefit from more Spanish experience in their development of Spanish vocabulary, compared to pre-pandemic peers. The observed differential effects of English experience between cohorts suggest potential compensatory mechanisms in language learning during disrupted formal education.

The Impact of COVID-19 Pandemic on Financial performance An Applied Study on EGX 30 listed companies in Egypt

Impact of COVID-19 pandemic on treatment patterns for stage I Non-Small Cell Lung Cancer in the Netherlands.

Impact of COVID-19 pandemic on characteristics, extent, and trends in child maltreatment in 34 Euro-CAN COST Action Countries: a scoping review of the literature.