Wider Impact Research Articles

Sexual Health During COVID-19: A Scoping Review.

IntroductionThe COVID-19 pandemic impacted profoundly on the wellbeing and social interactions of the world population, and all dimensions of sexual health were potentially affected by globally implemented preventive measures.ObjectivesThe scoping review aimed to compile existing research investigating possible effects of COVID-19 lockdowns on adult sexual health, that is, sexual behavior, functioning, and satisfaction. Further, studies on the interplay between mental health and sexual well-being during the pandemic were reviewed.MethodsThe review was conducted in accordance with guidelines established by the Joanna Briggs Institute and the Extension for Scoping Reviews (PRISMA-ScR) Checklist. On October 11–12, 2021, PubMed, Embase, PsycInfo, Cinahl, Cochrane, Sociological s and Scopus were systematically searched for relevant peer-reviewed papers employing quantitative methodology. Additionally, unpublished (“grey”) research studies on the subject were retrieved. The screening, data extraction, and analysis of evidence were conducted by 4 independent reviewers using an iterative approach.ResultsBased on 107 studies included, the scoping review showed that the pandemic had had a wide impact on all dimensions of sexual health. Except for solo sex activities, mainly negative COVID-19 implications were identified, although findings were, in sum, characterized by complexity and unpredictability. Thus, sexual behavior, functioning, and satisfaction during the pandemic appeared to be mitigated by a broad range of sociodemographic and contextual factors. Finally, sexual health seemed deeply entwined with overall mental health.ConclusionThe scoping review revealed a broad range of COVID-19-related effects on sexual health, including an overall decline in partnered sex and a concurrent increase in solo sex activities. It also emphasized a need for future research to shed light on possible long-term consequences of the pandemic in various population groups and on all aspects of sexual health.Toldam NE, Graugaard C, Meyer R, et al. Sexual Health During COVID-19: A Scoping Review. Sex Med Rev 2022;10:714–753.

Local community attitudes towards mangrove forest conservation

Local communities have preferences and expectations regarding mangrove ecosystems that are typically underrepresented in valuation studies. Therefore, this study identifies how the local community of Mahahual (Mexico) perceives the ecosystem services provided by the mangrove forest and how these preferences differ between households. A survey was designed by one of the authors and local stakeholders building on previous knowledge and experts (local environmental research centre and non-governmental organisation Takata and its experts in biology and coastal conservation, ecotourism businesses’ owners, and the mayor of the village). The survey is used to cover a wide range of ecosystem services such as carbon sequestration, recreation and cultural activities as well as improved connectivity with local seagrass beds and coral reefs. Ecosystem services were specifically chosen by biologists and ecologists of the local NGO to perfectly reflect the local mangroves ecosystem. The small land area of the village, its low population and its rapid expansion offer a unique context, aiming at preserving the natural environment while keeping in mind that the main economy is based on tourism. While mangroves are greatly appreciated for the local protective services they provide such as coastal protection, local inhabitants also care about services that have a wider impact such as biodiversity and carbon sequestration. We find that the educational background of local inhabitants plays an important role in determining the importance of local ecosystem services and that information provision can help to counterbalance this effect. We also observe that preferences for specific ecosystem services differ based on how close residents live to the mangroves and to the coast, which accentuates the different needs and ideas of the households based on their local neighbourhood.

Alterations in the jejunal microbiota and fecal metabolite profiles of rabbits infected with Eimeria intestinalis

BackgroundRabbit coccidiosis is a major disease caused by various Eimeria species and causes enormous economic losses to the rabbit industry. Coccidia infection has a wide impact on the gut microbiota and intestinal biochemical equilibrium. In the present study, we established a model of Eimeria intestinalis infection in rabbits to evaluate the jejunal microbiota and fecal metabolite profiles.MethodsRabbits in the infected group were orally inoculated with 3 × 103E. intestinalis oocysts. On the eighth day of infection, jejunal contents and feces were collected for 16S rRNA gene sequencing and liquid chromatography–tandem mass spectrometry (LC–MS/MS) analysis, respectively. Jejunum tissues were harvested for hematoxylin and eosin (H&E), periodic acid-Schiff (PAS), and immunohistochemistry (IHC) staining.ResultsHistopathological analysis showed that the whole jejunum was parasitized by E. intestinalis in a range of life cycle stages, and PAS staining showed that E. intestinalis infection caused extensive loss of goblet cells. IHC staining revealed that TNF-α expression was higher in the E. intestinalis infection group. Moreover, both the jejunal microbiota and metabolites significantly altered after E. intestinalis infection. At the genus level, the abundances of Escherichia and Enterococcus significantly increased in the infected group compared with the control group, while those of Oscillospira, Ruminococcus, Bacteroides, Akkermansia, Coprococcus, and Sarcina significantly decreased. In addition, 20 metabolites and two metabolic pathways were altered after E. intestinalis infection, and the major disrupted metabolic pathway was lipid metabolism.ConclusionsEimeria intestinalis infection induced intestinal inflammation and destroyed the intestinal homeostasis at the parasitized sites, leading to significant changes in the gut microbiota and subsequent corresponding changes in metabolites.Graphical

Pelatihan Pembuatan Poster Edukasi Dan Koleksi Museum Bagi Anggota Ikatan Pemandu Museum Indonesia (IPMI)

Museums are one of the tourist destinations, especially educational and cultural tourism for the community. All resources in the museum including museum guides have an important role. In addition to being a guide, museum guide, and providing services for visitors, museum guides must also have other skills in communicating material or all things in the museum, including communicating in the form of posters that can be published. For two years, the world has been hit by the COVID-19 pandemic, and Indonesia is no exception. This pandemic has had a wide impact on all sectors of people's lives, including education and tourism. In 2022, the Ministry of Tourism and Creative Economy begins to launch a program to revive the slumped tourism industry. The Indonesian Museum Guides Association (IPMI) as a unifying forum and communication between museum guides in Indonesia welcomed this. One of them is by synergizing with Bina Sarana Informatika University in community service activities. In this activity, the lecturers who are members of the community service group help partners to provide training on making educational posters and museum collections for museum guides. This method of implementing Community Service activities is carried out online, through the zoom meeting application, due to the current pandemic situation in PPKM Level 3 status, so mass gathering in large numbers is not possible. The outputs of this activity include press releases and questionnaire results from both partners and participants.

Integrating Community Partnership Program in Cengkeh Afo: A Community-based Tourist Attraction

Cengkeh Afo, a spice-based tourist attraction in North Maluku, is situated in the forest area behind Mount Gamalama. It has the potential to attract both domestic and international tourists through community-based tourism (CBT). The area is managed by the Cengkeh Afo Gamalama Spices (CAGS) community that uses the world’s oldest clove spot as an icon for the Spice Island. The community partnership program (PKM) has been integrated in response to the COVID-19 pandemic, which has had a wide impact on business and tourism. The PKM was integrated to build collaboration among the community for building the CAGS management capacity. Mastering basic English, managing data on tourist visits, utilizing local wisdom related to traditional gastronomy (local cuisine), mastering technology in managing tourism promotion, and understanding the application of the CHSE health protocol in tourism services in the region are among PKM’s goals for partnerships with the CAGS community. The qualitative approach was used in this research. Data were gathered through observation, questionnaires, and interviews in a field survey. The results showed that by working together the CAGS community has met the criteria for communitybased tourism service. Collaboration with research counterparts has aided the CAGS community’s capacity-building in its service.
 Keywords: Cengkeh Afo, community-based tourism, capacity-building

Discovering the effect metrics for innovation projects

Working life-integrated innovation projects have become a common part of education. An innovation project is a social phenomenon of learning that brings the competence of several individuals together in a social process through which a novel idea is turned into practical reality to convey value to its users. University–industry innovation collaboration research has mainly understood the role of the university as a partner responsible for research. However, these projects are often based on student teamwork, an open challenge from real working life and a predefined intention to produce a concrete, novel, and innovative product, service, or new operating model into use. The outcomes are meant to be taken into use to convey value for business and society. A paucity of empirical research exists on the development and assessment of these innovation education programs based on their effects on the surrounding society. The variables that are important in studying the effects of innovation education projects on surrounding society, participating companies, and organisations must be identified. In this study, a set of effect measurement scale variables were discovered through a document analysis and focus group interviews. The findings imply the importance of recognising the effects of the project both on the clients' and their organisations' goals (project output, benefits of participation, and what survives) and the wider impact of the projects on the surrounding society (impacts on the daily lives of citizens; well-being and health; economy, ecology, digitalisation; and social matters). Thus, a preliminary impact assessment model is suggested. Keywords: Innovation project, university-industry collaboration, impact, higher education, innovation pedagogy, document analysis, focus group

Advancing Nursing Science Through Site-Based Clinical Inquiry: Designing Problem Pyramids.

Advancing Nursing Science Through Site-Based Clinical Inquiry: Designing Problem Pyramids.

Abstract 5214: Copper chelation overcomes the immunosuppressive tumor microenvironment in neuroblastoma

Abstract Immunotherapy remains a promising approach in the treatment of high-risk neuroblastoma, however efficacy is hampered by the immunosuppressive tumor microenvironment. We previously reported a link between intratumoral copper levels and Programmed Death-Ligand 1 (PD-L1) expression and therefore sought to elucidate the wider impact of copper chelation on immune evasion strategies (Voli et al 2020). Here we profile key elements of the neuroblastoma tumor microenvironment which work in concert to promote immunosuppression and tumor progression. Using the murine TH-MYCN model, animals were treated daily with the copper chelation agent tetraethylenepentamine (TEPA) for seven days before tumor resection and processing. Transcriptome analyses using single-cell RNA-sequencing revealed copper chelation positively skewed the functional status of tumor, immune and stromal compartments to enhance the anti-tumor immune response. This was supported by a tissue microarray screen using NanoString Digital Spatial Profiling which identified increased immune cell infiltration and regions of active tumor killing. High-resolution mass-spectrometry detected upregulation of major histocompatibility complex (MHC) proteins and exclusive antigenic signatures in peptide repertoires. A multiplex cytokine array indicated an improved anti-tumorigenic response underscored by T cell and Natural Killer cell activation. Importantly, combination of copper chelation and anti-GD2 antibody therapy led to tumor regression and significantly improved survival in vivo. Collectively, this study demonstrates the ability of copper chelation to successfully mitigate tumoral immune evasion strategies while providing remarkable insight into neuroblastoma biology. Findings provide crucial evidence in support of combining clinically approved copper chelators with immunotherapy to improve outcomes for neuroblastoma patients. Citation Format: Jourdin R. Rouaen, Daniele Mercatelli, Federica Saletta, Ensieh M. Poursani, Jayne E. Murray, Nicodemus Tedla, Federico M. Giorgi, Orazio Vittorio. Copper chelation overcomes the immunosuppressive tumor microenvironment in neuroblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5214.

Review: Branding Brazil: Transforming Citizenship on Screen, by Leslie L. Marsh

Review: <i>Branding Brazil: Transforming Citizenship on Screen</i>, by Leslie L. Marsh

The impact of financial distress, sustainability report disclosures, and firm size on earnings management in the banking sector of Indonesia, Malaysia, and Thailand

Research Question: Does financial distress, sustainability report disclosures, and firm size have an effect on earnings management? Motivation: Researchers want to know the effect of financial distress, sustainability report disclosures, and firm size on earnings management. Idea: The purpose of this paper is to determine the impact of Financial Distress (FD), Sustainability Report (SR), and Firm Size (FS) on earnings management in the banking sector of Indonesia, Malaysia and Thailand. Data: The data for this research is taken from the financial reports, annual reports, and sustainability reports issued by the companies from 2019 to 2020. The populations in this study are banking companies listed on the Indonesian, Malaysian, and Thailand Stock Exchanges. The samples used are 43 public banking companies in Indonesia, 10 public banking companies in Malaysia, and 8 public banking companies in Thailand. Tools: This study uses a regression model made with E-Views 10. Findings: The results show that financial distress has a significant influence on earnings management, sustainability reports have no influence on earnings management, and firm size has an influence on earnings management, but only in Malaysia’s and Thailand’s banking companies. Contribution: The results of this study are expected to provide ideas and reference materials regarding financial distress, disclosure of corporate sustainability reports, firm size, and earnings management practices. For companies, especially from the banking sector, this study is expected to provide information that they must be careful in reporting financial statements that will be published considering that banking companies are a business entity that receives and safeguards money owned by the public and lends out this money in the form of loans or credits. Banks are the main financial institutions in the financial system that drive the economy in a country. If a banking company experiences a financial crisis, it will have a wide impact on the financial system and economic sector in a country. The results of this study are also expected to help investors make investment decisions in a company and the results of this study are expected to help creditors in making funding decisions in a company.

Carbon Neutralization: The exploration of clean energy and ecological environment to achieve low carbon emission

Climate change is already affecting the entire world, with extreme weather conditions due to burning fossil fuels like coal, oil and gas. In this context, the term “Carbon Neutralization” is proposed. The term is used in the context of carbon dioxide-releasing processes associated with transportation, energy production, agriculture, and industry. Carbon Neutralization means having a balance between emitting carbon and absorbing carbon from the atmosphere in carbon sinks. Switching energy systems from fossil fuels to renewables like solar or wind will reduce the emissions driving climate change. Carbon Neutralization is copublished by Wiley and Wenzhou University, China. Carbon Neutralization is an international journal that addresses the growing scientific interests and needs in cutting-edge energy technology involving carbon utilization and carbon emission control. It serves as a high-quality platform for researchers working in a wide variety of scientific areas to communicate their findings and critical opinions as well as bring the communities of advanced material and energy together to contribute to this emerging field. Carbon Neutralization aims at publishing environmental science, ecosystems, carbon capture and storage, renewable energy, solar energy, fuel cells, batteries, hydrogen energy, energy harvesting devices, bioenergy, biofuels, electrocatalysis, photocatalysis, and so forth. It prompts new technologies leading to the control of carbon emission and green production of carbon materials. The journal recognizes the complexity of issues, and therefore particularly welcomes innovative interdisciplinary research with wide impact. Carbon Neutralization invites you to submit original research and review articles, editorials, short communications, and letters to the editor. We encourage contributors to read the authors' guidelines (https://onlinelibrary.wiley.com/page/journal/27693325/homepage/author-guidelines), grasping the criteria of each article type. Carbon Neutralization adopts an open-access publishing model, and all published articles are freely accessed through the Wiley Online Library (https://onlinelibrary.wiley.com/r/carbon-neutralization). The Editorial Board of Carbon Neutralization is comprised of prominent experts around the world spanning across multiple research fields. Our Honorary Editor-in-Chief, Prof. Rose Amal, from University of New South Wales, Sydney, Australia, is an ARC Laureate Fellow. She is recognized as a pioneer and leading authority in the fields of fine particle technology, photocatalysis, and functional nanomaterials having made significant contributions to these related areas of research. Our Editors-in-Chief are Prof. Shulei Chou and Prof. Min Zhao, both of them are from Wenzhou University, who are responsible for the whole publication process of Carbon Neutralization. Assisting the Editors-in-Chief to expedite the peer review process, three Associate Editors are on board, including Prof. Dawei Wang (University of New South Wales, Sydney, Australia), Prof. Jianbing Li (University of Northern British Columbia, Prince George, Canada), and Prof. Hui Ying Yang (Singapore University of Technology and Design, Singapore, Singapore). Ultimately, it is our strong belief that with you as our passionate readers, resourceful authors, critical commentators, and reviewers, Carbon Neutralization will rapidly emerge into a leading open-access journal in the cross-field of clean energy and environmental science. The authors declare no conflict of interest.

Tropical Cyclone Track Prediction with an Encoding-to-Forecasting Deep Learning Model

Abstract Recently, with the accumulation of remote sensing data, the traditional tropical cyclone (TC) track prediction methods (e.g., dynamic methods and statistical methods) have limitations in prediction efficiency and accuracy when dealing with a large amount of data. However, deep learning methods begin to show their advantages to capture the complex spatiotemporal features in high-dimensional data. The task of TC track prediction based on remote sensing images can be formulated as a spatiotemporal sequence-to-sequence problem. Therefore, a novel encoding-to-forecasting model with convolutional long short-term memory (ConvLSTM) and spatial attention network (SAN-EFSModel) was proposed to predict TC tracks in this paper, which can fully extract the long-term spatial and temporal features. The proposed model was evaluated on the real remote sensing images in the western North Pacific Ocean to forecast 24-h TC tracks. Compared with ECMWF-HRES model and NCEP-GFS model, the proposed method has a better prediction accuracy in the testing set with an average position error about 30 km less. Compared with the deep learning methods, the proposed method also has the best performance. Significance Statement Tropical cyclones have a great impact on human life and natural environment due to their high frequency of occurrence, heavy degree of harm, wide impact range, and long disaster chain. In this article, we propose an encoding-to-forecasting model with convolutional long short-term memory (ConvLSTM) and spatial attention network (SAN-EFSModel) to predict tropical cyclone tracks, in which the SAN module and the convolution module of ConvLSTM have the ability to extract spatial features, and the long short-term memory (LSTM) module of ConvLSTM can extract temporal features from remote sensing images and tropical cyclone tracks. The results show that the average position error (APE) of our proposed method has about 30% improvement in a 24-h forecast compared with prevailing numerical weather prediction models.

Multicultural counseling: The strategy of social fasilitator of post-conflict education and psychosocial guidance in multicultural society

Unfortunately, multicultural problems manifested in patterns of thought, attitude, and behavior of intolerance are still seen in many societies over the past decade. It started to become common that certain groups attacked other ethnic and racial groups thereby causing conflict. This might be due to the handling of cases that are not ideal and appropriate, situations of intolerance, and social conflicts that have a wide impact, including causing psychological problems such as anxiety, hatred, violence, or depression. This study aimed to critically examine psychological coping strategies carried out in various countries to assist post-conflict victims with trauma, especially in multicultural societies. This study used an integrative review approach to analyze nine selected articles about psychological strategy and social education for post-conflict settings from 2010 to 2021 by reputable journals or publications. The results showed that the post-conflict victim handling strategy in various countries is carried out using psychosocial approaches and counseling/narrative therapy which are considered the most effective to help victims with trauma. Multicultural skills are an important part of post-conflict psychological handling, and hence is recommended multicultural counseling as a post-conflict psychological treatment and social education model is widely applied by societies with a high level of diversity.

Social Vulnerability and Mental Health Inequalities in the "Syndemic": Call for Action.

Covid-19 is referred to as a “syndemic,” i.e., the consequences of the disease are exacerbated by social and economic disparity. Poor housing, unstable work conditions, caste, class, race and gender based inequities and low incomes have a profound effect on mental health and wellbeing. Such disparities are increasing between, among and within countries and are exacerbated by human rights violations, in institution and in society, stigma and discrimination. Social capital can mediate health outcomes, through trust and reciprocity, political participation, and by mental health service systems, which can be coercive or more open to demand of emancipation and freedom. Societal inequalities affect especially vulnerable groups, and Covid itself had a wider impact on the most socially vulnerable and marginalized populations, suffering for structural discrimination and violence. There are complex relations among these social processes and domains, and mental health inequalities and disparity. Participation and engagement of citizens and community organizations is now required in order to achieve a radical transformation in mental health. A Local and Global Action Plan has been launched recently, by a coalition of organizations representing people with lived experience of mental health care; who use services; family members, mental health professionals, policy makers and researchers, such as the International Mental Health Collaborating Network, the World Federation for Mental Health, the World Association for Psychosocial Rehabilitation, the Global Alliance of Mental Illness Advocacy Networks (GAMIAN), The Mental Health Resource Hub in Chennai, India, The Movement for Global Mental Health (MGMH) and others. The Action Plan addresses the need for fundamental change by focusing on social determinants and achieving equity in mental health care. Equally the need for the politics of wellbeing has to be embedded in a system that places mental health within development and social justice paradigm, enhancing core human capabilities and contrasting discriminatory practices. These targets are for people and organizations to adopt locally within their communities and services, and also to indicate possible innovative solutions to Politics. This global endeavor may represent an alternative to the global mental discourse inspired by the traditional biomedical model.

EDUKASI PROTOKOL KESEHATAN DAN STRATEGI PEMASARAN ONLINE UMKM MASYARAKAT DI WILAYAH KELURUHAN MAYANGAN KOTA PASURUAN DIERA PANDEMI COVID19

The COVID-19 pandemic has had a wide impact on various fields, including small and medium-sized businesses. The solution to the existing problems is through educational activities about health protocols for adapting new habits in business premises in the era of the Covid-19 pandemic, socialization about processing management and product marketing strategies and product packaging, and online marketing training through social media. The results of the service activities carried out showed an increase in partner knowledge about health protocols in the place of business by 100%, processing management and marketing strategies by 80%, and an increase in partner knowledge and skills in online marketing by 70%.

Practical diagnostic tips for the Sjögren Clinic: pearls, myths and mistakes.

More than 90 years have passed since Hendrik Sjögren began to consider that behind the dryness that several of his patients presented, there could be a systemic disease potentially linked to abnormal immune responses. For many years, the disease was mostly considered a minor syndrome compared with other systemic autoimmune diseases such as systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and vasculitis, and advances in its understanding were slow and little recognised. The irruption of new technologies at the end of the 20th century rapidly promoted the development of international projects with a wide impact and diffusion. In the last 20 years, a significant improvement has been achieved in epidemiological determinants, pathogenic mechanisms, diagnostic accuracy, and a standardised therapeutic approach for patients with Sjögren's syndrome (SS). These developments have provided the tools for an early diagnosis and personalised management for most patients. However, a significant number of early myths and ongoing controversies are still making the appropriate management of SS difficult in daily clinical practice. This review provides a selection of pearls, myths, and mistakes that may serve as practical diagnostic tips for the Sjögren Clinic in four specific scenarios: defining the appropriate epidemiological background, enabling the earliest diagnostic suspicion as possible, improving the systemic characterisation of the disease, and designing an optimal follow-up of patients.

An assessment of the vaccination of school-aged children in England against SARS-CoV-2

BackgroundChildren and young persons are known to have a high number of close interactions, often within the school environment, which can facilitate rapid spread of infection; yet for SARS-CoV-2, it is the elderly and vulnerable that suffer the greatest health burden. Vaccination, initially targeting the elderly and vulnerable before later expanding to the entire adult population, has been transformative in the control of SARS-CoV-2 in England. However, early concerns over adverse events and the lower risk associated with infection in younger individuals means that the expansion of the vaccine programme to those under 18 years of age needs to be rigorously and quantitatively assessed.MethodsHere, using a bespoke mathematical model matched to case and hospital data for England, we consider the potential impact of vaccinating 12–17 and 5–11-year-olds. This analysis is reported from an early model (generated in June 2021) that formed part of the evidence base for the decisions in England, and a later model (from November 2021) that benefits from a richer understanding of vaccine efficacy, greater knowledge of the Delta variant wave and uses data on the rate of vaccine administration. For both models, we consider the population wide impact of childhood vaccination as well as the specific impact on the age groups targeted for vaccination.ResultsProjections from June suggested that an expansion of the vaccine programme to those 12–17 years old could generate substantial reductions in infection, hospital admission and deaths in the entire population, depending on population behaviour following the relaxation of control measures. The benefits within the 12–17-year-old cohort were less marked, saving between 660 and 1100 (95% PI (prediction interval) 280–2300) hospital admissions and between 22 and 38 (95% PI 9–91) deaths depending on assumed population behaviour. For the more recent model, the benefits within this age group are reduced, saving on average 630 (95% PI 300–1300) hospital admissions and 11 (95% PI 5–28) deaths for 80% vaccine uptake, while the benefits to the wider population represent a reduction of 8–10% in hospital admissions and deaths. The vaccination of 5–11-year-olds is projected to have a far smaller impact, in part due to the later roll-out of vaccines to this age group.ConclusionsVaccination of 12–170-year-olds and 5–11-year-olds is projected to generate a reduction in infection, hospital admission and deaths for both the age groups involved and the population in general. For any decision involving childhood vaccination, these benefits needs to be balanced against potential adverse events from the vaccine, the operational constraints on delivery and the potential for diverting resources from other public health campaigns.

Assessing the impact of a statewide effort to improve breastfeeding rates: A RE-AIM evaluation of CHAMPS in Mississippi.

Communities and Hospitals Advancing Maternity Practices (CHAMPS) is a public health initiative, operating in Mississippi since 2014, to improve maternal and child health practices and reduce racial disparities in breastfeeding. Using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, this study assessed CHAMPS, which used a Quality Improvement intervention at hospitals, and engaged intensively with local community partners. The study team assessed outcomes through quantitative data (2014–2020) from national sources, Mississippi hospitals, community partners and CHAMPS programme records, and qualitative data from focus groups. With 95% of eligible Mississippi hospitals enrolled into CHAMPS, the programme reached 98% of eligible birthing women in Mississippi, and 65% of breastfeeding peer counsellors in Mississippi's Special Supplemental Nutrition Programme for Women, Infants and Children. Average hospital breastfeeding initiation rates rose from 56% to 66% (p < 0.05), the proportion of hospitals designated Baby‐Friendly or attaining the final stages thereof rose from 15% to 90%, and 80% of Mississippi Special Supplemental Programme for Women, Infants, and Children districts engaged with CHAMPS. CHAMPS also maintains a funded presence in Mississippi, and all designated hospitals have maintained Baby‐Friendly status. These findings show that a breastfeeding‐focused public health initiative using broad‐based strategic programming involving multiple stakeholders and a range of evaluation criteria can be successful. More breastfeeding promotion and support programmes should assess their wider impact using evidence‐based implementation frameworks.

Factors associated with the utilization of health services among patients with hypertension during the Covid-19 pandemic: a cross-sectional study in West Lombok Regency, Indonesia

The Covid-19 pandemic has had a wide impact on all areas of life, especially health. One of the serious impacts that need to be addressed is the utilization of health services among people with a history of co-morbidities, the most common of which is hypertension. The purpose of this study was to determine the factors associated with the utilization of health services among patients with hypertension during the Covid-19 pandemic in West Lombok Regency, Indonesia. This study used a cross-sectional study design involving 435 hypertensive patients, selected using cluster sampling. The research instrument was a questionnaire, and the data was analyzed using univariate (frequency and proportion), bivariate (Chi-square and Fisher’s exact test), and multivariate analysis (multiple logistic regression). The majority of respondents (72.4%) utilized health services, and from the results of the multivariate analysis, the significant factors associated with the utilization were health status (Adj.OR: 0.25; p&lt;0.001); availability (Adj.OR: 6.79; p&lt;0.001); and acceptability (Adj.OR: 0.06; p&lt;0.001). Improving the utilization of health services among patients with hypertension is necessary, as is expanding access to hypertension health services through strengthening health centers, mobile health center services, community integrated services for non-communicable diseases, and home visits.

Post-COVID Condition in Adults and Children Living in the Same Household in Italy: A Prospective Cohort Study Using the ISARIC Global Follow-Up Protocol.

BackgroundEmerging evidence shows that both adults and children may develop post-acute sequelae of SARS-CoV-2 infection (PASC). The aim of this study is to characterise and compare long-term post-SARS-CoV-2 infection outcomes in adults and children in a defined region in Italy.MethodsA prospective cohort study including children (≤18 years old) with PCR-confirmed SARS-CoV-2 infection and their household members. Participants were assessed via telephone and face-to-face visits up to 12 months post-SARS-CoV-2 diagnosis of household index case, using the ISARIC COVID-19 follow-up survey.ResultsOf 507 participants from 201 households, 56.4% (286/507) were children, 43.6% (221/507) adults. SARS-CoV-2 positivity was 87% (249/286) in children, and 78% (172/221) in adults. The mean age of PCR positive children was 10.4 (SD = 4.5) and of PCR positive adults was 44.5 years (SD = 9.5), similar to the PCR negative control groups [children 10.5 years (SD = 3.24), adults 42.3 years (SD = 9.06)]. Median follow-up post-SARS-CoV-2 diagnosis was 77 days (IQR 47–169). A significantly higher proportion of adults compared to children reported at least one persistent symptom (67%, 68/101 vs. 32%, 57/179, p < 0.001) at the first follow up. Adults had more frequently coexistence of several symptom categories at both follow-up time-points. Female gender was identified as a risk factor for PASC in adults (p 0.02 at 1–3 months and p 0.01 at 6–9 months follow up), but not in children. We found no significant correlation between adults and children symptoms. In the paediatric group, there was a significant difference in persisting symptoms between those with confirmed SARS-CoV-2 infection compared to controls at 1–3 months follow up, but not at 6–9 months. Conversely, positive adults had a higher frequency of persisting symptoms at both follow-up assessments.ConclusionOur data highlights that children can experience persistent multisystemic symptoms months after diagnosis of mild acute SARS-CoV-2 infection, although less frequently and less severely than co-habitant adults. There was no correlation between symptoms experienced by adults and children living in the same household. Our data highlights an urgent need for studies to characterise PASC in whole populations and the wider impact on families.