Impact of the Pandemic was Minor Compared to Systemic Decrease in Fidelity of Assertive Community Treatment Services- A Provincial Study in Ontario, Canada

Assertive Community Treatment (ACT) model is the gold standard in community psychiatry serving people with severe mental illness. With its outreach-based design, the pandemic has profoundly affected the operations and functioning of ACT. The Dartmouth ACT Scale (DACTS) provides a standardized comprehensive and quantitative way to evaluate ACT quality. Results could inform nature of impact and identify areas for improvement. Current online survey used DACTS during the pandemic in April-May 2021. Clinical and administrative leadership of the 80 ACT teams in Ontario, Canada cross-sectionally rated ACT quality one-year pre-Covid (2018-2019) and one-year post the start of Covid (2020-2021). The overall pre-Covid Ontario ACT DACTS fidelity was 3.65. The pandemic led to decreases in all domains of DACTS (Human Resources: -4.92%, p < 0.001, 95% CI [0.08-0.27]; Organizational Boundary: -1.03%, p < 0.013,95%CI [0.01-0.07]; and Nature of Services: -6.18%, p < 0.001, 95%CI [0.16-0.26]). These changes were accounted by expected lower face-to-face encounters, time spent with clients, reduction in psychosocial services, less interactions with hospitals and diminished workforces. The magnitude of change was modest (-3.84%, p < 0.001, 95%CI [0.09-0.19]). However, the Ontario ACT pre-Covid DACTS was substantially lower (-13.5%) when compared to that from a similar survey 15 years ago (4.22), suggestive of insidious systemic level loss of fidelity. Quantitative fidelity evaluation helped to ascertain specific pandemic impact. Changes were significant and specific, but overall relatively modest when compared to the larger system level drop over the last decade. There is both evidence for model adaptability and resilience during Covid disruption, and concerns over larger downward drift in ACT fidelity and quality.

The Impact of COVID-19 on Plastic Surgery Residents Across the World: A Country-, Region-, and Income-level Analysis

BACKGROUND

The COVID-19 pandemic has upended graduate medical education globally. We investigated the COVID-19 impact on learning inputs and expected learning outputs of plastic surgery residents across the world.

METHODS

We administered an online survey capturing training inputs before and during the pandemic and retrieved residents' expected learning outputs compared with residents who completed their training before COVID. The questionnaire reached residents across the world through the mobilization of national and international societies of plastic surgeons.

RESULTS

The analysis included 412 plastic surgery residents from 47 countries. The results revealed a 44% decline (ranging from - 79 to 10% across countries) and an 18% decline (ranging from - 76 to across 151% countries) in surgeries and seminars, respectively, per week. Moreover, 74% (ranging from 0 to 100% across countries) and 43% (ranging from 0 to 100% across countries) of residents expected a negative COVID-19 impact on their surgical skill and scientific knowledge, respectively. We found strong correlations only between corresponding input and output: surgeries scrubbed in with surgical skill (ρ = -0.511 with p < 0.001) and seminars attended with scientific knowledge (ρ = - 0.274 with p = 0.006).

CONCLUSIONS

Our ranking of countries based on their COVID-19 impacts provides benchmarks for national strategies of learning recovery. Remedial measures that target surgical skill may be more needed than those targeting scientific knowledge. Our finding of limited substitutability of inputs in training suggests that it may be challenging to make up for lost operating room time with more seminars. Our results support the need for flexible training models and competency-based advancement.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Mercury budgets in the suspended particulate matters of the Yangtze River

Riverine processes are crucial for the biogeochemical cycle of mercury (Hg). The Yangtze River, the largest river in East Asia, discharges a substantial amount of Hg into the East China Sea. However, the influencing factors of the Hg budget and its recent trends remain unclear. This study quantitatively analyzed the total Hg concentration (THg) in suspended particulate matter (SPM) in the Yangtze River and calculated the Hg budget in 2018 and 2021. The results showed that the total Hg concentrations varied substantially along the river, with concentrations ranging from 23 to 883 μg/kg in 2018 and 47 to 146 μg/kg in 2021. The average Hg flux to China Sea in 2018 and 2021 were approximately 10 Mg/yr, lower than in 2016 (48 Mg/yr). Over 70% of the SPM was trapped in the Three Gorges Dam (TGD), and 22 Mg/yr of Hg settled in the TGD in 2018 and 10 Mg/yr in 2021. Hg fluxes in the Yangtze River watershed were driven by various factors, including decreased industrial emissions, increased agriculture emissions, and decreased soil erosion flux. We found that in the upper reach of the Yangtze River changed from sink to source of Hg possibly due to the resuspension of sediments, which implies that the settled sediments could be a potential source of Hg for downstream. Overall, emission control policies may have had a positive impact on reducing Hg flux to the East China Sea from 2016 to 2021, but more efforts are needed to further reduce Hg emissions.

Experiences from the international frontlines: An exploration of the perceptions of airport employees during the COVID-19 pandemic

The aviation industry is one of the sectors that has been heavily impacted by the pandemic. While the major body of literature has focused on passenger experience and behaviour, this study focuses on airport employees instead-their experiences, perceptions, and preferences following the emergence of COVID-19. More than 1000 participants from 4 major airports-Amsterdam Airport Schiphol, Singapore Changi Airport, Taipei Taoyuan Airport, and Zurich Airport-representing over 10 different occupations, have provided a variety of sentiments about the airport as an employment ecosystem in the wake of COVID-19. Quantitatively and qualitatively surveying four different airports enabled a cross-border analysis of the results to identify interesting geographic contrasts, as well as global themes, among the responses. Regional differences regarding, the feeling of preparedness, confidence in measures, and optimism are presented. A significant difference in confidence in non-pharmaceutical measures between employees from Asian and European airports is shown. Wants and needs such as better physical/IT workplace infrastructure and more flexibility regarding job scope and hours are pointed out. The results of this research provide insights for future airport employee experience research by outlining areas to study in greater detail. Furthermore, practical implications for airport stakeholders and companies arising from the challenges experienced by the workforce are laid out to provide guidance to prepare for similar circumstances in the future and navigate the aftermath of and recovery from the pandemic.

Carbon footprint of tourism in Spain: Covid-19 impact and a look forward to recovery

Tourism is very vulnerable to climate change and the disruption of Covid-19, facing two challenges: fighting climate change pursuing its carbon emissions goals, and recovering from the complex pandemic effects. We contribute to the incomplete understanding of tourism emissions pandemic impact and in different post-covid recovery scenarios. Using official data on tourists' consumption, we calculate the carbon footprint of tourism in Spain in 2019 and 2020 under different recovery pathways, including changes in consumption patterns and emissions efficiency, using a multiregional input-output model. Results show that the carbon footprint of tourism in Spain fell by 63% in 2020 compared to pre-pandemic levels, which would be aligned with the current sectoral decarbonisation target. However, the new tourists' consumption patterns resulting from the pandemic are insufficient to increase tourism sustainability if they imply pre-pandemic consumption levels. The results provide empirical ground for the binary debate on "recovery or reform".

Comparison of work efficiency in factory workers: pre & post covid lockdown - a cross sectional study

BACKGROUND

The COVID-19 pandemic's impact on economies worldwide has caused changes in work patterns, reduced productivity, and job losses, particularly affecting factory workers. Lockdown measures have also led to reduced physical activity levels, which is a significant risk factor for chronic diseases. This study aims to investigate efficiency of factory workers pre and post lockdown periods. The findings will contribute to identifying evidence-based strategies to minimize the negative impact of lockdown measures on factory workers' productivity and health.

MATERIALS AND METHODS

A cross-sectional study was conducted to assess the work performance of employees in a medicine manufacturing unit. Data was collected from factory workers online and study period was January 2021 to April 2022. Survey includes close ended questions regarding work performance of employees before lockdown period (Before 20/03/2020) and performance after lockdown period (After August 2020). The sample size of 196 employees selected through simple random sampling. A questionnaire consisting of demographic factors, work details, and work performance was prepared using pretested standard tools, including the Individual Work Performance Questionnaire (IWPQ), the World Health Organization Health and Work Performance Questionnaire (HPQ), and the Stanford Presenteeism Scale (SPS-6). The collected data was analysed using descriptive statistics and a paired t-test.

RESULTS

The study found that prior to lockdown, 99% of employees consistently had higher performance, with 71.4% ranking in the top 10. However, after lockdown, the percentage of employees with high performance decreased to 91.8%, with only 63.3% ranking in the top 10. These differences were statistically significant, indicating a decrease in work efficiency of 8.1%. Before lockdown, employees worked longer hours, including on off days, while after lockdown, a small proportion missed work due to various reasons, resulting in better quality work.

CONCLUSION

In conclusion, the study highlights the significant impact of the COVID-19 pandemic on the work efficiency of factory workers. The findings indicate a decrease in work efficiency after the lockdown, coupled with an increase in employee stress. This suggests that the pandemic has brought about unique challenges for factory workers that need to be addressed to maintain their well-being and productivity. This study emphasizes the importance of creating a supportive work environment that prioritizes the mental and physical health of employees, especially during times of crisis.

Important role of acute care surgery during pandemic time

Pandemic impacts acute care surgery for diseases, such as gallbladder disease and acute appendicitis. At the early stage of coronavirus disease 2019 (COVID-19) pandemic, the case number of patients needing surgery decreased in hospitals from different countries. This decline was associated with the stay-home order and fear of getting COVID-19 infection. However, recent reports show that the case number for acute surgery returns to the normal level, which is comparable to that before the beginning of the pandemic. In addition, a variety of diseases show more severe than the cases before the pandemic, which might be caused by factors such as lack of regular follow-up and screening diagnosis and infection of viruses.

Tourism amid COVID-19 pandemic: impacts and implications for building resilience in the eco-tourism sector in Ghana's Savannah region

The novel coronavirus which first emerged in Wuhan, China has affected many sectors of the global economy particularly, the tourism sector. While prior studies have explored how pandemics and crisis in the tourism sector can be managed, only a few have tackled how the tourism industry, especially in developing countries can be restructured to withstand shocks and remain resilient in the face of crisis such as the COVID-19 pandemic in the future. This article sheds light on the socio-economic and ecological effects of the COVID-19 pandemic on the eco-tourism sector of Ghana's Savannah region while offering short and long term strategies for building resilience to withstand shocks. Between September and October 2020, data was collected in the tourism enclave of the Savannah region in Ghana using focus group discussions and interviews. Results show that the major socio-economic impact of the pandemic was the loss of livelihoods. Ecological impacts were however mixed – both positive and negative. The study concludes that socio-economic impacts have been severe because they are closely tied to tourism. The study therefore recommends that immediate measures including stimulus packages be offered to local enterprises affected by the pandemic. In the long term, efforts should be made to diversify the local economy and promote domestic tourism in the country.

Analyzing the ultimate impact of COVID-19 in Africa

The Covid-19 pandemic has spread quickly across the globe in late 2019 and this has continued into 2020, causing a complete closure of daily routines, depleting global resources and, in extreme cases, causing loss of life. In Africa, with its hot climate, decision makers try to get people to their work as health care professionals or sometimes access health care facilities. For the peak four months; April, May, June, and July, the virus appeared, spread, and began to decrease. This study aims at analyzing the direct impact of Covid-19 in Africa according to the available data until July 2020. It provides statistics and policies prepared by African countries for this pandemic with the aid of other developed countries' experiences. From studying such applicable policies, it can be seen in a number of cases that lockdown restrictions, school and workplace closures, and limitations to the internal movement have the chief effect of reducing virus spread. Change in travel behavior and number of visitors appear in response to such a crisis. Regarding the potential economic repercussions in the studied period, GDP shows a sharp drop of 3.4%, appearing as a reduction of 6% on the price of oil, reducing the number of tourists by 46%, and causing fluctuations in currency. These suggest a mutual influence between the crisis and the transport sector.

The repercussions and challenges of COVID-19 in the hotel industry: Potential strategies from a case study of Indonesia

The COVID-19 pandemic has hit the tourism and hospitality sector hard. Hotel managers face uncertainty in this environment in order to survive. This study explores the impact of COVID-19 on the hospitality industry, particularly hotels in Indonesia, one of the largest developing countries. It examines the challenges faced by hotel managers and the strategies used to survive. Through the lens of complexity theory, we discuss whether the strategies being deployed are beneficial, redundant, or detrimental for hospitality businesses. Based on semi-structured interviews with 13 hotel managers in Jakarta, Bandung, and Bali, the findings shed light on the various challenges to hotels. We also highlight which challenges could turn into opportunities. The findings show that the strategies that managers are deploying could be detrimental in the future. Potential future research directions are also discussed.

The impact of COVID19 nationwide lock-down on STEMI hospitalization and outcomes in South India

Covid-19 Nationwide lockdown for social containment was implemented on the 23rd of March 2020. The objective of this study was to look at the impact of lockdown on STEMI (<24hrs window period). This study was done in 2 phases, 43 days before (phase1) and 43 days during lockdown (phase 2). During the lockdown, there was a 31% decrease in hospital admission rates, 11.5% and 9.38% proportional increase in diabetics and hypertensive patients presenting with STEMI. The public must be educated about the existing important health problems in the community along with the pandemic warnings.