The Educational and Health Impact of COVID-19 on Children With Special Needs: A Systematic Review

RESEARCH OBJECTIVE: Governments across the world were forced to impose social distancing and lockdown measures to prevent the spread of COVID-19, caused by coronavirus SARS-CoV-2 that emerged in December 2019. Following the declaration of COVID-19 as a pandemic, the disruptions, including restrictive measures such as school closures had severe impacts on the physical, emotional and mental health of all people, especially children with special needs. There was also scant data, particularly in low-to-middle-income countries. Existing literature stems mostly from western countries, thus the need to perform a comprehensive review on this topic. THE RESEARCH PROBLEM AND METHODS: The primary objective of the systematic review is to understand the impact of COVID-19 and restrictive measures such as school closures on the educational outcomes and physical and mental health of school-going children with special needs. THE PROCESS OF ARGUMENTATION: This systematic review used the PRISMA 2020 checklist where four databases  and grey literature were searched for full text articles, peer reviewed publications in the English language that were published during January 2019–December 2021. RESEARCH RESULTS: The literature search identified 1294 publications, of which 25 key papers were selected. These studies investigate the impact on children with special needs across the globe, with a majority of papers from Europe. We found that COVID-19 and the digitalization of schooling had severe impacts on the physical and mental health of children with special needs and their parents/caregivers. CONCLUSIONS, RECOMMENDATIONS AND APPLICABLE VALUE OF RESEARCH: These studies highlight the need for an inclusive school environment to ensure that the learning outcomes for children everywhere are achieved. Further, a hybrid model that includes classroom learning with novel inventive methods would be beneficial for children with special needs.

Early deprivation alters structural brain development from middle childhood to adolescence

Hypotheses concerning the biologic embedding of early adversity via developmental neuroplasticity mechanisms have been proposed on the basis of experimental studies in animals. However, no studies have demonstrated a causal link between early adversity and neural development in humans. Here, we present evidence from a randomized controlled trial linking psychosocial deprivation in early childhood to changes in cortical development from childhood to adolescence using longitudinal data from the Bucharest Early Intervention Project. Changes in cortical structure due to randomization to foster care were most pronounced in the lateral and medial prefrontal cortex and in white matter tracts connecting the prefrontal and parietal cortex. Demonstrating the causal impact of exposure to deprivation on the development of neural structure highlights the importance of early placement into family-based care to mitigate lasting neurodevelopmental consequences associated with early-life deprivation

Patterns of antibiotic use, pathogens, and prediction of mortality in hospitalized neonates and young infants with sepsis: A global neonatal sepsis observational cohort study (NeoOBS)

BACKGROUND: There is limited data on antibiotic treatment in hospitalized neonates in low- and middle-income countries (LMICs). We aimed to describe patterns of antibiotic use, pathogens, and clinical outcomes, and to develop a severity score predicting mortality in neonatal sepsis to inform future clinical trial design. METHODS AND FINDINGS: Hospitalized infants <60 days with clinical sepsis were enrolled during 2018 to 2020 by 19 sites in 11 countries (mainly Asia and Africa). Prospective daily observational data was collected on clinical signs, supportive care, antibiotic treatment, microbiology, and 28-day mortality. Two prediction models were developed for (1) 28-day mortality from baseline variables (baseline NeoSep Severity Score); and (2) daily risk of death on IV antibiotics from daily updated assessments (NeoSep Recovery Score). Multivariable Cox regression models included a randomly selected 85% of infants, with 15% for validation. A total of 3,204 infants were enrolled, with median birth weight of 2,500 g (IQR 1,400 to 3,000) and postnatal age of 5 days (IQR 1 to 15). 206 different empiric antibiotic combinations were started in 3,141 infants, which were structured into 5 groups based on the World Health Organization (WHO) AWaRe classification. Approximately 25.9% (n = 814) of infants started WHO first line regimens (Group 1-Access) and 13.8% (n = 432) started WHO second-line cephalosporins (cefotaxime/ceftriaxone) (Group 2-"Low" Watch). The largest group (34.0%, n = 1,068) started a regimen providing partial extended-spectrum beta-lactamase (ESBL)/pseudomonal coverage (piperacillin-tazobactam, ceftazidime, or fluoroquinolone-based) (Group 3-"Medium" Watch), 18.0% (n = 566) started a carbapenem (Group 4-"High" Watch), and 1.8% (n = 57) a Reserve antibiotic (Group 5, largely colistin-based), and 728/2,880 (25.3%) of initial regimens in Groups 1 to 4 were escalated, mainly to carbapenems, usually for clinical deterioration (n = 480; 65.9%). A total of 564/3,195 infants (17.7%) were blood culture pathogen positive, of whom 62.9% (n = 355) had a gram-negative organism, predominantly Klebsiella pneumoniae (n = 132) or Acinetobacter spp. (n = 72). Both were commonly resistant to WHO-recommended regimens and to carbapenems in 43 (32.6%) and 50 (71.4%) of cases, respectively. MRSA accounted for 33 (61.1%) of 54 Staphylococcus aureus isolates. Overall, 350/3,204 infants died (11.3%; 95% CI 10.2% to 12.5%), 17.7% if blood cultures were positive for pathogens (95% CI 14.7% to 21.1%, n = 99/564). A baseline NeoSep Severity Score had a C-index of 0.76 (0.69 to 0.82) in the validation sample, with mortality of 1.6% (3/189; 95% CI: 0.5% to 4.6%), 11.0% (27/245; 7.7% to 15.6%), and 27.3% (12/44; 16.3% to 41.8%) in low (score 0 to 4), medium (5 to 8), and high (9 to 16) risk groups, respectively, with similar performance across subgroups. A related NeoSep Recovery Score had an area under the receiver operating curve for predicting death the next day between 0.8 and 0.9 over the first week. There was significant variation in outcomes between sites and external validation would strengthen score applicability. CONCLUSION: Antibiotic regimens used in neonatal sepsis commonly diverge from WHO guidelines, and trials of novel empiric regimens are urgently needed in the context of increasing antimicrobial resistance (AMR). The baseline NeoSep Severity Score identifies high mortality risk criteria for trial entry, while the NeoSep Recovery Score can help guide decisions on regimen change. NeoOBS data informed the NeoSep1 antibiotic trial (ISRCTN48721236), which aims to identify novel first- and second-line empiric antibiotic regimens for neonatal sepsis. TRIAL REGISTRATION: ClinicalTrials.gov, (NCT03721302)

Debunking claims and prioritizing public health: India's bold stand against tobacco imagery on OTT platforms

India has taken a ground-breaking step in public health by mandating anti-tobacco warnings and disclaimers on over-the-top (OTT) platforms. Concerns over the prevalence of tobacco imagery in media, including OTT platforms, prompted this decision due to its role in normalizing and glamorizing smoking, particularly among the youth. The Indian government aims to comprehensively address this issue and protect public health. This article reviews recent news articles on the developments in the 2023 amendments to Cigarette and other tobacco products act COTPA 2004 and relevant studies on the ill effects of tobacco imagery to form the viewpoint. To effectively implement the new order, clear guidelines, and standards need to be established. Additionally, comprehensive awareness and education campaigns should be launched, while strict monitoring and enforcement mechanisms must be implemented. Supporting research initiatives should evaluate the impact of the warnings, and multiple stakeholders should be involved in the decision-making process. India's commitment to protecting public health and curbing tobacco advertisements on OTT platforms necessitates clear guidelines, awareness campaigns, monitoring and enforcement mechanisms, research initiatives, and stakeholder engagement. This government order aligns with international public health frameworks and can serve as a precedent for other countries. By implementing these measures, we can counter the normalization and glamorization of tobacco use and create a healthier future

Debunking claims and prioritizing public health: India’s bold stand against tobacco imagery on OTT platforms

India has taken a ground‑breaking step in public health by mandating anti‑tobacco warnings and disclaimers on over‑the‑top (OTT) platforms. Concerns over the prevalence of tobacco imagery in media, including OTT platforms, prompted this decision due to its role in normalizing and glamorizing smoking, particularly among the youth. The Indian government aims to comprehensively address this issue and protect public health. This article reviews recent news articles on the developments in the 2023 amendments to Cigarette and other tobacco products act COTPA 2004 and relevant studies on the ill effects of tobacco imagery to form the viewpoint. To effectively implement the new order, clear guidelines, and standards need to be established. Additionally, comprehensive awareness and education campaigns should be launched, while strict monitoring and enforcement mechanisms must be implemented. Supporting research initiatives should evaluate the impact of the warnings, and multiple stakeholders should be involved in the decision‑making process. India’s commitment to protecting public health and curbing tobacco advertisements on OTT platforms necessitates clear guidelines, awareness campaigns, monitoring and enforcement mechanisms, research initiatives, and stakeholder engagement. This government order aligns with international public health frameworks and can serve as a precedent for other countries. By implementing these measures, we can counter the normalization and glamorization of tobacco use and create a healthier future.</p

Supply chain performance and economic growth: The impact of COVID-19 disruptions

Reliable supply chains are crucial to the productivity and economic growth of nations. Despite the recognition of its importance, especially brought to the forefront by the challenges of the coronavirus crises, formal research on the contribution of supply chain logistics is less forthcoming. This paper uses data on 130 nations to examine the relative effects of different aspects of supply chain logistics, including overall logistics performance, and the performance of the input and output dimensions of logistics, on economic growth. The results show that improvements in the supply chain logistics performance yield positive growth dividends. Further, the input and output dimensions of logistics performance have positive growth effects, with some quantitative differences. Significantly, the growth impact of logistics performance varies across nations with different growth rates. Implications for public policy and spillovers for COVID-19 initiatives are discussed

Modeling Cue-integration in Emotion Inferences

Inferences of other’s emotion states are influenced by multiple sources including target cues such as facial movements and the situational context. Our understanding of how information from these cues is integrated is limited, however. We examined whether people integrate information from faces and situations to infer emotions as predicted by an existing model of affective cognition. We applied a Bayesian cue-integration model to a dataset that includes a variety of complex social situations that reflect the heterogeneity of emotion contexts in social lives. Results indicate that when viewing both faces and situations, situation information alone predicted people’s inference about emotions better than Bayesian cue-integration model. However, there was some variability in this pattern across emotion categories as the Bayesian cue-integration model best predicted inferences for emotion categories of amusement and happiness. These findings better our understanding of the interplay between facial and situational cues in informing emotion inferences

Psychological effects of early marriage: A study of adolescents

Early marriage is a serious issue in our society, which is faced by many girls and boys all over the world. In India, at least 1.5 million girls each year get married before they even turn 18. A large number is also applicable for boys. Due to various reasons, early marriage is still prevalent in our society. Early marriage can have a serious impact on psychological, physical, and emotional health. The paper will use the interview method to study the psychological impact of early marriages on adolescents. Using the random sampling method, 20 interviews are taken from the villages of Telangana for the study. The paper will study the different challenges that individuals face when married way too early and the awareness will be raised regarding the same. Studying the social consequences is also a part of the paper

Neonatal meningitis secondary to Elizabethkingia meningoseptica infection

Introduction: Elizabethkingia meningoseptica, a rare cause of sepsis and meningitis in neonates, often associated with a wide spectrum of clinical presentation. The objective of the study was to describe the clinical characteristics and outcome of neonates, who developed meningitis secondary to Elizabethkingia meningoseptica infection at a tertiary care Neonatal unit in India. Methods: This retrospective study was conducted in the neonatal unit of a tertiary care hospital in New Delhi. The clinical data including demographic data, clinical presentation, management, and outcome data were collected and analyzed. Results: During the study, 7 neonates with meningitis secondary to Elizabethkingia infection were identified. Majority of the neonates were preterm with a median gestational age of 31 (interquartile range: 29–33.5) weeks and a median birth weight of 1250 g (interquartile range: 1024–2065). The median age of onset of symptoms was 7 days. Lethargy (100%), apnea (85%), seizure (71%), and feeding difficulties (42%) were the common clinical presentations. Overall mortality during the period was 28.5%, and 60% of the survivor developed hydrocephalus. Isolated strains were resistant to the commonly used antibiotics (piperacillin-tazobactam, aminoglycosides, meropenem, and colistin) effective against Gram-negative organisms. The environmental screening was done but the potential source of infection could not be identified conclusively. Conclusion: Meningitis in neonates caused by Elizabethkingia represents a potentially life-threatening infection and is often associated with significant neurological impairment, especially in premature neonates. A prolonged duration of antibiotic therapy, longer hospital stay, and likelihood of adverse neurologic sequelae during the hospital stay and follow-up should be anticipated in such cases of meningitis

Understanding the value of biobank attributes to researchers using a conjoint experiment

Abstract Biobanks are important in biomedical and public health research, and future healthcare research relies on their strength and capacity. However, there are financial challenges related to the operation of commercial biobanks and concerns around the commercialization of biobanks. Non-commercial biobanks depend on grant funding to operate and could be valuable to researchers if they can enable access to quality specimens at lower costs. The objective of this study is to estimate the value of specific biobank attributes. We used a rating-based conjoint experiment approach to study how researchers valued handling fee, access, quality, characterization, breadth of consent, access to key endemics, and time taken to fulfil requests. We found that researchers placed the greatest relative importance on the quality of specimens (26%), followed by the characterization of specimens (21%). Researchers with prior experience purchasing biological samples also valued access to key endemic in-country sites (11.6%) and low handling fees (5.5%) in biobanks