On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a global health pandemic. The impact of COVID-19 on mental health has received widespread attention, but almost no longitudinal studies exist that examine changes in children's mental health during its initial emergence. Using a regression discontinuity natural experiment via a longitudinal cohort design, the present study examines trajectories of children's mental health from December 2019 to March 2020. Participants were 231 children (female n = 106 [45.8%]; average age = 5.69, SD = 2.09) in 22 early childhood education classrooms across Toronto, Canada. Children's mental health was assessed via educator reports on the Strengths and Difficulties Questionnaire in gender-adjusted percentiles, with the Impairment Rating Scale serving as a secondary measure. Data were analyzed with 3-level (classroom, individual, and time) Markov Chain Monte Carlo estimation (MCMC) growth curve models. Of the three assessments conducted per child, many of the final assessments occurred formally after the pandemic announcement and prior to the closing of childcare centres. Results suggest that male children enrolled in early childhood education showed a modest decline in mental health problems prior to the pandemic announcement by the WHO. However, following the WHO announcement, male children's mental health problems worsened significantly. No post-pandemic differences over time were observed for females. This study provides the first longitudinal evidence in Canada of heightened risk to children's mental health during the early emergence of the COVID-19 pandemic. Findings support initiatives aimed at increasing access to mental health care for children during and after the pandemic, in addition to incorporating mental health in home and school based educational services. Public Significance StatementThis study suggests that Canadian children's mental health problems, as reported by early childhood educators and leading up unto the childcare shutdown, increased during the early emergence of COVID-19, specifically for boys. Findings highlight the need for school-based mental health services, including support for teachers and early childhood educators, during the pandemic. Mental health services for children who have returned to school during COVID-19 remain a major priority, in addition to telehealth, home-based education, and parental supports for families who are keeping children at home.
Significant variability in emergency presentation of CRC requires local audit and examination of the reasons for delay in diagnosis and targeted measures to improve performance in non-emergency referral pathways.
Abstract-The impact of 1,2-dichlorobenzene on soil microbial biomass in the presence and absence of fresh plant residues (roots) was investigated by assaying total vital bacterial counts, vital fungal hyphal length, total culturable bacterial counts, and culturable fluorescent pseudomonads. Diversity of the fluorescent pseudomonads was investigated using fatty acid methyl ester (FAME) characterization in conjunction with metabolic profiling of the sampled culturable community (Biolog). Mineralization of [ 14 C]1,2-dichlorobenzene was also assayed. Addition of fresh roots stimulated 1,2-dichlorobenzene mineralization by over 100%, with nearly 20% of the label mineralized in root-amended treatments by the termination of the experiment. Presence of roots also buffered any impacts of 1,2-dichlorobenzene on microbial numbers. In the absence of roots, 1,2-dichlorobenzene greatly stimulated total culturable bacteria and culturable pseudomonads in a concentration-dependent manner. 1,2-Dichlorobenzene, up to concentrations of 50 g/ g soil dry weight had little or no deleterious effects on microbial counts. The phenotypic diversity of the fluorescent pseudomonad population was unaffected by the treatments, even though fluorescent pseudomonad numbers were greatly stimulated by both roots and 1,2-dichlorobenzene. The presence of roots had no detectable impact on the bacterial community composition. No phenotypic shifts in the natural population were required to benefit from the presence of roots and 1,2-dichlorobenzene. The metabolic capacity of the culturable bacterial community was altered in the presence of roots but not in the presence of 1,2-dichlorobenzene. It is argued that the increased microbial biomass and shifts in metabolic capacity of the microbial biomass are responsible for enhanced degradation of 1,2-dichlorobenzene in the presence of decaying plant roots.
BackgroundEndoscopic antireflux radiofrequency treatment (Stretta) offers a therapeutic alternative for patients suffering from refractory gastro-oesophageal reflux disease (GORD). Current evidence suggests that the treatment may improve symptoms of GORD and decrease requirement for proton pump inhibitor (PPI) therapy.MethodsProspective assessment of patients undergoing Stretta, between October 2014 and February 2016, in a UK tertiary referral centre was carried. All patients were assessed for suitability using endoscopy, contrast studies, and pH and manometry studies. The Gastro-oesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL) was used to evaluate symptoms along with PPI dependency, pre-Stretta and post-Stretta treatment. Patients were followed up by outpatient clinic appointment and telephone consultation.ResultsFifty consecutive patients were followed up for a median of 771 days (range 499–1162) following treatment with Stretta. The average GERD-HRQL score improved from 46.2/75 (±14.2) preprocedure to 15.2/75 (±17.3) postprocedure. Dissatisfaction with GORD as measured in the GERD-HRQL decreased from 100% to 10% with three patients showing no improvement (non-responders) at follow up and two late failures at the time of this review. There were no complications and all cases were carried out as day cases.ConclusionThere are currently few effective therapeutic alternatives to antireflux surgery for refractory GORD. This series corroborates the value and safety of Stretta as a viable option for selected patients who are unwilling or unable to undergo an operation. Stretta improves quality of life and decreases PPI dependency in selected patients with GORD.
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