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Archives of Academic Emergency Medicine. 2020; 8(1): e74


The Potential Role of Super Spread Events in SARS-COV-2
Pandemic; a Narrative Review
Anthony M. Kyriakopoulos1∗, Apostolis Papaefthymiou2,3, Nikolaos Georgilas4, Michael Doulberis3,5, Jannis

1. Department of Research and Development, Nasco AD Biotechnology Laboratory, Piraeus 18536, Greece.

2. Department of Gastroenterology, University Hospital of Larisa, Larisa 41110, Greece.

3. Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, 54642
Macedonia, Greece.

4. Department of Nephrology, Agios Pavlos Hospital of Thessaloniki, Thessaloniki 55134, Macedonia, Greece.

5. Division of Gastroenterology and Hepatology, University Medical Department Kantonsspital Aarau, Aarau 5001, Switzerland.

Received: August 2020; Accepted: August 2020; Published online: 21 September 2020

Abstract: Coronaviruses, members of Coronaviridae family, cause extensive epidemics of vast diseases like severe acute
respiratory syndrome (SARS) and Coronavirus Disease-19 (COVID-19) in animals and humans. Super spread
events (SSEs) potentiate early outbreak of the disease and its constant spread in later stages. Viral recombination
events within species and across hosts lead to natural selection based on advanced infectivity and resistance.
In this review, the importance of containment of SSEs was investigated with emphasis on stopping COVID-19
spread and its socio-economic consequences. A comprehensive search was conducted among literature avail-
able in multiple electronic sources to find articles that addressed the “potential role of SSEs on severe acute
respiratory syndrome coronavirus 2 (SARS-COV-2) pandemic” and were published before 20th of August 2020.
Overall, ninety-eight articles were found eligible and reviewed. Specific screening strategies within potential su-
per spreading host groups can also help to efficiently manage severe acute respiratory syndrome coronavirus 2
(SARS-COV-2) epidemics, in contrast to the partially effective general restriction measures. The effect of SSEs on
previous SARS epidemics has been documented in detail. However, the respective potential impact of SSEs on
SARS-COV-2 outbreak is composed and presented in the current review, thereby implying the warranted effort
required for effective SSE preventive strategies, which may lead to overt global community health benefits. This
is crucial for SARS-COV-2 pandemic containment as the vaccine(s) development process will take considerable
time to safely establish its potential usefulness for future clinical usage.

Keywords: Pandemics; epidemics; coronavirus; severe acute respiratory syndrome coronavirus 2; disease outbreaks; cost
of illness; mass vaccination

Cite this article as: Kyriakopoulos AM, Papaefthymiou A, Georgilas N, Doulberis M, Kountouras J. The Potential Role of Super Spread Events

in SARS-COV-2 Pandemic; a Nar


Psychosocial factors associated with the
mental health of indigenous children living
in high income countries: a systematic
Christian Young1,2*, Camilla Hanson1,2, Jonathan C. Craig1,2, Kathleen Clapham3 and Anna Williamson4


Background: Indigenous children living in high income countries have a consistently high prevalence of mental
health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting.

Methods: A systematic review of studies published between 1996 and 2016 that quantitatively evaluated
the association between psychosocial variables and mental health among Indigenous children living in high
income countries was conducted. Psychosocial variables were grouped into commonly occurring domains.
Individual studies were judged to provide evidence for an association between a domain and either good
mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence
across all studies for each domain was assessed using the Grades of Recommendation, Assessment,
Development, and Evaluation (GRADE) guidelines.

Results: Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4
[9%]), including 58,218 participants aged 4–20 years. Most papers were cross-sectional (39, 83%) and measured
negative mental health outcomes (41, 87%). Children’s negative cohesion with their families and the presence
of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children’s
substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also
provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high
self-esteem and optimism were associated with increased positive mental health outcomes.

Conclusions: Quantitative research investigating Indigenous children’s mental health is largely cross-sectional
and focused upon negative outcomes. Indigenous children living in high income countries share many of
the same risk and protective factors associated with mental health. The evidence linking children’s familial
environment, psychological traits, substance use and experiences of discrimination with mental health
outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental
health of Indigenous children.

Keywords: Indigenous, Children, Adolescent, Mental health, Psychosocial, Review

* Correspondence:
1Sydney School of Public Health, The University of Sydney, Edward Ford
Building (A27), Fisher Road, Camperdown, NSW 2006, Australia
2Centre for Kidney Research, Westmead Institute for Medical Research, 179
Hawkesbury Rd, Westmead, NSW 2145, Australia
Full list of author information is available at the end of the article

© The Author(s). 2017 Open Access This article is di

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