Impacts of global climate change on coral reefs are being amplified by pulse heat stress events, including El Niño, the warm phase of the El Niño Southern Oscillation (ENSO). Despite reports of extensive coral bleaching and up to 97% coral mortality induced by El Niño events, a quantitative synthesis of the nature, intensity, and drivers of El Niño and La Niña impacts on corals is lacking. Herein, we first present a global meta-analysis of studies quantifying the effects of El Niño/La Niña-warming on corals, surveying studies from both the primary literature and International Coral Reef Symposium (ICRS) Proceedings. Overall, the strongest signal for El Niño/La Niña-associated coral bleaching was long-term mean temperature; bleaching decreased with decreasing long-term mean temperature (n = 20 studies). Additionally, coral cover losses during El Niño/La Niña were shaped by localized maximum heat stress and long-term mean temperature (n = 28 studies). Second, we present a method for quantifying coral heat stress which, for any coral reef location in the world, allows extraction of remotely-sensed degree heating weeks (DHW) for any date (since 1982), quantification of the maximum DHW, and the time lag since the maximum DHW. Using this method, we show that the 2015/16 El Niño event instigated unprecedented global coral heat stress across the world's oceans. With El Niño events expected to increase in frequency and severity this century, it is imperative that we gain a clear understanding of how these thermal stress anomalies impact different coral species and coral reef regions. We therefore finish with recommendations for future coral bleaching studies that will foster improved syntheses, as well as predictive and adaptive capacity to extreme warming events.
Background Public health mandates associated with COVID-19 added unprecedented stress on families, providers and the health care systems; including our ambulatory multidisciplinary cleft team care. In order to continue to provide responsive, multidisciplinary team (MDT) cleft and craniofacial care, it was essential to identify direct and indirect impacts of COVID-19 on our patients and families, whilst planning ahead for ongoing coordinated surgical, pediatric, and psychosocial interventions. Our team developed a short on-line psychosocial screening questionnaire that was administered prior to our MDT clinics, using a “What Matters to You” quality improvement (QI) format. Objectives 1.To establish and test the utility of a “What Matters to You” quality improvement (QI) questionnaire. 2.To use this questionnaire in order to understand the impact of the COVID-19 pandemic on patients and family access to health services. Design/Methods Our team developed a 5-question online smartphone-accessible survey and distributed this to families prior to their MDT clinic visit during the COVID-19 pandemic. We analyzed survey results from May 2020-October 2021 in order to understand the impact of COVID-19 on families as well as the utility of our survey system. Results Out of 110 sequential MDT visits, families reported that COVID impacted timely access to health services (20%); employment (32%); basic needs like food and shelter (13%); and social capital. Almost half (47%) reported less than 5 people to turn to for extra support. The most common concerns caregivers have about their children were development, learning, and/or school progress (38%); mental health (36%) and social emotional well-being (31%). Conclusion Our study shows that 5 key psychosocial screening questions can be utilized to facilitate care coordination, responsiveness, and triage for in-person and virtual care settings, and respond to family centred care priorities in the midst of evolving COVID-19 landscapes.
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