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There are growing concerns on the impact of COVID-19 on food security and child health in South Africa. A rapid SMS Maternal and Child Health survey was conducted in South Africa in June (n=3140) with a follow up in July (n=2287). Breastfeeding practices found in this survey confirmed findings from other studies: with high breastfeeding initiation rates and early introduction of other foods/mixed milk feeding. Logistic regression was conducted to explore the associations between breastfeeding, maternal depression and hunger in the household. The odds of hungry mothers breastfeeding were significantly lower (OR = 0.66; 95% CI: 0.44, 0.99). The prevalence of depression in this survey sample was 26.95%, but there was no association between breastfeeding behaviour and depression scores (OR = 0.89; 95% CI: 0.63, 1.27). A positive correlation was found between not breastfeeding and not going to the health clinic. Breastfeeding needs to be protected, promoted and supported; and mothers should be encouraged to continue to attend the health clinic. Further to communication to communities, supporting the breastfeeding mother to enable her to breastfeed and feel competent to do so is a critical gap that needs to be addressed. This support could include economic support to enable her to access a nutritious diet. Mothers also need reassurance on the quality of their breastmilk and their ability to breastfeed. Aside from the nutritional superiority, the safety and immune benefits of breastmilk may need to be asserted to counter concerns during the COVID-19 pandemic.

Many studies have shown that the COVID-19 pandemic can have a great influence on mental health. However, there is still not enough research to fully understand how people suffering from schizophrenia experience crisis situations such as a pandemic. This qualitative study aims to explore this subject. Ten outpatients suffering from schizophrenia were interviewed in a semi-structured format using an interview designed by the authors for the purpose of this study. The interviews were transcribed, and a conventional qualitative content analysis was conducted. The general themes identified in the content analysis were organized into four categories: first reactions to information about the pandemic; subjective assessment of the pandemic’s impact on patients’ mental health; patients’ attitudes towards the temporary limitations and lockdowns; psychiatric treatment and psychotherapy during the pandemic. A variety of different experiences were observed, but the general conclusion arising from the study suggests that the majority of the interviewed patients coped quite well with the pandemic and that the observed reactions were similar to the reactions of other groups described in the literature. The study also confirmed the importance of the continuity of psychiatric care for patients with schizophrenia.

The COVID-19 pandemic caused significant training disruptions during the 2020–2021 season, due to lockdowns, quarantines, and strict adherence to the pandemic protocols. The main purpose of this study was to determine how the pandemic training restrictions affected training volume and performance in one collegiate swim team. Cumulative training volume data across a 28-week season were compared between a pandemic (2020–2021) versus non-pandemic (2019–2020) season. The swimmers were categorized into three groups (sprinters, mid-distance, and long-distance) based on their training group. The performance times of 25 swimmers who competed in the regional championships, during both the non-pandemic and pandemic year, were compared via one-way ANOVA. Twenty-six male and 22 female swimmers commenced the 2020–2021 (pandemic) season, with 23% of the swimmers voluntarily opting out. Three COVID-19 cases were confirmed (2%) by the medical staff, with no long-term effects. Significant reductions in the average swim volume were verified in sprinters (32,867 ± 10,135 vs. 14,800 ± 7995 yards; p < 0.001), mid-distance (26,457 ± 10,692 vs. 17,054 ± 9.923 yards; p < 0.001), and long-distance (37,600 ± 14,430 vs. 22,254 ± 14,418 yards; p < 0.001) swimmers (non-pandemic vs. pandemic season, respectively). In the regional performance analyses, the sprinters swam faster (n = 8; −0.5 ± 0.6 s), while the mid-distance (n = 10; 0.17 ± 2.1 s) and long-distance (n = 7; 6.0 ± 4.9 s) swimmers swam slower (F = 11.76; p = 0.0003; r2 = 0.52). Thus, the pandemic caused significant reductions in swim training volume, with sprinters performing better and long-distance swimmers performing worse at the regional championships.

Aim: To assess the knowledge and perceptions of COVID-19 among pediatric dentists based on their dependent source of information. Methods: A descriptive-analytical cross-sectional survey using a self-administered questionnaire with 23 questions was sent via Google forms to pediatric dentists. All participants were divided into three groups [postgraduate residents (PGs), private practitioners (PP), and faculty (F)]. The comparison of knowledge and perception scores was made based on occupation, source of information, and descriptive statistics used for the analysis using SPSS 21.0 (IBM, Armonk, NY, USA). Results: A total of 291 pediatric dentists completed the survey, and the majority of them were females (65%). Overall, good mean scores were obtained for knowledge (9.2 ± 1.07) and perceptions (5.6 ± 1.5). The majority of the participants used health authorities (45%) to obtain updates on COVID-19, while social media (35.1%) and both (19.6%) accounted for the next two. A statistically significant difference (p < 0.05) was found among different pediatric dentists groups for relying on the source of information. Conclusion: Overall good pediatric dentists showed sufficient knowledge regarding COVID-19. The pediatric dentists’ age, occupation, and source of information influenced knowledge regarding COVID-19, whereas perceptions were influenced by age and gender of the participants. Health authorities successfully educated pediatric dentists than the social media

Healthcare professionals are at higher risk of developing and experiencing burnout. Parents may also suffer from prolonged stressful conditions that lead to physical and emotional exhaustion. Residential youth care workers assume a caregiving role that can lead to persistent stressful conditions that affect their relationship with the youth. In addition, the COVID-19 lockdown has had a negative impact on both the organization and the work, as well as on the lifestyle of workers and minors. In fact, during the pandemic, contact with families was not possible due to restrictions and this increased the need for caregivers to assume a parental role. This research aims to examine the risk of burnout in a sample of 75 healthcare professionals working with youths and the association with psychological traits. Then, we aim to evaluate these aspects during the COVID-19 lockdown The measurements, conducted in both February 2019 and April 2021, included six questionnaires: MBI to assess burnout, TAS_20 to explore alexithymic traits, COPE_NVI to assess coping strategies, FDS_R to quantify frustration intolerance at work, IRI for empathy, and FFMQ to investigate awareness and emotional regulation. Our sample shows a medium-high risk of developing burnout, which worsened during the pandemic. A worsening of emotional skills, paralleled by a greater empathic investment required by the emergency situation, and an assumed parental role is observable. Coping strategies correlate with burnout risk, as avoidance strategies were strongly associated with emotional exhaustion. These findings suggest an urgent need to develop targeted and timely interventions for healthcare professionals in order to prevent long-term consequences.

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Background: The COVID-19 pandemic was accompanied by multiple disruptions in the everyday lives of families. Previous research has underlined the negative impact of the pandemic on stress among parents and identified factors related to heightened levels of stress. Yet, several potential stressors have not been taken into account. Moreover, little is known about how general and pandemic-related stressors impacted help-seeking intentions for personal or family problems. Methods: We recruited N = 602 parents and their children (n = 101) for a cross-sectional online survey on parent, child and family well-being, stress and help need after the first wave of COVID-19 infections in Germany. Data were analysed using multinomial regression analyses to predict family help need, taking into account pre-pandemic help-seeking. Results: Parents showed high levels of stress, which were associated with pre-pandemic mental health, family functioning, pandemic related worries about finances, household workload and health worries. While 76.2% of families reported no during-pandemic help need, 11.3% reported a help need before and during the pandemic and 12.5% of families without prior help needs reported a new help need during the pandemic. Conclusions: The results of the present study underline the need for help service providers to adapt their offers.

Several cases of COVID-19-related mental disorders have emerged during the pandemic. In a case of femicide that occurred in Italy during the first phase of the pandemic, coinciding with a national lockdown, a discrepancy arose among forensic psychiatry experts, particularly toward the diagnosis of Brief Psychotic Disorder (BPD) related to COVID-19. We aimed to discuss the evaluation of the case through an integration of information and a literature review on comparable reported cases. An analysis of the diagnosis of brief acute psychosis was then performed, as well as a mini-review on cases of COVID-19-related psychosis. Results showed that psychotic symptomatology was characterized by polythematic delusions that always involved a SARS-CoV-2 infection. To a lesser extent, the delusions were accompanied by hallucinations, bizarre cognitive and associative alterations, insomnia, hyporexia, dysphoria, and suicidal behavior. No particularly violent acts with related injury or death of the victim were described. Finally, we could hypothesize that our case was better represented by a diagnosis of personality with predominantly narcissistic and partly psychopathic traits. The present case highlighted the importance, in the context of forensic psychiatry, of integrating assessments with the crime perpetrators, namely through accurate clinical interviews, neuropsychological tests, diachronic observations, and comparison with similar cases present in the literature. Such an integrated approach allows precise evaluation and reduces the odds of errors in a field, such as forensic psychiatry, where a diagnostic decision can be decisive in the judgment of criminal responsibility. Moreover, discerning forensics from health cases represents an important issue in risk management.

Background: The Lions Quest Skills for Adolescence (LQSFA) is an evidence-based social and emotional learning program for school students. It is implemented as a teacher-led extracurricular activity for children aged 10–15 years. From 2019 to 2022, the United Nations Office on Drugs and Crime, in collaboration with Lions Clubs International Foundation, implemented the LQSFA in 41 schools in Croatia. Due to the COVID-19 lockdown measures, the intervention was adjusted into a hybrid modality (in-class and online). We evaluated the experience that the teachers had with the LQSFA in a hybrid modality. Methods: We used a focus-group discussion approach to evaluate the experience of five LQSFA teachers. Results: Three themes emerged: (1) the appreciation of evidence-based programs by the teachers, (2) the benefit of the LQSFA on the parents, and (3) the length of the online version of the questionnaire tool that was used to assess pre- and post-LQSFA experiences among students was too long. These results indicate that the LQSFA is undergoing a scaling on a national level in Croatia, even when implemented in a hybrid setting. Conclusions: Using an evidence-based program such as the LQSFA was rewarding for teachers, despite the challenges in the administrative adjustments regarding the online and in-person class teaching. LQSFA filled an important gap during COVID19-related stress.

With the arrival of COVID-19, educational systems have had to adapt to the social and health situation immediately. This led to the appearance of the asynchronous teaching model. Throughout the pandemic, at the educational level, we can distinguish three phases, eminently online, hybrid, and finally, face-to-face. However, the perception of educational quality in these three educational moments, taking into account the psychometric profile and gender, has not been studied. Thus, 1093 university students from Ibero-American countries were analyzed. Through a questionnaire, demographic, academic, and psychological variables were analyzed at three moments during the evolution of the pandemic. Data suggest that, during the lockdown phase, while teaching was eminently online, students presented higher levels of stress and higher difficulty of learning; class attendance, convenience, preferred method of learning, grading score, and motivation were lower, compared to other phases of teaching (hybrid and face-to-face). During this period, females presented higher stress levels than males, as well as higher levels of anxiety and loneliness, without gender differences among the other studied variables. During the hybrid and face-to-face phases, male students presented higher values in the results of difficulty learning and demanding activities. No differences were seen regarding motivation, synchronous class attendance, learning level, grades, convenience, or preferred learning method. The results from the present study suggest that, despite the effect of the pandemic on mental health, asynchronous education is postulated as an effective teaching–learning alternative. Yet, a special focus should be given to female students.

The phenomenon of violence against children is a very complex one. There are many types of child abuse, and they are culturally dependent to a significant degree. Although studies show that children generally only suffer from mild COVID-19 infection, some social restrictions introduced during the pandemic, such as home isolation, may have many severe consequences on the population’s mental health. Studies on this topic suggest that violence against children increased during lockdown due to the COVID-10 pandemic. This narrative review summarizes this available literature on the subject and discusses the different forms of violence against children, their cultural aspects, the impact of the COVID-19 pandemic on the phenomenon of violence, the long-term consequences of the above, and forms of assistance for abused minors.

The study aims to assess pregnancy-specific stress among pregnant women in Spain during the first lockdown of the COVID-19 pandemic. Two samples of pregnant women from the south of Spain (Andalusia) were assessed using the Prenatal Distress Questionnaire (PDQ) and a sociodemographic and obstetric questionnaire. Group 1 (N = 155) was recruited face-to-face, whereas Group 2 (N = 78) was recruited online. Pregnancy-specific stress levels were significantly different in both groups. The face-to-face group (Group 1) had higher pregnancy-specific stress levels than the online group (Group 2). The online sample over-represents young adult pregnant women with high education levels and a high number of previous miscarriages. The face-to-face study seems more accessible to racially and ethnically diverse groups. The main concern among both groups was the risk of having a sick neonate. Research during the COVID-19 pandemic can benefit from using online resources to collect data to screen and identify perinatal mental health problems in a crisis environment. Nevertheless, researchers should be aware of the potential limitations this strategy can have, for example, certain groups of people may have limited access to the internet.

Background: Posttraumatic stress symptoms (PTSSs) and alcohol, tobacco, or nicotine use are frequently associated conditions. The COVID-19 pandemic has been a stressful situation globally and has worsened mental health conditions and addictions in the population. Our systematic review explores the links between PTSSs and (1) alcohol use and (2) tobacco or nicotine use during the COVID-19 pandemic. Methods: We searched the PubMed, PsycINFO, and Web of Science databases for studies published between January 2020 and 16 December 2021. We included studies published in English concerning adults or adolescents. Included articles dealt simultaneously with the COVID-19 pandemic, PTSSs, and alcohol, tobacco, or nicotine use. The reports included were cross-sectional, longitudinal, or cohort studies. We categorized the reports according to the population explored. Our main outcomes are the impacts of PTSSs on (1) alcohol use and (2) tobacco and nicotine use and their relation to COVID-19-related stressors (worries, exposure, lockdown, and infection, either of self or relatives). Results: Of the 503 reports identified, 44 were assessed for eligibility, and 16 were included in our review, encompassing 34,408 participants. The populations explored were the general population, healthcare workers, war veterans, patients with substance use disorders, and other vulnerable populations. Most studies were online surveys (14) with cross-sectional designs (11). Every study explored alcohol use, while only two assessed tobacco use. In most populations explored, a high level of PTSSs was associated with alcohol use increase. COVID-19-related stress was frequently correlated with either high PTSSs or alcohol use. In healthcare workers, PTSSs and alcohol use were not associated, while COVID-19 worries were related to both PTSSs and alcohol use. Discussion: 1. PTSSs and increased alcohol use are frequently associated, while COVID-19 worries might trigger both conditions and worsen their association. Alcohol use increase may represent either an inadequate way of coping with PTSSs or a vulnerability amid the COVID-19 pandemic, leading to PTSSs. As most studies were cross-sectional online surveys, longitudinal prospective studies are needed to ascertain the direction of the associations between these conditions. These studies need to be sufficiently powered and control for potential bias and confounders. 2. Our review highlighted that research about PTSSs and tobacco or nicotine use is scarce.

Lockdown policies have been implemented to reduce COVID-19 transmission worldwide. However, the shutdown of activities has resulted in large economic losses, and it has been widely reported that lockdown measures have resulted in improved air quality. Therefore, many previous studies have attempted to investigate the impacts of the COVID-19-induced lockdowns on the economy, environment, and COVID-19 spread. Nevertheless, the heterogeneity among countries worldwide in the economic, environmental, and public health aspects and the spatial effects of decomposition have not been well investigated in the existing related literature. In this study, based on the cross-sectional data of 158 countries in 2020 and the proposed nonlinear simultaneous spatial econometric models, we investigate the nonlinear and spatial impacts of the COVID-19-induced lockdowns on the economy, environment, and COVID-19 spread. The findings show that lockdowns have had statistically significant negative economic impacts and beneficial environmental consequences but no effect on COVID-19 spread. Noteworthily, this study also found the length of lockdown periods to affect the three domains of interest differently, with a piece of empirical evidence that the imposition of lockdowns for more than 31 days a year could result in economic impairments but contribute to environmental improvements. Lockdowns were shown to have substantially reduced PM2.5 not only in the countries that imposed the measures but also indirectly in the neighboring countries as a spatial spillover effect.

Older adults show lower physical activity. These changes altogether promote the development of overweight, obesity, and other chronic diseases. These factors substantially influence the quality of life and self-esteem of older adults. This phenomenon is especially visible after the lockdown caused by the COVID-19 pandemic. Objectives: Our study aimed to evaluate the effect of a 12-week reductive diet and a 12-week physical activity plan for older adults on the global self-esteem of lifestyle in 60–70-year-old women. Materials and methods: Our participants were 600 women with increased body mass (BMI > 25 kg/m2) aged 60–70 years. After the initial evaluation, the participants were randomly divided into three groups: CG—control group (n = 200); DI—dietary group (n = 200) that committed to a 12-week reductive diet; PA—physical activity group (n = 200) that committed to a 12-week physical activity plan. The global self-esteem score (using the SES Rosenberg scale) and the anthropometric measurements were collected before and after the 12-week study. In the statistical analysis of data, the significance level was assumed to be 0.05. Results: The global self-esteem score for all groups before the study started was 30–31 points, which corresponded to average self-esteem. After a 12-week dietary or physical activity intervention, the score in the DI group was 33, which corresponded with high self-esteem. In the CG group, the self-esteem score remained unchanged (30 points). The average body mass loss was 0.5 kg/m2 for CG, 1.92 kg/m2 for DI, and 1.10 kg/m2 for the PA group. The average waist–hip ratio (WHR) change for CG, DI, and PA was 1 cm, 1 cm, and 2 cm, respectively. A decrease in body mass and body composition indicators (BMI and WHR) corresponded to participants’ global self-esteem increase (p < 0.05); the greater the decrease noted for BMI and WHR, the greater the global self-esteem score that was achieved. In the CG group, a negative correlation between global self-esteem and BMI value (p < 0.05) was observed. Conclusions: A 12-week reductive diet and a 12-week regular physical activity plan lowered participants’ body mass. Adipose tissue content was reflected by decreased BMI and WHR indicators of participants from the DI and PA groups and was accompanied by higher global self-esteem scores.

COVID-19 expanded rapidly throughout the world, with enormous health, social, and economic consequences. Mental health is the most affected by extreme negative emotions and stress, but it has been an underestimated part of human life during the pandemic. We hypothesized that people may have responded to the pandemic spontaneously with increased interest in and creation of funny internet memes. Using Google and Google Trends, we revealed that the number of and interest in funny internet memes related to COVID-19 exploded during the spring 2020 lockdown. The interest in coronavirus memes was positively correlated with interest in mortality due to COVID-19 on a global scale, and positively associated with the real number of deaths and cases reported in different countries. We compared content of a random sample of 200 coronavirus memes with a random sample of 200 non-coronavirus memes found on the Internet. The sentiment analysis showed that coronavirus memes had a similar proportion of positive and negative words compared to non-coronavirus memes. However, an internet questionnaire revealed that coronavirus memes gained higher funniness scores than a random sample of non-coronavirus memes. Our results confirm that societies may have turned to humor to cope with the threat of SARS-CoV-2.

The COVID-19 pandemic had a strong impact on mental health. Multiple studies report the alarming prevalence of depression, anxiety, and stress-related conditions due to the lockdown measures. Nevertheless, somatization has been an overlooked topic in current literature despite its strong relationship with most mental health conditions. The aim of this study was to describe the prevalence of somatic symptoms and their associated factors in a sample of 3218 undergraduate students from Lima, Peru. A cross-sectional design was carried out. The prevalence of somatic symptoms was measured with the PHQ-15. As predictors of somatic symptom severity, we included psychopathological (depression, anxiety, and stress), psychological (perceived social support, resilience, satisfaction with life, and academic self-efficacy), and sociodemographic (e.g., age, sex, employment status, relationship status, daily hours of sleep) variables. A generalized linear model from a binomial family and a logit link function were applied based on a Factor Score Regression approach, with half of the sample presenting moderate-to-severe somatic symptoms. Anxiety was the strongest predictor of somatic symptom severity, followed by academic self-efficacy. Significant differences were found regarding sex, relationship status, daily hours of sleep and COVID-19 risk-related variables. In conclusion, interventions on reducing anxiety and promoting academic self-efficacy may have a stronger impact on somatic symptom severity and should focus on more vulnerable specific demographic groups such as females.

This study aims to examine the capacity of the Theory of Planned Behaviour (TPB) to explain the intention to use social networking sites by older people in two time periods, before and after confinement due to the COVID-19 epidemic, as well as the evolution of effects (paths) over time of TPB’s determinants. Based on interviews from samples of 384 and 383 elderly Chilean adults collected before and after confinement, the evolution of the effects (paths) was analysed using the TPB model applying the PLS-SEM technique. The intention to use social networks and its association with three factors were evaluated: attitude toward the behaviour, subjective norms, and perceived control over the behaviour. The model explains the intention to use social networks by 27% before confinement, increasing its magnitude to 50% after confinement. After the period of confinement, their attitudes become more significant, their perceptions of control become less important, and social pressures remain permanent in predicting the behaviour. In conclusion, better access and greater use of social networks by older people during the lockdown period increased the predictive strength of the attitude towards these technologies.

Under the clean air action plans and the lockdown to constrain the coronavirus disease 2019 (COVID-19), the air quality improved significantly. However, fine particulate matter (PM

Air is a diverse mixture of gaseous and suspended solid particles. Several new substances are being added to the air daily, polluting it and causing human health effects. Particulate matter (PM) is the primary health concern among these air toxins. The World Health Organization (WHO) addressed the fact that particulate pollution affects human health more severely than other air pollutants. The spread of air pollution and viruses, two of our millennium’s most serious concerns, have been linked closely. Coronavirus disease 2019 (COVID-19) can spread through the air, and PM could act as a host to spread the virus beyond those in close contact. Studies on COVID-19 cover diverse environmental segments and become complicated with time. As PM pollution is related to everyday life, an essential awareness regarding PM-impacted COVID-19 among the masses is required, which can help researchers understand the various features of ambient particulate pollution, particularly in the era of COVID-19. Given this, the present work provides an overview of the recent developments in COVID-19 research linked to ambient particulate studies. This review summarizes the effect of the lockdown on the characteristics of ambient particulate matter pollution, the transmission mechanism of COVID-19, and the combined health repercussions of PM pollution. In addition to a comprehensive evaluation of the implementation of the lockdown, its rationales—based on topographic and socioeconomic dynamics—are also discussed in detail. The current review is expected to encourage and motivate academics to concentrate on improving air quality management and COVID-19 control.

Background: The measures taken to contain the COVID-19 pandemic have led to significant changes in people’s daily lives. This paper examines changes in substance use during the first lockdown (March–July 2020) and investigates mental health burdens in substance users with increased consumption of alcohol, nicotine or tetrahydrocannabinol (THC) in Germany compared to users with unchanged or reduced consumption. Method: In a cross-sectional online survey, 2369 people were asked about their mental health and their substance use during the first lockdown in Germany. Results: Of the participants, 28.5% increased their alcohol use, 28.8% their use of tobacco products, and 20.6% their use of THC-containing products during the pandemic. The groups with increased alcohol, nicotine, and THC use during the first lockdown reported more depressive symptoms and anxiety. Individuals who reported increased consumption of alcohol or nicotine were also more likely to experience loneliness and have suicidal thoughts and were more often stressed due to social distancing. Conclusion: Alcohol, nicotine and THC increased in a subgroup of consumers who reported to have more mental health problems compared to individuals who did not increase their consumption. This increased substance use could, therefore, be understood as a dysfunctional strategy to cope with negative emotions during the lockdown.

Food delivery applications (FDAs) shined during COVID-19 global lockdown restrictions. Consequently, lifestyle changes imposed a greater use of these applications over this period. These changes may strongly influence the nutritional health of individuals, particularly adult Saudi females. A cross-sectional study was performed to examine the influence of using FDAs during COVID-19 lockdown restrictions on attitude behaviours, including dietary habits and preferences among Saudi adult females. Participants voluntarily submitted their answers to a questionnaire administered via the Google Survey platform. Results illustrated that most Saudi female users of FDAs were aged between 18–24 years with 64.9%, 91.5% being single and 37% ordering food online within one to two days a month. There was a significant association between the influence of using FDAs during COVID-19 lockdown restrictions and age, education, and average days of ordering food online (p ˂ 0.05). Another important factor is that higher education was associated with more frequent use of the FDAs, there were direct relationships between education level and using FDAs, 58% of the participants were educated as undergraduate or postgraduate. Although lifestyle changes increased the use of FDAs during COVID-19 global lockdown restrictions, these changes may negatively affect individuals’ dietary habits and preferences, particularly adult Saudi females. These findings can aid in promoting healthy diet management globally and in Saudi Arabia unless the governments lead to significant beneficial changes toward improving food delivery applications.

During the first lockdown in Israel, citizens were instructed to visit community clinics only for urgent cases. However, they were not informed that emergency departments (EDs) were safe. Reports from the National Ambulance Services showed a 22% increase in at-home deaths during the lockdown. Perhaps, the reason is because some critically ill patients postponed referrals and came “at the last minute”. After the first lockdown, the Ministry of Health (MOH) declared that hospital EDs were safe. The objective of the study was to examine the rates of admission from EDs to hospital wards, and non-COVID-19 in-hospital deaths during the first lockdown in Israel, compared with the second and third lockdowns. From the business intelligence software of the Rambam Medical Center in Israel, we collected data about the rates of admission to the ED, the non-COVID-19 in-hospital deaths during the three lockdowns, during the same periods in the previous three years, and the main five causes of non-COVID-19 deaths. Data comparison was done using multiple chi-square tests. ED admission numbers were significantly higher during the first lockdown than during the second (χ2 (1, n = 36,245) = 24.774, p = 0.00001) and third lockdowns (χ2 (1, n = 36,547) = 8.7808, p = 0.0030). We found a significantly higher number of non-COVID-19 in-hospital deaths vs. discharges during the first lockdown than in the second and third lockdowns (χ2 (2, n = 26,268) = 7.794, p = 0.0203) The number of deaths due to respiratory diseases was significantly higher during the first lockdown than in the second lockdown (χ2 (1, n = 572) = 8.8185, p = 0.0029) and in the third lockdown (χ2 (1, n = 624) = 9.0381, p = 0.0026), and deaths from infectious diseases were higher during the first lockdown than during both the second and third lockdowns (χ2 (1, n = 566) = 5.9479, p = 0.0147, and χ2 (1, n = 624) = 9.5978, p = 0.0019), respectively. The onset of CVA and CVD are abrupt, while respiratory and infectious diseases may have an insidious pattern; this may have led patients to postpone referrals to hospitals to the “last minute” during the first lockdown, perhaps due to fears of contracting COVID-19, and as a result of vague instructions. Citizens and policymakers must be made aware of this point during future pandemics.

The recent health crises (e.g., COVID-19, Ebola and Monkeypox) have pointed out huge disparities in vaccine accessibility across the world. Nonetheless, certain governments have instituted vaccine passport policies (VPPs) to manage public health, raising mixed concerns from the public. Focusing on COVID-19 outbreak as an example, this review and commentary article utilises an institutional theory perspective to uncover the factors contributing to the global vaccine divide. We also explore the wider impact of VPPs to determine whether such tools promote freedom or social exclusion. Our insights shed light on a controversial and increasingly divisive policy with an international dimension and institutional implications. For instance, while some argue that VPPs may be relatively better than the blunt instrument of lockdowns, VPPs also implicate access and discrimination concerns. Given the various reasons for global vaccine disparities, a hybrid policy that combines vaccine passports with other public health practices (e.g., rapid lateral flow/affordable polymerase chain reaction (PCR) tests and good hygiene) may be more viable. Furthermore, while VPPs may not be desirable and acceptable domestically, they may be inevitable for international travel.

The COVID-19 pandemic caused by the novel coronavirus instigated a worldwide lockdown that affected students mitigating various psychological issues including depression, stress, and anxiety. This study aimed to assess the impact of COVID-19 pandemic on undergraduate university students’ psychological status in terms of depression, anxiety, and stress. A total of 206 students from the Higher College of Technology (HCT), Sharjah Campuses participated in this descriptive cross-sectional study. Data were collected between March and May 2021. Participants completed an online survey including a demographic data questionnaire and the depression, anxiety, stress scale (DASS-21). The mean depression, stress, and anxiety scores were 15.56 (±11.573), 17.13 (±10.946), and 14.90 (±10.523) respectively. Categorically, most students (33.3%) reported no depression, while 26.1% of students reported moderate depression. For stress, the majority (44.4%) experienced no stress, while 19.8% reported moderate stress. Strikingly, 36.7% of students reported extreme severe anxiety, with 28% reporting no anxiety. Students with history of depression, stress, and anxiety symptoms reported a statistically significant mean difference in depression, stress, and anxiety compared with those with no previous history of those symptoms. We conclude with a recommendation to expand mental health screening among undergraduate university students and design appropriate therapeutic modalities.

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The COVID-19 pandemic put pressure on health systems, affecting populations’ use of health services, especially those experiencing increased difficulties in healthcare access, as some migrant groups. This study aimed to investigate access and use of health services during the COVID-19 pandemic among migrants in Portugal. A mixed-methods approach was used. A community-based cross-sectional survey was conducted involving migrant communities residing in the Lisbon Metropolitan Area. Analyses of a subsample of participants (n = 929) examined factors associated with perceived worsening of access to health services during the pandemic. Semi-structured interviews with 14 migrants were conducted and thematically analyzed to further understand experiences and difficulties in health services’ use. Around 44% of surveyed participants reported worsening of access to health services since the pandemic, more frequently women, those with lower income, and those who perceived being at moderate or high risk for COVID-19 infection. Digital change in services and lack of formal and informal support during lockdowns were highlighted by interviewers as main barriers in access to healthcare for migrants. The pandemic renewed concerns about inequalities in healthcare access among migrants. It is key that in following years health systems are able to address the potential accumulated burden of disease.

The conflict between work and family demands increased during the COVID-19 pandemic due to changes in lifestyle related to the lockdown. This study examines the associations between work-family conflict (WFC) and family-work conflict (FWC) with work-specific, family-specific, and well-being-related variables during the second wave of the COVID-19 pandemic. The results may be used in practice to improve the well-being of employees by adjusting home-based work and family areas of life to dynamic changes during the pandemic. The sample of 736 adults from Poland (53.26%) and Ukraine (46.74%), aged between 19 and 72 (M = 39.40; SD = 10.80), participated in the study. The cross-sectional study was performed using an online survey, including sociodemographic variables, measures of WFC, time pressure, remote work assessment (RWAS), physical health (GSRH), life satisfaction (SWLS), perceived stress (PSS-10), anxiety (GAD-7), and depression (PHQ-9). This study showed numerous inter-group differences in all variables across the country, gender, relationship status, parenthood, caring for children under 12, and remote working status. A high WFC is more likely among Polish workers (than Ukrainian workers), people with a low level of self-perceived time pressure, and high symptoms of stress. Caring for children under 12, low self-perceived time pressure, and high stress can predict FWC. Various paths lead from perceived stress via WFC and FWC, physical health, anxiety, and depression to life satisfaction, as suggested by the structural equation modeling analysis. Parents of children under 12 and women are the most vulnerable groups for increased WFC, FWC, and worse mental health and well-being. Prevention programs should focus on reducing stress, anxiety, and work demands in these adult populations. A unique contribution to the existing knowledge revealed patterns of associations between WFC and FWC in relation to well-being dimensions in a cross-cultural context during the pandemic.

The final year of high school is a challenging phase of adolescents’ lives and substance use can play an important role. We examined changes in the frequency and quantity of alcohol and cannabis use, and demographic correlates among Grade 12 students of 2020. Students (N = 844) from nine schools retrospectively self-reported changes in substance use after the easing of COVID-19 lockdowns (back to school), compared to before the pandemic. Changes in use were examined with age, gender, Aboriginal or Torres Islander, parental and family characteristics, and truancy. Thirty-one percent of students reported that they used alcohol less frequently, and 24% reported that they used it more frequently compared to pre-COVID-19. Most students (46%) reported that they used cannabis less, while a subset reported using more frequently (22%). A history of truancy was associated with an increased frequency (OR = 2.13 [1.18–3.83]) of cannabis use. A substantial minority of adolescents used more alcohol and cannabis after the initial COVID-19 lockdown period. Students in their final year who reported increased use may benefit from increased support to manage their substance use.

During the lockdown for the coronavirus disease 2019 (COVID-19), entire populations were instructed to live in home confinement. We investigated the effects of the COVID-19 lockdown on the physical activity (PA) and mental health of students and employees in a Colombian University. A cross-sectional study was conducted through an online survey during the first isolation. A total of 431 respondents (192 males) aged 18–60 years old (28.1 ± 11.1 years) participated. The international Physical Activity Questionnaire (IPAQ) and the short version of the Psychological General Well-Being Index (PGWBI-S) were used. The lockdown had a negative effect on PA levels, with students exhibiting the greatest decrease (~34%; p ˂ 0.001) compared to employees (~24%; p ˂ 0.01). The analysis showed a greater change in PA behavior before and during the lockdown in highly active student participants (5750 vs. 5141 MET min/week; p < 0.05). Additionally, the psychological assessment revealed a lower score in students compared to employees in the male (70.1 vs. 82.6) and female groups (60.2 vs. 79.6). Moreover, the results revealed an influence of sex, with only the female students exhibiting a state of distress. Self-reported PA and psychological well-being were compromised during the COVID-19 lockdown in the academic community, with students and females being more affected.

The aim of this study was to investigate the spatiotemporal association between socioeconomic deprivation and the incidence of COVID-19 and how this association changes through the seasons due to the existence of restrictive public health measures. A retrospective observational study was conducted among COVID-19 cases that occurred in the Apulia region from 29 February 2020 to 31 December 2021, dividing the period into four phases with different levels of restrictions. A generalized estimating equation (GEE) model was applied to test the independent effect of deprivation on the incidence of COVID-19, taking into account age, sex, and regional incidence as possible confounding effects and covariates, such as season and levels of restrictions, as possible modifying effects. The highest incidence was in areas with a very high deprivation index (DI) in winter. During total lockdown, no rate ratio between areas with different levels of DI was significant, while during soft lockdown, areas with very high DI were more at risk than all other areas. The effects of social inequalities on the incidence of COVID-19 changed in association with the seasons and restrictions on public health. Disadvantaged areas showed a higher incidence of COVID-19 in the cold seasons and in the phases of soft lockdown.

Organisations have long played an effective role in advocating for and actioning crucial developmental and humanitarian functions around the world, often under challenging conditions, as well as servicing the health needs of persons with disabilities. This article reports on the experiences of organisations of (or that serve) persons with disabilities, hereafter called service providers, during the COVID-19 lockdown period in South Africa beginning 26 March 2020. Organisations participated in an online survey as well as virtual narrative interviews to voice out their experiences. Five major themes emerged: (1) difficulties in keeping the doors open; (2) continued care under lockdown; (3) restructuring of care (4) government systems and policies; and (5) reaching out to offer and receive support. The findings demonstrate that the South African government failed to ensure targeted support to organisations of persons with disabilities. A remarkable feature of the organisations we interviewed for this small study was their agility in responding creatively to the challenges they faced, despite the difficulties. There is a need for government support to include targeted efforts to support organisation of persons with disabilities during pandemics to avoid worsening service gaps.

A vast amount of literature has highlighted that restrictions imposed by the COVID-19 pandemic, such as lockdowns and the resulting interruption of face-to-face academic activities, strongly disrupted students’ daily routine and undermined their well-being. Through a mixed method approach, this study was aimed at investigating the association between students’ experience of the health emergency and their resilience levels during the first pandemic outbreak. Between April and May 2020, 421 Italian university students attending Health Sciences, Humanities, and Political Sciences courses completed the Resilience Scale for Adults (RSA), provided narratives about the emergency by answering an open-ended question, and filled out a demographic questionnaire. Results showed that narratives about community/society issues were by far the most recurrent ones across disciplinary areas, while a significantly higher percentage of students from Humanities focused on study/university. Health Sciences students were more likely to provide narratives concerning social commitment, and they reported significantly higher resilience levels than Humanities students. A higher percentage of students with moderate resilience focused their narratives on the study/university domain, compared to students with high resilience. Findings suggest the importance of supporting students’ resilience to counterbalance their academic concerns in both times of crisis and ordinary times.

Background: Life-threatening events, such as the COVID-19 pandemic, may generate feelings of insecurity and fear in the affected population, particularly children. Parents’ ability to help children cope with negative emotions is essential during challenging periods. The current study aims to analyse the coping strategies adopted by Italian caregivers concerning their children’s fears about COVID-19. Method: An online survey was administered during the Italian lockdown to 649 parents of at least one child aged 5 to 17 years old. Respondents completed the survey for themselves and their children. In addition, a qualitative content analysis of the data from the open-ended question was conducted (N = 569; 87.9% women; MAge = 45 years). Results: Several themes were identified. Firstly, families’ primary approach was ‘communication and meaning-making’. Secondly, another essential strategy was ‘the importance of safe space’, enabled by keeping routine in place and creating a loving and caring environment. Thirdly, other factors relevant to managing children’s fears were ‘adaptation’, ‘religion’, ‘a positive attitude’, and ‘humour and hope’. Finally, the last two strategies significant and valuable for Italian families were ‘flexibility’ and ‘maintaining virtual contacts. Conclusion: During the pandemic COVID-19, parents may have used various strategies to protect their children from stress. Future research could investigate single parents’ coping strategies explicitly developed during the COVID-19 lockdown.

Global COVID-19 lockdown measures have led to an apparent decrease in physical activity. This study aimed to explore the explanatory function of self-control’s mediating role between self-efficacy and physical activity among college students. The analysis used the data of 1627 university students (aged 19.41 ± 0.66, range 17–28, 40.5% males) at Shanghai Jiao Tong University. Self-efficacy, self-control, and physical activity were tested, respectively, by the general self-efficacy scale, the new brief self-control scale, and the International Physical Activity Questionnaire (IPAQ) scale, which were analyzed by SPSS software. Correlation analysis showed that self-efficacy, self-control, and physical activity were related in pairs. Comparing the two dimensions of self-control, we found that self-discipline mediated the relationship between self-efficacy and PA, and impulse control did not mediate the relationship. Regarding the gender difference according to multi-group analysis, findings showed that females need higher self-discipline from the path of self-efficacy to physical activity improvement than males.

Insufficient physical activity is considered a strong risk factor associated with non-communicable diseases. This study aimed to assess the impact of COVID-19 on physical (in)activity behavior in 10 Arab countries before and during the lockdown. A cross-sectional study using a validated online survey was launched originally in 38 different countries. The Eastern Mediterranean regional data related to the 10 Arabic countries that participated in the survey were selected for analysis in this study. A total of 12,433 participants were included in this analysis. The mean age of the participants was 30.3 (SD, 11.7) years. Descriptive and regression analyses were conducted to examine the associations between physical activity levels and the participants' sociodemographic characteristics, watching TV, screen time, and computer usage. Physical activity levels decreased significantly during the lockdown. Participants' country of origin, gender, and education were associated with physical activity before and during the lockdown (p < 0.050). Older age, watching TV, and using computers had a negative effect on physical activity before and during the lockdown (p < 0.050). Strategies to improve physical activity and minimize sedentary behavior should be implemented, as well as to reduce unhealthy levels of inactive time, especially during times of crisis. Further research on the influence of a lack of physical activity on overall health status, as well as on the COVID-19 disease effect is recommended. 2022 by the authors. Scopus

Due to their individual developmental and learning needs, adolescents with autism spectrum disorder (ASD) benefit from a variety of educational, medical, and therapeutic services. During the COVID-19 pandemic, these services were discontinued or significantly reduced, which may have resulted in increased difficulties in coping with various areas of life. The purpose of this study was to explore how the pandemic affected the psychosocial and educational functioning of students with ASD. A qualitative, problem-focused interview method was used. The obtained material was subjected to interpretive phenomenological analysis. The study involved 10 secondary school students diagnosed with ASD. The assessment of the effects of the pandemic on the functioning of people with ASD is inconclusive. The respondents noted both negative and positive effects of lockdown. On the positive side, they were able to spend time with their family, isolate themselves from difficult social relationships and feel better. Among the negative effects, adolescents point to difficulties in emotional functioning—increased levels of stress and anxiety, as well as increased feelings of loneliness and difficulties with online education. The study showed the varied experiences of young people with autism during the pandemic, highlighting the significant need to support some of them in terms of their emotional, social and educational functioning.

In this study, we evaluated the perception of distance online learning in undergraduate dental students in two different European countries during the second lockdown of the COVID-19 pandemic to explore sustainable undergraduate educational and examination e-learning forms. Dental students from Dental school of Athens, National and Kapodistrian university of Athens (N1_3rd preclinical year = 131, N2_4th clinical year = 119) and Dental school of Copenhagen (3rd preclinical year N3 = 85) completed the mixed-designed Dental e-Learning process Questionnaire (DeLQ) distributed in a google form. Responses to closed-ended questions were collected on a five-point Likert scale. Descriptive statistics were applied, and non-parametric Kruskal–Wallis tests were used to examine student groups. N1 (90% strongly agree) students reported that “e-learning is a suitable education method for theory in dentistry” at a significant level and more often than N2 (43% strongly disagree). N1 and N2 students strongly agreed that they preferred face-to-face teaching rather than distance e-learning. A relatively low number of N1 (31%) students believed that e-learning prepares them sufficiently for their practical training while none of the (0%) N2 cohort agreed. A low percentage of students in both years (N1 = 31%, N2 = 23%) believed that e-learning prepared them for their exams. Additionally, N1 = 60% and N2 = 66% preferred hybrid learning. Only 26% (N1) and 19.5% (N2) desired e-learning to continue after the COVID-19 pandemic. Nearly half of the participants believed the online exam model to be unreliable (N1 = 49%, N2 = 43%). Overall, students considered distance e-learning as an educational method applicable only to theoretical lessons. However, the lack of physical communication and interaction in distance learning led students to prefer a blended method. Students of the two faculties seemed to agree on many points, but there were also specific differences attributable to the differences in the programs and educational culture of the two countries.

This study examined the stresses and wellbeing of international postgraduate health and nursing students at a tertiary education institute in New Zealand who were mainly essential frontline healthcare workers during the COVID-19 lockdown. Quantitative and qualitative data were collected by purposeful sampling (n = 43). The study utilised a cross-sectional survey, along with the Short Form of Cohen’s Perceived Stress Scale (PSS-10), adapted for the COVID-19 lockdown, and followed by semi-structured individual interviews. This study is the first in New Zealand to demonstrate that, with a mean PSS-10 score of 21.7 (±7.1), international health students experienced higher than optimal levels of stress, with supporting qualitative data identifying four themes for the sources of stress: (1) familial relationships, (2) essential work, (3) finances, and (4) study. However, these students coped because of the extensive support provided by their education institute and employers. These students played a critical role in the pandemic’s response and made a significant public health contribution by working in the frontline of the COVID-19 outbreak. Considering the global shortage of healthcare workers and understanding the key challenges, means of coping and support provisions, as we have here, offer insights for building and maintaining a resilient and resourceful health workforce through international health and nursing students in New Zealand and elsewhere.

Background. The emergency caused by the SARS-CoV-2 pandemic exacerbated psychological distress. Our aim was to investigate the impact of breast cancer on patients’ lives during the Italian lockdown. Methods. Sixty-five female breast cancer patients were studied, assessing the level of psychological distress with the Hospital Anxiety and Depression Scale (HADS) and the impact of the cancer diagnosis (Impact of Event Scale-Revised—IES—R). In addition, we compared these data with a matched group of breast cancer patients enrolled in 2019. Results. Patients enrolled in 2020 had statistically higher levels of anxious symptomatology and higher levels of traumatic symptomatology due to the cancer diagnosis. A mediation analysis was performed to determine how the experience of distress due to COVID-19 negatively impacted the level of anxiety and amplified the impact of the diagnosis with a significant increase in traumatic symptoms. Conclusions. Considering the vulnerability of these patients and the serious and novel situation that the healthcare system is currently facing, we would like to point out the importance of structured and organised psychological support for these patients.

The landscape and its perception influence the quality of life of a local community. Recreation areas bring a lot of benefits to society, also in terms of mental health. Open space and contact with nature, particularly during a crisis such as the pandemic, help alleviate the effects of the lockdown and social isolation. The study objective was to determine whether and to what extent the COVID-19 pandemic influenced the importance of recreation areas and the perception of landscape among students—a social group that experiences mood disorders increasingly often and has been severely affected by the lockdown. A survey was conducted in two stages, using a Google Forms online survey. A total of 381 students from universities in Lublin participated in the survey. The survey showed that the significance of recreation areas increased during the pandemic. The perception of landscape changed as well: the value of nature, scenic views, and the therapeutic effect of the landscape began to be appreciated to a greater extent. The survey results indicate the need to ensure the diversity of green areas and improve their accessibility. Designing these areas should also consider quiet areas as well as ensuring green mobility and places of recreation.